Menu
Back to Journals » International Journal of Chronic Obstructive Pulmonary Disease » Volume 5
Factors associated with opioid dispensation for patients with COPD and lung cancer in the last year of life: A retrospective analysis
Authors Goodridge D, Lawson J, Rocker G, Marciniuk D, Rennie D
Published 15 April 2010 Volume 2010:5 Pages 99—105
DOI https://doi.org/10.2147/COPD.S9938
Review by Single anonymous peer review
Peer reviewer comments 3
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
© 2010 The Author(s). This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution - Non Commercial (unported, v3.0) License.
By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms.