title: Prescription patterns of analgesics in the last 3 months of life: a retrospective analysis of 10202 lung cancer patients.
abstract: 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)).
  
  
  CONCLUSIONS
  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.
authors.affiliation: King's College London, School of Medicine, Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, Bessemer Road, London SE5 9PJ, UK. wei.gao@kcl.ac.uk
authors.forename: W
authors.initials: W
authors.lastname: Gao
authors.forename: M
authors.initials: M
authors.lastname: Gulliford
authors.forename: I J
authors.initials: IJ
authors.lastname: Higginson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D010818:Practice Patterns, Physicians'; D012907:Smoking; D013727:Terminal Care; D013997:Time Factors
chemical_list: D000700:Analgesics