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Palliative care opioids

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https://www.readbyqxmd.com/read/29454083/incidence-of-acute-suppurative-sialadenitis-in-end-stage-cancer-patients-a-retrospective-observational-study
#1
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
#2
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
#3
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
#4
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
https://www.readbyqxmd.com/read/29440819/intravenous-lignocaine-infusion-for-intractable-pain-in-ewing-s-sarcoma
#5
Nivedita Page
A 23-year-old female presented to our palliative care center with Ewing's sarcoma of the humerus with lung metastases. Pain in her arm was unrelieved by nonsteroidal anti-inflammatory drugs, neuropathic medication as well as morphine. She could not tolerate any further increase in opioid dose but was so distraught due to the pain that she wanted to die. An intravenous lignocaine infusion in a dose of 2 mg/kg was given over an hour for three successive days. This successfully relieved her pain after which she was settled with her original medication...
January 2018: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/29436434/updates-in-palliative-care-overview-and-recent-advancements-in-the-pharmacological-management-of-cancer-pain
#6
Helen Wood, Andrew Dickman, Angela Star, Jason W Boland
Pain is a common symptom in many types of cancer. Interdisciplinary team management, including pain assessment, explanation to the patient/family, treating the reversible, non-pharmacological treatments and reassessment are essential. This article focuses on the pharmacological management of cancer pain, and overviews and updates on the recent advances in this field. Both non-opioid and opioid analgesia as well as coanalgesics (adjuvants) are reviewed. Within non-opioid analgesia the risks of non-steroidal anti-inflammatory drugs (NSAIDs) are considered and recommendations for NSAIDs in patients at risk of gastrointestinal and cardiovascular toxicity are made...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29436433/updates-in-palliative-care-recent-advancements-in-the-pharmacological-management-of-symptoms
#7
Angela Star, Jason W Boland
Symptom management is an important part of both palliative care and end-of-life care. This article will examine the recent research evidence about drugs commonly used for symptom management in adult patients receiving palliative care. In particular, the management of symptoms where recent palliative care-based evidence has changed recommended practice will be reviewed. This includes: breathlessness, delirium, nausea and vomiting in bowel obstruction, opioid-induced constipation and upper respiratory tract secretions...
February 2018: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/29410087/characteristics-of-unscheduled-and-scheduled-outpatient-palliative-care-clinic-patients-at-a-comprehensive-cancer-center
#8
Ahsan Azhar, Angelique N Wong, Agustina A Cerana, Vishidha R Balankari, Madhuri Adabala, Diane D Liu, Janet L Williams, Eduardo Bruera
CONTEXT: There is limited literature regarding outpatient palliative care and factors associated with unscheduled clinic visits. OBJECTIVE: To compare characteristics of patients with unscheduled vs scheduled outpatient palliative care clinic visits. METHODS: Medical records of 183 unscheduled cancer new out-patients and 104 unscheduled follow-up (FU) patients were compared with random samples of 361 and 314 scheduled new patients and FU patients, respectively...
January 31, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29409684/ongoing-strategies-and-updates-on-pain-management-in-gynecologic-oncology-patients
#9
REVIEW
Kari E Hacker, R Kevin Reynolds, Shitanshu Uppal
The opioid crisis in the United States has been declared a public health emergency. Various governmental agencies, cancer care organizations and the Centers for Disease Control and Prevention have issued guidelines in hopes of managing this crisis. Curbing over-prescription of opioids by medical professionals has been a central theme in many of these guidelines. Gynecologic oncologists encounter patients with a variety of pain sources, including acute pain secondary to the underlying malignancy or surgical procedures as well as chronic pain related to the malignancy and the sequelae of treatments rendered...
February 3, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29386222/is-palliative-care-support-associated-with-better-quality-end-of-life-care-indicators-for-patients-with-advanced-cancer-a-retrospective-cohort-study
#10
Lucy E Ziegler, Cheryl L Craigs, Robert M West, Paul Carder, Adam Hurlow, Pablo Millares-Martin, Geoff Hall, Michael I Bennett
OBJECTIVES: This study aimed to establish the association between timing and provision of palliative care (PC) and quality of end-of-life care indicators in a population of patients dying of cancer. SETTING: This study uses linked cancer patient data from the National Cancer Registry, the electronic medical record system used in primary care (SystmOne) and the electronic medical record system used within a specialist regional cancer centre. The population resided in a single city in Northern England...
