Are Opioids the Best Medication - Essay Example

The paper aims to establish the amount of doses to be prescribed to a patient, which can support survival. The research compares the effect of the administration of opioids in two settings- The Hospital (The Hospice) and The Hospital Home Unit. Analyzing the tests of the results was done using only one model: the Cox regression (univariate and multivariate forms of analysis). What is missing in these analyses is what actual time opioids should be administered, the amount of doses to be prescribed, and the condition of the patient. The author tried to show the significance of the research by using The Hospital Home Unit. The administration of morphine was in two groups: those that were given low doses and those with high doses. Consideration was also made for double doses. The data was analyzed using the most preferred model- the Cox regression. The costs of carrying out individual research and also all research work were not indicated. The pain of terminally ill patients could not be established- thus the research was not objective, but subjective. Only one Physician did the analysis of the data, which may not be reliable.  

Purpose and Research Questions

            The purpose of the research is to find out whether opioids are the best medication to be administered to terminally ill patients and whether such opioids can lengthen the survival of the patient. The research questions to be asked are: Is there any difference in carrying out the research at The Hospice and The Hospital Home Unit? What Cancer patients are to be considered during the research? At what stage the administration of opioids is to be administered? What type of data is to be collected and what model of analysis is to be used? The above research cannot be seriously taken as conclusive, since the research setting was done only at The Hospital Home Unit, and all cancer cases were not considered individually and collectively leading to bias. The application of one analysis model -the Cox regression model was not adequate. Other models like Beslow approximation or Linear and logistic analysis could have been used concurrently.

Literature Review

            Qualitative and quantitative studies were necessary for the research. The actual measurements of opioids, the duration of time of administration, and the cost of research and costs to the patient provide convincing results among other quantitative data.  The measurements of pain and suffering cannot be determined and therefore subjective. The references of time are indicated in the research. The time of the research was retrospective and, therefore not so relevant since circumstances may have changed. The weaknesses of the research were highlighted. The weaknesses include the retrospective design of the research and the inadequacy of the data used. However the indicated strengths are the specific use of Cox regression to explore high doses of opioids and double doses on the survival of the terminally ill patients at Home Unit, and also the use of The Hospital Home Unit. This acknowledgment gives validity to the research findings. However, the findings cannot be conclusive since the objective of whether there is a link between the use of opioids in terminally ill patients and their survival before death is not addressed. The research did not also address whether pain suppression increases the survival of terminally ill patients.

            It did not indicate why and how pain neurotransmitters compete with morphine and whether it is safe to prescribe higher doses of morphine. Another issue not addressed is why the use of opioids did not shorten survival –and that survival was higher when there are high doses- a claim, that may support the findings of other researchers. The findings did not explain why there is longer survival for patients who take higher doses as compared to those who take lower doses. Another explanation missing is why there is an adjustment of the difference when demographic and clinical variables are included for patients who receive more than two-fold doses (Benqoechea & Gutierrez, 2010). The research did not indicate what happens when a terminally ill patient reacts to opioids when the was a previous administration of other drugs like midazolam, or reactions to opioids when a disease like cancer is in different stages. There is no sufficient explanation as to why there are different tumors in different types of cancers. Also, the confidence level applied during the analysis is not mentioned. However, the research paper (Benqoechea & Gutierrez, 2010)include tables and graph) are detailed. The research paper has a well-updated bibliography.

Conceptual and Theoretical Framework

            The research work involved the idea that there might be a link between the use of morphine and the time a terminally ill patient takes before the patient dies. There is also a possible link between intensive care or monitoring of a patient and the effective use of doses. The outcome of the research findings may be determined by specifying all these ideas and translating them into logical data.