Effectiveness of opioid rotation in the control of cancer pain: the ROTODOL study.

Autor:	González-Barboteo J; Palliative Care Service, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Chair of Palliative Care, Center for Health and Social Studies, University of Vic., Barcelona, Spain; Palliative Care Research Group, IDIBELL, Universitary Bellvitge Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Alentorn XG; Director of World Health Organization Collaborating Centre for Public Health Palliative Care Programmes, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Director of Chair of Palliative Care, Center for Health and Social Studies, University of Vic., Barcelona, Spain; Palliative Care Research Group, IDIBELL, Universitary Bellvitge Hospital, L'Hospitalet de Llobregat, Barcelona, Spain., Manuel FA; Chief of Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Professor of Complutense, University of Madrid, Madrid, Spain., Candel VA; Chief of Medical Oncology Service, Hospital Arnau de Vilanova, Valencia, Spain; Professor of Medical Oncology, Medical Oncology Service, Hospital Arnau de Vilanova, Universitat de Valencia, Valencia, Spain., Eito MA; Chief of Radiotherapy Oncology Service, Hospital Universitario Provincial Reina Sofía, Córdoba, Spain., Sánchez-Magro I; Medical Director of Medical Department, Grünenthal Iberia, Madrid, Spain., Álvarez MN; Medical Department, Grünenthal Iberia, Madrid, Spain., Martín FJ; Clinical Research Unit, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain., Porta-Sales J; Chief of Palliative Care Service Research Unit, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Palliative Care Research Group, IDIBELL, Universitary Bellvitge Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
Jazyk:	angličtina
Zdroj:	Journal of opioid management [J Opioid Manag] 2014 Nov-Dec; Vol. 10 (6), pp. 395-403.
DOI:	10.5055/jom.2014.0236
Abstrakt:	Objective: To assess the effectiveness of opioid rotation (OR) to manage cancer pain. To describe the adverse events (AEs) associated with OR. Setting: Thirty-nine tertiary hospital services. Patients: Sixty-seven oncological patients with cancer-related pain treated at outpatient clinics. Intervention: Prospective multicenter study. Pain intensity was scored using a Numerical Rating Scale (NRS) of 0-10. Average pain (AP) intensity in the last 24 hours, breakthrough pain (BTP), and the number of episodes of BTP on the days before and 1 week after OR were assessed. The pre-OR and post-OR opioid were recorded. The presence and intensity of any AEs occurring after OR were also recorded. Results: In the 67 patients evaluated, 75 ORs were recorded. In all cases, the main reason for OR was poor pain control. Pain intensity decreased by ≥2 points after OR in 75.4 percent and 57.8 percent of cases for AP and BTP, respectively. If the initial NRS score was ≥4, a decrease below <4 accounted for 50.9 percent and 32.3 percent of cases for AP and BTP, respectively. The number of episodes of BTP also decreased significantly (p<0.001). A total of 107 AEs were reported, most of which were mild in intensity, with gastrointestinal symptoms predominating. Conclusions: Opioid rotation appears to be both safe and effective in the management of basal and breakthrough cancer pain.
Databáze:	MEDLINE
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