Author(s): Charalambous H, Protopapa E, Gavrielidou D, Avgousti V
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Abstract BACKGROUND: Prescription of opioids based on morphine equivalence data per capita is very low in Cyprus. Three studies were undertaken to evaluate the prescribing habits of physicians in Cyprus for cancer patients with pain. METHODS: Data were collected regarding the presence and severity of pain and prescription of analgesia in a cross-sectional study of 141 patients receiving outpatient chemotherapy within the Bank of Cyprus Oncology Centre (BOCOC), in a retrospective study of 90 new lung cancer patients referred to one Oncologist in the BOCOC, and in a prospective study of 100 new cancer patients referred to the BOCOC. In the first study, the results reflected the prescribing habits of oncologists within the oncology centre, whilst the second and third studies reflected the prescribing habits of physicians outside the oncology centre. RESULTS: In the three studies, 56.0\%, 48.1\% and 57.7\%, respectively, of patients with pain were prescribed analgesia. The majority of patients were prescribed paracetamol and non-steroidal anti-inflammatory drugs, and only 8.6\%, 11.5\% and 0\%, respectively, of patients were prescribed strong opioids. In the last two studies, following their oncology appointment the prescription of analgesia to patients with pain, increased to 80.8\% and 73.1\%, respectively, whilst the prescription of strong opioids, increased to 28.8\% and 34.6\%, respectively, reflecting oncologists' practice. CONCLUSION: There is under-treatment of pain in cancer patients, both within and outside a tertiary oncology centre in Cyprus. Particularly there is low prescribing of strong opioids. There is a need to look further into the barriers that prevent physicians prescribing opioids in Cyprus, as well as to patients' attitudes towards analgesia and opioids, and to set up training programs to address these issues.
This article was published in Ann Oncol
and referenced in Journal of Palliative Care & Medicine