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Palliative care opioids

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https://www.readbyqxmd.com/read/29649402/end-of-life-treatments-in-pediatric-patients-at-a-government-tertiary-cancer-center-in-india
#1
Jean Jacob, Jaskirt K Matharu, Gayatri Palat, Sudha Sinha, Eva Brun, Thomas Wiebe, Mikael Segerlantz
AIM: The primary objective of this study was to describe demographics and end-of-life treatments of children with cancer at a government tertiary cancer center in India. METHODS: A retrospective review was undertaken of medical charts of all children younger than 18 years, who died as inpatients while undergoing treatment at the pediatric oncology department between April and September 2016. Data were collected on demographics, diagnosis, treatments, survival, palliative care involvement, and symptoms at end of life...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29622698/value-of-supportive-care-pharmacogenomics-in-oncology-practice
#2
REVIEW
Jai N Patel, Lauren A Wiebe, Henry M Dunnenberger, Howard L McLeod
Genomic medicine provides opportunities to personalize cancer therapy for an individual patient. Although novel targeted therapies prolong survival, most patients with cancer continue to suffer from burdensome symptoms including pain, depression, neuropathy, nausea and vomiting, and infections, which significantly impair quality of life. Suboptimal management of these symptoms can negatively affect response to cancer treatment and overall prognosis. The effect of genetic variation on drug response-otherwise known as pharmacogenomics-is well documented and directly influences an individual patient's response to antiemetics, opioids, neuromodulators, antidepressants, antifungals, and more...
April 5, 2018: Oncologist
https://www.readbyqxmd.com/read/29619568/global-supply-and-demand-of-opioids-for-pain-management
#3
REVIEW
Sreekumar Kunnumpurath, Natasha Julien, Gopal Kodumudi, Anamika Kunnumpurath, Vijay Kodumudi, Nalini Vadivelu
PURPOSE OF REVIEW: The goal of this review is to evaluate the global supply and demand of opioids used for pain management and discuss how it relates to the utilization of opioids around the world. The purpose of the review is also to determine the factors that contribute to inappropriate pain management. RECENT FINDINGS: The total global production of opium for opioid manufacturing is enough to supply the growing global demands. However, licit opioids are only consumed by 20% of the world population...
April 4, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29609700/use-of-topical-morphine-to-relieve-painful-pressure-ulcers
#4
Sandra L Discala, Danny Basri, Christine M Vartan, Michael A Silverman
INTRODUCTION: Topical morphine is a potential treatment option for painful pressure ulcers in hospice and palliative care patients who favor avoidance of systemic opioid therapy. CASE: A 65-year-old male African-American veteran with a painful stage 3 sacral pressure injury was hesitant to take systemic opioids to control his pain, as he wished to stay alert for family and friends. Topical morphine was initiated, and within 24 hours the patient reported a significant reduction in pain on the numeric rating scale...
April 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29599349/patient-reported-symptom-burden-rate-of-completion-of-palliative-radiotherapy-and-30-day-mortality-in-two-groups-of-cancer-patients-managed-with-or-without-additional-care-by-a-multidisciplinary-palliative-care-team
#5
Carsten Nieder, Astrid Dalhaug, Ellinor Haukland, Kirsten Engljähringer
BACKGROUND/AIM: The aim of this study was to analyze differences in symptom burden, baseline and outcome parameters, including completion of palliative radiotherapy and 30-day mortality, between patients treated with palliative radiotherapy (RT) who were managed exclusively by regular oncology staff or a multidisciplinary palliative care team (MPCT) in addition. PATIENTS AND METHODS: This was a retrospective single-institution analysis. Comparison of two groups of patients: MPCT versus none (n=36 and 65, respectively)...
April 2018: Anticancer Research
https://www.readbyqxmd.com/read/29558226/management-of-copd-in-end-of-life-care-by-spanish-pulmonologists
#6
Patricia Sobradillo Ecenarro, Marta Inchausti Iguiñiz, Sandra Pedrero Tejada, Nuria Marina Malanda, María Alfonso Imizcoz, Laura Ansola Marlasca, Bernardino Alcázar Navarrete
Chronic obstructive pulmonary disease is progressive and in its advanced stage is associated with major disability. Previous studies suggest that patients with this disease receive little palliative care, even in very advanced stages. Given this, our objectives were to describe the clinical practice of Spanish pulmonologists in the care of patients with end-stage chronic obstructive pulmonary disease, to identify potential barriers to implementing palliative care in these patients and to correlate these responses with doctor's years of experience...
March 20, 2018: COPD
https://www.readbyqxmd.com/read/29535905/frequency-and-prognostic-impact-of-consistently-low-edmonton-symptom-assessment-system-score-in-the-patients-treated-with-palliative-radiotherapy
#7
Carsten Nieder, Thomas A Kämpe
Introduction Our department's standard work-flow includes assessment of all the patients with the Edmonton Symptom Assessment System (ESAS), a one-sheet questionnaire addressing 11 major symptoms and wellbeing on a numeric scale of zero-10, before the palliative radiotherapy (PRT). Based on previous research, we hypothesized that the patients with minimal or moderate total symptom burden might have better overall survival after the PRT than those with at least one higher symptom score. Methods We performed a retrospective analysis of 94 patients and calculated actuarial survival from the first day of the PRT (Kaplan-Meier method)...
