Pain and metastatic cancer: Opioid prescribing practices and perceptions of their effectiveness

IntroductionPain management in patients with metastatic cancer is a major challenge. The aim of this study is to analyse opioid prescribing practices and evaluate their effectiveness as perceived by patients.MethodsA descriptive, prospective study was conducted at the hospital pharmacy over a period of six months. Data were collected through direct interviews with patients. The study included patients diagnosed with metastatic cancer who were treated with opioids. The data collected concerned the demographic and clinical characteristics of the patients, as well as the prescription modalities, perceived efficacy and adverse effects of opioids.ResultsA total of 144 patients were included, with a mean age of 49.5 years. The most frequent tumour site was the breast (25.9%). Metastases were predominantly bone metastases (52.4%). The intensity of perceived pain was high, with a score of ≥7 on the visual analogue scale in 94% of patients before the initiation of analgesic treatment. Morphine was the most commonly prescribed opioid (61.8%). Tramadol and the combination of paracetamol and codeine were also widely used. The perceived efficacy of opioids was positive for 78.5% of patients, with complete pain relief in 41.7%. However, 21.5% of patients reported persistent pain despite analgesic treatment. The leading adverse effect was constipation (39%).Discussion/ConclusionThis study highlights the importance of pain management, one of the four core components of supportive cancer care, with morphine remaining the opioid of choice for providing effective analgesia. However, the high frequency of adverse effects underscores the need for improved symptomatic management strategies. This study has several limitations. Nevertheless, it provides valuable real-world insights into opioid use in cancer pain management and emphasizes the need for larger, multicenter studies to validate and further expand these findings.