Opioid use in patients aged 90 years or older with terminal cancer in a palliative care unit: a single-center retrospective observational study.

PURPOSE: The number older patients with cancer who are terminally ill is expected to increase with global population aging. However, reports on the actual use of opioids for pain relief in patients aged ≥ 90 years with cancer at the end of life are limited.

METHODS

To investigate opioid use in older patients with cancer aged ≥ 90 years who died in a palliative care unit. Patients with cancer who died in the palliative care unit between August 2020 to August 2024 and were aged ≥ 90 years were included. We analyzed their data on opioid use, including opioid type and route of administration, and morphine equivalent daily dose (MEDD), at the time of death.

RESULTS

Ninety-one patients with cancer were included in the study. Their median age was 92.0 years (interquartile range [IQR] 91.0-93.0). Seventy-six patients (83.5%) were administered opioids at the time of death, and hydromorphone delivered via continuous subcutaneous injection was the most common (41 patients). The median MEDD at the time of death for the 76 patients was 19.6 mg/day (IQR 12-42). Four patients were administered high doses of opioids (MEDD of > 120 mg/day) at the time of death.

CONCLUSION

Of the patients aged ≥ 90 years with cancer who were terminally ill, more than 80% had used opioids. Their median MEDD tended to be low at 19.6 mg/day. Future studies are required to help appropriately use opioids for patients aged ≥ 90 years with cancer.