ArticleJournal of pain and symptom management2013
Frequency and predictors of patient deviation from prescribed opioids and barriers to opioid pain management in patients with advanced cancer.
Article in Journal of pain and symptom management, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
35 citing papers in PubMed, 1 synthesis or guideline pooled it, 78 citations in OpenAlex.
- A systematic review of health care interventions for pain in patients with advanced cancer.The American journal of hospice & palliative care · 2014Pooled it
- MyPainPal, a Novel mHealth App to Improve Pain in Patients With Advanced Cancer: Single-Arm Pilot Study.JMIR cancer · 2025Trial
- Pain, symptom distress, and pain barriers by age among patients with cancer receiving hospice care: Comparison of baseline data.Journal of geriatric oncology · 2021Trial
- Mobile Health and Gamification of Chronic Pain Management: A Narrative Review.Current pain and headache reports · 2025Review
- Effectiveness of Long-Term Opioid Therapy for Chronic Pain in an Outpatient Palliative Medicine Clinic.Journal of palliative medicine · 2024Article
- The Stigma Surrounding Opioid Use as a Barrier to Cancer-Pain Management: An Overview of Experiences with Fear, Shame, and Poorly Controlled Pain in the Context of Advanced Cancer.Current oncology (Toronto, Ont.) · 2023Review
- Barriers to Pain Management: Incongruence in Black Cancer Caregiving Dyads.Journal of pain and symptom management · 2022Article
- Article
- 5-HTThe Korean journal of physiology & pharmacology : official journal of the Korean Physiological Society and the Korean Society of Pharmacology · 2021Article
- Assessment tools for problematic opioid use in palliative care: A scoping review.Palliative medicine · 2021Article
- Gaps in the Use of Long-Acting Opioids Within Intervals of Consecutive Days Among Cancer Outpatients Using Electronic Pill Caps.Pain medicine (Malden, Mass.) · 2021Observational
- National Patterns in Prescription Opioid Use and Misuse Among Cancer Survivors in the United States.JAMA network open · 2020Article
- Article
- Stringent Control of Opioids: Sound Public Health Measures, but a Step Too Far in Palliative Care?Current oncology reports · 2020Review
- Review
- Factors influencing non-adherence to opioids in cancer patients: a mixed-methods cross-sectional study.F1000Research · 2020Article
- Relationship Between Adherence to Opioid Analgesics and Pain Beliefs Among Patients with Cancer Pain at Tertiary Care Hospitals in Malaysia.Patient preference and adherence · 2020Article
- Safe Opioid Use, Storage, and Disposal Strategies in Cancer Pain Management.The oncologist · 2019Review
- Patient Patterns and Perspectives on Using Opioid Regimens for Chronic Cancer Pain.Journal of pain and symptom management · 2019Article
- Prevalence of Concurrent Prescription Opioid and Hazardous Alcohol Use Among Older Women: Results from a Cross-Sectional Study of Community Members.Journal of community health · 2019Article
Corrections and comments
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Authors and funding
8 authors at 3 institutions in 2 countries.
Funding
Abstract
contextApproximately 80% of patients with advanced cancer report pain and receive opioids. Information is limited about deviations from prescribed opioid doses and barriers to pain control, but poor opioid adherence has been reported in 49%-70% of patients.
objectivesTo evaluate the frequency and severity of self-reported opioid deviation and barriers to opioid pain management in outpatients with advanced cancer.
methodsWe surveyed 198 patients and collected pain scores (0-10), prescribed opioid dose, confidential patient-reported opioid prescription dose and intake (as long as there was no severe opioid deviation), barriers to pain management (Barriers Questionnaire-II [BQ-II]) scores, and adherence scores. Opioid deviation was defined as <70% or >130% of the prescribed dose.
resultsMedian patient age was 55 years; 91 (46%) were female. Median pain intensity and morphine equivalent daily dose were 4 (interquartile range=3-7) and 120mg (interquartile range=45-270mg), respectively. Prescribed and patient-reported prescribed doses were highly correlated for regular (r=0.90, P<0.001) and regular plus breakthrough opioid intake (r=0.94, P<0.001). Nineteen (9.6%) patients deviated. Deviation was more frequent in males (P=0.039) and nonwhites (P=0.0270). Nonwhite patients had higher scores on the BQ-II than white patients (P=0.038). Low adherence scores were significantly associated with higher BQ-II scores (1.99±0.80) for lower motivation score vs. 1.61±0.77 for higher score, P=0.007; and 2.13±0.79 for lower knowledge score vs. 1.57±0.72 for higher score, P=0.001.
conclusionVery few patients reported dose deviations, which were mostly toward lower dose. More research is necessary to better characterize the frequency and predictors of opioid deviation in this population.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.