Assessment of Medications Administered Concomitantly with Opioid Analgesics for Cancer Pain Management, Based on the Titration Period of Opioids

摘要

To improve the quality of life (QOL) of cancer patients, it is important to promote the use of appropriate medication with analgesics, and also medicines to combat adverse effects. In the present study, to clarify the usefulness of rescue opioid analgesics, non-opioid analgesics, laxatives against constipation and anti-emetics to combat nausea, which are the adverse effects of opioid analgesics, we investigated retrospectively the titration period for completion of the dose of opioid analgesics as an indicator of the time of opioid use. Alonger titration time was needed to achieve adequate analgesia for patients with severe cancer pain than for those with milder pain. The prescription rate for anti-emetics was significantly lower in the group with titration periods of more than 3 days than that in the group with titration periods of 3 days or less. The titration period from the time of opioid use in the group prescribed rescue opioid analgesics, RD(+,+), was significantly shorter than that in the group for whom rescue opioid analgesics were not prescribed, RD(-,+). The titration period from the time of opioid use in the group prescribed non-opioid analgesics, NO(-,+),was significantly shorter than that in the group for whom non-opioid analgesics were not prescribed, NO(-，+). The titration period from the time of opioid use in the group prescribed anti-emetics, AE(+,+), was significantly shorter than that in the group for whom anti-emetics were not prescribed, AE(+,+). The titration period from the time of opioid use in the group prescribed rescue opioid analgesics, non-opioid analgesics, laxatives and anti-emetics was significantly shorter than that in the group for whom such drugs were not prescribed. The present findings suggest that it is possible to shorten the titration period from the time of opioid use by employing rescue opioid analgesics, non-opioid analgesics, laxatives and anti-emetics, and thus to manage cancer patients with severe pain.