Assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population

Opioid analgesics remain the corner stone of effective management of moderate to severe pain. Morphine in its oral and parenteral form is one of the most affordable options left to treat severe cancer pain in most Palliative centres in India. The main objective of our study was to assess the safety...

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Autores principales:	Jayan Sreelakshmi, Stephen Stephy, Koshy Kevin Tom, Abraham Nikhil John, Daniel Sunitha, Anila K N
Formato:	article
Lenguaje:	EN
Publicado:	Sciendo 2020
Materias:	palliative care opioids pain morphine cancer non cancer Medicine R
Acceso en línea:	https://doaj.org/article/d3febd57847947d7a581d2ec97cd2f94
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spelling	oai:doaj.org-article:d3febd57847947d7a581d2ec97cd2f942021-12-05T14:11:06ZAssessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population2300-667610.2478/cipms-2020-0035https://doaj.org/article/d3febd57847947d7a581d2ec97cd2f942020-12-01T00:00:00Zhttps://doi.org/10.2478/cipms-2020-0035https://doaj.org/toc/2300-6676Opioid analgesics remain the corner stone of effective management of moderate to severe pain. Morphine in its oral and parenteral form is one of the most affordable options left to treat severe cancer pain in most Palliative centres in India. The main objective of our study was to assess the safety and effectiveness, as well as the prescribing pattern of immediate release oral morphine on the Indian population attending Pain and Palliative Care in a multi-speciality hospital. Within the sample population, 74.8% of all patients achieved a pain score reduction of less than or equal to 3 within the 72nd hour. Although the mean baseline pain score was similar in the cancer (8.23±0.75) and the non-cancer (8.26±0.98) group, the mean pain score at the 24th and 72nd hours were significantly different (5.6±1.29 in cancer and 5.09±1.26 in the non-cancer group within the 24th hour, followed by 3.66±1.479 and 3.12±0.88 after the 72nd hour, respectively). The majority of the patients (58.3%) were prescribed at a frequency of 5 mg every 4th hourly, with double dose at bedtime. A similar prescribing trend was seen in both the cancer and non-cancer groups. Moreover, 14 patients underwent dose escalation – with 12 belonging to the cancer group, while 11 patients falling under the cancer group required a switch to different therapy. The major adverse drug reactions (ADR) observed in both study groups were constipation (89.2%), fatigue (37.4%), dry mouth (36%) and nausea/vomiting (23%). The severity of nausea/vomiting and sleepiness was higher in the cancer group whereas itching was more predominant among the non-cancer group.Jayan SreelakshmiStephen StephyKoshy Kevin TomAbraham Nikhil JohnDaniel SunithaAnila K NSciendoarticlepalliative careopioidspainmorphinecancernon cancerMedicineRENCurrent Issues in Pharmacy and Medical Sciences, Vol 33, Iss 4, Pp 184-190 (2020)
institution	DOAJ
collection	DOAJ
language	EN
topic	palliative care opioids pain morphine cancer non cancer Medicine R
spellingShingle	palliative care opioids pain morphine cancer non cancer Medicine R Jayan Sreelakshmi Stephen Stephy Koshy Kevin Tom Abraham Nikhil John Daniel Sunitha Anila K N Assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population
description	Opioid analgesics remain the corner stone of effective management of moderate to severe pain. Morphine in its oral and parenteral form is one of the most affordable options left to treat severe cancer pain in most Palliative centres in India. The main objective of our study was to assess the safety and effectiveness, as well as the prescribing pattern of immediate release oral morphine on the Indian population attending Pain and Palliative Care in a multi-speciality hospital. Within the sample population, 74.8% of all patients achieved a pain score reduction of less than or equal to 3 within the 72nd hour. Although the mean baseline pain score was similar in the cancer (8.23±0.75) and the non-cancer (8.26±0.98) group, the mean pain score at the 24th and 72nd hours were significantly different (5.6±1.29 in cancer and 5.09±1.26 in the non-cancer group within the 24th hour, followed by 3.66±1.479 and 3.12±0.88 after the 72nd hour, respectively). The majority of the patients (58.3%) were prescribed at a frequency of 5 mg every 4th hourly, with double dose at bedtime. A similar prescribing trend was seen in both the cancer and non-cancer groups. Moreover, 14 patients underwent dose escalation – with 12 belonging to the cancer group, while 11 patients falling under the cancer group required a switch to different therapy. The major adverse drug reactions (ADR) observed in both study groups were constipation (89.2%), fatigue (37.4%), dry mouth (36%) and nausea/vomiting (23%). The severity of nausea/vomiting and sleepiness was higher in the cancer group whereas itching was more predominant among the non-cancer group.
format	article
author	Jayan Sreelakshmi Stephen Stephy Koshy Kevin Tom Abraham Nikhil John Daniel Sunitha Anila K N
author_facet	Jayan Sreelakshmi Stephen Stephy Koshy Kevin Tom Abraham Nikhil John Daniel Sunitha Anila K N
author_sort	Jayan Sreelakshmi
title	Assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population
title_short	Assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population
title_full	Assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population
title_fullStr	Assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population
title_full_unstemmed	Assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population
title_sort	assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on indian population
publisher	Sciendo
publishDate	2020
url	https://doaj.org/article/d3febd57847947d7a581d2ec97cd2f94
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Assessment of safety and effectiveness of oral morphine on patients attending pain and palliative care: a study on Indian population

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