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Alleviating pain is undoubtedly a critical component of palliative care in lung cancer. Our study was initiated to examined trends in opioid prescription\u2010level outcomes as potential indicators of undertreated pain in China.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This study used data on 1330 patients diagnosed with lung cancer of urban city medical insurance in China who died between 2014 and 2017. Opioid prescription\u2010level outcomes were determined by annual trends of the proportion of patients filling an opioid prescription, the total dose of opioids filled by decedents, and morphine milligram equivalents per day (MMED) at the EOL (defined as the 60\u2009days before death). We further analyzed monthly changes in the number of opioid prescriptions filled, MMED, and mean daily dose of opioids per prescription (MDDP) of the last 60\u2009days of life by year at death and age, respectively.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 959 patients with exact dates of death were included, with 432 cases (45.06%; 95% CI: 44.36%\u201345.77%) receiving at least one opioid prescription at the EOL. The declining trends were shown in the proportion of patients filling any opioid prescription, the total dose of opioids filled by decedents and MMED, with an annual decrease of 0.341% (<jats:italic>p<\/jats:italic>\u2009=\u20090.01), 104.23\u2009mg (<jats:italic>p<\/jats:italic>\u2009=\u20090.011) and 2.84\u2009mg (<jats:italic>p<\/jats:italic>\u2009=\u20090.014), respectively. Within the 31\u201360\u2009days to the 0\u201330\u2009days of life, the MMED declined 6.08\u2009mg (95% CI: \u22127.14 to \u22125.03; <jats:italic>p<\/jats:italic>\u2009=\u20090.000351), while the number of opioid prescriptions rose 0.66 (95% CI: 0.160\u20131.16; <jats:italic>p<\/jats:italic>\u2009=\u20090.025). Like the MMED, the MDDP fell 4.11\u2009mg (95% CI: \u22125.86 to \u22122.37; <jats:italic>p<\/jats:italic>\u2009=\u20090.005) within the last month before death compared to the previous month.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Terminal lung cancer populations in urban China have experienced reduced access to opioids at the EOL. The clinicians did not prescribe a satisfactory dose of opioids per prescription, while the patients suffered increasing pain in the last 30\u2009days of life. Sufficient opioid analgesic administration should be advocated for lung cancer patients during the EOL period.<\/jats:p><\/jats:sec>","DOI":"10.1111\/1759-7714.15240","type":"journal-article","created":{"date-parts":[[2024,2,7]],"date-time":"2024-02-07T07:32:21Z","timestamp":1707291141000},"page":"693-701","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Trends in pain undertreatment among lung cancer patients at the <scp>EOL<\/scp>: Analysis of urban city medical insurance data in China"],"prefix":"10.1111","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9595-7459","authenticated-orcid":false,"given":"Jiani","family":"Zheng","sequence":"first","affiliation":[{"name":"Department of Medical Oncology Sun Yat\u2010sen University Cancer Center  Guangzhou People's Republic of China"},{"name":"State Key Laboratory of Oncology in South China Guangdong Provincial Clinical Research Center for Cancer  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