Tags

Type your tag names separated by a space and hit enter

Factors predicting requirement of high-dose transdermal fentanyl in opioid switching from oral morphine or oxycodone in patients with cancer pain.
Clin J Pain. 2011 Oct; 27(8):664-7.CJ

Abstract

OBJECTIVES

To identify predictive factors requiring high-dose transdermal fentanyl in opioid switching from oral morphine or oxycodone to transdermal fentanyl in patients with cancer pain.

METHODS

The participants were 76 hospitalized terminal cancer patients who underwent opioid switching from oxycodone or morphine sustained-release tablet to transdermal fentanyl at our hospital between January 2009 and June 2010. The conversion dose was calculated as transdermal fentanyl (25 μg/h)/oral morphine (60 mg) or oxycodone (40 mg)=1. The response evaluated was the dose conversion ratio [transdermal fentanyl/oral morphine or oxycodone (conversion dose to fentanyl)]=Y and was taken to be 0 for Y≤1, 1 for 1<Y≤2, 2 for 2<Y≤3, and 3 for 3<Y. Predictors evaluated were factors potentially impacting pain. Ordered logistic regression analysis was carried out to identify the predictive factors requiring high-dose transdermal fentanyl in opioid switching.

RESULTS

Breast cancer [odds ratio (OR)=8.218; 95% confidence interval (CI), 1.219-55.407; P=0.0305], total protein level (OR=0.630; 95% CI, 0.408-0.974; P=0.0377), alanine aminotransferase level (OR=1.017; 95% CI, 1.001-1.033; P=0.0390), advanced age (OR=3.700; 95% CI, 1.360-10.063; P=0.0104), and male sex (OR=3.702; 95% CI, 1.355-10.115; P=0.0107) were found to be significant predictive factors requiring high-dose transdermal fentanyl in opioid switching.

DISCUSSION

Our study indicates that breast cancer, total protein, alanine aminotransferase, advanced age, and male sex are significant predictors of a need for higher dose transdermal fentanyl in opioid switching. Our results are considered likely to contribute to the establishment of evidence-based medicine in pain relief and palliative care.

Links

Aggregator Full Text

Authors+Show Affiliations

Kanbayashi Y
Departments of Pain Treatment and Palliative Care Unit, Kyoto Prefectural University of Medicine, Graduate School of Medical Science, Kyoto, Japan.
Hosokawa T
No affiliation info available
Okamoto K
No affiliation info available
Fujimoto S
No affiliation info available
Konishi H
No affiliation info available
Otsuji E
No affiliation info available
Yoshikawa T
No affiliation info available
Takagi T
No affiliation info available
Miki T
No affiliation info available
Taniwaki M
No affiliation info available

MeSH

Administration, CutaneousAdolescentAdultAgedAged, 80 and overAnalgesics, OpioidChildFemaleFentanylHumansLogistic ModelsMaleMiddle AgedMorphineNeoplasmsOdds RatioOxycodonePainPain ManagementPredictive Value of TestsRetrospective StudiesYoung Adult

Pub Type(s)

Journal Article

Language

eng

PubMed ID

21471811

Citation

Kanbayashi, Yuko, et al. "Factors Predicting Requirement of High-dose Transdermal Fentanyl in Opioid Switching From Oral Morphine or Oxycodone in Patients With Cancer Pain." The Clinical Journal of Pain, vol. 27, no. 8, 2011, pp. 664-7.
Kanbayashi Y, Hosokawa T, Okamoto K, et al. Factors predicting requirement of high-dose transdermal fentanyl in opioid switching from oral morphine or oxycodone in patients with cancer pain. Clin J Pain. 2011;27(8):664-7.
Kanbayashi, Y., Hosokawa, T., Okamoto, K., Fujimoto, S., Konishi, H., Otsuji, E., Yoshikawa, T., Takagi, T., Miki, T., & Taniwaki, M. (2011). Factors predicting requirement of high-dose transdermal fentanyl in opioid switching from oral morphine or oxycodone in patients with cancer pain. The Clinical Journal of Pain, 27(8), 664-7. https://doi.org/10.1097/AJP.0b013e3182168fed
Kanbayashi Y, et al. Factors Predicting Requirement of High-dose Transdermal Fentanyl in Opioid Switching From Oral Morphine or Oxycodone in Patients With Cancer Pain. Clin J Pain. 2011;27(8):664-7. PubMed PMID: 21471811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Factors predicting requirement of high-dose transdermal fentanyl in opioid switching from oral morphine or oxycodone in patients with cancer pain. AU - Kanbayashi,Yuko, AU - Hosokawa,Toyoshi, AU - Okamoto,Kousuke, AU - Fujimoto,Sawako, AU - Konishi,Hideyuki, AU - Otsuji,Eigo, AU - Yoshikawa,Toshikazu, AU - Takagi,Tatsuya, AU - Miki,Tsuneharu, AU - Taniwaki,Masafumi, PY - 2011/4/8/entrez PY - 2011/4/8/pubmed PY - 2012/1/19/medline SP - 664 EP - 7 JF - The Clinical journal of pain JO - Clin J Pain VL - 27 IS - 8 N2 - OBJECTIVES: To identify predictive factors requiring high-dose transdermal fentanyl in opioid switching from oral morphine or oxycodone to transdermal fentanyl in patients with cancer pain. METHODS: The participants were 76 hospitalized terminal cancer patients who underwent opioid switching from oxycodone or morphine sustained-release tablet to transdermal fentanyl at our hospital between January 2009 and June 2010. The conversion dose was calculated as transdermal fentanyl (25 μg/h)/oral morphine (60 mg) or oxycodone (40 mg)=1. The response evaluated was the dose conversion ratio [transdermal fentanyl/oral morphine or oxycodone (conversion dose to fentanyl)]=Y and was taken to be 0 for Y≤1, 1 for 1<Y≤2, 2 for 2<Y≤3, and 3 for 3<Y. Predictors evaluated were factors potentially impacting pain. Ordered logistic regression analysis was carried out to identify the predictive factors requiring high-dose transdermal fentanyl in opioid switching. RESULTS: Breast cancer [odds ratio (OR)=8.218; 95% confidence interval (CI), 1.219-55.407; P=0.0305], total protein level (OR=0.630; 95% CI, 0.408-0.974; P=0.0377), alanine aminotransferase level (OR=1.017; 95% CI, 1.001-1.033; P=0.0390), advanced age (OR=3.700; 95% CI, 1.360-10.063; P=0.0104), and male sex (OR=3.702; 95% CI, 1.355-10.115; P=0.0107) were found to be significant predictive factors requiring high-dose transdermal fentanyl in opioid switching. DISCUSSION: Our study indicates that breast cancer, total protein, alanine aminotransferase, advanced age, and male sex are significant predictors of a need for higher dose transdermal fentanyl in opioid switching. Our results are considered likely to contribute to the establishment of evidence-based medicine in pain relief and palliative care. SN - 1536-5409 UR - https://www.unboundmedicine.com/medline/citation/21471811/Factors_predicting_requirement_of_high_dose_transdermal_fentanyl_in_opioid_switching_from_oral_morphine_or_oxycodone_in_patients_with_cancer_pain_ L2 - https://doi.org/10.1097/AJP.0b013e3182168fed DB - PRIME DP - Unbound Medicine ER -