* Corresponding Author
Luaran Penggunaan Analgesik Opiat pada Pasien Kanker
https://doi.org/10.22146/jmpf.48052 Salma Fajar Puspita(1), Zullies Ikawati, Apt.(2*), Retno Muliawati(3)
(1) Magister Farmasi Klinik, Fakultas Farmasi, Universitas Gadjah Mada
(2) Department of Pharmacology, Faculty of Pharmacy, Universitas Gadjah Mada
(3) RSUP Dr. Sardjito, Yogyakarta
(*) Corresponding Author
Abstract
Cancer pain might reduce the quality of life of cancer patients. Opioids are the drug of choice in cancer pain management. Fentanyl and other opioids are often prescribed. This study was aimed to compare the pain intensity reduction and quality of life of patients with cancer pain using transdermal fentanyl and other opioids. This prospective cohort study Oinvolved cancer outpatients with pain at the Tulip International Cancer Center of RSUP Dr. Sardjito, Yogyakarta fulfilling inclusion and exclusion criteria. Follow-up was carried out 2 weeks after recruitment. Pain intensity and quality of life were obtained through interview process using Numerical Rating Scale (NRS) and EORTC QLQ-C30 questionnaire. Patient demographic and disease status were obtained from medical records. Clinical outcomes (reduction in pain intensity and achievement of pain targets) and quality of life in the transdermal fentanyl and oral opioid groups were presented descriptively because of the low research power. Total respondents involved were 111 patients, 13 (11.71%) patients used transdermal fentanyl and 98 (88.29%) patients used oral opiates. The effect of opioid on reduction of pain intensity, achievement of pain targets and quality of life cannot be justified even though descriptively transdermal fentanyl shows better outcomes than oral opioid. The reduction of pain intensity was influenced by age (p = 0,000) and global health status was influenced by the stage of the cancer (p = 0.045).
Keywords
Full Text:
PDFReferences
1. Wang H, Naghavi M, Allen C, et al. Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980–2015: a systematic analysis for the Global Burden of Disease Study 2015. Lancet. 2016. doi:10.1016/S0140-6736(16)31012-1
2. Vos T, Abajobir AA, Abbafati C, et al. Global, regional, and national incidence, prevalence, and years lived with disability for 328 diseases and injuries for 195 countries, 1990-2016: A systematic analysis for the Global Burden of Disease Study 2016. Lancet. 2017. doi:10.1016/S0140-6736(17)32154-2
3. van Leeuwen M, Husson O, Alberti P, et al. Understanding the quality of life (QOL) issues in survivors of cancer: towards the development of an EORTC QOL cancer survivorship questionnaire. Health Qual Life Outcomes. 2018;16(1):114. doi:10.1186/s12955-018-0920-0
4. Damodar G, Gopinath S, Vijayakumar S, Rao AY. Reasons for low quality of life in South Indian cancer patient population: a prospective observational study. Indian J Pharm Sci. 2014;76(1):2-9. http://www.ncbi.nlm.nih.gov/pubmed/24799733. Accessed July 23, 2019.
5. Wang H-L, Kroenke K, Wu J, Tu W, Theobald D, Rawl SM. Cancer-related pain and disability: a longitudinal study. J Pain Symptom Manage. 2011;42(6):813-821. doi:10.1016/j.jpainsymman.2011.02.019
6. Temel JS, Blinderman CD, Jacobsen J, Pirl WF, Billings JA, Lynch TJ. Early Palliative Care for Patients with Metastatic Non–Small-Cell Lung Cancer. N Engl J Med. 2010. doi:10.1056/NEJMoa1000678
7. Hjermstad MJ, Kaasa S, Caraceni A, et al. Characteristics of breakthrough cancer pain and its influence on quality of life in an international cohort of patients with cancer. BMJ Support Palliat Care. 2016;6(3):344-352. doi:10.1136/bmjspcare-2015-000887
8. Thinh DHQ, Sriraj W, Mansor M, et al. Analgesic Prescription Patterns and Pain Outcomes in Southeast Asia: Findings From the Analgesic Treatment of Cancer Pain in Southeast Asia Study. J Glob Oncol. 2018. doi:10.1200/jgo.17.00055
9. Koyyalagunta D, Bruera E, Solanki DR, et al. A systematic review of randomized trials on the effectiveness of opioids for cancer pain. Pain Physician. 2012.
10. Ho KY, Ahn JS, Calimag MM, et al. Inadequate treatment practices for pain relief and adverse event management in cancer patients across 10 countries/regions in Asia: a call for greater efforts to improve standards for patient care. Asia Pac J Clin Oncol. 2018;14(3):159-166. doi:10.1111/ajco.12696
11. Sloot S, Boland J, Snowden JA, et al. Side effects of analgesia may significantly reduce quality of life in symptomatic multiple myeloma: a cross-sectional prevalence study. Support Care Cancer. 2015. doi:10.1007/s00520-014-2358-1
12. Meng Z, Yu J, Acuff M, et al. Tolerability of Opioid Analgesia for Chronic Pain: A Network Meta-Analysis. Sci Rep. 2017;7(1):1995. doi:10.1038/s41598-017-02209-x
13. Perwitasari DA, Atthobari J, Dwiprahasto I, et al. Translation and validation of EORTC QLQ-C30 into Indonesian version for cancer patients in Indonesia. Jpn J Clin Oncol. 2011. doi:10.1093/jjco/hyq243
14. Fayers P, Aaronson NK, Bjordal K, Groenvold M, Curran D, Bottomley A. EORTC QLQ-C30 Scoring Manual. European Organisation for Research and Treatment of Cancer; 2001.
