台灣癌末住院病人止痛藥使用情況

The Use of Analgesics in Terminal Cancer Patients in Taiwan

疼痛是癌末病人最常見的症狀，疼痛控制的品質也常以嗎啡類藥物使用劑量來評估。我們由1998年1月至2006年12月健保資料庫樣本，來分析癌末住院病人使用嗎啡類止痛藥的情況。在樣本中共有3,255位病人符合研究收案條件，其中626位病人曾在安寧病房住院，他們使用嗎啡類止痛藥的劑量高於一般病房的病人約1.8倍。分析使用的劑型，在安寧病房常以芬坦尼貼片，而在一般病房常以佩西汀注射劑。整體而言，癌末病人的嗎啡使用量仍低於西方國家。

Pain is one of the most common symptoms in cancer patients. The dosage of morphine consumption reflects the quality of pain control in the country. Material and Method: We enroll patients with terminal cancer from 1,000,000 insured sampling of National Health Insurance claim database from 1998 January to 2006 December. These patients are divided into two groups: ever admitted at hospice ward or never admitted at hospice ward. The pain control and the usage of analgestics are record and calculated. Result: There were 3,255 patients were enrolled, and 626 patients ever admitted at hospice ward. The equivalent morphine dose was much higher in hospice ward. Transdermal fentanyl patch was the most common form for pain control in hospice ward; and meperidine was the most common form in non-hospice ward. Conclusion: Patient had better pain control under hospice service. But the morphine consumption was still much lower than western country.