Chinellato Alessandro, Terrazzani Gianni, Debetto Patrizia, Zambon Paola, Guzzinati Stefano, Walley Tom, Giusti Pietro
Office of Pharmaceutical Service, Local Health Authority no. 9, Treviso, Italy.
Br J Clin Pharmacol. 2006 Jul;62(1):130-3. doi: 10.1111/j.1365-2125.2006.02600.x.
We evaluated patterns of use of opioids in palliative care across one region in Italy by cross-referencing a cancer registry with unique patient identifiers, with prescription databases. There were 90 803 patients in the registry, of whom 39 597 died during the study period. Only 8539 (21%) of these were prescribed opioids at the time of their death. Prescribed daily doses of oral morphine used (45 mg) and of buprenorphine (0.71 mg) were low compared with injected morphine (28.6 mg, equivalent to approximately 90 mg of oral morphine) and especially with doses of transdermal fentanyl (1.13 mg, equivalent to approximately 180 mg morphine). The reasons for this acceptance of transdermal fentanyl and reluctance to use oral morphine are unclear, but it seems that more effort in educating healthcare professionals and patients about the use of morphine would be useful. The use of more detailed prescribing data such as prescribed or received daily doses can add to our understanding of headline prescribing data.
我们通过将癌症登记处带有唯一患者标识符的数据与处方数据库交叉对照，评估了意大利一个地区姑息治疗中阿片类药物的使用模式。登记处有90803名患者，其中39597人在研究期间死亡。这些死亡患者中只有8539人（21%）在死亡时开具了阿片类药物处方。与注射用吗啡（28.6毫克，相当于约90毫克口服吗啡）相比，尤其是与透皮芬太尼剂量（1.13毫克，相当于约180毫克吗啡）相比，口服吗啡（45毫克）和丁丙诺啡（0.71毫克）的每日处方剂量较低。接受透皮芬太尼而不愿使用口服吗啡的原因尚不清楚，但似乎加大对医护人员和患者进行吗啡使用教育的力度会有所帮助。使用更详细的处方数据，如每日处方或接受剂量，可以增进我们对总体处方数据的理解。
