{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T04:51:43Z","timestamp":1782449503788,"version":"3.54.5"},"reference-count":21,"publisher":"MDPI AG","issue":"7","license":[{"start":{"date-parts":[[2022,6,28]],"date-time":"2022-06-28T00:00:00Z","timestamp":1656374400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Pharmaceuticals"],"abstract":"<jats:p>Cancer-related pain constitutes a dominant reason for admission to emergency services, and a significant patient and healthcare challenge. Evidence points to the rising prevalence of opioid misuse in this patient group. We sought to compare drug delivery in an oncology-dedicated emergency department (OED) and a general emergency department (GED) within the same hospital. As such, we obtained patient and drug-related data for OED and GED during a designated three-month period, and compared them using Fisher\u2019s exact test, chi-square tests and the Mann-Whitney test. In total, 584 patients had 922 visits to emergency services (OED n = 479; GED n = 443), and were given 1478 drugs (OED n = 557; GED n = 921). Pain was a prominent chief complaint among visitors to the OED (17%) and GED (21%). Approximately a fifth of all drugs used were analgesics (OED\u201418.5%; GED\u201420.4%), however, in the GED, 51.6% (n = 97) were used for non-pain-related admissions, compared with 33.0% (n = 34) in OED. Opioid usage significantly differed between emergency settings. The GED administered three times as many intravenous opioids (p &lt;0.001), a narrower spectrum of oral and intravenous drugs (p = 0.003) and no rapid-acting opioids, significantly fewer pain adjuvants (10.9% versus 18.7%, p &lt; 0.001), and, finally, non-guideline-recommended drugs for pain, such as meperidine and benzodiazepines. Taken together, compared with the GED, the management of cancer-related pain in the OED was more personalized, and characterized by fewer intravenous opioids, enhanced diversity in drug type, route and method of delivery. Efforts should be directed toward reduction of disparities in the treatment of cancer pain in emergency settings.<\/jats:p>","DOI":"10.3390\/ph15070805","type":"journal-article","created":{"date-parts":[[2022,6,29]],"date-time":"2022-06-29T01:48:38Z","timestamp":1656467318000},"page":"805","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Approach to Cancer Pain Management in Emergency Departments: Comparison of General and Oncology Based Settings"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4123-1107","authenticated-orcid":false,"given":"Ilit","family":"Turgeman","sequence":"first","affiliation":[{"name":"Cancer Center, Emek Medical Center, Afula 1834111, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8840-4648","authenticated-orcid":false,"given":"Salvatore","family":"Campisi-Pinto","sequence":"additional","affiliation":[{"name":"Research Authority, Emek Medical Center, Afula 1834111, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maher","family":"Habiballah","sequence":"additional","affiliation":[{"name":"Division of Oncology, Rambam Health Care Center, Haifa 31096, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gil","family":"Bar-Sela","sequence":"additional","affiliation":[{"name":"Cancer Center, Emek Medical Center, Afula 1834111, Israel"},{"name":"Technion Integrated Cancer Center, Faculty of Medicine, Technion\u2014Israel Institute of Technology, Haifa 31096, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2022,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"135","DOI":"10.1097\/NCC.0000000000000360","article-title":"A Systematic Review of Emergency Department Use Among Cancer Patients","volume":"40","author":"Lash","year":"2017","journal-title":"Cancer Nurs."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1081\/CNV-50482","article-title":"The epidemiology of cancer pain","volume":"23","author":"Goudas","year":"2005","journal-title":"Cancer Investig."},{"key":"ref_3","unstructured":"World Health Organization (2011). Cancer Pain Relief with a Guide to Opioid Availability, World Health Organization."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"378","DOI":"10.1177\/1049909111410298","article-title":"Opioid and Adjuvant Analgesics: Compared and Contrasted","volume":"28","author":"Khan","year":"2011","journal-title":"Am. J. Hosp. Palliat. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1111\/acem.12861","article-title":"Risk for Opioid Misuse Among Emergency Department Cancer Patients","volume":"23","author":"Anderson","year":"2016","journal-title":"Acad. Emerg. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"24","DOI":"10.1200\/EDBK_100020","article-title":"Pain Management for Patients with Advanced Cancer in the Opioid Epidemic Era","volume":"39","author":"Dalal","year":"2019","journal-title":"Am. Soc. Clin. Oncol. Educ. Book"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"230","DOI":"10.1200\/JCO.2018.36.30_suppl.230","article-title":"Opioid-associated deaths in patients with cancer: A population study of the opioid epidemic over the past 10 years","volume":"36","author":"Chino","year":"2018","journal-title":"J. Clin. Oncol."