January 6, 2018: Curēus
https://www.readbyqxmd.com/read/29497252/challenges-of-using-methadone-in-the-indian-pain-and-palliative-care-practice
#8
REVIEW
Vidya Viswanath, Gayatri Palat, Srini Chary, Ann Broderick
Palliative care providers across India lobbied to gain access to methadone for pain relief and this has finally been achieved. Palliative care activists will count on the numerous strengths for introducing methadone in India, including the various national and state government initiatives that have been introduced recognizing the importance of palliative care as a specialty in addition to improving opioid accessibility and training. Adding to the support are the Non-Governmental Organizations (NGOs), the medical fraternity and the international interactive and innovative programs such as the Project Extension for Community Health Outcome...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29497246/methadone-is-now-available-in-india-is-the-long-battle-over
#9
EDITORIAL
M R Rajagopal
Context: Morphine and fentanyl had so far been the only available opioids in India in step three of the World Health Organization analgesic ladder. Especially for those not tolerating morphine and particularly for those developing neurotoxicity, an inexpensive alternative was essential. Many years of advocacy by palliative care activists have resulted in methadone being now available for sale in India for pain management. However, the characteristic pharmacokinetics and pharmacodynamics of methadone raise potential issues of safety...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29493809/use-of-attention-deficit-hyperactivity-disorder-medication-among-older-adults-in-denmark
#10
Stina Schultz Ormhøj, Anton Pottegård, Christiane Gasse, Lotte Rasmussen
AIM: Knowledge on the use of attention-deficit/hyperactivity disorder (ADHD) medication among older adults is limited. We hypothesized that ADHD medication is used off-label in adults ≥50 years as part of palliative care in e.g. cancer patients. The aim of this study was to describe the use of ADHD medication among adults ≥50 years in Denmark. METHODS: Using the Danish health registries, we identified new users ≥50 years of ADHD medication during 2000-2012...
March 1, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29484867/-neurosurgical-interventions-for-intractable-oncological-pain
#11
REVIEW
Assaf Berger, Rotem Tellem, Michal Arad, Uri Hochberg, Tal Gonen, Ido Strauss
Pain is one of the most common symptoms among cancer patients, and particularly in those who suffer from metastatic or terminal disease. There is great importance in delivering good pain management to these patients in order to alleviate their suffering, improve their functional status and their overall quality of life. In most cases, pain management is based on pharmacotherapy with opioids and other medications. However, there are selected patients for whom pharmacotherapy does not achieve acceptable pain relief or is associated with marked side effects...
February 2018: Harefuah
https://www.readbyqxmd.com/read/29479766/how-do-patients-with-cancer-pain-view-community-pharmacy-services-an-interview-study
#12
Zoe Edwards, Alison Blenkinsopp, Lucy Ziegler, Michael I Bennett
Pain experienced by many patients with advanced cancer is often not well controlled and community pharmacists are potentially well placed to provide support. The study objective was to explore the views and experiences of patients with advanced cancer about community pharmacies, their services and attitudes towards having a community pharmacist pain medicines consultation. Purposive sampling of GP clinical information systems was used to recruit patients with advanced cancer, living in the community and receiving opioid analgesics in one area of England, UK between January 2015 and July 2016...
February 26, 2018: Health & Social Care in the Community
https://www.readbyqxmd.com/read/29473770/exploring-factors-contributing-to-medication-errors-with-opioids-in-australian-specialist-palliative-care-inpatient-services-a-multi-incident-analysis
#13
Nicole Heneka, Tim Shaw, Debra Rowett, Samuel Lapkin, Jane L Phillips
BACKGROUND: Opioid errors have the potential to cause significant patient harm. These high-risk medications are used in high volumes in palliative care services to manage pain and other symptoms. Palliative patients are at greater risk of harm from opioid errors, as they are generally older and taking numerous medications to manage multiple comorbidities. Understanding factors contributing to opioid errors in inpatient palliative care services is a largely underexplored, yet, essential aspect of patient safety...
February 23, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29466977/the-rotterdam-elderly-pain-observation-scale-repos-is-reliable-and-valid-for-non-communicative-end-of-life-patients
#14
Anniek D Masman, Monique van Dijk, Joost van Rosmalen, Frans P M Baar, Dick Tibboel, Anneke A Boerlage
BACKGROUND: In palliative care, administration of opioids is often indispensable for pain treatment. Pain assessment may help recognize pain and guide treatment in non-communicative patients. In the Netherlands the Rotterdam Elderly Pain Observation Scale (REPOS) is recommended to this aim, but not yet validated. Therefore the objective of this study was to validate the REPOS in non-communicative or unconscious end-of-life patients. METHODS: In this observational study, the primary researcher applied the REPOS, while both the researcher and a nurse applied the Numeric Rating Scale (NRS)...
