Single-patient multiple crossover studies to determine the effectiveness of paracetamol in relieving pain suffered by patients with advanced cancer taking regular opioids: A pilot study

What is already known about the topic? Paracetamol is a useful adjunct when used in combination with “weak opioids” for chronic pain in palliative care patients with advanced cancer; however, it is not certain that there is continuing benefit when used in conjunction with “strong” opioids. What this paper adds? N-of-1 trials allowed individual treatment decisions to be made for each participant: there was no added benefit for any of the participants, although no conclusion about the added benefit of paracetamol above regular opioids was possible for the group, due to insufficient numbers recruited. Implications for practice, theory, or policy Paracetamol may not provide added benefit above regular opioids; this should be assessed on a case-by-case basis to justify the extra tablet load.