• Susannah Hall, Rollin M Gallagher, Edward Gracely, Calvin Knowlton, and Douglas Wescules.
• excelleRx Institute, Philadelphia, Pennsylvania 19106, USA. shall@excellerx.com
• Pain Med. 2003 Jun 1;4(2):125-34.

ObjectiveThe objective of the current study is to describe correlations between age, gender, and primary cancer site and sustained-release opioid doses prescribed for hospice patients at the end of life.Patients And SettingThis study included all 7,201 hospice patients referred to a North American palliative care specialty pharmacy with the primary diagnosis of cancer and who were prescribed transdermal fentanyl, sustained-release oral morphine, or sustained-release oxycodone.DesignThis is a retrospective analysis of the final sustained-release morphine, oxycodone, or transdermal fentanyl doses prescribed to cancer patients, according to pharmacy records. Comparisons between sex and age group were performed with chi-square tests. Mann-Whitney U tests were used to compare mean doses between the sexes. Analyses of covariance (ANCOVA) were used to compare opioid doses between genders and among primary cancer sites while controlling for age.ResultsThe inverse association between age group and dose was highly significant. For example, final opioid doses ConclusionsBoth primary tumor site and patient age were associated with final opioid dose. Further investigation is warranted to determine which primary tumor sites are associated with unusually high opioid doses and may highlight the need to optimize adjuvant medication therapy if neuropathic and/or inflammatory pain mechanisms are involved and to refer to pain specialists when appropriate.

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