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Opioid prescribing for cancer pain in Latin America: systematic review
  1. ofelia Leiva1,
  2. Emeka Chukwusa2,
  3. Kennedy Nkhoma2,
  4. Mariana Dittborn3,
  5. Pamela Turrillas4 and
  6. Tania Pastrana5
  1. 1Sección Medicina Palliativa, Pontificia Universidad Católica de Chile, Santiago, Chile
  2. 2King's College London, London, UK
  3. 3Centro de Bioética, Facultad de Medicina, Universidad del Desarrollo, Santiago, Chile
  4. 4Superintendency of Pensions, Ministry of Labor and Social Security, Santiago, Chile
  5. 5Department of Palliative Medicine, RWTH Aachen University, Aachen, Germany
  1. Correspondence to Dr ofelia Leiva, Sección Medicina Palliativa, Pontificia Universidad Católica de Chile, Santiago, Chile; ofelia.leiva{at}gmail.com

Abstract

Objective To explore opioid prescribing patterns for cancer pain in Latin America (LA).

Methods A systematic review was conducted adhering to Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Relevant databases, including MEDLINE, EMBASE, PubMed, LILACS and Scielo, were searched from inception to June 2023. Empirical studies of opioid prescription patterns in adult palliative care patients with cancer pain were included. Methodological quality was assessed using the Effective Public Health Practice Project tool. Data were analysed using narrative synthesis. Descriptive statistical analyses were conducted using SPSS V.28 (IBM). Categorical variables were summarised using frequencies and percentages and continuous variables as means or medians.

Results Seventeen studies from six countries were included. Ten were observational, while seven were experimental, including five randomised controlled trials (RCT) and two non-RCT. Most were low or moderate methodological quality. Out of 7809 patients, morphine (54%) and tramadol (18%) were the most prescribed opioids. The median of morphine equivalent daily dose was 26 mg (IQR 26–41).

Conclusion Latin America shows lower opioid consumption rates compared with high-income countries for control pain management (CPM). More rigorous research on CPM in LA is needed. Additionally, a comprehensive review of opioid prescription patterns, including non-cancer diagnoses, is necessary.

  • Palliative Care
  • Pain
  • Cancer
  • Drug administration

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Footnotes

  • X @ofeleiva

  • Contributors OL, EC and KN were responsible for conceptual ideas and study design. OL was responsible for planning, organising, conduct the search strategy, data collection and reporting. EC, KN, MD, TP and PT were responsible for critical review and editing of report. All authors read and approved the final version of this short report.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; internally peer reviewed.