Background Tapentadol is a relatively new centrally-acting analgesic medication. Tapentadol is approved for the treatment of severe chronic pain and may reduce the need for strong opioids and reduce side effect burden. However, there is limited data about the use of tapentadol in palliative care. This project aimed to evaluate use of tapentadol in a hospital specialist palliative care unit.

Methods This project included the following: 1) Retrospective case note review of tapentadol use in all inpatients receiving care in a UK hospital specialist palliative care unit over a 12 month period. The primary outcome was whether pain improved following tapentadol use. The following information was collected: reason for initiation, initial dose, titration regime, side-effects, treatment duration, discontinuation reason and quality of discharge information.

2) Anonymised survey of healthcare professionals working within the palliative care team regarding their knowledge about, and use of, tapentadol.

Results Tapentadol was used in 10 individuals. Mean age 65 years; 6 (60%) were male and 4 (40%) were female, all patients had cancer. There was an improvement of pain in 5 (50%) patients; this was identified through electronic clinical records. Nine (90%) received a starting dose of 50 mg BD. The final dose given was 50 mg BD in 5 (50%) people, followed by 100 mg BD in 4 (40%) and 150 mg BD in one (10%). Tapentadol was discontinued in five (50%) due to side effects, inability to swallow and renal failure. Eleven healthcare professionals completed the questionnaire. Of the respondents, 5 (45%) had prescribed or given advice on prescribing tapentadol and 10 (91%) indicated that they would like further training.

Conclusion Tapentadol was used in small number of individuals who all had cancer pain. Our data suggests that tapentadol may be beneficial in palliative care. More research and staff education is important to ensure effective use.