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

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dc.contributor.authorWong, A.K.
dc.contributor.authorSomogyi, A.A.
dc.contributor.authorRubio, J.
dc.contributor.authorPham, T.D.
dc.contributor.authorLe, B.
dc.contributor.authorKlepstad, P.
dc.contributor.authorPhilip, J.
dc.date.issued2023
dc.description.abstractOpioid 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.
dc.description.statementofresponsibilityAaron K. Wong, Andrew A. Somogyi, Justin Rubio, Tien Dung Pham, Brian Le, Pal Klepstad, and Jennifer Philip
dc.identifier.citationCancers, 2023; 15(14):1-11
dc.identifier.doi10.3390/cancers15143676
dc.identifier.issn2072-6694
dc.identifier.issn2072-6694
dc.identifier.orcidSomogyi, A.A. [0000-0003-4779-0380]
dc.identifier.urihttps://hdl.handle.net/2440/139107
dc.language.isoen
dc.publisherMDPI AG
dc.relation.granthttp://purl.org/au-research/grants/nhmrc/2014035
dc.rights© 2023 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
dc.source.urihttps://doi.org/10.3390/cancers15143676
dc.subjectopioid; analgesics; advanced cancer; palliative care
dc.titleEffectiveness of Opioid Switching in Advanced Cancer Pain: A Prospective Observational Cohort Study
dc.typeJournal article
pubs.publication-statusPublished

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