title: [Calculation of the number of terminally ill patients through their use of opioid analgesics and tumor mortality].
abstract: OBJECTIVE
  To find the number of patients in terminal care in Madrid Health District 3.
  
  
  METHODS
  Ecological, descriptive study.
  
  
  METHODS
  Eleven Health Districts. Madrid, Spain, 2002.
  
  
  METHODS
  Two models were used to calculate the number of patients in terminal care and were compared with data from the Primary Care Service Portfolio. Model A: consumption of morphine and fentanyl. The number of defined daily doses (DDD) of these active principles and the DDD per 1000 inhabitants and day (DID) were calculated. Prescription details: prescriptions charged to Social Security from registered doctors in Madrid (primary care and specialists). Model B: tumor mortality, i.e. the number of deaths due to tumors in the year 2000, published in 2004.
  
  
  RESULTS
  The number of terminal patients calculated by the 2 models in 7 of the 11 Health Districts and in the Community of Madrid is higher than in the Primary Care Service Portfolio. In the Community of Madrid, morphine and fentanyl are prescribed basically in primary care (96%). There was an important jump in fentanyl prescription from 2001 to 2002, due to the main fentanyl prescribed being transdermal.
  
  
  CONCLUSIONS
  There are differences between the models in calculation of terminal patients. Moreover, the models offer heterogeneous results between health districts. Fentanyl consumption has become greater than morphine use in Madrid. The registers of terminal patients and/or their recruitment need to be improved.
authors.affiliation: Gerencia de Atención Primaria, Area 3, Madrid, Spain. eescortell.gapm03@salud.madrid.org
authors.forename: E
authors.initials: E
authors.lastname: Escortell-Mayor
authors.forename: O
authors.initials: O
authors.lastname: Larrubia-Muñoz
authors.forename: D
authors.initials: D
authors.lastname: Troncoso-Viejo
authors.forename: R
authors.initials: R
authors.lastname: Martínez-Martínez
authors.forename: A
authors.initials: A
authors.lastname: López-Romero
authors.forename: C
authors.initials: C
authors.lastname: de Miguel-Sánchez
mesh_terms: D000701:Analgesics, Opioid / Q000627:therapeutic use*; D004363:Drug Utilization; D006801:Humans; D015233:Models, Statistical; D009369:Neoplasms / Q000188:drug therapy* / Q000401:mortality; D013727:Terminal Care / Q000706:statistics & numerical data; D019452:Terminally Ill / Q000706:statistics & numerical data*
chemical_list: D000701:Analgesics, Opioid