{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T13:23:02Z","timestamp":1783084982931,"version":"3.54.6"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"12","license":[{"start":{"date-parts":[[2025,9,22]],"date-time":"2025-09-22T00:00:00Z","timestamp":1758499200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Cancer Center Research and Development Fund","award":["2023-A-24"],"award-info":[{"award-number":["2023-A-24"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Opioids are essential for cancer pain; however, regional and hospital prescribing variations in Japan remain poorly understood. This study aimed to investigate the regional and hospital functional differences in opioid prescribing among terminally ill patients with cancer in Japan using nationwide claims data.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analysed anonymized claims data from the DeSC database, focusing on patients who died of cancer in hospitals (2018\u20132022). We calculated opioid prescription prevalence and mean daily doses (converted to oral morphine equivalents) in the last 30\u00a0days of life. Outcomes were compared across regions and hospital functions using multivariate logistic and linear regression models adjusted for age, sex, and cancer type.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analysed 119\u2009850 decedents. Oxycodone injection use was highest in Tokai (16.4%) and South Kanto (15.7%), approximately four times that in Shikoku (4.0%). Transdermal fentanyl use ranged from 51.5% in Kyushu\/Okinawa to 25.4% in South Kanto. Oxycodone injections increased with hospital functionality (4.1% in non-acute care vs. 20.4% in university hospitals), whereas transdermal fentanyl use declined (56.7%\u201313.1%). Compared to South Kanto, adjusted odds ratios (ORs) for opioid prescribing were higher in Kyushu\/Okinawa (1.29) and lower in Kinki (0.68). For dose, no region exceeded South Kanto, and the lowest geometric mean ratio (GMR) was observed in Shikoku (0.87). No significant differences in adjusted ORs or GMRs were observed across hospital categories.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Opioid prescribing patterns varied across regions and hospital functions, with significant differences in both prevalence and dosing. These findings may contribute to advancing the uniform implementation of palliative care.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/jjco\/hyaf149","type":"journal-article","created":{"date-parts":[[2025,9,5]],"date-time":"2025-09-05T11:57:41Z","timestamp":1757073461000},"page":"1372-1377","source":"Crossref","is-referenced-by-count":1,"title":["Population-based claims study of regional and hospital function differences in opioid prescribing for cancer patients who died in hospital in Japan"],"prefix":"10.1093","volume":"55","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4265-1787","authenticated-orcid":false,"given":"Richi","family":"Takahashi","sequence":"first","affiliation":[{"name":"Division of Policy Evaluation, Institute for Cancer Control, National Cancer Center , Tokyo ,","place":["Japan"]},{"name":"Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitsunori","family":"Miyashita","sequence":"additional","affiliation":[{"name":"Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine , Sendai, Miyagi ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3658-4514","authenticated-orcid":false,"given":"Yoko","family":"Nakazawa","sequence":"additional","affiliation":[{"name":"Division of Policy Evaluation, Institute for Cancer Control, National Cancer Center , Tokyo ,","place":["Japan"]},{"name":"Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saho","family":"Wada","sequence":"additional","affiliation":[{"name":"Division of Quality Assurance Programs, Institute for Cancer Control, National Cancer Center , Tokyo ,","place":["Japan"]},{"name":"Department of Psycho-Oncology Service, National Cancer Center Hospital , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yutaka","family":"Matsuoka","sequence":"additional","affiliation":[{"name":"Division of Policy Evaluation, Institute for Cancer Control, National Cancer Center , Tokyo ,","place":["Japan"]},{"name":"Institute for Cancer Control, National Cancer Cente , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2025,9,22]]},"reference":[{"key":"2025120323370331300_ref1","doi-asserted-by":"publisher","first-page":"1151","DOI":"10.1200\/JCO.2010.30.7173","article-title":"Trajectory of performance status and symptom scores for patients with cancer during the last six months of life","volume":"29","author":"Seow","year":"2011","journal-title":"J Clin Oncol"},{"key":"2025120323370331300_ref2","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15030591","article-title":"Update on prevalence of pain in patients with cancer 2022: A systematic literature review and meta-analysis","volume":"15","author":"Snijders","year":"2023","journal-title":"Cancers (Basel)"},{"key":"2025120323370331300_ref3","volume-title":"The World Health Organization","author":"Palliative care"},{"key":"2025120323370331300_ref4","volume-title":"WHO guidelines for the pharmacological and radiotherapeutic management of cancer pain in adults and adolescents"},{"key":"2025120323370331300_ref5","doi-asserted-by":"publisher","first-page":"xi60","DOI":"10.1093\/annonc\/mdt504","article-title":"Next steps in access and availability of opioids for the treatment of cancer pain: Reaching the tipping