The aim of this study was to determine by consensus the components of an opioid essential prescription package (OEPP) to be used when initiating a prescription for the control of moderate to severe @entity1118 . Palliative care physicians (n=60) were sampled from the International Association for Hospice and Palliative Care (IAHPC) membership list to represent a range of countries of varying economic levels and diverse geographical regions. Using a Delphi study method, physicians were asked to rank preferences of drug and dosing schedule for first-line opioid, antiemetic, and laxative for the treatment of adults with @entity1118 due to @entity5 and other life-threatening conditions. Overall response rates after two Delphi survey rounds were 95% (n=57) and 82% (n=49), respectively. A consensus (set at >= 75% agreement) was reached to include @entity1286 as first-line opioid at a dose of 5   mg orally every 4 hours. Consensus was reached to include @entity1769 as a first-line antiemetic, but there was no consensus on "regular" or "as needed" administration. No consensus was reached regarding a first-line laxative, but a combination of senna and docusate secured 59% agreement. There was consensus (93% agreement) that laxatives should always be given regularly when opioid treatment is started. Further work is needed to establish a recommended dose of @entity1769 and a type and dose of laxative. The resulting OEPP is international in scope and is designed to ensure that opioids are better tolerated by reducing adverse effects of opioids, which could lead to more sustained improvements in @entity158 management.

XXXX management: the identification and development of the IAHPC opioid essential prescription package.

@entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1769 :: ('MESH:D008787', 'Chemical') :: ['metoclopramide'] @entity158 :: ('MESH:D010146', 'Disease') :: ['pain'] @entity1286 :: ('MESH:D009020', 'Chemical') :: ['morphine'] @entity1118 :: ('MESH:D059350', 'Disease') :: ['chronic pain']
@entity158 :: (MESH:D010146,Disease) :: ['Strategic pain']
