Under-prescription of Step III opioids in French cancer survivors with chronic pain: a call for integrated early palliative care in oncology

Chronic pain (CP) is a major concern in cancer survivors. Often underreported by patients, it is both under-assessed and undertreated by care providers.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Tags: Original Article Source Type: research

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This article represents the findings from the queries over the first three months ’ queries and brings further clarity to our initial findings.Methods This quality improvement (QI) project was reviewed and approved by the Orlando Health/UFHealth Cancer Center Joint Oncology Committee for 2018-19. We began recording results of all E-FORSCE queries occurring after the law ’s implementation of July 1, 2018 through September 30, 2018. We informed each patient that the PDMP query had become mandatory in Florida, and we discussed the results of each query with each patient. Each query examined the last 12 months of t...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Tags: kollas opioid pain quality improvement statte Source Type: blogs
The American population is getting older and sicker. More Americans are facing life-threatening illness when approaching end of life. Palliative care has grown to meet the complex needs of this population. And yet, according to a 2017 article in the journal Palliative Care, many people living with a chronic life-threatening illness either do not receive any palliative care, or receive services only in the last phase of their illness. The National Consensus Project Clinical Practice Guidelines for Quality Palliative Care also addressed this issue, stating that a goal of their recently updated guidelines is “to improve...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Caregiving End of life Pain Management Source Type: blogs
Conclusions and RelevanceAlthough a high proportion of patients received elements of palliative care, transitions to a goal of comfort or hospice happened very near death. Palliative care delivery can be improved by systematizing existing mechanisms, including prompts for earlier goals-of-care discussion, symptom screening, and spiritual care, and by building collaboration between primary and specialty palliative care services.
Source: Journal of General Internal Medicine - Category: Internal Medicine Source Type: research
Conclusion: There is substantial inadequacy in pain management in patients with cancer. The BPI-SF should be routinely used to evaluate pain severity, and analgesics should be prescribed equitably without discrimination with regard to gender and socioeconomic status of patients.
Source: Indian Journal of Palliative Care - Category: Palliative Care Authors: Source Type: research
Conclusions: Indian medical practitioners felt the need for formal pain management training. There is a lack of consensus on how to manage the pain using opioid analgesics. Tough regulations on medical and scientific use of opioids are the most commonly reported barrier to prescribing them.
Source: Indian Journal of Palliative Care - Category: Palliative Care Authors: Source Type: research
We report the successful use of low-dose ketamine infusion for the treatment of opioid-induced hyperalgesia in a 38-year-old woman presenting with psychosocial suffering and high opioid requirement secondary to pain from a poorly differentiated neuroendocrine tumor. Over the course of a month, her opioid requirement escalated to the gram level of oral morphine equivalents, upon which she was hospitalized at University of California San Diego Health for an acute on chronic pain crisis. Despite use of patient-controlled analgesia, her pain level remained unchanged for nearly 2 days after initiation of a low-dose ketamine inf...
Source: Journal of Pain and Palliative Care Pharmacotherapy - Category: Palliative Care Tags: J Pain Palliat Care Pharmacother Source Type: research
Erica S. Tarabadkar† and Michi M. Shinohara*† Division of Dermatology, University of Washington, Seattle, WA, United States Skin directed therapies (SDTs) serve important roles in the treatment of early stage cutaneous T-cell lymphoma (CTCL)/mycosis fungoides (MF), as well as managing symptoms and improving quality of life of all stages. There are now numerous options for topical therapies that demonstrate high response rates, particularly in early/limited MF. Phototherapy retains an important role in treating MF, with increasing data supporting efficacy and long-term safety of both UVB and PUVA as ...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
Intrathecal drug delivery has been well established an effective and safe method for the treatment of pain, including palliative cancer-related and chronic nonmalignant pain. In this article, we discuss the role of intrathecal pain therapy in the management of chronic, refractory nonmalignant pain. Common indications, patient selection criteria, medication options, complications, and adverse events are discussed within the context of results from randomized controlled trials, clinical consensus guidelines, and best available literature to date.
Source: Neurosurgery Clinics of North America - Category: Neurosurgery Authors: Source Type: research
Palliative care research has largely focused on patients with disease specific conditions such as advanced cancer, cardiac or pulmonary diseases. As patients age, however, they often develop chronic conditions that may lead to decreases in health-related quality of life or symptoms such as pain and dyspnea. As the population ages, the prevalence of patients with multi-morbidity also increases 1 but these patients may not be identified as having palliative care needs.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
This article offers a narrative review on the armamentarium of bone-targeting radiopharmaceuticals based on currently approved investigational and potentially useful radionuclides and examines their efficacy for the treatment of painful skeletal metastases. In addition, the article also highlights the processes, opportunities, and challenges involved in the development of bone-seeking radiopharmaceuticals. Radium-223 is the first agent in this class to show an overall survival advantage in castration-resistant prostate cancer (CRPC) patients with bone metastases. This review summarizes recent advances, current clinical pra...
Source: Current Medicinal Chemistry - Category: Chemistry Authors: Tags: Curr Med Chem Source Type: research
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