Article ; Online: Impact of mandated drug monitoring on opioid use during highly conformal radiotherapy for oropharynx cancer.
2023 Volume 12, Issue 6, Page(s) 1146–1154
Abstract: Background: Prescription drug monitoring programs (PDMPs) have proliferated due to increasing opioid-related deaths. We evaluated acute opioid use changes for 64 patients treated with highly conformal radiotherapy (RT) following a state-mandated PDMP.!## ...
| Abstract | Background: Prescription drug monitoring programs (PDMPs) have proliferated due to increasing opioid-related deaths. We evaluated acute opioid use changes for 64 patients treated with highly conformal radiotherapy (RT) following a state-mandated PDMP. Methods: Patients receiving proton therapy (PT) (n=40), intensity-modulated RT (IMRT) (n=14), or both (n=10) were divided into preintervention (n=26) and postintervention cohorts (n=38); records were reviewed retrospectively under an institutional review board (IRB)-approved tracking protocol. Dosages prescribed during acute therapy (during RT-3 months post-RT) and patient-reported pain (Defense and Veterans Pain Rating Scale) were endpoints. Dosages were treated as responses in Chi-square tests (three-level ordinal response). Results: Overall, 72% (n=46) received opioids; of which 22% (n=10) of all patients and 10% (n=2) of opioid-naive patients continued analgesic management 3 months post-RT. Median total doses were 975 and 1,025 morphine milligram equivalents (MME) in pre- and postintervention groups, with no significant differences in MME prescribed (P=0.8) or uncontrolled pain (P=0.3). Statistically significant factors were tonsil primaries (P<0.01) and alcohol use (P=0.02). Uncontrolled pain episodes during and post-RT did not vary per cohort (P=0.19). Conclusions: PDMP use was not associated with management changes in patient-reported acute pain during RT (IMRT or PT). Following highly conformal RT, few patients remained on narcotics 3 months post-RT. |
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| MeSH term(s) | Humans ; Analgesics, Opioid/adverse effects ; Retrospective Studies ; Drug Monitoring ; Opioid-Related Disorders/drug therapy ; Radiotherapy, Conformal ; Acute Pain/drug therapy ; Oropharyngeal Neoplasms/drug therapy ; Oropharyngeal Neoplasms/radiotherapy ; Oropharyngeal Neoplasms/chemically induced |
| Chemical Substances | Analgesics, Opioid ; MME (78185-58-7) |
| Language | English |
| Publishing date | 2023-10-27 |
| Publishing country | China |
| Document type | Journal Article |
| ZDB-ID | 2828544-X |
| ISSN | 2224-5839 ; 2224-5839 |
| ISSN (online) | 2224-5839 |
| ISSN | 2224-5839 |
| DOI | 10.21037/apm-23-404 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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