Project PEOLC23

The role of ethnicity in opioid prescribing and health service use in the last three months of life: a population-based comparative cohort study of cancer patients

In the UK, approximately 165,000 people die from cancer a year, a number expected to rise. Pain is very common among cancer patients, increasing to 80-90% at the end of life. It is highly distressing. Relief from cancer pain is a top national priority for patients/families and a human right.


Despite effective treatments, evidence of under-prescribing of pain medication is common but is not uniformly distributed across society. In the UK, we know from annual national surveys that cancer patients from Black, Asian and ethnicity diverse (BAED) communities are dissatisfied with how their pain is managed. No research has examined analgesic prescribing for pain across different ethnic groups at the end of life. Without answers, it’s impossible to know where/what solutions are required.

Project aims 

We want to study, for the first time in the UK, the painkillers prescribed to people with cancer at the end of life to find out if there are differences by ethnic group.

Project activity 

  • With our PPI members, we will study databases called the Clinical Practice Research Datalink and Hospital Episode Statistics. They contain anonymised information for millions of people about their ethnicity, illnesses, GP visits, hospital and A&E admissions and medicines, including cancer painkillers.
  • With this data, we will be able to find people with advanced cancer and which painkillers were prescribed to them.
  • We will work out if there are differences in the type and number of painkillers prescribed to people from different BAED groups, along with other reasons that might explain this.

Anticipated impact

  • This study will find out if more or fewer painkillers are prescribed to people with cancer at the end of life from different ethnic groups in all settings (home, care homes, hospitals and hospices).
  • With our PPI members, we will share what we find in a medical journal and YouTube for health professionals locally and nationally so they can learn and improve their care.
  • This study will lead to a ‘path to change’ improving understanding of prescribing cancer painkillers across different ethnic groups.
  • Future work will include talking with people with advanced cancer from BAED backgrounds and especially those groups where we find that fewer painkillers have been prescribed than expected.
  • We will also talk with health professionals about how they talk about and manage cancer pain among people from BAED backgrounds, especially those where we find fewer painkillers have been prescribed than expected, so we can find solutions that make a difference.

Who is involved?

Principle Investigator

Prof J Koffmann (, Hull York Medical School (HYMS)

Researchers and institutions

  • Stephen Barclay, University of Cambridge 

  • Rashmi Kumar, Kings College London
  • Sabrina Bajwah, Kings College London 

Contact us

Prof J Koffmann (, Hull York Medical School (HYMS)