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Palliative care opioids

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https://www.readbyqxmd.com/read/28097432/attitudes-of-palliative-home-care-physicians-towards-palliative-sedation-at-home-in-italy
#1
Sebastiano Mercadante, Francesco Masedu, Alessandro Mercadante, Franco Marinangeli, Federica Aielli
BACKGROUND: Information about the attitudes towards palliative sedation (PS) at home is limited. AIM: The aim of this survey was to assess the attitudes of palliative care physicians in Italy regarding PS at home. DESIGN: A questionnaire was submitted to a sample of palliative care physicians, asking information about their activity and attitudes towards PS at home. SETTING: This is a survey of home care physicians in Italy who were involved in end-of-life care decisions at home...
January 17, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28063863/correlation-between-observational-scales-of-sedation-and-comfort-and-bispectral-index-scores-bis
#2
Michael Barbato, Greg Barclay, Jan Potter, Wilf Yeo, Joseph Chung
CONTEXT: When palliative care patients enter the phase of unconsciousness preceding death it is standard practice to initiate or continue a subcutaneous infusion of an opioid plus or minus a sedative. The doses are determined somewhat empirically and adjustments are based on clinical assessment and observational measures of sedation and comfort. Following reports that these observational measures could be misleading, this study assesses their validity by comparing them with an objective measure of sedation, the Bispectral Index score (BIS)...
January 4, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28039504/end-of-life-care-for-head-and-neck-cancer-patients-a-population-based-study
#3
Tzu-Lung Kuo, Ching-Heng Lin, Rong-San Jiang, Ting-Ting Yen, Chen-Chi Wang, Kai-Li Liang
PURPOSE: Head and neck cancers (HNCs) usually present a poor prognosis and cause high morbidity rates. Recent surveys have demonstrated that HNC incidence rates are still on the increase in many countries. Our study objective was to assess the end-of-life care for patients with HNCs in Taiwan. METHODS: Data was retrieved from Taiwan's National Health Insurance Research Database, where we identified patients who had been diagnosed with HNCs from January 1997 to December 2010...
December 30, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28028266/-case-study-a-successful-cooperation-of-clinic-pharmacist-and-pharmacies-in-home-palliative-care-with-pca-pump
#4
Michiyo Kawana, Haruko Yuge, Hirokazu Sakurai, Minoru Hatsuta, Yuko Osuga, Masayoshi Hirohara, Kazuki Kushida
To make a good end at home and provide good palliative care for patients with cancer are urgent issues in Setagaya ward, as shown by certain statistics. Medical opioids are greatly needed for palliative care; as patient controlled analgesia(PCA) develops, it can lead to decisions by patients and their families to receive end-of-life care at home because the patient can choose to receive the same advanced palliative care received at the hospital. With in-home palliative care, given the rapid change in the medical condition of the patient and the sentiment of the family, the role of pharmacists is to quickly and reliably supply the pharmaceuticals and medical equipment that doctors need...
December 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28026706/patterns-and-trends-in-long-term-opioid-use-for-non-cancer-pain-in-british-columbia-2005-2012
#5
Kate Smolina, Emilie J Gladstone, Kimberly Rutherford, Steven G Morgan
OBJECTIVES: We aimed to calculate trends in incidence and prevalence rates of long-term opioid use for non-cancer pain, as well as to describe the characteristics of long-term opioid users and their patterns of opioid use. METHODS: We used population-based linked health care and socio-demographic administrative data for British Columbia (BC) between 2005 and 2012. We included individuals who had at least one episode of long-term opioid use during the study period and who were not cancer or palliative care patients...
