Morphine sulphate tablets in hospice practice
Bonifant, J.D.; Clark-Reynolds, M.
Postgraduate Medical Journal 67(Suppl): S74-S78
1991
ISSN/ISBN: 0032-5473 PMID: 1758821 Document Number: 385452
Sustained release morphine sulphate tablets (MST Continus), have been available for use in New Zealand since 1984. They have become the major opioid in use for palliative and terminal care. The Mary Potter Hospice was founded in 1978 and is New Zealand's largest hospice. The records of 100 consecutive patients admitted to the Mary Potter Hospice Program who were prescribed morphine sulphate tablets (MST) were collected prospectively in order to document current hospice usage of MST. It was found that MST was widely tolerated and was highly successful in controlling pain in the majority of patients. There was a wide dosage range and the dose required appears independent of pathology, age of patient or previous analgesic exposure. It was rapidly apparent when MST had been employed inappropriately. The commonest reasons for cessation of medication were death of the patient or their moribund state. Contrary to expectations nausea and vomiting were not frequent causes of stopping medication, neither were confusion nor altered states of consciousness. The advantages of MST were demonstrated giving evidence for the reasons this agent is now the principle opioid employed in palliative and terminal care in the Mary Potter Hospice.