A comparison of opioid dose between home palliative care and hospital palliative care
Abstract Objective While opioids are a key part of palliative care, few studies have evaluated opioid demand in the home care context. This study aims to compare opioid usage in home care and hospital care settings. Methods This cross-sectional study retrospectively recruited patients receiving pall...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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BMC
2024-01-01
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| Series: | BMC Primary Care |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12875-024-02265-z |
| _version_ | 1797276423656833024 |
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| author | Hiroyoshi Iwata Shuhei Hamada Hiroko Harada Katsuhiro Kusaka |
| author_facet | Hiroyoshi Iwata Shuhei Hamada Hiroko Harada Katsuhiro Kusaka |
| author_sort | Hiroyoshi Iwata |
| collection | DOAJ |
| description | Abstract Objective While opioids are a key part of palliative care, few studies have evaluated opioid demand in the home care context. This study aims to compare opioid usage in home care and hospital care settings. Methods This cross-sectional study retrospectively recruited patients receiving palliative care in home care and hospital settings, between November 2018 and October 2020. Opioid prescriptions were standardized to oral morphine equivalent (OME) doses at 7 and 14 days prior to death and analyzed. Additional analysis performed multivariable linear regression on the outcome of OME at 7 days, adjusting for medical setting and confounders in patients with opioid prescriptions. Results After 21 exclusions, 209 patients (48 home care and 161 hospital care) were eligible for analysis. The home care group had a higher mean age (74.8 years) and Palliative Prognosis Score (50), than the hospital group (70.1 and 40, respectively). Mean OME at 7 and 14 days before death was numerically higher in the home care group (72.8 mg/day and 53.0 mg/day, respectively) than the hospital care group (57.7 mg/day and 35.7 mg/day). Student’s t-test produced p-values of 0.49 and 0.32, and the Wilcoxon rank sum test found p-values of 0.24 and 0.11 at 7 and 14 days, respectively. Multivariable regression analysis of the home care group found mean OME of 40.7 mg/day; 95% confidence interval [-0.62, 82.0 (mg/day)], p = 0.06. Additional analysis found a p-value of 0.06 for medical setting. Conclusions We did not find a statistically significant difference in opioid use between home care and hospital care. However, the numerically higher rate of use in the home care group suggests that further research is warranted. |
| first_indexed | 2024-03-07T15:28:04Z |
| format | Article |
| id | doaj.art-b3f35ae03a8e45b48c7e76969be1ac1f |
| institution | Directory Open Access Journal |
| issn | 2731-4553 |
| language | English |
| last_indexed | 2024-03-07T15:28:04Z |
| publishDate | 2024-01-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Primary Care |
| spelling | doaj.art-b3f35ae03a8e45b48c7e76969be1ac1f2024-03-05T16:37:06ZengBMCBMC Primary Care2731-45532024-01-012511810.1186/s12875-024-02265-zA comparison of opioid dose between home palliative care and hospital palliative careHiroyoshi Iwata0Shuhei Hamada1Hiroko Harada2Katsuhiro Kusaka3Center for Environmental and Health Sciences, Hokkaido UniversityDepartment of Home Care Medicine, Ebetsu Visiting Home Care ClinicDepartment of Palliative Internal Medicine, Sapporo City General HospitalDepartment of Home Care Medicine, Ebetsu Visiting Home Care ClinicAbstract Objective While opioids are a key part of palliative care, few studies have evaluated opioid demand in the home care context. This study aims to compare opioid usage in home care and hospital care settings. Methods This cross-sectional study retrospectively recruited patients receiving palliative care in home care and hospital settings, between November 2018 and October 2020. Opioid prescriptions were standardized to oral morphine equivalent (OME) doses at 7 and 14 days prior to death and analyzed. Additional analysis performed multivariable linear regression on the outcome of OME at 7 days, adjusting for medical setting and confounders in patients with opioid prescriptions. Results After 21 exclusions, 209 patients (48 home care and 161 hospital care) were eligible for analysis. The home care group had a higher mean age (74.8 years) and Palliative Prognosis Score (50), than the hospital group (70.1 and 40, respectively). Mean OME at 7 and 14 days before death was numerically higher in the home care group (72.8 mg/day and 53.0 mg/day, respectively) than the hospital care group (57.7 mg/day and 35.7 mg/day). Student’s t-test produced p-values of 0.49 and 0.32, and the Wilcoxon rank sum test found p-values of 0.24 and 0.11 at 7 and 14 days, respectively. Multivariable regression analysis of the home care group found mean OME of 40.7 mg/day; 95% confidence interval [-0.62, 82.0 (mg/day)], p = 0.06. Additional analysis found a p-value of 0.06 for medical setting. Conclusions We did not find a statistically significant difference in opioid use between home care and hospital care. However, the numerically higher rate of use in the home care group suggests that further research is warranted.https://doi.org/10.1186/s12875-024-02265-zPalliative careHome palliative careOpoid |
| spellingShingle | Hiroyoshi Iwata Shuhei Hamada Hiroko Harada Katsuhiro Kusaka A comparison of opioid dose between home palliative care and hospital palliative care BMC Primary Care Palliative care Home palliative care Opoid |
| title | A comparison of opioid dose between home palliative care and hospital palliative care |
| title_full | A comparison of opioid dose between home palliative care and hospital palliative care |
| title_fullStr | A comparison of opioid dose between home palliative care and hospital palliative care |
| title_full_unstemmed | A comparison of opioid dose between home palliative care and hospital palliative care |
| title_short | A comparison of opioid dose between home palliative care and hospital palliative care |
| title_sort | comparison of opioid dose between home palliative care and hospital palliative care |
| topic | Palliative care Home palliative care Opoid |
| url | https://doi.org/10.1186/s12875-024-02265-z |
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