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Palliative care opioids

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https://www.readbyqxmd.com/read/28807366/prospective-screening-with-the-validated-opioid-risk-tool-demonstrates-gynecologic-oncology-patients-are-at-low-risk-for-opioid-misuse
#1
Christine Garcia, Carolyn Lefkowits, Elizabeth Pelkofski, Leslie Blackhall, Linda R Duska
OBJECTIVE: To characterize risk for opioid misuse among gynecologic oncology patients. METHODS: The Opioid Risk Tool (ORT), a validated screen for opioid misuse risk, was administered to a convenience sample of patients with gynecologic cancer receiving opioid prescriptions in gynecologic oncology or palliative care clinics from January 2012-June 2016. Demographic and clinical information was abstracted on chart review. The primary outcome was ORT risk level (low vs...
August 11, 2017: Gynecologic Oncology
https://www.readbyqxmd.com/read/28805336/matrix-stimulation-in-cancer-pain-methodology-safety-and-effectiveness
#2
M Mücke, M Tils, R Conrad, D Kravchenko, H Cuhls, L Radbruch, M Marinova, V Peuckmann-Post, R Rolke
BACKGROUND: This feasibility study addresses the applicability of matrix electrodes for the reduction of ongoing pain in cancer patients via low-frequency electrical stimulation (LFS). METHODS: Low-frequency matrix stimulation (4 Hz) was applied to the skin within the 'Head's zones' referring to the tumour localization of cancer pain patients. Pain at baseline was compared to a 3-day treatment interval consisting of 5 min of matrix stimulation in the morning and evening followed by a 3-day follow-up period without therapy...
August 14, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/28803090/palliative-care-in-rwanda-aiming-for-universal-access
#3
Eric L Krakauer, Marie-Aimee Muhimpundu, Diane Mukasahaha, Jean-Claude Tayari, Christian Ntizimira, Blaise Uhagaze, Théodosie Mugwaneza, Aimable Ruzima, Egide Mpanumusingo, Magnus Gasana, Vincent Karamuka, Jean-Luc Nkurikiyimfura, Paul Park, Peter Barebwanuwe, Neo Tapela, Shekinah N Elmore, Gene Bukhman, Mhoira Leng, Liz Grant, Agnes Binagwaho, Richard Sezibera
In 2011, Rwanda's Ministry of Health (MoH) set a goal of universal access to palliative care by 2020. Toward this audacious egalitarian and humanitarian goal, the MoH worked with partners to develop palliative care policies and a strategic plan, secure adequate supplies of opioid for the country, initiate palliative care training programs, and begin studying a model for integrating coordinated palliative care into the public healthcare system at all levels. It also initiated training of a new cadre of home-based care practitioners (HBCPs) to provide palliative care in the home...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803078/safety-and-effectiveness-of-palliative-drug-treatment-in-the-last-days-of-life-a-systematic-literature-review
#4
REVIEW
Kristian Jansen, Dagny Faksvåg Haugen, Lisa Pont, Sabine Ruths
CONTEXT: Dying patients commonly experience potentially distressing symptoms. Palliative care guidelines recommend opioids, anticholinergics, antipsychotics and benzodiazepines for symptom relief. OBJECTIVES: To systematically review the effectiveness and safety of palliative drug treatment in the last days of life of adult patients, focusing on the management of pain, dyspnea, anxiety, restlessness, and death rattle. METHODS: A systematic search of the literature published before December 2016 in PubMed/MEDLINE, Embase, CINAHL, PsycINFO, Cochrane, ClinicalTrials...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803076/palliative-care-in-vietnam-long-term-partnerships-yield-increasing-access
#5
Eric L Krakauer, Dang Huy Quoc Thinh, Quach Thanh Khanh, Hoang Thi Mong Huyen, Tran Diep Tuan, Than Ha Ngoc The, Do Duy Cuong, Tran Van Thuan, Nguyen Phi Yen, Pham Van Anh, Nguyen Thi Phuong Cham, Kathleen P Doyle, Nguyen Thi Hai Yen, Luong Ngoc Khue
Palliative care began in Vietnam in 2001, but steady growth in palliative care services and education commenced several years later when partnerships for ongoing training and technical assistance by committed experts were created with the Ministry of Health (MoH), major public hospitals, and medical universities. An empirical analysis of palliative care need by the MoH in 2006 was followed by national palliative care clinical guidelines, initiation of clinical training for physicians and nurses, and revision of opioid prescribing regulations...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803074/hospice-palliative-care-development-in-hungary
#6
Agnes Csikos, Csilla Busa, Katalin Muszbek
During the past 25 years many developmental steps have occurred in Hungary in palliative care. Further education and service development is needed to provide a quality palliative care for all the Hungarian people. Hungary has a universal health care system with a developed infrastructure. The first Hungarian hospice team started in 1991. At that time the concept of hospice care was unknown. Symptom control and psychosocial support for the dying patient was inadequate. The regulatory framework was based on the 1997 Health Care Act which was followed by significant palliative care legislation including documents on the legal requirements for palliative care (2004)...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803073/leadership-development-initiative-growing-global-leaders%C3%A2-advancing-palliative-care
