Opioid Disposal Practices of Patients With Life-Limiting Cancers in an Outpatient Palliative Care Clinic: A Cross-Sectional Study
- 1 June 2023
- journal article
- research article
- Published by Mary Ann Liebert Inc in Journal of Palliative Medicine
- Vol. 26 (6), 816-825
- https://doi.org/10.1089/jpm.2022.0355
Abstract
Background: Patients with life-limiting cancers are commonly prescribed opioids to manage pain, dyspnea, and cough. Proper prescription opioid disposal is essential to prevent poisonings and deaths. Objective: We examined opioid disposal practices of patients referred to a Canadian outpatient palliative care clinic (OPCC). The primary objective was to determine the prevalence of OPCC patients who did not routinely dispose their opioids. The secondary objectives were to examine their methods of opioid disposal and to identify patient characteristics associated with routine disposal of opioids. Design and Setting: This cross-sectional study involved a retrospective chart review of new, adult patients who were seen in a Canadian OPCC (September 2018–August 2019) and completed a survey about opioid-related constructs: source of prescriptions, use, storage, disposal, and knowledge about associated harms. Results: Among the 122 study participants, half (58/111, 52.3%) reported that they did not routinely dispose their opioids. The most common method of disposal was by giving them to pharmacists (69/88, 78.4%). Cannabis use (odds ratio [OR]: 3.7, 95% confidence interval [CI]: 1.1–11.8) and neuropathic medication use (OR: 3.0, 95% CI: 1.2–7.2) were positively associated with routine disposal of opioids. Conversely, reports of an increased amount of opioid use in the past six months were negatively associated with routine disposal of opioids (OR: 0.38, 95% CI: 0.16–0.88). Conclusion: The high prevalence of people with life-limiting illnesses who do not routinely dispose their opioids requires increased attention. Interventions, such as education, are needed to reduce medication waste and opioid-related harms.Keywords
This publication has 21 references indexed in Scilit:
- The Impact of an Educational Program on Patient Practices for Safe Use, Storage, and Disposal of Opioids at a Comprehensive Cancer CenterThe Oncologist, 2017
- Medication Sharing, Storage, and Disposal Practices for Opioid Medications Among US AdultsJAMA Internal Medicine, 2016
- Frequency of unsafe storage, use, and disposal practices of opioids among cancer patients presenting to the emergency departmentPalliative & Supportive Care, 2016
- Taking stock of medication wastage: Unused medications in US householdsResearch in Social and Administrative Pharmacy, 2015
- The oncology palliative care clinic at the Princess Margaret Cancer Centre: an early intervention model for patients with advanced cancerSupportive Care in Cancer, 2014
- Patterns of Storage, Use, and Disposal of Opioids Among Cancer OutpatientsThe Oncologist, 2014
- Introduction of a Self-Report Version of the Prescription Drug Use Questionnaire and Relationship to Medication Agreement NoncomplianceJournal of Pain and Symptom Management, 2008
- Opioid Use and Survival at the End of Life: A Survey of a Hospice PopulationJournal of Pain and Symptom Management, 2006
- The use of opioids and sedatives at the end of lifeThe Lancet Oncology, 2003
- Screening for Addiction in Patients with Chronic Pain and “Problematic” Substance Use: Evaluation of a Pilot Assessment ToolJournal of Pain and Symptom Management, 1998