Opioid epidemic and prescribing in hospice and palliative care: a review of the literature

Background: Rising rates of opioid abuse worldwide have led to the implementation of policies to curb opioid prescribing. It is unknown what impact these policies have on prescribing within the setting of hospice and palliative care. Objectives: To determine the current state of the science of opioid prescribing in hospice and palliative care in relation to the opioid epidemic and associated policies. Methods: A systematic integrative literature review was conducted using the Cumulative Index of Nursing and Allied Health Literature (CINAHL), PubMed, ProQuest Central and SCOPUS. Results: Most of the existing literature examines physician perspectives related to opioid prescribing in primary care settings. Ample evidence exists that policies can and do affect rates of opioid prescribing in specialties outside of hospice and palliative care. There is limited evidence to suggest how these policies affect opioid prescribing in hospice and palliative care. However, the available evidence suggests that opioids are necessary in hospice and palliative care in order to manage pain. Conclusion: Further research is necessary to examine the possible negative impact of the opioid epidemic on opioid prescribing in hospice and palliative care.