#7
Frank D Ferris, Shannon Y Moore, Mary V Callaway, Kathleen M Foley
The International Palliative Care Leadership Development Initiative (LDI) is a model demonstration project that aimed to expand the global network of palliative care leaders in low and moderate-resource countries who are well positioned to apply their new leadership skills. Thirty-nine palliative medicine physicians from 25 countries successfully completed the 2-year curriculum that included three thematic residential courses, mentorship and site visits by senior global palliative care leaders, and personal projects to apply their new leadership skills...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801006/palliative-care-in-kazakhstan
#8
Gulnara Kunirova, Ainur Shakenova
In Kazakhstan, like most ex-Soviet Union countries palliative care began in the late 1990's with the opening of the Almaty Hospice in 1999. Since that time, several palliative care services have opened in urban centers but there is little coverage in rural areas. Palliative care has grown due to the collaborative work of Parliament leaders, Ministry of Health, local governments officials, Public Health Higher School, National Center for Health Development, academic medical institutions, oncology and palliative care experts, NGO's, Soros Foundation Kazakhstan, and international experts...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801003/who-public-health-model-a-roadmap-for-palliative-care-development
#9
Mary V Callaway, Stephen R Connor, Kathleen M Foley
The Open Society Foundation's International Palliative Care Initiative (IPCI) began to support palliative care development in Central and Eastern Europe and the Former Soviet Union in 1999. Twenty-eight country representatives were invited to discuss the need for palliative care in their countries and to identify key areas that should be addressed to improve the care of adults and children with life-limiting illnesses. As a public health concern, progress in palliative care requires integration into health policy, education and training of health care professionals, availability of essential pain relieving medications, and health care services...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801000/palliative-care-development-in-ukraine
#10
Victoria Tymoshevska, Kseniya Shapoval-Deinega
There are approximately 1 million cancer patients in Ukraine and 90,000 cancer deaths a year, 35% of these are diagnosed in the late stage of disease. Ukraine has the most severe HIV epidemic in the region with more than 200,000 persons living with HIV/AIDS and 6000-10000 deaths annually. The morphine consumption rate is among the lowest in the. The first palliative care services were established in 1996 and the number has slowly increased with services provided in inpatient units, home and day care programs and by a range of health care providers...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28797851/palliative-care-development-in-georgia
#11
Nina Kiknadze, Pati Dzotsenidze
Georgia has established the foundational measures for a national palliative care program-policy, education, drug availability, and implementation. Amendments to legislation needed to develop palliative care have been approved. Palliative care has been recognized as a subspecialty in oncology, critical care, internal medicine and surgery. The National Plan for Palliative Care for 2011-2016 was approved. Opioids, especially oral morphine, are available on a limited basis for patients at home but oral morphine is not available for patients in the hospital...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28792784/improved-pain-control-in-terminally-ill-cancer-patients-by-introducing-low-dose-oral-methadone-in-addition-to-ongoing-opioid-treatment
#12
Per Fürst, Staffan Lundström, Pål Klepstad, Sara Runesdotter, Peter Strang
BACKGROUND: Cancer pain is often not well controlled and there is a need for improved treatment strategies. Methadone exhibits unique properties among opioids and recent reports show promising results from adding a low dose of methadone to regular opioid therapy. OBJECTIVE: To examine the effects of oral low-dose methadone added to regular scheduled opioids in terminally ill patients with complex cancer-related pain. DESIGN: This was a retrospective chart review...
August 9, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28782703/the-contribution-of-the-international-pain-policy-fellowship-in-improving-opioid-availability-in-georgia
#13
Pati Dzotsenidze, Martha A Maurer, Dimitri Kordzaia, Ioseb Abesadze, Mary M Skemp Brown, Aaron M Gilson, James F Cleary
In the Republic of Georgia, the incidence and prevalence of cancer is increasing, signifying a growing need for palliative care and pain relief, including with controlled opioid medicines. As a signatory to the Single Convention, the Georgian government has a responsibility to ensure the adequate availability of controlled medicines for medical purposes, however the consumption of morphine is very low, suggesting a high occurrence of unrelieved pain. In Georgia, palliative care development began in the 2000s including the adoption of a policy document in 2005, the creation of the National Palliative Care Coordinator in 2006 and important changes in Georgian legislation in 2007 and 2008, which served to lay a foundation for improving opioid availability...
