Researchers study patterns of opioid use in metastatic breast cancer patients
Some metastatic breast cancer patients are taking smaller doses of opioid prescriptions over decreased amounts of time, according to Penn State College of Medicine and Penn State Cancer Institute researchers. They say the results indicate that clinicians may be more aware of the negative impacts of prolonged opioid use and are seeking alternative pain management options.
Chan Shen, PhD, chief of the Department of Surgery’s Division of Outcomes, Research and Quality, led a research team that studied insurance claims data from more than 24,000 metastatic breast cancer patients between the years 2006 and 2015. They determined the number of patients who filled a prescription for an opioid and calculated the days’ supply and daily morphine milligram equivalents from one year before diagnosis until one year after diagnosis.
“Opioid use among metastatic breast cancer patients has not been well studied,” Shen said. “Clinicians must carefully balance pain management with the risks of opioid side effects or misuse. Our study aimed to identify trends in opioid use to see whether this balance is being maintained.”
The researchers found that 46.8% of patients had an opioid prescription within one year before their metastatic breast cancer diagnosis and that 81.4% of patients had an opioid prescription within one year after their diagnosis. While the proportion of patients with opioid prescriptions after diagnosis was relatively stable from 2006 to 2015, the median daily morphine milligram equivalents and median days’ supply decreased over time. Most of that decline occurred in the subgroup of patients who had prior prescription opioid use.
“Prior use of opioids is predictive of higher dosage and prolonged use of opioids, so clinicians should be cognizant of prior opioid use when developing optimal pain management plans,” said Dr. Kristina Newport, co-author and chief of palliative medicine at Penn State Health Milton S. Hershey Medical Center. “This study helps us to understand the current management of pain for people with metastatic breast cancer so we can target our efforts to help women live as well as possible with their disease.”
Eric Schaefer, Shouhao Zhou, Nelson Yee, Daleela Dodge and Douglas Leslie of Penn State College of Medicine and J. Douglas Thornton of University of Houston also contributed to this research. The researchers declare no conflicts of interest.
This research was partially supported by the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the NIH.
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