Opioid Prescribing and Use Among Cancer Survivors: A Mapping Review of Observational and Intervention Studies

J Pain Symptom Manage. 2022 Apr;63(4):e397-e417. doi: 10.1016/j.jpainsymman.2021.10.015. Epub 2021 Nov 5.

Abstract

Context: Recent years show a sharp increase in research on opioid use among cancer survivors, but evidence syntheses are lacking, leaving knowledge gaps. Corresponding research needs are unclear.

Objectives: To provide an evidence synthesis.

Methods: We searched PubMed and Embase, identifying articles related to cancer, and opioid prescribing/use published through September 2020. We screened resulting titles/abstracts. Relevant studies underwent full-text review. Inclusion criteria were quantitative examination of and primary focus on opioid prescribing or use, and explicit inclusion of cancer survivors. Exclusion criteria included end-of-life opioid use and opioid use as a secondary or downstream outcome (for intervention studies). We extracted information on the opioid-related outcome(s) examined (including definitions and terminology used), study design, and methods.

Results: Research returned 16,591 articles; 296 were included. Only 22 of 296 studies evaluated an intervention. There were 105 studies evaluating outcomes indicative of potentially high-risk, nonrecommended, or avoidable opioid use, e.g., continuous use-described as chronic use, prolonged use, and persistent use (n = 17); use after completion of curative-intent treatment-described as chronic opioid use, long-term opioid use, persistent opioid use, prolonged opioid use, continued opioid use, late opioid use, post-treatment opioid use (n = 27); use of opioids concurrent with other potentially high-risk medications (n = 13), and opioid misuse (n = 14).

Conclusions: We found lack of consistency in the measurement of and terms used to describe similar opioid use outcomes, and a lack of interventional research targeting well-documented patterns of potentially nonrecommended, potentially avoidable, or potentially high-risk opioid prescribing or use.

Keywords: Syntheses; chronic; high-risk; interventional; observational.

Publication types

  • Review

MeSH terms

  • Analgesics, Opioid / therapeutic use
  • Cancer Survivors*
  • Humans
  • Neoplasms* / drug therapy
  • Opioid-Related Disorders* / drug therapy
  • Practice Patterns, Physicians'

Substances

  • Analgesics, Opioid