• Acta clinica Croatica · Sep 2020

    Should we treat pain in the elderly palliative care cancer patients differently?

    • Marin Golčić, Renata Dobrila-Dintinjana, Goran Golčić, Ivana Plavšić, Lidija Gović-Golčić, Borislav Belev, Domagoj Gajski, and Krešimir Rotim.
    • 1Department of Radiotherapy and Oncology, Rijeka University Hospital Centre, Rijeka, Croatia; 2Primorje-Gorski Kotar County Health Centre, Rijeka, Croatia; 3General Practice Office, Rijeka, Croatia; 4Department of Oncology, Zagreb University Hospital Centre, Zagreb, Croatia; 5Department of Neurosurgery, Sestre milosrdnice University Hospital Centre, Zagreb, Croatia; 6Department of Anatomy and Physiology, University of Applied Health Sciences, Zagreb, Croatia; 7University of Zagreb, School of Dental Medicine, Zagreb, Croatia; 8Faculty of Medicine, Josip Juraj Strossmayer University of Osijek, Osijek, Croatia.
    • Acta Clin Croat. 2020 Sep 1; 59 (3): 387-393.

    AbstractOpioids are considered the cornerstone of pain management in palliative care. Available data suggest that older patients use different analgesics and lower opioid doses compared to younger patients. However, it has not been elucidated yet whether such dosing is associated with worse pain levels or shorter survival in the palliative care setting. We evaluated the relationship among pain scores, quality of life, opioid dose, and survival in palliative care cancer patients in a hospice setting. A total of 137 palliative care cancer patients were analyzed prospectively. We divided patients into two groups using the age of 65 as a cut-off value. Younger patients exhibited significantly higher pain ratings (5.14 vs. 3.59, p=0.01), although older patients used almost 20 mg less oral morphine equivalent (OME) on arrival (p=0.36) and 55 mg OME/day less during the last week (p=0.03). There were no differences in survival between the two groups (17.36 vs. 17.58 days). The elderly patients also used nonsteroidal analgesics less often and paracetamol more often. Hence, using lower opioid doses in older palliative care cancer patients does not result in worse pain rating, and could be a plausible approach for pain management in this patient group.

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