{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,18]],"date-time":"2026-04-18T01:11:37Z","timestamp":1776474697219,"version":"3.51.2"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T00:00:00Z","timestamp":1715472000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005612","name":"Shionogi","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005612","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100016568","name":"Nippon Zoki Pharmaceutical","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100016568","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Neuropsychopharm Rep"],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>Opioid availability for the palliative care of patients with advanced cancer is increasing globally. However, opioid availability remains extremely low in Japan. We investigated whether pain is appropriately controlled by low\u2010dose opioid prescriptions in patients with advanced cancer in Japan.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A web\u2010based nationwide survey for caregivers from 2000 community comprehensive support care centers was performed in Japan to assess details about pain in the 30\u2009days before patients died of end\u2010stage cancer. Separately, the data for opioid prescription doses and medical services in the 90\u2009days before the death of patients with cancer were extracted from a health insurance claim database.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Responses from 1034 responders were retrieved and 665 patients were included. In total, 254 patients (38.2%) complained of severe\u2010to\u2010intolerable cancer\u2010related pain. The median cumulative prescription dose of opioids in the 90\u2009days before patient death was 311.0\u2009mg by oral morphine equivalent doses. Multiple regression analyses across prefectures revealed that the proportion of patients with severe\u2010to\u2010intolerable cancer\u2010related pain was negatively associated with the cumulative opioid consumption expressed as morphine\u2010equivalent doses within 90\u2009days before death.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>The very low availability of opioids for patients with end\u2010stage cancer could result in high rate of severe\u2010to\u2010intolerable cancer\u2010related pain patients. There were several limitations in this study, and the interpretations of the findings should be carefully. However, the increase in the absolute dose of opioids could improve the palliative care framework to the pain control levels of the global standard.<\/jats:p><\/jats:sec>","DOI":"10.1002\/npr2.12448","type":"journal-article","created":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T02:35:17Z","timestamp":1715567717000},"page":"502-511","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["High prevalence of severe pain is associated with low opioid availability in patients with advanced cancer: Combined database study and nationwide questionnaire survey in Japan"],"prefix":"10.1002","volume":"44","author":[{"given":"Maiko","family":"Hasegawa\u2010Moriyama","sequence":"first","affiliation":[{"name":"Department of Pain and Palliative Medical Sciences, Faculty of Medicine The University of Tokyo  Tokyo Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7878-2557","authenticated-orcid":false,"given":"Yasuhide","family":"Morioka","sequence":"additional","affiliation":[{"name":"Medical Affairs Department Shionogi &amp; Co., Ltd.  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