<abstract xmlns="http://www.w3.org/1999/xhtml">

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.
</abstract>

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.

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

Current Issues in Pharmacy and Medical Sciences

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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...

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

Published Online: Jan 29, 2021

Page range: 184 - 190

Received: Aug 02, 2019

Accepted: Jun 04, 2020

DOI: https://doi.org/10.2478/cipms-2020-0035

Keywords
palliative care, opioids, pain, morphine, cancer, non cancer

© 2020 Sreelakshmi Jayan et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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

Published Online: Jan 29, 2021

Page range: 184 - 190

Received: Aug 02, 2019

Accepted: Jun 04, 2020

DOI: https://doi.org/10.2478/cipms-2020-0035

Keywordspalliative care, opioids, pain, morphine, cancer, non cancer

© 2020 Sreelakshmi Jayan et al., published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

Keywords
palliative care, opioids, pain, morphine, cancer, non cancer