February 21, 2018: BMC Palliative Care
https://www.readbyqxmd.com/read/29465470/opioid-addiction-diversion-and-abuse-in-chronic-and-cancer-pain
#15
Vijay Kata, Matthew B Novitch, Mark R Jones, Best O Anyama, Erik M Helander, Alan D Kaye
PURPOSE OF REVIEW: The primary cause of overdose death in the United States is related to pharmaceutical opioids. A few particular populations that struggle with adverse outcomes related to opioid abuse are those in palliative care, those with chronic pain, and those receiving pain treatments secondary to cancer or chemotherapy. RECENT FINDINGS: There have been massive efforts to decrease the use of opioid abuse in patient care in a gestalt manner, but palliative care provides unique challenges in applying these reduction tactics used by other specialties...
February 19, 2018: Current Opinion in Supportive and Palliative Care
https://www.readbyqxmd.com/read/29460263/methadone-as-anticancer-treatment-hype-hope-or-hazard-a-series-of-case-reports-and-a-short-review-of-the-current-literature-and-recommendations-of-the-societies
#16
Gudrun Kreye, Eva-Katharina Masel, Klaus Hackner, Beate Stich, Friedemann Nauck
Recently, the use of methadone in cancer patients has increased due to in vitro studies indicating that methadone is capable of inducing cell death. However, thus far there are no relevant clinical studies indicating that the use of methadone can prolong survival in cancer patients. Based on low-quality evidence, methadone is a drug that has similar analgesic benefits to morphine and has a role in the management of cancer pain in adults. Other opioids such as morphine, hydromorphone, and fentanyl are easier to manage but may be more expensive than methadone in many economies...
February 19, 2018: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29454083/incidence-of-acute-suppurative-sialadenitis-in-end-stage-cancer-patients-a-retrospective-observational-study
#17
Hiroaki Watanabe, Takuya Odagiri, Yasuyuki Asai
CONTEXT: Acute suppurative sialadenitis (hereafter referred to as sialadenitis) is accompanied by pain and fever and can diminish the quality of life (QOL) in end-stage cancer patients; however, its incidence is not clear. OBJECTIVES: We conducted this study to elucidate the incidence of sialadenitis in end-stage cancer patients. METHODS: Retrospective review, observational study based on patients' medical records SUBJECTS: 726 consecutive cancer patients who died on the palliative care unit of our hospital between April 2012 and November 2016 were included...
February 14, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29452704/substance-use-disorder-among-current-cancer-patients-rates-and-correlates-nationally-in-the-department-of-veterans-affairs
#18
Pochu Ho, Robert Rosenheck
BACKGROUND: Substance use disorders (SUDs) are known to cause or complicate treatment of many types of cancers. OBJECTIVES: We sought to systematically assess rates of current SUDs among patients currently in treatment for cancer. METHODS: The National Veteran Health Administration administrative data from fiscal year 2012 were used to compare veterans with both cancer and comorbid SUDs to veterans with cancer but no SUDs and those with a SUD but no cancer...
January 10, 2018: Psychosomatics
https://www.readbyqxmd.com/read/29451835/characteristics-and-outcomes-of-advanced-cancer-patients-who-received-palliative-care-at-a-public-hospital-compared-with-those-at-a-comprehensive-cancer-center
#19
Marvin Omar Delgado-Guay, Jeannette Ferrer, Jewel Ochoa, Hilda Cantu, Janet L Williams, Minjeong Park, Eduardo Bruera
BACKGROUND: Patients with advanced cancer experience severe physical, psychosocial, and spiritual distress requiring palliative care (PC). There are limited literature regarding characteristics and outcomes of patients evaluated by PC services at public hospitals (PHs). Objective, Design, Setting/Subjects, and Measurements: To compare the outcomes of advanced cancer patients undergoing PC at a PH and those at a comprehensive cancer center (CCC). We reviewed 359 consecutive advanced cancer patients (PH, 180; CCC, 179) undergoing PC...
February 16, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29446066/resource-use-during-the-last-6-months-of-life-of-individuals-dying-with-and-of-alzheimer-s-disease
#20
Kristof Faes, Joachim Cohen, Lieven Annemans
OBJECTIVES: To compare resource use during the last 6 months of life of individuals diagnosed with Alzheimer's disease (AD) but for whom AD was not formally identified as the underlying cause of death (dying with AD) with that of those who had AD as underlying cause of death (dying of AD). DESIGN: Full-population retrospective analysis. SETTING: Belgium. PARTICIPANTS: All Belgian decedents in 2012. MEASUREMENTS: We linked participants' healthcare, population, and death certificate data...
February 15, 2018: Journal of the American Geriatrics Society
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