point?","volume":"24","author":"Cleary","year":"2013","journal-title":"Ann Oncol"},{"key":"2025120323370331300_ref6","doi-asserted-by":"publisher","first-page":"41","DOI":"10.4137\/SART.S2345","article-title":"Prescription opioid usage and abuse relationships: An evaluation of state prescription drug monitoring program efficacy","volume":"3","author":"Reisman","year":"2009","journal-title":"Subst Abuse"},{"key":"2025120323370331300_ref7","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1016\/S0140-6736(21)02252-2","article-title":"Responding to the opioid crisis in North America and beyond: Recommendations of the Stanford-Lancet Commission","volume":"399","author":"Humphreys","year":"2022","journal-title":"Lancet"},{"key":"2025120323370331300_ref8","doi-asserted-by":"publisher","first-page":"e0250972","DOI":"10.1371\/journal.pone.0250972","article-title":"Trends in opioid prescribing practices in South Korea, 2009-2019: Are we safe from an opioid epidemic?","volume":"16","author":"Cho","year":"2021","journal-title":"PloS One"},{"key":"2025120323370331300_ref9","doi-asserted-by":"publisher","first-page":"241","DOI":"10.1016\/j.therap.2024.11.008","article-title":"Monitoring opioid analgesic misuse, abuse and dependence: What to the data from addictovigilance tell us about the situation in France?","volume":"80","author":"Lapeyre-Mestre","year":"2025","journal-title":"Therapie"},{"key":"2025120323370331300_ref10","doi-asserted-by":"publisher","first-page":"e88","DOI":"10.1016\/S2468-2667(20)30260-7","article-title":"Geographical and socioeconomic disparities in opioid access in Mexico, 2015-19: A retrospective analysis of surveillance data","volume":"6","author":"Goodman-Meza","year":"2021","journal-title":"Lancet Public Health"},{"key":"2025120323370331300_ref11","volume-title":"Reports published by the International Narcotics Control Board in 2015","author":"Availability of Internationally Controlled Drugs: Ensuring Adequate Access for Medical and Scientific Purposes"},{"key":"2025120323370331300_ref12","doi-asserted-by":"publisher","first-page":"987","DOI":"10.1007\/s40122-022-00409-6","article-title":"Prevalence of and risk factors for prescription opioid misuse, abuse, diversion and doctor shopping in Japan: A survey study","volume":"11","author":"Takasusuki","year":"2022","journal-title":"Pain Ther"},{"key":"2025120323370331300_ref13","volume-title":"Appendix 3: Consumption of Medical Narcotics in Japan. Ministry of Health, Labour and Welfare","author":"Guidance on the Appropriate Use of Medical Narcotics"},{"key":"2025120323370331300_ref14","doi-asserted-by":"publisher","first-page":"377","DOI":"10.1093\/jjco\/hyae189","article-title":"Hospital function-associated deaths among patients with cancer: A comprehensive national study using death records in Japan","volume":"55","author":"Takahashi","year":"2025","journal-title":"Jpn J Clin Oncol"},{"key":"2025120323370331300_ref15","volume-title":"Medical and Healthcare Database Utilization Committee, Japanese Society for Pharmacoepidemiology","author":"Survey of Japanese databases in Japan available for clinical\/pharmacoepidemiology"},{"key":"2025120323370331300_ref16","doi-asserted-by":"publisher","first-page":"498","DOI":"10.1093\/jjco\/hyaf022","article-title":"Analysis of medical practices used as indicators in the fourth basic plan for the promotion of cancer control in Japan","volume":"55","author":"Takahashi","year":"2025","journal-title":"Jpn J Clin Oncol"},{"key":"2025120323370331300_ref17","doi-asserted-by":"publisher","first-page":"1297","DOI":"10.1093\/jjco\/hyac122","article-title":"Trends in strong opioid prescription for cancer patients in Japan from 2010 to 2019: An analysis with large medical claims data","volume":"52","author":"Takahashi","year":"2022","journal-title":"Jpn J Clin Oncol"},{"key":"2025120323370331300_ref18","volume-title":"WHO collaborating Centre for Drug Statistics Methodology","author":"the ATC\/DDD system"},{"key":"2025120323370331300_ref19","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1007\/s11912-019-0854-7","article-title":"Managing pain in the older cancer patient","volume":"21","author":"Finnerty","year":"2019","journal-title":"Curr Oncol Rep"},{"key":"2025120323370331300_ref20","doi-asserted-by":"publisher","first-page":"4373","DOI":"10.1200\/JCO.2012.42.0919","article-title":"Opioid prescribing for cancer pain during the last 3 months of life: Associated factors and 9-year trends in a nationwide United Kingdom cohort study","volume":"30","author":"Higginson","year":"2012","journal-title":"J Clin Oncol"}],"container-title":["Japanese Journal of Clinical Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jjco\/article-pdf\/55\/12\/1372\/64339294\/hyaf149.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jjco\/article-pdf\/55\/12\/1372\/64339294\/hyaf149.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,4]],"date-time":"2025-12-04T04:37:11Z","timestamp":1764823031000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jjco\/article\/55\/12\/1372\/8260794"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,9,22]]},"references-count":20,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2025,9,22]]},"published-print":{"date-parts":[[2025,12,3]]}},"URL":"https:\/\/doi.org\/10.1093\/jjco\/hyaf149","relation":{},"ISSN":["1465-3621"],"issn-type":[{"value":"1465-3621","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2025,12]]},"published":{"date-parts":[[2025,9,22]]}}}