abstract JCO: Opioid Prescription After Pain Assessment: A Population-Based Cohort of Elderly Patients With Cancer - Sunnybrooke Health Sciences Centre, Toronto, Canada

Opioid Prescription After Pain Assessment: A Population-Based Cohort of Elderly Patients With Cancer

 Abstract

Purpose The purpose of this study was to measure opioid prescription (OP) rates in elderly cancer outpatients around the time of assessment for pain and to evaluate factors associated with receiving OPs for those with severe pain. 

Patients and Methods The cross-sectional cohort includes all patients with cancer in Ontario older than age 65 years who completed a pain assessment as part of a provincial initiative of systematic symptom screening. Patients were assigned to mutually exclusive categories by pain score severity: 0, 1 to 3 (mild), 4 to 6 (moderate), and 7 to 10 (severe). We linked multiple provincial health databases to examine the proportion of patients with an OP within 7 days after or 30 days before the assessment date. We examined factors associated with OPs for patients with pain scores of 7 to 10. 

Results The proportion of patients with an OP increased as pain score severity increased: 10% of those with no pain, 24% of those with mild pain, 45% of those with moderate pain, and 67% of those with severe pain. More specifically, for those with severe pain, 41% filled an OP within 7 days of assessment for pain, and 26% had an OP from the 30 days before assessment for pain, leaving 33% without an OP. In multivariable analysis, factors associated with OPs are younger age, male sex, comorbid illness, cancer type, and assessment at home. 

Conclusion Despite a generous time window for capturing OPs, the proportion of patients without an OP seems high. Further knowledge translation is required to maximize the impact of the symptom screening initiative in Ontario and to optimize management of cancer-related pain.

open access: Cancer in older patients: an analysis of elderly oncology - Is it even possible to define when someone is elderly?

Blogger's Note: (ie. opinion) this paper definitely has some 'language' issues, obviously (?) not patient/consumer reviewed

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Conclusion

The field of onco-geriatrics is vastly expanding. The demand from older patients is increasing, and is predicted to continue to expand for the foreseeable future. Life expectancy has increased, and in turn has patient expectations regarding the quality of their lives in the latter decades of age. The burden of oncology in the elderly will need to take a modern approach regarding the management of these patients. The use of screening and predictive tools can help make better decisions for these patients. Continued collaboration between organisations has also helped to develop the management of these patients; the International Society of Geriatric Oncology (SIOG) was founded in 2000 with a purpose to advance the art, science and practice of oncology in elderly patients and maintain a high common standard of healthcare in elderly patients with cancer [16]. This and other similar steps forward will hopefully bring a more tailored and higher standard of care to older oncology patients.

Cancer Clinical Trial: Existential Issues in Elderly People With Cancer [Conditions: Cancer] (aged people with cancer)

Detailed Clinical Trial Description

Existential and spiritual issues in elderly people with cancer are scarcely investigated with respect to the content and importance of these aspects to this patient group in terms of living with their disease and benefit from specialist health treatment and care. The present study is an independent doctoral study that also has an initial function for an intended multidisciplinary research project with the working title "Aged people with cancer".

Arms, Groups and Cohorts in this Clinical Trial

: Cancer in elderly people