January 31, 2018: BMJ Open
https://www.readbyqxmd.com/read/29336714/urinary-retention-and-medication-utilization-on-a-palliative-care-unit-a-retrospective-observational-study
#11
T Graham Bergstra, Iris Gutmanis, Janette Byrne, Cathy Faulds, Patricia Whitfield, Sarah McCallum, Joshua Shadd
Urinary retention is a common problem at end-of-life that may be a result of medications used to control other symptoms. To determine whether use of retention-causing drugs was associated with catheterization for urinary retention among palliative care unit (PCU) patients, the authors reviewed charts of 91 consecutively admitted patients to a hospital-based PCU. Utilization of eight classes of retention-causing medications (opioids, antidopaminergics, benzodiazepines, anticholinergics, antidepressants, calcium channel antagonists, nonsteroidal anti-inflammatory drugs [NSAIDs], and H1 histamine antagonists) was compared between those catheterized for urinary retention (n = 34) and those never catheterized (n = 31)...
January 16, 2018: Journal of Pain & Palliative Care Pharmacotherapy
https://www.readbyqxmd.com/read/29333821/opioid-treatment-for-mixed-pain-in-pediatric-patients-assisted-by-the-palliative-care-team-five-years-of-experience
#12
María L Yazde Puleio, Karina V Gómez, Ana Majdalani, Vilma Pigliapoco, Gisella Santos Chocler
Pain is defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Depending on its pathophysiological mechanism, it may be classified into nociceptive, neuropathic, and mixed pain. If pain is moderate to severe, a strong opioid should be administered and, when this is the case, morphine is the drug of choice. If morphine is ineffective or causes intolerable adverse effects, opioid rotation is recommended. Our objective was to describe the drug management for mixed pain used in patients assisted by the Palliative Care team of Hospital General de Niños Pedro de Elizalde between August 2011 and September 2015...
February 1, 2018: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/29317008/patients-with-advanced-cancer-and-depression-report-a-significantly-higher-symptom-burden-than-non-depressed-patients
#13
Kjersti Støen Grotmol, Hanne C Lie, Jon Håvard Loge, Nina Aass, Dagny Faksvåg Haugen, Patrick C Stone, Stein Kaasa, Marianne Jensen Hjermstad
OBJECTIVE: Clinical observations indicate that patients with advanced cancer and depression report higher symptom burden than nondepressed patients. This is rarely examined empirically. Study aim was to investigate the association between self-reported depression disorder (DD) and symptoms in patients with advanced cancer controlled for prognostic factors. METHOD: The sample included 935 patients, mean age 62, 52% males, from an international multicentre observational study (European Palliative Care Research Collaborative - Computerised Symptom Assessment and Classification of Pain, Depression and Physical Function)...
January 10, 2018: Palliative & Supportive Care
https://www.readbyqxmd.com/read/29316883/active-ingredients-of-a-person-centred-intervention-for-people-on-hiv-treatment-analysis-of-mixed-methods-trial-data
#14
Keira Lowther, Richard Harding, Victoria Simms, Aabid Ahmed, Zipporah Ali, Nancy Gikaara, Lorraine Sherr, Hellen Kariuki, Irene J Higginson, Lucy Ellen Selman
BACKGROUND: A new model of care is required to meet the changing needs of people living with HIV (PLWH), particularly in low and middle-income countries, where prevalence is highest. We evaluated a palliative care intervention for PLWH in Mombasa, Kenya. Although we found no effect on pain (primary outcome), there was a positive effect on mental health (secondary outcome) in the intervention group. To inform replication and implementation, we have determined the active ingredients of the intervention and their mechanisms of action...
