Cancer pain management in a hospice setting was studied in the present article. Drug treatments were studied at five time points: at the time of transfer to hospice, at 2nd day, two weeks, and two months following transfer to hospice care, as well as one day before death.
Patients and methods: Records of 138 consecutive cancer patients treated in hospice in 2010 were studied regarding the drugs given during their stay. The most common cancer was gastro-intestinal cancer (33%), followed by lung (16%) and breast cancer (11%). Data were collected from patients' records and coded in a validated manner for statistical analysis.
Results: The median length of stay in hospice was 14 days (range=2-376 days). Upon transfer, 63% of patients were administered regularly-dosed opioids, 76.8% during the second day at hospice, and 89.9% of the patients received opioids one day prior to death. A significant change was observed in the more frequent subcutaneous administration during hospice stay (p<0.0001). Break-through pain was recorded on the second day in hospice by 52 % of patients, and by 76% on the day prior to death.
Conclusion: Individual patients' needs determined the dose range, but this was not the case for administration route of strong opioids during hospice care.
Keywords: End-of-life care; hospice; opioids; pain.
Copyright© 2014 International Institute of Anticancer Research (Dr. John G. Delinassios), All rights reserved.