Article Text
PDF
Abstract
Please confirm that an ethics committee approval has been applied for or granted: Yes: I’m uploading the Ethics Committee Approval as a PDF file with this abstract submission
Background and Aims Pain management in terminally ill patients is challenging, influenced by misconceptions about opioids and a lack of education among healthcare professionals. Our aim is to describe the use of opioids in terminally ill patients from January 2019 to December 2019 in a medical training center hospital in Brazil.
Methods A retrospective cross-sectional study analyzed 43 medical records of patients in palliative care using of opioids in 24 hours and 7 days, at the University Hospital Lauro Wanderley, João Pessoa-PB, Brazil, who died in 2019. The research followed inclusion criteria, excluding cases of emergency care and less than 24 hours of hospitalization.
Results The study analyzed 43 medical records. 86% of patients used opioids in the last 24 hours, mainly intravenous drugs as fentanyl (figure 1). Tramadol had the highest dosages and fentanyl the lowest (figure 2). Dipyrone was the most common adjuvant (78.4% in the last 24 hours, 76.8% in the last seven days). There was no significant difference in conversion to oral morphine between periods and the equivalent opioid load did not show a normal distribution (Shapiro-Wilk = 0,75 and 0,56, p < 0,001) (figure 3).
Conclusions The underuse of opioids reveals gaps in clinical practice, influenced by social stigmas and lack of knowledge. The choice of fentanyl highlights its effectiveness, but there is a tendency to use it instead of morphine. Heterogeneity in prescribing highlights the need for clearer guidelines. The study has limitations, such as its retrospective nature and gaps in documentation, highlighting the importance of improving data collection.
Distribution of opioid use by administration time
Distribution of opioid use by dosage
Opioid load equivalent to oral morphine