August 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28745577/advanced-cancer-pain-the-search-for-genetic-factors-correlated-with-interindividual-variability-in-opioid-requirement
#14
Maja Matic, Joost Lm Jongen, Laure Elens, Saskia N de Wildt, Dick Tibboel, Peter Ae Sillevis Smitt, Ron Hn van Schaik
AIM: To assess association between genetic variants and opioid requirement in cancer patients. MATERIALS & METHODS: A prospective observational trial of 243 advanced cancer patients with inadequate analgesia treated by the palliative care team was analyzed for ABCB1, ARRB2, COMT, GCH1, IL1RN, KCNJ6, OPRM1, RHBDF2, SCN9A and Stat6 polymorphisms. RESULTS: For patients carrying OPRM1 118AG/GG and COMT 472GG (Val158Val) or these genotypes alone, a significant higher median percentage dose increase was observed (95...
August 2017: Pharmacogenomics
https://www.readbyqxmd.com/read/28711751/the-conversion-ratio-from-intravenous-hydromorphone-to-oral-opioids-in-cancer-patients
#15
Akhila Reddy, Marieberta Vidal, Saneese Stephen, Karen Baumgartner, Sara Dost, Ann Nguyen, Yvonne Heung, Simeon Kwan, Angelique Wong, Imelda Pangemanan, Ahsan Azhar, Supakarn Tayjasanant, Edenmae Rodriguez, Jessica Waletich, Kyu-Hyoung Lim, Jimin Wu, Diane Liu, Janet Williams, Sriram Yennurajalingam, Eduardo Bruera
BACKGROUND: The lack of knowledge of the accurate conversion ratio (CR) between intravenous (IV) and oral hydromorphone and opioid rotation ratio (ORR) between IV hydromorphone and oral morphine equivalent daily dose (MEDD) may lead to poorly controlled pain or overdosing in cancer inpatients. We aimed to determine the CR and ORR from IV hydromorphone to oral hydromorphone and MEDD (obtained from oral morphine and oxycodone). METHODS: 4745 consecutive inpatient palliative care consults during 2010-14 were reviewed for conversions from IV hydromorphone to oral hydromorphone, morphine or oxycodone...
July 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#16
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28699421/global-cancer-pain-management-a-systematic-review-comparing-trials-in-africa-europe-and-north-america
#17
Charles A Odonkor, Gabriel Kim, Michael Erdek
AIM: Despite the rise in cancer survivorship, few reviews have examined the quality of studies of cancer pain management and practices around the globe. With a void in trials spanning multiple geographical settings, this review evaluates the quality of cancer trials across three continents. MATERIALS & METHODS: A literature review and search of established databases was conducted to identify eligible studies. The Cochrane method, the Jadad Score and a cancer pain-specific ad hoc tool were used to evaluate quality of studies...
July 12, 2017: Pain Management
https://www.readbyqxmd.com/read/28664359/adverse-cardiac-events-associated-with-incident-opioid-drug-use-among-older-adults-with-copd
#18
Nicholas T Vozoris, Xuesong Wang, Peter C Austin, Douglas S Lee, Anne L Stephenson, Denis E O'Donnell, Sudeep S Gill, Paula A Rochon
PURPOSE: We evaluated whether incident opioid drug use was associated with adverse cardiac events among older adults with chronic obstructive pulmonary disease (COPD). METHODS: This was an exploratory, retrospective cohort study using health administrative data from Ontario, Canada, from 2008 to 2013. Using a validated algorithm, we identified adults aged 66 years and older with non-palliative COPD. Hazard ratios (HR) were estimated for adverse cardiac events within 30 days of incident opioid receipt compared to controls using inverse probability of treatment weighting using the propensity score...
June 29, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28663419/dangerous-ideas-gps-should-stop-prescribing-opioid-medication-except-for-palliative-care
#19
Sarah Alderson
No abstract text is available yet for this article.
July 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/28661900/palliative-care-and-interstitial-lung-disease
#20
Sabrina Bajwah, Janelle Yorke
PURPOSE OF REVIEW: The palliative care needs of people with interstitial lung disease (ILD) have recently been highlighted by the National Institute for Health and Care Excellence. All people with progressive ILD should receive best supportive care to improve symptom control and quality of life and where possible this should be evidence based. RECENT FINDINGS: Deaths from ILD are increasing and deaths in hospital are more common compared to home. People with ILD experience a wide range of symptoms including breathlessness and cough...
September 2017: Current Opinion in Supportive and Palliative Care
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