Opioid prescribing patterns at the end of life in an asian advanced cancer cohort - differences by palliative care consultation status

Sep 22, 2026

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Opioid prescribing near death varies across settings, while evidence for Asian advanced cancer populations remains limited. This retrospective cohort study evaluated end-of-life opioid prescribing patterns and how they differ by whether patients received a palliative care consultation. Using matched Korean National Health Insurance claims linked to tertiary hospital records, prescriptions were assessed across the last 30 days by time interval and opioid strength. Results showed higher and more persistent strong opioid use with palliative care, especially 30–15 days before death.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages10

Reading Time25 min

AccessFree to download

Abstract

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Methods

Results

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Supportive Care in Cancer (2026) 34:387 [https://doi.org/10.1007/s00520-026-10621-1](https://doi.org/10.1007/s00520-026-10621-1) Opioid prescribing patterns at the end of life in an asian advanced cancer cohort: differences by palliative care consultation status Hak Jun Kim1 · Jin‑Ah Sim2,3 · Shin Hye Yoo4,5 Received: 6 December 2025 / Accepted: 25 March 2026 / Published online: 30 March 2026 © The Author(s) 2026 Abstract Purpose Opioid prescribing at the end of life varies widely across clinical contexts, yet real-world evidence from Asian advanced cancer populations remains limited. This study characterized end-of-life opioid prescribing patterns and examined differences according to palliative care consultation status. Methods We conducted a retrospective cohort study using tertiary hospital clinical records linked to Korean National Health Insurance claims data. Patients with advanced cancer who received a palliative care consultation were matched 1:1 with those without consultation using propensity scores. Opioid prescribing during the last 30 days of life was evaluated, including time-specific patterns across three intervals (30–15, 14–8, and 7–0 days before death) and opioid strength (strong vs. weak) . Results Among 18,048 eligible patients, 3,742 were matched in each group. Opioid prescriptions were more common among patients who received palliative care, with the largest differences observed 30–15 days before death and narrowing toward the final week. Strong opioid use remained consistently higher in the palliative care group across all intervals, whereas weak opioid use showed minimal variation. Differences were most pronounced in older adults and in stomach, colorectal, and pancreatobiliary cancers. Conclusion Patients who received a palliative care consultation showed different patterns of end-of-life opioid prescribing, especially for strong opioids. Understanding such variation may support ongoing efforts to improve symptom management near the end of life. Keywords Palliative care · Opioid analgesics · Neoplasms · Pain management Hak Jun Kim and Jin-Ah Sim these authors equally contribute to this manuscript. * Shin Hye Yoo[ifi1024@snu.ac.kr](ifi1024@snu.ac.kr) 1 Department of AI Convergence, Hallym University, Chuncheon, Republic of Korea 2 Graduate School of Public Health and Healthcare Management, The Catholic University of Korea, Seoul, Republic of Korea 3 Department of Population and Quantitative Health Science, UMass Chan Medical School, Worcester, MA, USA 4 Center for Palliative Care and Clinical Ethics, Seoul National University Hospital 101, Daehak-Ro, Jongno-Gu, Seoul 03080, Republic of Korea 5 Department of Human Systems Medicine, Seoul National University College of Medicine, Seoul, Republic of Korea Introduction Pain is among the most prevalent and distressing symptoms in patients with advanced cancer, requiring prompt and effective management. Inadequate control of cancer-related pain can lead to a significant decline in the quality of life [1, 2], unnecessary healthcare utilization, such as emergency department visits or hospitalizations [3, 4], and increased healthcare costs [5] . Opioid analgesics remain the mainstay of pharmacological treatments for moderate to severe cancer pain [6, 7]. However, growing concerns about opioid misuse and the broader opioid epidemic have contributed to more cautious prescribing practices in recent years [8–11], affecting both cancer and non-cancer populations [3, 12, 13] . Consequently, ensuring access to effective opioid therapy has become a central challenge in cancer pain management [13] . Despite clear clinical indications, opioids appear to be underused in certain patient groups, including older adults, patients with limited access to palliative care services, and those with specific cancer types associated with a more favorable prognosis [14–16] . Factors contributing to this underuse [9, 12–14, 17] include stigma, ina

FAQs

What was the purpose of the study on opioid prescribing at the end of life?

The study characterized opioid prescribing patterns during the end of life and examined differences based on palliative care consultation status in Asian advanced cancer patients.

How were patients selected and how was palliative care consultation status handled?

A retrospective cohort study used linked tertiary hospital records and Korean National Health Insurance claims. Patients who received palliative care consultation were matched 1:1 with those without consultation using propensity scores.

What did the study find about strong versus weak opioid prescribing?

Strong opioid use was consistently higher in the palliative care group across all assessed intervals, while weak opioid use showed minimal variation.

Sep 22, 2026

Upload by Kyle