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Opioids and driving: education gaps in advanced cancer
  1. Nagtha Anil1,
  2. Natasha Smallwood2,3 and
  3. Sadie Dunn4,5,6
  1. 1 The University of Melbourne Melbourne Medical School, Melbourne, Victoria, Australia
  2. 2 Department of Respiratory and Sleep Medicine, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  3. 3 Department of Medicine (Royal Melbourne Hospital), University of Melbourne Faculty of Medicine, Dentistry and Health Sciences, Melbourne, Victoria, Australia
  4. 4 Department of Palliative Care, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
  5. 5 Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
  6. 6 Department of Palliative Care, Royal Melbourne Hospital, Melbourne, Victoria, Australia
  1. Correspondence to Dr Sadie Dunn, Department of Palliative Care, Peter MacCallum Cancer Centre, Melbourne, VIC 3050, Australia; Sadie.Dunn{at}petermac.org

Abstract

Objectives Opioids may impair the ability to drive safely, particularly when first prescribed or with dose titration. We investigated whether clinicians evaluate driving status and provide opioid-related driving advice when initiating opioids among people with advanced lung cancer.

Methods A retrospective medical record review of outpatients with advanced non-small cell lung cancer seen at an Australian tertiary referral centre between 1 January 2015 and 31 December 2019 was undertaken to determine frequency of opioid prescription and documentation of driving status and education regarding driving safety while taking opioids.

Results Of 1022 patients screened, 205 were commenced on opioid therapy. Forty-seven (23%) patients had driving status documented. According to medical records, education about driving safety while on opioids was provided to two (1%) patients on opioid initiation. Ten (5%) patients received opioid-related driving education at least once at follow-up appointments. The content of the education was infrequently documented, and when documented, focused on opioid side effects impacting driving. Opioid doses were often escalated at follow-up appointments.

Conclusions According to documentation in medical records, clinicians infrequently assessed driving status on opioid initiation and rarely provided education regarding opioid-related driving risks. Further research and clearer guidance regarding opioids and driving safety in the cancer population are required.

  • lung
  • quality of life
  • symptoms and symptom management
  • communication

https://doi.org/10.1136/bmjspcare-2020-002824

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    Footnotes

    • Contributors SD and NS designed the study, assisted with data analysis and interpretation and co-wrote the manuscript. NA collected and analysed the data and co-wrote the manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.