Effectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study

Wong, AK; Somogyi, AA; Rubio, J; Pham, TD; Le, B; Klepstad, P; Philip, J

Author(s): Wong, AK; Somogyi, AA; Rubio, J; Pham, TD; Le, B; Klepstad, P; Philip, J;
Details: Publication Year 2023-07-19,Volume 15,Issue #14,Page 3676
Journal Title: Cancers
Publication Type: Research article
Abstract: Opioid switching is a common practice of substituting one opioid for another to improve analgesia or adverse effects; however, it has limited evidence. This study aimed to examine the effectiveness of opioid switching in advanced cancer. This multi-center prospective cohort study recruited patients assessed to switch opioids (opioid switch group) or to continue ongoing opioid treatment (control group). Clinical data (demographics, opioids) and validated instruments (pain and adverse effects) were collected over two timepoints seven days apart. Descriptive analyses were utilized. Non-parametric tests were used to determine differences. Fifty-four participants were recruited (23 control group, 31 switch group). At the follow-up, opioid switching reduced pain (worst, average, and now) (p < 0.05), uncontrolled breakthrough pain (3-fold reduction, p = 0.008), and psychological distress (48% to 16%, p < 0.005). The switch group had a >/=25% reduction in the reported frequency of seven moderate-to-severe adverse effects (score >/= 4), compared to a reduction in only one adverse effect in the control group. The control group experienced no significant pain differences at the follow-up. Opioid switching is effective at reducing pain, adverse effects, and psychological distress in a population with advanced cancer pain, to levels of satisfactory symptom control in most patients within 1 week.
Publisher: MDPI
Keywords: advanced cancer; analgesics; opioid; palliative care
Department(s): Palliative Care
PubMed ID: 37509337
Publisher's Version: https://doi.org/10.3390/cancers15143676
Open Access at Publisher's Site: https://doi.org/10.3390/cancers15143676
Terms of Use/Rights Notice: Refer to copyright notice on published article.

Creation Date: 2023-10-24 04:50:21

Last Modified: 2023-10-24 04:50:48