{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,12]],"date-time":"2026-03-12T01:29:41Z","timestamp":1773278981389,"version":"3.50.1"},"reference-count":42,"publisher":"SAGE Publications","issue":"8","license":[{"start":{"date-parts":[[2003,12,1]],"date-time":"2003-12-01T00:00:00Z","timestamp":1070236800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2003,12]]},"abstract":"<jats:p> The clinical importance of routine drug monitoring of serum concentrations of morphine, morphine-6-glucuronide (M6G) and morphine-3-glucuronide (M3G) during chronic morphine therapy is not established. We measured morphine, M6G and M3G serum concentrations in cancer pain patients receiving oral ( n = 263, median dose 80 mg\/24 hours) or subcutaneous (sc) ( n = 35, median dose 110 mg\/24 hours) morphine. Regression analyses were performed to investigate if serum concentrations of morphine, M3G and M6G predicted pain intensity (Brief Pain Inventory), health-related quality-of-life variables (EORTC QLQ-C30) and cognitive function (Mini-Mental Score). Serum concentrations were also compared in patients categorized as morphine \u2019treatment successesfland \u2018treatment failures\u2019. <\/jats:p><jats:p> We observed that serum concentrations of morphine, M6G or M3G did not predict pain intensity, cognitive function, nausea or tiredness. \u2018Treatment failuresflcaused by nausea, tiredness, cognitive failure or constipation did not have statistically significant different morphine, M6G and M3G serum concentrations than patients classified as \u2019treatment successes\u2019. <\/jats:p><jats:p> In conclusion, this study did not observe any concentration\u2013effect relationships of morphine, M3G or M6G with pain intensity, nausea, constipation, tiredness or cognitive failure in blood samples obtained during routine clinical drug monitoring in cancer patients. This result suggests that therapeutic drug monitoring as a routine tool during chronic morphine treatment has limited value for clinical decision making. <\/jats:p>","DOI":"10.1191\/0269216303pm835oa","type":"journal-article","created":{"date-parts":[[2021,12,15]],"date-time":"2021-12-15T18:51:23Z","timestamp":1639594283000},"page":"679-687","source":"Crossref","is-referenced-by-count":49,"title":["Routine drug monitoring of serum concentrations of morphine, morphine-3-glucuronide and morphine-6-glucuronide do not predict clinical observations in cancer patients"],"prefix":"10.1177","volume":"17","author":[{"given":"Pal","family":"Klepstad","sequence":"first","affiliation":[{"name":"Department of Anaesthesia and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway and Unit for Applied Clinical Research, Department of Environmental Medicine, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Petter C","family":"Borchgrevink","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ola","family":"Dale","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kolbj\u00f8rn","family":"Zahlsen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trond","family":"Aamo","sequence":"additional","affiliation":[{"name":"Department of Clinical Pharmacology, St Olavs University Hospital, Trondheim, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter","family":"Fayers","sequence":"additional","affiliation":[{"name":"Unit for Applied Clinical Research, Department of Environmental Medicine, Norwegian University of Science and Technology, Trondheim, Norway and the Department of Public Health, University of Aberdeen, Aberdeen, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bj\u00f8rn","family":"Fougner","sequence":"additional","affiliation":[{"name":"Unit for Applied Clinical Research, Department of Environmental Medicine, Norwegian University of Science and Technology, Trondheim, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stein","family":"Kaasa","sequence":"additional","affiliation":[{"name":"Unit for Applied Clinical Research, Department of Environmental Medicine, Norwegian University of Science and Technology, Trondheim, Norway and Palliative Medicine Unit, Department of Oncology, St Olavs University Hospital, Trondheim, Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2003,12,1]]},"reference":[{"key":"atypb1","doi-asserted-by":"publisher","DOI":"10.1097\/00007691-199101000-00001"},{"key":"atypb2","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00268-J"},{"key":"atypb3","first-page":"477","volume":"251","author":"Paul