Prescription patterns of analgesics in the last 3 months of life: a retrospective analysis of 10202 lung cancer patients

BACKGROUND: To describe the prescription patterns of analgesics during the last 3 months of life in lung cancer and to determine the associated factors. METHODS: Data on lung cancer patients (N=10 202) who died during 2000–2008 were extracted from the General Practice Research Database (GPRD). This database records prescriptions of patients received from UK general practices (GP), but not those from non-GP routes. Prescription prevalences were estimated. The associated factors were investigated using log-binomial regression. RESULTS: The overall prescription prevalences were 50.4% (95% confidence interval (CI): 49.4–51.4%) for level 1 (e.g., paracetamol), 34.1% (95% CI: 33.2–35.0%) for level 2 (weak opioids), and 55.5 % (95% CI: 54.5–56.4%) for level 3 analgesics (strong opioids). Prescription prevalence of analgesics of all levels showed an increasing trend over the period 2000–2008 (annual increases range: 1.1–1.5%) but a decreasing trend with age (average decrease per group range: −5.8 to −1.8%). Patients in the older age groups were less likely to be prescribed level 3 analgesics than those in the younger age groups (PR(‘90+’ vs ‘<50’)=0.55 (95% CI: 0.45–0.67); PR(‘80−89’ vs ‘<50’)=0.73 (95% CI: 0.66–0.79); PR(‘70−79’ vs ‘<50’)=0.84 (95% CI: 0.77–0.90)). CONCLUSION: Analgesics have been increasingly prescribed in lung cancer. However, analgesics, especially at level 3, were relatively under-prescribed to people older than 70 years, warranting further investigation.