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Pain in last days of life — DGM MCQ

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ModerateEnd-of-life carePain in last days of lifeDGM

An 88-year-old woman with metastatic bowel cancer has pain that worsens on movement. She can no longer swallow modified-release morphine. eGFR is 42 mL/min/1.73 m2 and she is drowsy but rousable. What is the most appropriate management?

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Correct answer: B — Convert opioid to an appropriate subcutaneous regimen and review response

When oral opioids cannot be taken in the last days of life, an appropriate subcutaneous opioid regimen with monitoring is indicated. Stopping analgesia would cause avoidable distress. Renal function and sedation should inform opioid choice and dose.

Reference: NICE NG31; BNF Palliative care