Evaluation of Longitudinal Self-reported Sedation and Opioid-Induced Respiratory Depression or Overdose Risk in Patients with Cancer Receiving Outpatient Palliative Care

Purpose Self-reported sedation is a distressing symptom impacting quality of life (QoL) in patients with cancer. Patients with cancer may also be at risk of experiencing opioid-induced respiratory depression (OIRD)/overdose. This study examined the association of longitudinal, self-reported sedation and OIRD/overdose risk in patients with cancer receiving outpatient palliative care. Methods At each visit, self-reported sedation scores and Commercially Insured health Plan Risk Index for Overdose or Serious Opioid-induced Respiratory Depression (CIP-RIOSORD) predictive factors were collected. Data were separated between patients without (i.e., score ≤ 4) versus with (i.e., score ≥ 5) sedation and were analyzed via the Wilcoxon-Mann Whitney. Observed OIRD/overdose events were evaluated up to 6 months or patient expiration from 506 visits. Results At the first visit, patients without sedation and with sedation accounted for 66% (n = 172) and 34% (n = 90), respectively. For visits 1 (n = 262), 2 (n = 151), and 3 (n = 93), there was no difference in CIP-RIOSORD score between patients without or with sedation (p > 0.05). For visits 1 and 3, we observed weak or no associations (r = -0.03 to 0.12) between self-reported sedation and CIP-RIOSORD scores. At visit 2, a weak association was observed for patients without sedation (r = 0.22, p ≤ 0.05). There were no observed OIRD/overdose events. Conclusion In patients with cancer receiving outpatient palliative care, we observed weak-to-no associations between longitudinal, self-reported sedation and prediction of OIRD/overdose risk.