{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,2]],"date-time":"2025-08-02T16:58:12Z","timestamp":1754153892097,"version":"3.41.2"},"reference-count":0,"publisher":"Canadian Society of Healthcare-Systems Pharmacy","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Can J Hosp Pharm"],"abstract":"<jats:p>Background: Opioids are known to induce delirium, and the incidence of delirium induced by individual opioids has been investigated. However, only a limited number of studies have examined the incidence of delirium induced by oral hydromorphone.\nObjective: To investigate whether differences exist in the incidence of delirium associated with oral morphine and oral hydromorphone during the initiation phase of treatment.\nMethods: The participants were opioid-naive inpatients with cancer who started oral morphine or oral hydromorphone at Shizuoka Cancer Center (in Shizuoka, Japan) between June 2017 and November 2020. The incidence of delirium in the first week of opioid use was compared between the 2 groups.\nResults: A total of 90 patients met the inclusion criteria, 27 who received oral hydromorphone and 63 who received oral morphine. The incidence rate of delirium in the oral hydromorphone group tended to be higher (19%, 5\/27) than in the oral morphine group (8%, 5\/63), although the difference was not statistically significant (odds ratio 0.4, 95% confidence interval, 0.1\u20131.4, p = 0.16 by the Fisher exact test). Propensity score matching was used to control for differences in patient background as confounders in the development of delirium, following which the incidence rate of delirium remained higher, but not significantly so, in the oral hydromorphone group (11%, 2\/19) than in the oral morphine group (5%, 1\/19) (odds ratio 0.5, 95% confidence interval 0.04\u20135.7, p &gt; 0.99 by the Fisher exact test).\nConclusions: There was no statistically significant difference in the incidence of delirium between those who received morphine and those who received hydromorphone, which suggests that for opioid-naive inpatients with cancer, oral hydromorphone can be used in a manner similar to that for oral morphine.\nKeywords: delirium, oral opioids, morphine, hydromorphone\nR\u00c9SUM\u00c9\nContexte : Les opio\u00efdes sont connus pour induire un d\u00e9lire, et l\u2019incidence du d\u00e9lire induit par des opio\u00efdes individuels a fait l\u2019objet d\u2019\u00e9tudes. Cependant, seul un nombre limit\u00e9 de celles-ci s\u2019est pench\u00e9 sur l\u2019incidence du d\u00e9lire induit par l\u2019hydromorphone orale.\nObjectif : \u00c9tudier s\u2019il existe des diff\u00e9rences dans l\u2019incidence du d\u00e9lire associ\u00e9 \u00e0 la morphine orale et \u00e0 l\u2019hydromorphone orale pendant la phase d\u2019initiation du traitement.\nM\u00e9thodologie : La population \u00e0 l\u2019\u00e9tude se composait de patients hospitalis\u00e9s na\u00effs aux opio\u00efdes atteints de cancer; ils ont commenc\u00e9 \u00e0 prendre de la morphine orale ou de l\u2019hydromorphone orale au Shizuoka Cancer Center (\u00e0 Shizuoka, au Japon) entre juin 2017 et novembre 2020. L\u2019incidence du d\u00e9lire au cours de la premi\u00e8re semaine de consommation d\u2019opio\u00efdes a \u00e9t\u00e9 compar\u00e9e entre les 2 groupes.\nR\u00e9sultats : Au total, 90 patients r\u00e9pondaient aux crit\u00e8res d\u2019inclusion : 27 avaient re\u00e7u de l\u2019hydromorphone et 63 de la morphine. Le taux d\u2019incidence du d\u00e9lire dans le groupe \u00ab hydromorphone orale \u00bb avait tendance \u00e0 \u00eatre plus \u00e9lev\u00e9 (19 %, 5\/27) que dans le groupe \u00ab morphine orale \u00bb (8 %, 5\/63), bien que la diff\u00e9rence ne soit pas statistiquement significative (rapport de cotes [RC] 0,4, intervalle de confiance [IC] \u00e0 95 %, 0,1-1,4, p = 0,16 par le test exact de Fisher). L\u2019appariement par score de propension a \u00e9t\u00e9 utilis\u00e9 pour contr\u00f4ler les diff\u00e9rences dans les ant\u00e9c\u00e9dents des patients comme facteurs de confusion dans le d\u00e9veloppement du d\u00e9lire, apr\u00e8s quoi le taux d\u2019incidence du d\u00e9lire est rest\u00e9 plus \u00e9lev\u00e9, mais pas de mani\u00e8re significative, dans le groupe \u00ab hydromorphone orale \u00bb (11 %, 2\/19) que dans le groupe \u00ab morphine orale \u00bb (5 %, 1\/19) (RC 0,5, IC \u00e0 95 % 0,04-5,7, p &gt; 0,99 par le test exact de Fisher.\nConclusions : Aucune diff\u00e9rence statistiquement significative dans l\u2019incidence du d\u00e9lire entre les personnes ayant re\u00e7u de la morphine et celles ayant re\u00e7u de l\u2019hydromorphone n\u2019a \u00e9t\u00e9 observ\u00e9e. Cela laisse supposer que pour les patients hospitalis\u00e9s na\u00effs aux opio\u00efdes atteints de cancer, l\u2019hydromorphone orale peut \u00eatre utilis\u00e9e d\u2019une mani\u00e8re similaire \u00e0 l\u2019utilisation de la morphine orale.\nMots-cl\u00e9s : d\u00e9lire, opio\u00efdes oraux, morphine, hydromorphone<\/jats:p>","DOI":"10.4212\/cjhp.3515","type":"journal-article","created":{"date-parts":[[2025,1,16]],"date-time":"2025-01-16T08:20:43Z","timestamp":1737015643000},"source":"Crossref","is-referenced-by-count":1,"title":["Incidence of Delirium during the Initiation Phase of Morphine and Hydromorphone Therapy in Cancer Patients: A Retrospective Comparative Study"],"prefix":"10.4212","volume":"78","author":[{"given":"Hironori","family":"Tanaka","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rei","family":"Tanaka","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takeshi","family":"Kamoshida","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shigeki","family":"Morimoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junya","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsu","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tetsumi","family":"Sato","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Akiyoshi","family":"Saitoh","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daisuke","family":"Yamada","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mina","family":"Kondo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kenji","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chieko","family":"Takahashi","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michihiro","family":"Shino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2732","published-online":{"date-parts":[[2025,1,15]]},"container-title":["Canadian Journal of Hospital Pharmacy"],"original-title":[],"link":[{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3515\/5508","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3515\/5510","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/download\/3515\/5508","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,23]],"date-time":"2025-07-23T16:59:35Z","timestamp":1753289975000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cjhp-online.ca\/index.php\/cjhp\/article\/view\/3515"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,15]]},"references-count":0,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,3,12]]}},"URL":"https:\/\/doi.org\/10.4212\/cjhp.3515","relation":{},"ISSN":["1920-2903","0008-4123"],"issn-type":[{"type":"electronic","value":"1920-2903"},{"type":"print","value":"0008-4123"}],"subject":[],"published":{"date-parts":[[2025,1,15]]},"article-number":"e3515"}}