},{"key":"ref_8","unstructured":"National Institute on Drug Abuse (2022, January 23). Magnitude, Available online: www.drugabuse.gov."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"301","DOI":"10.1634\/theoncologist.2014-0341","article-title":"Responding to Acute Care Needs of Patients with Cancer: Recent Trends Across Continents","volume":"21","author":"Young","year":"2016","journal-title":"Oncologist"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"2205","DOI":"10.1007\/s00520-012-1478-8","article-title":"Emergency department cancer unit and management of oncologic emergencies: Experience in Asan Medical Center","volume":"20","author":"Ahn","year":"2012","journal-title":"Support. Care Cancer"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"e1567","DOI":"10.1200\/OP.20.01081","article-title":"Effective Patient Selection for an Oncology-Dedicated Emergency Service: A Retrospective Study","volume":"17","author":"Turgeman","year":"2021","journal-title":"JCO Oncol. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2683","DOI":"10.1200\/JCO.2010.34.2816","article-title":"Why Do Patients with Cancer Visit Emergency Departments? Results of a 2008 Population Study in North Carolina","volume":"29","author":"Mayer","year":"2011","journal-title":"J. Clin. Oncol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"4543","DOI":"10.1007\/s00520-021-05987-3","article-title":"Cancer pain management in the emergency department: A multicenter pro-spective observational trial of the Comprehensive Oncologic Emergencies Research Network (CONCERN)","volume":"29","author":"Coyne","year":"2021","journal-title":"Support. Care Cancer"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"6387","DOI":"10.21873\/anticanres.12998","article-title":"Cancer Patients in the Emergency Department: A \u201cNightmare\u201d that Might Become a Virtuous Clinical Pathway","volume":"38","author":"Legramante","year":"2018","journal-title":"Anticancer Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"231","DOI":"10.1177\/0269216320957561","article-title":"The burden of serious health-related suffering among cancer decedents: Global projections study to 2060","volume":"35","author":"Sleeman","year":"2020","journal-title":"Palliat. Med."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"857952","DOI":"10.1155\/2014\/857952","article-title":"Differential prescribing of opioid analgesics according to physician specialty for Medicaid patients with chronic noncancer pain diagnoses","volume":"19","author":"Ringwalt","year":"2014","journal-title":"Pain Res. Manag."},{"key":"ref_17","unstructured":"Portenoy, R.K., Mehta, Z., and Ahmed, E. (2022, February 13). Cancer Pain Management with Opioids: Managing Analgesia. UpToDate. Available online: https:\/\/www.uptodate.com\/contents\/cancer-pain-management-with-opioids-optimizing-analgesia."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"510","DOI":"10.1016\/0885-3924(94)90112-0","article-title":"The benzodiazepines as adjuvant analgesics","volume":"9","author":"Reddy","year":"1994","journal-title":"J. Pain Symptom Manag."},{"key":"ref_19","unstructured":"National Comprehensive Cancer Network (2022, February 13). Adult Cancer Pain (Version 1.2022). Available online: https:\/\/www.nccn.org\/professionals\/physician_gls\/pdf\/pain.pdf."},{"key":"ref_20","unstructured":"FDA (2022, June 20). FDA Warns About Serious Risks and Death When Combining Opioid Pain or Cough Medicines with Benzodiazepines; Requires Its Strongest Warning, Available online: https:\/\/www.fda.gov\/media\/99761\/download."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Yang, Z., Yang, R., Kwak, M.J., Odaisat, A., Lin, J., Begley, C.E., Reyes-Gibby, C.C., and Yeung, S.-C.J. (2018). Oncologic emergencies in a cancer center emergency department and in general emergency departments countywide and nationwide. PLoS ONE, 13.","DOI":"10.1371\/journal.pone.0191658"}],"container-title":["Pharmaceuticals"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1424-8247\/15\/7\/805\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T23:39:51Z","timestamp":1760139591000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1424-8247\/15\/7\/805"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,6,28]]},"references-count":21,"journal-issue":{"issue":"7","published-online":{"date-parts":[[2022,7]]}},"alternative-id":["ph15070805"],"URL":"https:\/\/doi.org\/10.3390\/ph15070805","relation":{},"ISSN":["1424-8247"],"issn-type":[{"value":"1424-8247","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,6,28]]}}}