title: Errors in opioid prescribing: a prospective survey in cancer pain.
abstract: BACKGROUND
  Cancer pain is debilitating and has multidimensional consequences. It can be treated adequately in up to 90% of patients by following pain management guidelines. Nevertheless, inadequate pain control remains a global problem.
  
  
  OBJECTIVE
  We surveyed prescribing patterns in patients referred to our Palliative Medicine Program (PMP) to identify common errors in opioid use.
  
  
  METHODS
  Consecutive cancer patients seen by our PMP were prospectively surveyed for the presence of pain and errors in opioid prescribing at the time of initial consultation. Our recommendations to correct and optimize pain management also were recorded.
  
  
  RESULTS
  One hundred eighty-six consecutive cancer patients were screened. One hundred seventeen (63%) had cancer pain, 151 opioid prescribing errors were detected, and 147 different recommendations were made. Most common were failure to order around-the-clock opioids for constant pain, and the failure to treat or prevent opioid side effects. Multiple errors were more common in females, but the sex difference did not reach statistical significance. There was no difference in the errors by pain severity or reason for consultation.
  
  
  CONCLUSIONS
  Opioid prescribing errors were common. Females may be at greater risk of multiple errors. A PM consultation program is effective in identifying and correcting a wide variety of opioid prescribing errors.
authors.affiliation: The Harry R Horvitz Center for Palliative Medicine, Taussig Cancer Institute, The Cleveland Clinic, Cleveland, Ohio 44195, USA.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Shaheen
authors.forename: Susan B
authors.initials: SB
authors.lastname: Legrand
authors.forename: Declan
authors.initials: D
authors.lastname: Walsh
authors.forename: Bassam
authors.initials: B
authors.lastname: Estfan
authors.forename: Mellar P
authors.initials: MP
authors.lastname: Davis
authors.forename: Ruth L
authors.initials: RL
authors.lastname: Lagman
authors.forename: Mohammad
authors.initials: M
authors.lastname: Riaz
authors.forename: Bushra
authors.initials: B
authors.lastname: Cheema
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000627:therapeutic use*; D015897:Comorbidity; D005260:Female; D006801:Humans; D008297:Male; D008508:Medication Errors / Q000706:statistics & numerical data*; D008875:Middle Aged; D009369:Neoplasms / Q000188:drug therapy* / Q000453:epidemiology*; D009820:Ohio / Q000453:epidemiology; D010146:Pain / Q000453:epidemiology* / Q000517:prevention & control*; D055656:Prescriptions / Q000706:statistics & numerical data*; D015995:Prevalence; D011446:Prospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D014213:Tretoquinol; D055815:Young Adult
chemical_list: D000701:Analgesics, Opioid; D014213:Tretoquinol