January 10, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29313129/characteristics-and-care-pathways-of-advanced-cancer-patients-in-a-palliative-supportive-care-unit-and-an-oncological-ward
#15
Sebastiano Mercadante, Paolo Marchetti, Claudio Adile, Amanda Caruselli, Patrizia Ferrera, Andrea Costanzi, Alessandra Casuccio
BACKGROUND: A supportive palliative care unit (SPCU) may have a positive impact on patients' care. The aim of this study was to compare the pattern of patients admitted to a specialized SPCU and to a traditional oncologic ward (OW) in a consecutive sample of advanced cancer patients. METHODS: Data on patients demographics, reasons for and kind of admission, care-giver, anticancer treatments, being on/off treatment or uncertain, origin setting, who proposed hospital admission, the use of opioids, and hospitalization were gathered...
January 8, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29282114/risk-factors-for-addiction-among-patients-receiving-prescribed-opioids-a-systematic-review-protocol
#16
Amber Cragg, Jeffrey P Hau, Stephanie A Woo, Christine Liu, Mary M Doyle-Waters, Corinne M Hohl
BACKGROUND: Opioid addiction prevention has become an urgent public health priority, with several countries declaring a state of emergency due to rising death tolls from opioid abuse. Reducing the risk of developing addiction among opioid-naïve patients exposed to prescribed opioids during the process of medical care may be an important primary prevention strategy. Our objective is to synthesize the available evidence about factors associated with the development of addiction among patients first exposed to prescribed opioids, with a focus on opioid-naïve patients...
December 28, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29275945/the-supply-of-prescription-opioids-contributions-of-episodic-care-prescribers-and-high-quantity%C3%A2-prescribers
#17
Todd Schneberk, Brian Raffetto, David Kim, David L Schriger
STUDY OBJECTIVE: We determine episodic and high-quantity prescribers' contribution to opioid prescriptions and total morphine milligram equivalents in California, especially among individuals prescribed large amounts of opioids. METHODS: This was a cross-sectional descriptive analysis of opioid prescribing patterns during an 8-year period using the de-identified Controlled Substance Utilization Review and Evaluation System (CURES) database, the California subsection of the prescription drug monitoring program...
December 21, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29261818/update-in-hospital-palliative-care-symptom-management-communication-caregiver-outcomes-and-moral-distress
#18
Rachel D Havyer, Daniel H Pomerantz, Robert L Jayes, Patricia F Harris, Stephanie M Harman, Aziz A Ansari
BACKGROUND: Updated knowledge of the palliative care (PC) literature is needed to maintain competency and best address the PC needs of hospitalized patients. We critiqued the recent PC literature with the highest potential to impact hospital practice. METHODS: We reviewed articles published between January 2016 and December 2016, which were identified through a handsearch of leading journals and a MEDLINE search. The final 9 articles selected were determined by consensus based on scientific rigor, relevance to hospital medicine, and impact on practice...
December 20, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29244992/oral-morphine-use-in-south-india-a-population-based-study
#19
M R Rajagopal, Safiya Karim, Christopher M Booth
Purpose Access to opioids for pain control is recognized as an urgent issue in low- and middle-income countries. Here we report temporal and regional trends in morphine use in Kerala, India. Methods Oral morphine use data for the State of Kerala (2012 to 2015) was used to describe temporal trends, regional variation, and provider characteristics. Total morphine use was calculated for each district of Kerala to derive an annual per capita use rate (milligrams per capita). Each provider was classified as government, private, nongovernment organization (NGO), or NGO partnership...
December 2017: Journal of Global Oncology
https://www.readbyqxmd.com/read/29243546/changes-in-medication-use-in-a-cohort-of-patients-with-advanced-cancer-the-international-multicentre-prospective-european-palliative-care-cancer-symptom-study
#20
Kristel Paque, Monique Elseviers, Robert Vander Stichele, Koen Pardon, Marianne J Hjermstad, Stein Kaasa, Tinne Dilles, Martine De Laat, Simon Van Belle, Thierry Christiaens, Luc Deliens
BACKGROUND: Information on medication use in the last months of life is limited. AIM: To describe which medications are prescribed and deprescribed in advanced cancer patients receiving palliative care in relation to time before death and to explore associations with demographic variables. DESIGN: Prospective study, using case report forms for monthly data collection. Medication included cancer treatment and 19 therapeutic groups, grouped into four categories for: (1) cancer therapy, (2) specific cancer-related symptom relief, (3) other symptom relief and (4) long-term prevention...
December 1, 2017: Palliative Medicine
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