Evidence map›Paper›PMID 40804545›Full record

SynthesisInternational journal of clinical oncology2025

Opioid switching to improve delirium symptoms in patients with cancer: a systematic review.

Kousuke Yamanaka, Takaaki Hasegawa, Yoshinobu Matsuda, Shinichiro Inoue, Hitoshi Tanimukai, Saho Wada, Jun Kako, Japan Psycho-Oncology Society/the Japanese Association of Supportive Care in Cancer’s Clinical Practice Guidelines for Delirium in Cancer Patients Group

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of clinical oncology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Kousuke YamanakaIwao Pharmacy Japanese Red Cross Hospital Front Mitasu Ise Branch, Ise, 516-0008, Japan.
Takaaki HasegawaCenter for Psycho-Oncology and Palliative Care, Nagoya City University Hospital, Mizuho-Cho, Mizuho-Ku, Nagoya, 467-8601, Japan. takaaki_hase@bird.ocn.ne.jp.ORCID http://orcid.org/0000-0001-7894-4528
Yoshinobu MatsudaDepartment of Psychosomatic Internal Medicine, NHO Kinki Chuo Chest Medical Center, Sakai, 591-8555, Japan.ORCID http://orcid.org/0000-0001-5092-9377
Shinichiro InoueDepartment of Nursing, Niimi University, Niimi, 718-8585, Japan.
Hitoshi TanimukaiGraduate School of Nursing, Nagoya City University, Nagoya, 467-8601, Japan.ORCID http://orcid.org/0000-0001-8375-4040
Saho WadaDivision of Quality Assurance Programs, National Cancer Center Institute for Cancer Control, Tokyo, 104-0045, Japan.ORCID http://orcid.org/0000-0001-6809-4339
Jun KakoGraduate School of Medicine, Mie University, Tsu, 514-8507, Japan.ORCID http://orcid.org/0000-0001-6875-6275
Japan Psycho-Oncology Society/the Japanese Association of Supportive Care in Cancer’s Clinical Practice Guidelines for Delirium in Cancer Patients Group

Funding

Japanese Society for the Promotion of Science 23K16438
6 · The paper itself

Abstract

backgroundDelirium is a common and distressing symptom in patients with cancer, while opioids-which are essential in managing cancer pain-can cause delirium. Opioid switching is a widely used strategy for the management of opioid-induced delirium; however, its efficacy is yet to be verified. This systematic review aimed to determine opioid switching's efficacy and safety for managing opioid-induced delirium in patients with cancer.

methodsThis systematic review was conducted in accordance with the PRISMA guidelines. We searched four databases (PubMed, Cochrane Controlled Register of Trials, Cochrane Library, and Ichishi-Web) on September 6, 2023, with an updated PubMed search on October 20, 2024. Our review included studies on opioid switching for managing delirium in patients with cancer. If there were less than two randomized controlled trials (RCTs), we included observational studies. Data extraction and evaluation were independently conducted by two reviewers using the GRADE evaluation. The study protocol was registered (UMIN000051787).

resultsThe literature search identified seven observational studies without a control group; however, no RCTs were found. Four observational studies reported improvements in the severity of delirium symptoms. No study reported worsening pain or dyspnea after opioid switching. According to the GRADE framework, all outcomes were graded very low on certainty.

conclusionsAlthough observational studies imply opioid switching's effectiveness for managing opioid-induced delirium in patients with cancer, there is a lack of RCTs and the level of evidence is very low. Thus, RCTs are warranted to confirm opioid switching's efficacy.

Indexed as

Analgesics, OpioidCancer PainDeliriumDrug SubstitutionNeoplasmsHumansObservational Studies as TopicAnalgesics, OpioidDeliriumNeoplasmsOpioidPalliative careSystematic review

Identifiers

PMID40804545

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.