Opioid Risk Stratification in an Outpatient Palliative Care Clinic (TH310B)

Approximately a quarter of patients in academic cancer centers are at high risk for opioid abuse.1,2 At Dana-Farber Cancer Institute, we sought to create a high-reliability process within our palliative care clinic that risk stratifies our patients for opioid abuse using the Opioid Risk Tool (ORT).
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research

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Multiple randomized clinical trials have demonstrated that palliative care improves the quality of life of individuals with serious medical illness. Research also suggests that in patients with advanced cancer, palliative care ’s focus on symptom management, coping with illness, goals of care, and treatment decisions may be associated with improved patient quality of life in part by increasing patients’ use of active (versus passive) and approach-oriented (versus avoidant) coping strategies. However, without a framewo rk outlining the process that individuals with serious medical illness and their loved ones un...
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Tags: Special Article Source Type: research
Authors: Thudium M, Bette B, Tonguc T, Ghaei S, Conrad R, Becher MU, Mücke M, Luechters G, Strunk H, Marinova M Abstract Introduction: High-intensity focused ultrasound (HIFU) for pancreatic cancer is a growing therapeutic field which has been proven to reduce cancer pain and provide a local tumor control additionally to standard palliative care. However, less is known about the multidisciplinary and especially anesthesiological management of HIFU treatment although an interdisciplinary approach is crucial for treatment success.Material and methods: Anesthesiological and radiological records of 71 HIFU-treated...
Source: International Journal of Hyperthermia - Category: Internal Medicine Tags: Int J Hyperthermia Source Type: research
Authors: Martin EJ, Bruggeman AR, Nalawade VV, Sarkar RR, Qiao EM, Rose BS, Murphy JD Abstract BACKGROUND: Patients with advanced esophageal cancer often experience pain and dysphagia, yet the optimal palliative management remains unclear. This retrospective study evaluated outcomes and adverse effects of palliative radiotherapy (RT) compared with esophageal stenting among a cohort of U.S. veterans with metastatic esophageal cancer. PATIENTS AND METHODS: We identified 1,957 veterans in the United States with metastatic esophageal cancer who received palliative RT to the esophagus or esophageal stenting, and ass...
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Tags: J Natl Compr Canc Netw Source Type: research
Purpose of review An increasing number of patients are turning to cannabis and cannabinoids for management of their palliative and nonpalliative cancer pain and other cancer-related symptoms. Canadians have a legal framework for access to medical cannabis, which provides a unique perspective in a setting lacking robust clinical evidence. This review seeks to delineate the role of cannabis and cannabinoids in cancer pain management and offers insight into the Canadian practice. Recent findings A cohort study using nabiximols on advanced cancer pain in patients already optimized on opioids, over 3 weeks, demonstrated im...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research
Purpose of review Continual refinement and further stratification of childhood cancer treatment has led to increased survivorship with recognized improvements in many long-term health outcomes. Despite this progress, persisting pain prevalence in childhood cancer survivors is increasing and emerging as a significant long-term health concern. Recent findings Currently, there is no guidance on how to approach and manage persisting pain in survivors of childhood cancer. Summary Clinicians should work with children and young people to optimize the management of pain and other symptoms on treatment. Focusing on an early...
Source: Current Opinion in Supportive and Palliative Care - Category: Palliative Care Tags: PAIN: CANCER: Edited by Anthony H. Dickenson and Paul Farquhar-Smith Source Type: research
Palliative care providers are consulted frequently to manage complex symptoms in medically complex patients. Supportive care of patients with hormone-receptor positive breast cancer often involves consideration of ongoing medical therapy such as tamoxifen. Tamoxifen is an estrogen-receptor modulator with known association with mood disturbances, hot flashes, and fatigue. As palliative care providers, we must be aware of how to optimally manage these challenging symptoms while avoiding drug-drug interactions that could negatively impact the disease prognosis.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Tags: Letter Source Type: research
Authors: Flöther L Abstract Alleviation of physical complaints through pain management and symptom control represents an essential part of a palliative treatment concept. Persistent cancer pain in palliative care leads to a significant reduction in quality of life. Evaluation of pain on the basis of a detailed pain history allows recognition of the types of pain and initiation of a corresponding effective pain therapy. The basis of cancer pain therapy in palliative patients is transdermal and oral administration of long-acting analgesics according to a fixed time schedule. Especially i...
Source: HNO - Category: ENT & OMF Tags: HNO Source Type: research
This article provides an overview of the evidence on the risks and benefits of using medical cannabis for the indications of chronic pain, cancer-related pain, cancer cachexia, dementia, and Alzheimer's disease. Currently, there is insufficient evidence to determine the effectiveness and safety of cannabinoids for most reviewed indications, with the exception of chronic pain. Future research is required before palliative care clinicians can make evidence-based decisions on the integration of medical cannabis as adjunct therapies. PMID: 32312410 [PubMed - in process]
Source: The Medical Clinics of North America - Category: General Medicine Authors: Tags: Med Clin North Am Source Type: research
This article provides an overview of the evidence on the risks and benefits of using medical cannabis for the indications of chronic pain, cancer-related pain, cancer cachexia, dementia, and Alzheimer ’s disease. Currently, there is insufficient evidence to determine the effectiveness and safety of cannabinoids for most reviewed indications, with the exception of chronic pain. Future research is required before palliative care clinicians can make evidence-based decisions on the integration of m edical cannabis as adjunct therapies.
Source: Medical Clinics of North America - Category: Primary Care Authors: Source Type: research
AbstractPurpose of ReviewTo describe several effective imaging-guided, minimally invasive treatments to relieve cancer-associated pain in oncologic patients. Clinical applications, technical considerations, and current controversies are addressed.Recent FindingsThe great variability in tumor subtype, location, and growth rates dictate the necessity for a tailored treatment approach. While opioids and radiotherapy may provide adequate relief for some patients, alternative minimally invasive procedures may augment theses more traditional treatments or even provide superior palliative relief. Recent image-guided percutaneous ...
Source: Current Oncology Reports - Category: Cancer & Oncology Source Type: research
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