D","year":"1989","journal-title":"J Pharmacol Exp Ther"},{"key":"atypb4","doi-asserted-by":"publisher","DOI":"10.1038\/clpt.1992.42"},{"key":"atypb5","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(95)00148-4"},{"key":"atypb6","doi-asserted-by":"publisher","DOI":"10.1007\/s002280050003"},{"key":"atypb7","doi-asserted-by":"publisher","DOI":"10.1177\/096032719000900509"},{"key":"atypb8","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00148-8"},{"key":"atypb9","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(95)00198-0"},{"key":"atypb10","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.1998.tb05378.x"},{"key":"atypb11","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)90088-4"},{"key":"atypb12","doi-asserted-by":"publisher","DOI":"10.1067\/mcp.2000.111934"},{"key":"atypb13","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(97)00142-5"},{"key":"atypb14","doi-asserted-by":"publisher","DOI":"10.1034\/j.1399-6576.2003.00138.x"},{"key":"atypb15","doi-asserted-by":"publisher","DOI":"10.1093\/jnci\/85.5.365"},{"key":"atypb16","volume-title":"EORTC QLQ-C30 scoring manual","author":"Fayers P","year":"1995"},{"key":"atypb17","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(83)90143-4"},{"key":"atypb18","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(02)00526-2"},{"key":"atypb19","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(01)00409-2"},{"key":"atypb20","doi-asserted-by":"crossref","first-page":"189","DOI":"10.1016\/0022-3956(75)90026-6","volume":"12","author":"Folstein MF","year":"1975","journal-title":"J Psychiatr Res"},{"key":"atypb21","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0142(19970215)79:4<835::AID-CNCR21>3.0.CO;2-#"},{"key":"atypb22","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(194811)1:4<634::AID-CNCR2820010410>3.0.CO;2-L"},{"key":"atypb23","doi-asserted-by":"publisher","DOI":"10.1093\/jat\/21.5.346"},{"key":"atypb24","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(94)00178-H"},{"key":"atypb25","doi-asserted-by":"publisher","DOI":"10.1097\/00002508-199909000-00003"},{"key":"atypb26","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1996.608"},{"key":"atypb27","doi-asserted-by":"publisher","DOI":"10.1038\/bjc.1995.268"},{"key":"atypb28","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199324050-00005"},{"key":"atypb29","doi-asserted-by":"publisher","DOI":"10.1191\/026921699678158579"},{"key":"atypb30","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(96)03102-8"},{"key":"atypb31","doi-asserted-by":"publisher","DOI":"10.1016\/0304-3959(92)90065-J"},{"key":"atypb32","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1213\/00000539-199901000-00021","volume":"88","author":"Smith MT","year":"1999","journal-title":"Anesth Analg"},{"key":"atypb33","doi-asserted-by":"publisher","DOI":"10.1016\/0885-3924(91)90961-3"},{"key":"atypb34","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(97)00020-1"},{"key":"atypb35","doi-asserted-by":"publisher","DOI":"10.1016\/S0885-3924(98)00043-8"},{"key":"atypb36","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(98)00140-7"},{"key":"atypb37","doi-asserted-by":"publisher","DOI":"10.1097\/00000542-200005000-00030"},{"key":"atypb38","doi-asserted-by":"publisher","DOI":"10.1016\/S0304-3959(00)00486-3"},{"key":"atypb39","first-page":"358","volume":"19","author":"Crain SM","year":"1998","journal-title":"TiPS"},{"key":"atypb40","doi-asserted-by":"publisher","DOI":"10.1111\/j.1476-5381.1995.tb15125.x"},{"key":"atypb41","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(00)04515-3"},{"key":"atypb42","doi-asserted-by":"publisher","DOI":"10.1191\/026921601668441770"}],"container-title":["Palliative Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1191\/0269216303pm835oa","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1191\/0269216303pm835oa","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,3,2]],"date-time":"2025-03-02T00:53:32Z","timestamp":1740876812000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1191\/0269216303pm835oa"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2003,12]]},"references-count":42,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2003,12]]}},"alternative-id":["10.1191\/0269216303pm835oa"],"URL":"https:\/\/doi.org\/10.1191\/0269216303pm835oa","relation":{},"ISSN":["0269-2163","1477-030X"],"issn-type":[{"value":"0269-2163","type":"print"},{"value":"1477-030X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2003,12]]}}}