skip to content
Dovepress - Open Access to Scientific and Medical Research
View our mobile site

8852

Factors associated with opioid dispensation for patients with COPD and lung cancer in the last year of life: A retrospective analysis

Original Research

(1967) Views  (595) Full article downloads

Authors: Donna Goodridge, Josh Lawson, Graeme Rocker, et al

Published Date April 2010 Volume 2010:5 Pages 99 - 105
DOI: http://dx.doi.org/10.2147/COPD.S9938

Donna Goodridge1, Josh Lawson2, Graeme Rocker3, Darcy Marciniuk4, Donna Rennie1,2

1College of Nursing, 2Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Saskatchewan, Canada; 3Faculty of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada; 4College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada

Background: For patients in late stages of chronic obstructive pulmonary disease (COPD), dyspnea is often refractory to conventional treatment. We know little about the use of opioids in ameliorating dyspnea in this population. In this study we explored factors associated with opioid dispensation within the last year of life and differences in opioid dispensation for persons with lung cancer or COPD.

Methods: In this retrospective cohort study we used administrative health data gained from 1,035 residents of Saskatchewan, Canada to examine patterns of community opioid dispensation in the last year of life. Factors associated with opioid use were determined using multiple logistic regression.

Results: When compared with those with lung cancer, fewer patients with COPD were given opioids within the last week of life; the last month of life, and the last 3 months of life. After adjusting for relevant predictors, patients with lung cancer were more than twice as likely as those with COPD to fill prescriptions for the following: morphine (odds ratio [OR] 2.36, 95% confidence interval [CI]: 1.52–3.67); hydromorphone (OR 2.69, 95% CI: 1.53–4.72); transdermal fentanyl (OR 2.25, 95% CI: 1.28–3.98); or any of these opioids (OR 2.61, 95% CI: 1.80–3.80).

Conclusion: These opioids are dispensed only for a small proportion of patients with COPD at the end of their lives. Future researchers could explore the efficacy and safety of opioid use for patients with advanced COPD, and whether their limited use is justified.

Keywords: COPD, lung cancer, dyspnea, opioid dispensation, palliative care








Readers of this article also read:

Fat-free mass change after nutritional rehabilitation in weight losing COPD: role of insulin, C-reactive protein and tissue hypoxia
Preventing and managing exacerbations in COPD – critical appraisal of the role of tiotropium
Management of COPD in general practice in Denmark – participating in an educational program substantially improves adherence to guidelines
Potential role of stem cells in management of COPD
Health care utilization history, GOLD guidelines, and respiratory medication prescriptions in patients with COPD
Clinical relevance of maximal inspiratory pressure: determination in COPD exacerbation
A day at a time: caregiving on the edge in advanced COPD
Cost-effectiveness of combination fluticasone propionate–salmeterol 250/50 μg versus salmeterol in severe COPD patients
Changes in six-minute walking distance during pulmonary rehabilitation in patients with COPD and in healthy subjects
Onset of action of indacaterol in patients with COPD: Comparison with salbutamol and salmeterol-fluticasone
  • Journal Indexing

    See where all the Dove Press journals are indexed

  • Testimonials

    "You do a tremendous job!!" Ruben Restrepo, The University of Texas Health Science Center at San Antonio