title: Opioid-prescribing Practices in Chronic Cancer Pain in a Tertiary Care Pain Clinic.
abstract: BACKGROUND
  Under treatment of pain is a recognized global issue. Opioid analgesic medication is the mainstay of treatment in cancer patients as per the World Health Organization (WHO) pain relief ladder, yet 50% of cancer patients worldwide do not receive adequate pain relief or are undertreated.
  
  
  OBJECTIVE
  The aim of this study was to audit the ongoing opioid-prescribing practices in our tertiary cancer pain clinic during January-June 2010.  MATERIALS #ENTITYSTARTX00026;
  
  
  METHODS
  The prescribed type of opioid, dose, dosing interval, and laxatives details were analyzed.
  
  
  RESULTS
  Five hundred pain files were reviewed and 435 were found complete for audit. Three hundred forty-eight (80%) patients were prescribed opioids. Two hundred fifty-nine (74.4%) received weak opioids while 118 (33.9%) received strong opioids. A total of 195 (45%) patients had moderate and 184 (42%) had severe pain. Ninety-three (26.7%) patients received morphine; however, only 31.5% (58 of 184) in severe pain received morphine as per the WHO pain ladder. Only 73 of 93 (78.4%) patients received an adequate dose of morphine with an adequate dosing interval and only 27 (29%) were prescribed laxatives with morphine.
  
  
  CONCLUSIONS
  This study shows that the under treatment of pain and under dosing of opioids coupled with improper side effect management are major issues.
authors.affiliation: Department of Anaesthesiology, Critical Care and Pain, Tata Memorial Centre, Parel, Mumbai, Maharashtra, India.
authors.forename: Raghu S
authors.initials: RS
authors.lastname: Thota
authors.forename: Pn
authors.initials: P
authors.lastname: Jain
authors.forename: Sumitra G
authors.initials: SG
authors.lastname: Bakshi
authors.forename: Chhaya N
authors.initials: CN
authors.lastname: Dhanve