title: Effectiveness of opioid rotation in the control of cancer pain: the ROTODOL study.
abstract: OBJECTIVE
  To assess the effectiveness of opioid rotation (OR) to manage cancer pain. To describe the adverse events (AEs) associated with OR.
  
  
  METHODS
  Thirty-nine tertiary hospital services.
  
  
  METHODS
  Sixty-seven oncological patients with cancer-related pain treated at outpatient clinics.
  
  
  METHODS
  Prospective multicenter study. Pain intensity was scored using a Numerical Rating Scale (NRS) of 0-10. Average pain (AP) intensity in the last 24 hours, breakthrough pain (BTP), and the number of episodes of BTP on the days before and 1 week after OR were assessed. The pre-OR and post-OR opioid were recorded. The presence and intensity of any AEs occurring after OR were also recorded.
  
  
  RESULTS
  In the 67 patients evaluated, 75 ORs were recorded. In all cases, the main reason for OR was poor pain control. Pain intensity decreased by ≥2 points after OR in 75.4 percent and 57.8 percent of cases for AP and BTP, respectively. If the initial NRS score was ≥4, a decrease below <4 accounted for 50.9 percent and 32.3 percent of cases for AP and BTP, respectively. The number of episodes of BTP also decreased significantly (p<0.001). A total of 107 AEs were reported, most of which were mild in intensity, with gastrointestinal symptoms predominating.
  
  
  CONCLUSIONS
  Opioid rotation appears to be both safe and effective in the management of basal and breakthrough cancer pain.
authors.affiliation: Palliative Care Service, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Chair of Palliative Care, Center for Health and Social Studies, University of Vic., Barcelona, Spain; Palliative Care Research Group, IDIBELL, Universitary Bellvitge Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Jesús
authors.initials: J
authors.lastname: González-Barboteo
authors.affiliation: Director of World Health Organization Collaborating Centre for Public Health Palliative Care Programmes, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Director of Chair of Palliative Care, Center for Health and Social Studies, University of Vic., Barcelona, Spain; Palliative Care Research Group, IDIBELL, Universitary Bellvitge Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Xavier Gómez-Batiste
authors.initials: XG
authors.lastname: Alentorn
authors.affiliation: Chief of Oncology Department, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Professor of Complutense, University of Madrid, Madrid, Spain.
authors.forename: Felipe A Calvo
authors.initials: FA
authors.lastname: Manuel
authors.affiliation: Chief of Medical Oncology Service, Hospital Arnau de Vilanova, Valencia, Spain; Professor of Medical Oncology, Medical Oncology Service, Hospital Arnau de Vilanova, Universitat de Valencia, Valencia, Spain.
authors.forename: Vicente Alberola
authors.initials: VA
authors.lastname: Candel
authors.affiliation: Chief of Radiotherapy Oncology Service, Hospital Universitario Provincial Reina Sofía, Córdoba, Spain.
authors.forename: M Amalia Palacios
authors.initials: MA
authors.lastname: Eito
authors.affiliation: Medical Director of Medical Department, Grünenthal Iberia, Madrid, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Sánchez-Magro
authors.affiliation: Medical Department, Grünenthal Iberia, Madrid, Spain.
authors.forename: Marta Neira
authors.initials: MN
authors.lastname: Álvarez
authors.affiliation: Clinical Research Unit, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: F Javier Pérez
authors.initials: FJ
authors.lastname: Martín
authors.affiliation: Chief of Palliative Care Service Research Unit, Hospital Duran I Reynals, Institut Català d'Oncologia, L'Hospitalet de Llobregat, Barcelona, Spain; Palliative Care Research Group, IDIBELL, Universitary Bellvitge Hospital, L'Hospitalet de Llobregat, Barcelona, Spain.
authors.forename: Josep
authors.initials: J
authors.lastname: Porta-Sales
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000701:Analgesics, Opioid / Q000008:administration & dosage* / Q000009:adverse effects; D059390:Breakthrough Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D059350:Chronic Pain / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D004334:Drug Administration Schedule; D057915:Drug Substitution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications*; D010147:Pain Measurement; D011446:Prospective Studies; D012720:Severity of Illness Index; D013030:Spain; D062606:Tertiary Care Centers; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000701:Analgesics, Opioid