Errors in Opioid Prescribing: A Prospective Survey in Cancer Pain
Abstract Context Cancer pain is debilitating and has multidimensional consequences. It can be treated adequately in up to 90% of patients by following pain management guidelines. Nevertheless, inadequate pain control remains a global problem. Objectives We surveyed prescribing patterns in patients r...
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| Veröffentlicht in: | Journal of pain and symptom management 2010-04, Vol.39 (4), p.702-711 |
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| creator | Shaheen, Philip E., MD LeGrand, Susan B., MD, FACP Walsh, Declan, MSc, FACP, FRCP (Edin) Estfan, Bassam, MD Davis, Mellar P., MD, FCCP Lagman, Ruth L., MD, MPH Riaz, Mohammad, MD Cheema, Bushra, MD |
| description | Abstract Context Cancer pain is debilitating and has multidimensional consequences. It can be treated adequately in up to 90% of patients by following pain management guidelines. Nevertheless, inadequate pain control remains a global problem. Objectives We surveyed prescribing patterns in patients referred to our Palliative Medicine Program (PMP) to identify common errors in opioid use. Methods Consecutive cancer patients seen by our PMP were prospectively surveyed for the presence of pain and errors in opioid prescribing at the time of initial consultation. Our recommendations to correct and optimize pain management also were recorded. Results One hundred eighty-six consecutive cancer patients were screened. One hundred seventeen (63%) had cancer pain, 151 opioid prescribing errors were detected, and 147 different recommendations were made. Most common were failure to order around-the-clock opioids for constant pain, and the failure to treat or prevent opioid side effects. Multiple errors were more common in females, but the sex difference did not reach statistical significance. There was no difference in the errors by pain severity or reason for consultation. Conclusion Opioid prescribing errors were common. Females may be at greater risk of multiple errors. A PM consultation program is effective in identifying and correcting a wide variety of opioid prescribing errors. |
| doi_str_mv | 10.1016/j.jpainsymman.2009.09.009 |
| format | Article |
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It can be treated adequately in up to 90% of patients by following pain management guidelines. Nevertheless, inadequate pain control remains a global problem. Objectives We surveyed prescribing patterns in patients referred to our Palliative Medicine Program (PMP) to identify common errors in opioid use. Methods Consecutive cancer patients seen by our PMP were prospectively surveyed for the presence of pain and errors in opioid prescribing at the time of initial consultation. Our recommendations to correct and optimize pain management also were recorded. Results One hundred eighty-six consecutive cancer patients were screened. One hundred seventeen (63%) had cancer pain, 151 opioid prescribing errors were detected, and 147 different recommendations were made. Most common were failure to order around-the-clock opioids for constant pain, and the failure to treat or prevent opioid side effects. Multiple errors were more common in females, but the sex difference did not reach statistical significance. There was no difference in the errors by pain severity or reason for consultation. Conclusion Opioid prescribing errors were common. Females may be at greater risk of multiple errors. A PM consultation program is effective in identifying and correcting a wide variety of opioid prescribing errors.</description><identifier>ISSN: 0885-3924</identifier><identifier>EISSN: 1873-6513</identifier><identifier>DOI: 10.1016/j.jpainsymman.2009.09.009</identifier><identifier>PMID: 20413057</identifier><identifier>CODEN: JSPME2</identifier><language>eng</language><publisher>New York, NY: Elsevier Inc</publisher><subject>Adolescent ; Adult ; Aged ; Aged, 80 and over ; Analgesics, Opioid - therapeutic use ; Anesthesia & Perioperative Care ; Biological and medical sciences ; Cancer ; cancer pain ; Comorbidity ; Female ; Humans ; Male ; Medical sciences ; Medication Errors - statistics & numerical data ; Middle Aged ; Neoplasms - drug therapy ; Neoplasms - epidemiology ; Ohio - epidemiology ; Opioid prescribing errors ; Opioids ; Pain ; Pain - epidemiology ; Pain - prevention & control ; Pain Medicine ; Palliative medicine ; Pharmacology. Drug treatments ; Prescribing ; Prescriptions - statistics & numerical data ; Prevalence ; Prospective Studies ; Risk Assessment ; Risk Factors ; Side effects ; Tretoquinol ; Young Adult</subject><ispartof>Journal of pain and symptom management, 2010-04, Vol.39 (4), p.702-711</ispartof><rights>U.S. Cancer Pain Relief Committee</rights><rights>2010 U.S. Cancer Pain Relief Committee</rights><rights>2015 INIST-CNRS</rights><rights>Copyright (c) 2010 U.S. Cancer Pain Relief Committee. Published by Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c569t-a87d0bfb47710ce1969513f2271b679586f2ced031e7a168a65ee75a817a385b3</citedby><cites>FETCH-LOGICAL-c569t-a87d0bfb47710ce1969513f2271b679586f2ced031e7a168a65ee75a817a385b3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://dx.doi.org/10.1016/j.jpainsymman.2009.09.009$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>315,781,785,3551,27926,27927,31002,45997</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=22694203$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/20413057$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Shaheen, Philip E., MD</creatorcontrib><creatorcontrib>LeGrand, Susan B., MD, FACP</creatorcontrib><creatorcontrib>Walsh, Declan, MSc, FACP, FRCP (Edin)</creatorcontrib><creatorcontrib>Estfan, Bassam, MD</creatorcontrib><creatorcontrib>Davis, Mellar P., MD, FCCP</creatorcontrib><creatorcontrib>Lagman, Ruth L., MD, MPH</creatorcontrib><creatorcontrib>Riaz, Mohammad, MD</creatorcontrib><creatorcontrib>Cheema, Bushra, MD</creatorcontrib><title>Errors in Opioid Prescribing: A Prospective Survey in Cancer Pain</title><title>Journal of pain and symptom management</title><addtitle>J Pain Symptom Manage</addtitle><description>Abstract Context Cancer pain is debilitating and has multidimensional consequences. It can be treated adequately in up to 90% of patients by following pain management guidelines. Nevertheless, inadequate pain control remains a global problem. Objectives We surveyed prescribing patterns in patients referred to our Palliative Medicine Program (PMP) to identify common errors in opioid use. Methods Consecutive cancer patients seen by our PMP were prospectively surveyed for the presence of pain and errors in opioid prescribing at the time of initial consultation. Our recommendations to correct and optimize pain management also were recorded. Results One hundred eighty-six consecutive cancer patients were screened. One hundred seventeen (63%) had cancer pain, 151 opioid prescribing errors were detected, and 147 different recommendations were made. Most common were failure to order around-the-clock opioids for constant pain, and the failure to treat or prevent opioid side effects. Multiple errors were more common in females, but the sex difference did not reach statistical significance. There was no difference in the errors by pain severity or reason for consultation. Conclusion Opioid prescribing errors were common. Females may be at greater risk of multiple errors. A PM consultation program is effective in identifying and correcting a wide variety of opioid prescribing errors.</description><subject>Adolescent</subject><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Analgesics, Opioid - therapeutic use</subject><subject>Anesthesia & Perioperative Care</subject><subject>Biological and medical sciences</subject><subject>Cancer</subject><subject>cancer pain</subject><subject>Comorbidity</subject><subject>Female</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Medication Errors - statistics & numerical data</subject><subject>Middle Aged</subject><subject>Neoplasms - drug therapy</subject><subject>Neoplasms - epidemiology</subject><subject>Ohio - epidemiology</subject><subject>Opioid prescribing errors</subject><subject>Opioids</subject><subject>Pain</subject><subject>Pain - epidemiology</subject><subject>Pain - prevention & control</subject><subject>Pain Medicine</subject><subject>Palliative medicine</subject><subject>Pharmacology. Drug treatments</subject><subject>Prescribing</subject><subject>Prescriptions - statistics & numerical data</subject><subject>Prevalence</subject><subject>Prospective Studies</subject><subject>Risk Assessment</subject><subject>Risk Factors</subject><subject>Side effects</subject><subject>Tretoquinol</subject><subject>Young Adult</subject><issn>0885-3924</issn><issn>1873-6513</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2010</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>7QJ</sourceid><recordid>eNqNkluL1DAUgIMo7jj6F6Q-yD51PEmamw_CMKwXWNiF1eeQpqeS2mlrMh2Yf2_KjBd8UQiEwHduXw4hryhsKFD5ptt0kwtDOu33btgwALNZDphHZEW14qUUlD8mK9BalNyw6oo8S6kDAMElf0quGFSUg1Arsr2JcYypCENxN4UxNMV9xORjqMPw9W2xzc8xTegP4YjFwxyPeFrYnRs8xuI-d_GcPGldn_DF5V6TL-9vPu8-lrd3Hz7ttrelF9IcSqdVA3VbV0pR8EiNNLnJljFFa6mM0LJlHhvgFJWjUjspEJVwmirHtaj5mlyf805x_D5jOth9SB773g04zsmqiinGVR7xnyTnBnSVy6-JOZM-T5kitnaKYe_iyVKwi2rb2T9U20W1XQ6YHPvyUmWu99j8ivzpNgOvL4BL3vVtzM5C-s0xaSoGPHO7M4fZ3jFgtMkHzH6bELN424zhv9p591cW34ch5MLf8ISpG-c45O-x1CZmwT4su7GsBs1bAZoJ_gNoe7WK</recordid><startdate>20100401</startdate><enddate>20100401</enddate><creator>Shaheen, Philip E., MD</creator><creator>LeGrand, Susan B., MD, FACP</creator><creator>Walsh, Declan, MSc, FACP, FRCP (Edin)</creator><creator>Estfan, Bassam, MD</creator><creator>Davis, Mellar P., MD, FCCP</creator><creator>Lagman, Ruth L., MD, MPH</creator><creator>Riaz, Mohammad, MD</creator><creator>Cheema, Bushra, MD</creator><general>Elsevier Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope><scope>7QJ</scope></search><sort><creationdate>20100401</creationdate><title>Errors in Opioid Prescribing: A Prospective Survey in Cancer Pain</title><author>Shaheen, Philip E., MD ; LeGrand, Susan B., MD, FACP ; Walsh, Declan, MSc, FACP, FRCP (Edin) ; Estfan, Bassam, MD ; Davis, Mellar P., MD, FCCP ; Lagman, Ruth L., MD, MPH ; Riaz, Mohammad, MD ; Cheema, Bushra, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c569t-a87d0bfb47710ce1969513f2271b679586f2ced031e7a168a65ee75a817a385b3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2010</creationdate><topic>Adolescent</topic><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Analgesics, Opioid - therapeutic use</topic><topic>Anesthesia & Perioperative Care</topic><topic>Biological and medical sciences</topic><topic>Cancer</topic><topic>cancer pain</topic><topic>Comorbidity</topic><topic>Female</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Medication Errors - statistics & numerical data</topic><topic>Middle Aged</topic><topic>Neoplasms - drug therapy</topic><topic>Neoplasms - epidemiology</topic><topic>Ohio - epidemiology</topic><topic>Opioid prescribing errors</topic><topic>Opioids</topic><topic>Pain</topic><topic>Pain - epidemiology</topic><topic>Pain - prevention & control</topic><topic>Pain Medicine</topic><topic>Palliative medicine</topic><topic>Pharmacology. Drug treatments</topic><topic>Prescribing</topic><topic>Prescriptions - statistics & numerical data</topic><topic>Prevalence</topic><topic>Prospective Studies</topic><topic>Risk Assessment</topic><topic>Risk Factors</topic><topic>Side effects</topic><topic>Tretoquinol</topic><topic>Young Adult</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Shaheen, Philip E., MD</creatorcontrib><creatorcontrib>LeGrand, Susan B., MD, FACP</creatorcontrib><creatorcontrib>Walsh, Declan, MSc, FACP, FRCP (Edin)</creatorcontrib><creatorcontrib>Estfan, Bassam, MD</creatorcontrib><creatorcontrib>Davis, Mellar P., MD, FCCP</creatorcontrib><creatorcontrib>Lagman, Ruth L., MD, MPH</creatorcontrib><creatorcontrib>Riaz, Mohammad, MD</creatorcontrib><creatorcontrib>Cheema, Bushra, MD</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><jtitle>Journal of pain and symptom management</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Shaheen, Philip E., MD</au><au>LeGrand, Susan B., MD, FACP</au><au>Walsh, Declan, MSc, FACP, FRCP (Edin)</au><au>Estfan, Bassam, MD</au><au>Davis, Mellar P., MD, FCCP</au><au>Lagman, Ruth L., MD, MPH</au><au>Riaz, Mohammad, MD</au><au>Cheema, Bushra, MD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Errors in Opioid Prescribing: A Prospective Survey in Cancer Pain</atitle><jtitle>Journal of pain and symptom management</jtitle><addtitle>J Pain Symptom Manage</addtitle><date>2010-04-01</date><risdate>2010</risdate><volume>39</volume><issue>4</issue><spage>702</spage><epage>711</epage><pages>702-711</pages><issn>0885-3924</issn><eissn>1873-6513</eissn><coden>JSPME2</coden><abstract>Abstract Context Cancer pain is debilitating and has multidimensional consequences. It can be treated adequately in up to 90% of patients by following pain management guidelines. Nevertheless, inadequate pain control remains a global problem. Objectives We surveyed prescribing patterns in patients referred to our Palliative Medicine Program (PMP) to identify common errors in opioid use. Methods Consecutive cancer patients seen by our PMP were prospectively surveyed for the presence of pain and errors in opioid prescribing at the time of initial consultation. Our recommendations to correct and optimize pain management also were recorded. Results One hundred eighty-six consecutive cancer patients were screened. One hundred seventeen (63%) had cancer pain, 151 opioid prescribing errors were detected, and 147 different recommendations were made. Most common were failure to order around-the-clock opioids for constant pain, and the failure to treat or prevent opioid side effects. Multiple errors were more common in females, but the sex difference did not reach statistical significance. There was no difference in the errors by pain severity or reason for consultation. Conclusion Opioid prescribing errors were common. Females may be at greater risk of multiple errors. A PM consultation program is effective in identifying and correcting a wide variety of opioid prescribing errors.</abstract><cop>New York, NY</cop><pub>Elsevier Inc</pub><pmid>20413057</pmid><doi>10.1016/j.jpainsymman.2009.09.009</doi><tpages>10</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Adolescent Adult Aged Aged, 80 and over Analgesics, Opioid - therapeutic use Anesthesia & Perioperative Care Biological and medical sciences Cancer cancer pain Comorbidity Female Humans Male Medical sciences Medication Errors - statistics & numerical data Middle Aged Neoplasms - drug therapy Neoplasms - epidemiology Ohio - epidemiology Opioid prescribing errors Opioids Pain Pain - epidemiology Pain - prevention & control Pain Medicine Palliative medicine Pharmacology. Drug treatments Prescribing Prescriptions - statistics & numerical data Prevalence Prospective Studies Risk Assessment Risk Factors Side effects Tretoquinol Young Adult |
| title | Errors in Opioid Prescribing: A Prospective Survey in Cancer Pain |
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