Prescription patterns of analgesics in the last 3 months of life: a retrospective analysis of 10 202 lung cancer patients

BACKGROUND: To describe the prescription patterns of analgesics during the last 3 months of life in lung cancer and to determine the associated factors. METHODS: Data on lung cancer patients (N = 10 202) who died during 2000-2008 were extracted from the General Practice Research Database (GPRD). This database records prescriptions of patients received from UK general practices (GP), but not those from non-GP routes. Prescription prevalences were estimated. The associated factors were investigated using log-binomial regression. RESULTS: The overall prescription prevalences were 50.4% (95% confidence interval (CI): 49.4-51.4%) for level 1 (e. g., paracetamol), 34.1% (95% CI: 33.2-35.0%) for level 2 (weak opioids), and 55.5 % (95% CI: 54.5-56.4%) for level 3 analgesics (strong opioids). Prescription prevalence of analgesics of all levels showed an increasing trend over the period 2000-2008 (annual increases range: 1.1-1.5%) but a decreasing trend with age (average decrease per group range: -5.8 to -1.8%). Patients in the older age groups were less likely to be prescribed level 3 analgesics than those in the younger age groups (PR'90+' (vs) ('<50') = 0.55 (95% CI: 0.45-0.67); PR'80-89' (vs) ('<50') = 0.73 (95% CI: 0.66-0.79); PR'70-79' (vs '<50') = 0.84 (95% CI: 0.77-0.90)). CONCLUSION: Analgesics have been increasingly prescribed in lung cancer. However, analgesics, especially at level 3, were relatively under-prescribed to people older than 70 years, warranting further investigation. British Journal of Cancer (2011) 104, 1704-1710. doi:10.1038/bjc.2011.150 www.bjcancer.com Published online 3 May 2011 (C) 2011 Cancer Research UK