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      Storage, Disposal, and Use of Opioids Among Cancer Patients in Central China: A Multi-Center Cross-Sectional Study

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          Abstract

          Objective

          Unsafe opioid-related practices can lead to abuse, diversion, and accidental overdoses. In this study, we aimed to describe the patterns and beliefs regarding the storage, disposal, and use of opioids among Chinese patients with cancer in their home settings, which remain unclear.

          Methods

          A multicenter cross-sectional survey was conducted in Hubei Province from October 2022 to June 2023. We collected information on the storage, disposal, and use of opioids among cancer pain inpatients in the oncology department. Logistic regression was used to estimate the factors associated with unsafe disposal and use of opioids.

          Results

          The survey included 221 patients with a median age of 62 years. Only 3.2% stored their opioids under lock and key, and 49.8% were unaware of proper disposal methods. Nearly one-fifth (19.5%) reported having received information on the safe storage (14.0%) and/or disposal (10.0%) of opioids. A total of 44.3% reported unsafe use by sharing (1.8%), losing (4.1%), or taking opioids at a higher dose than prescribed (42.5%). Patients who did not receive information on the safe disposal of opioids (OR = 4.57, P = .0423), had a history of alcohol use (OR = 1.91, P = .0399), and used opioids other than morphine (OR = 2.31, P = .0461) had higher odds of unsafe disposal practices. Individuals with an associate degree/bachelor’s degree or above were less likely to dispose of (OR = 0.36, P = .0261) and use (OR = 0.31, P = .0127) opioids unsafely.

          Conclusion

          A significant proportion of Chinese patients with cancer exhibit unsafe practices in the storage, disposal, and use of opioids. The study highlights an urgent need for implementing routine education programs and drug “take-back” initiatives to improve opioid-related practices.

          Abstract

          Unsafe opioid-related practices can lead to abuse, diversion, and accidental overdoses. This article describes patterns and beliefs regarding the storage, disposal, and use of opioids among Chinese patients with cancer.

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          Most cited references27

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          Concurrent and predictive validity of a self-reported measure of medication adherence.

          Adherence to the medical regimen continues to rank as a major clinical problem in the management of patients with essential hypertension, as in other conditions treated with drugs and life-style modification. This article reviews the psychometric properties and tests the concurrent and predictive validity of a structured four-item self-reported adherence measure (alpha reliability = 0.61), which can be easily integrated into the medical visit. Items in the scale address barriers to medication-taking and permit the health care provider to reinforce positive adherence behaviors. Data on patient adherence to the medical regimen were collected at the end of a formalized 18-month educational program. Blood pressure measurements were recorded throughout a 3-year follow-up period. Results showed the scale to demonstrate both concurrent and predictive validity with regard to blood pressure control at 2 years and 5 years, respectively. Seventy-five percent of the patients who scored high on the four-item scale at year 2 had their blood pressure under adequate control at year 5, compared with 47% under control at year 5 for those patients scoring low (P less than 0.01).
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            Medication Sharing, Storage, and Disposal Practices for Opioid Medications Among US Adults

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              The Impact of an Educational Program on Patient Practices for Safe Use, Storage, and Disposal of Opioids at a Comprehensive Cancer Center

              Improper use, storage, and disposal of prescribed opioids can lead to diversion or accidental poisoning. The present study compared 300 adult cancer outpatients receiving opioids who had also received educational material (EM) with 300 patients who had not received EM. The use of EM on opioid safety for patients with advanced cancer was associated with improved patient‐reported safe opioid use, storage, and disposal. Background. Improper use, storage, and disposal of prescribed opioids can lead to diversion or accidental poisoning. Our previous study showed a large proportion of cancer patients have unsafe opioid practices. Our objective was to determine whether an improvement occurred in the patterns of use, storage, and disposal of opioids among cancer outpatients after the implementation of a patient educational program. Patients and Methods. Our palliative care (PC) clinic provides every patient with educational material (EM) on safe opioid use, storage, and disposal every time they receive an opioid prescription. We prospectively assessed 300 adult cancer outpatients receiving opioids in our PC clinic, who had received the EM, and compared them with 300 patients who had not received the EM. The previously used surveys pertaining to opioid use, storage, and disposal were administered, and demographic information was collected. Sharing or losing their opioids was defined as unsafe use. Results. Patients who received EM were more aware of the proper opioid disposal methods (76% vs. 28%; p  ≤ .0001), less likely to share their opioids with someone else (3% vs. 8%; p  = .0311), less likely to practice unsafe use of opioids (18% vs. 25%; p  = .0344), and more likely to be aware the danger of their opioids when taken by others ( p  = .0099). Patients who received the EM were less likely to have unused medication at home (38% vs. 47%; p  = .0497) and more likely to keep their medications in a safe place (hidden, 75% vs. 70%; locked, 14% vs. 10%; p  = .0025). Conclusion. The use of EM on opioid safety for patients with advanced cancer was associated with improved patient‐reported safe opioid use, storage, and disposal. Implications for Practice. Prescription opioid abuse is a fast‐growing epidemic that has become more prominent recently, even in the cancer pain population. A previous study reported that 26% of cancer outpatients seen in the supportive care center either lose their pain medications or share their pain medications with someone else. This study demonstrates that the implementation of an opioid educational program and distribution of educational material on opioid safety brings about an improvement in opioid storage, use, and disposal practices in patients being prescribed opioids for cancer‐related pain. Our study highlights the importance of consistent and thorough opioid education at every instance in which opioids are prescribed.
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                Author and article information

                Contributors
                Journal
                Oncologist
                Oncologist
                oncolo
                The Oncologist
                Oxford University Press (US )
                1083-7159
                1549-490X
                July 2024
                01 April 2024
                01 April 2024
                : 29
                : 7
                : e941-e948
                Affiliations
                Department of Pharmacy, Zhongnan Hospital of Wuhan University , Wuhan, China
                Department of Breast and Urological Radiation and Medical Oncology, Zhongnan Hospital of Wuhan University , Wuhan, China
                School of Public Health, Wuhan University , Wuhan, China
                Department of Pharmacy, Zhongnan Hospital of Wuhan University , Wuhan, China
                Department of Pharmacy, Zhongnan Hospital of Wuhan University , Wuhan, China
                Department of Pharmacy, Zhongnan Hospital of Wuhan University , Wuhan, China
                Department of Pharmacy, Zhongnan Hospital of Wuhan University , Wuhan, China
                Author notes
                Corresponding author: Hong Cheng, Department of Pharmacy, Zhongnan Hospital of Wuhan University, 169 Donghu Road, Wuchang District, Wuhan 430071, China. Tel.: 027 67812902. Email: chenghong@ 123456znhospital.cn

                Mi Zhang and Huili Chen Contributed equally.

                Author information
                https://orcid.org/0000-0001-8403-116X
                Article
                oyae049
                10.1093/oncolo/oyae049
                11224976
                38557816
                6ff5f93e-2c6e-41fa-b010-2df58bcdc381
                © The Author(s) 2024. Published by Oxford University Press.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 08 December 2023
                : 27 February 2024
                Page count
                Pages: 8
                Categories
                Symptom Management and Supportive Care
                AcademicSubjects/MED00010
                Oncolo/30

                Oncology & Radiotherapy
                opioid medication,cancer pain,storage,disposal,use
                Oncology & Radiotherapy
                opioid medication, cancer pain, storage, disposal, use

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