15. Swarm R, Abernethy P, Anghelescu DL, et al. Adult Cancer Pain. J Natl Compr Cancer Netw. 2010;8(9):1046-1086.
16. Wang D-D, Ma T-T, Zhu H-D, Peng C-B. Transdermal fentanyl for cancer pain: Trial sequential analysis of 3406 patients from 35 randomized controlled trials. J Cancer Res Ther. 2018;14(Supplement):S14-S21. doi:10.4103/0973-1482.171368
17. Yen CR, Tsou MY, Mandell MS, et al. An analysis of patient variables that influence intravenous patient-controlled analgesic use of morphine with quantile regression. Anesthesiology. 2010;112(3):688-695. doi:10.1097/ALN.0b013e3181cbd1f3
18. Symeonidi M, Panagiotou I, Tsilika E, Roumeliotou A, Galanos A, Mystakidou K. Factors Affecting Opioid Treatment in Cancer Patients. J Pharm Pharm Sci. 2018;21(1):256. doi:10.18433/jpps29396
19. Naples JG, Gellad WF, Hanlon JT. Managing pain in older adults: The role of opioid analgesics. Clin Geriatr Med. 2016;32(4):725-735. doi:10.1016/j.cger.2016.06.006.
20. Singh H, Banipal RPS, Singh B. Assessment of Adequacy of Pain Management and Analgesic Use in Patients With Advanced Cancer Using the Brief Pain Inventory and Pain Management Index Calculation. J Glob Oncol. 2016;3(3):235-241. doi:10.1200/JGO.2016.004663
21. Carlson CL. Effectiveness of the World Health Organization cancer pain relief guidelines: an integrative review. J Pain Res. 2016:20.
22. Bandieri E, Romero M, Ripamonti CI, et al. Randomized Trial of Low-Dose Morphine Versus Weak Opioids in Moderate Cancer Pain. J Clin Oncol Off J Am Soc Clin Oncol. 2016;34(5):436-442. doi:10.1200/JCO.2015.61.0733
23. Ahmedzai S, Brooks D. Transdermal fentanyl versus sustained-release oral morphine in cancer pain: preference, efficacy, and quality of life. The TTS-Fentanyl Comparative Trial Group. J Pain Symptom Manage. 1997;13(5):254-261.
24. Rudowska J. Management of breakthrough pain due to cancer. Contemp Oncol. 2012;16(6):498-501. doi:10.5114/wo.2012.32481
25. Devulder J, Jacobs A, Richarz U, Wiggett H. Impact of opioid rescue medication for breakthrough pain on the efficacy and tolerability of long-acting opioids in patients with chronic non-malignant pain. BJA Br J Anaesth. 2009;103(4):576-585. doi:10.1093/bja/aep253
26. Yang Q, Xie D-R, Jiang Z-M, et al. Efficacy and adverse effects of transdermal fentanyl and sustained-release oral morphine in treating moderate-severe cancer pain in Chinese population: a systematic review and meta-analysis. J Exp Clin Cancer Res. 2010;29:67. doi:10.1186/1756-9966-29-67
27. Thapa N, Maharjan M, Xiong Y, et al. Impact of cervical cancer on quality of life of women in Hubei, China. Sci Rep. 2018;8(1):11993. doi:10.1038/s41598-018-30506-6
28. Payne R, Mathias SD, Pasta DJ, Wanke LA, Williams R, Mahmoud R. Quality of life and cancer pain: satisfaction and side effects with transdermal fentanyl versus oral morphine. J Clin Oncol Off J Am Soc Clin Oncol. 1998;16(4):1588-1593. doi:10.1200/JCO.1998.16.4.1588
29. Brush DE. Complications of Long-Term Opioid Therapy for Management of Chronic Pain: The Paradox of Opioid-Induced Hyperalgesia. J Med Toxicol. 2012;8(4):387-392. doi:10.1007/s13181-012-0260-0
30. Velayudhan A, Bellingham G, Morley-Forster P. Opioid-induced hyperalgesia. Contin Educ Anaesth Crit Care Pain. 2014;14(3):125-129. doi:10.1093/bjaceaccp/mkt045
DOI: https://doi.org/10.22146/jmpf.48052
Article Metrics
Abstract views : 2528
| 
views : 2228
Refbacks
- There are currently no refbacks.
Copyright (c) 2019 JURNAL MANAJEMEN DAN PELAYANAN FARMASI (Journal of Management and Pharmacy Practice)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