December 27, 2016: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/28003771/heart-rate-variability-during-treatment-of-breakthrough-pain-in-patients-with-advanced-cancer-a-pilot-study
#6
Eva Katharina Masel, Patrick Huber, Tobias Engler, Herbert Hans Watzke
BACKGROUND: Decisions on the intensity of analgesic therapy and judgments regarding its efficacy are difficult at the end of life, when many patients are not fully conscious and pain is a very common symptom. In healthy individuals and in postoperative settings, nociception and subsequent pain relief have been shown to induce changes in the autonomic nervous system (ANS), which can be detected by measuring heart rate variability (HRV). OBJECTIVES: The changes in the ANS were studied by measuring HRV during opioid therapy for cancer breakthrough pain (CBTP) in palliative-care patients with cancer and compared these changes with patient-reported pain levels on a numeric rating scale (NRS)...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27980029/risk-stratification-for-opioid-misuse-in-children-adolescents-and-young-adults-a-quality-improvement-project
#7
Rachel Thienprayoon, Kelly Porter, Michelle Tate, Marshall Ashby, Mark Meyer
BACKGROUND: The Pediatric Palliative and Comfort Care Team (PACT) at Cincinnati Children's Hospital Medical Center (CCHMC) provides opioids to a large population of patients in the ambulatory setting. Before this project, PACT had no reliable system to risk stratify patients for opioid misuse. METHODS: The global aim was safe opioid prescribing by the palliative care team. The specific, measurable, achievable, realistic, and timely aim was as follows: "In patients who present for follow up with PACT, we will use the "opioid bundle" to increase risk stratification for opioid misuse from 0% to 90% over 5 months...
January 2017: Pediatrics
https://www.readbyqxmd.com/read/27907936/early-treatment-for-neonatal-abstinence-syndrome-a-palliative-approach
#8
Jennifer Hudson, Rachel Mayo, Lori Dickes, Liwei Chen, Windsor Westbrook Sherrill, Julie Summey, Bradley Dalton, Kindal Dankovich
Objective To describe medical, safety, and health care utilization outcomes associated with an early treatment model for neonatal opioid withdrawal. Study Design This is a retrospective review of 117 opioid-exposed infants born in a large regional hospital and treated in the level I nursery with methadone initiated within 48 hours of birth. Results For this cohort, mean length of stay was 8.3 days. Hospital safety events were infrequent; there were no medication errors or deaths. Within 30 days of discharge, 14% of infants visited the emergency department; 7% were readmitted...
December 1, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27898287/international-association-for-hospice-and-palliative-care-position-statement-euthanasia-and-physician-assisted-suicide
#9
Liliana De Lima, Roger Woodruff, Katherine Pettus, Julia Downing, Rosa Buitrago, Esther Munyoro, Chitra Venkateswaran, Sushma Bhatnagar, Lukas Radbruch
BACKGROUND: Reports about regulations and laws on Euthanasia and Physician Assisted Suicide (PAS) are becoming increasingly common in the media. Many groups have expressed opposition to euthanasia and PAS while those in favor argue that severely chronically ill and debilitated patients have a right to control the timing and manner of their death. Others argue that both PAS and euthanasia are ethically legitimate in rare and exceptional cases. Given that these discussions as well as the new and proposed laws and regulations may have a powerful impact on patients, caregivers, and health care providers, the International Association for Hospice and Palliative Care (IAHPC) has prepared this statement...
January 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27898139/farmakologisk-sm%C3%A3-rtlindring-har-central-roll-i-palliativ-v%C3%A3-rd-sm%C3%A3-rtfrihet-i-vila-och-acceptabel-natts%C3%A3-mn-%C3%A3-r-m%C3%A3-let-f%C3%A3-r-behandlingen-%C3%A2-som-b%C3%A3-r-individualiseras
#10
Staffan Lundström
Mechanism-based pain treatment in palliative care Pain is common among patients in palliative care and one of the most feared symptoms. Knowledge about effective pain management is therefore essential for clinicians. Successful pain management is mainly based on the medical history and clinical examination, resulting in an understanding of the present pain mechanism(s). The pain mechanism then forms the basis for the pharmacological treatment strategy which should be individualized and take into account factors such as kidney function, expected side effects, route of administration and concomitant medication...
November 22, 2016: Läkartidningen
https://www.readbyqxmd.com/read/27878605/-special-medical-problems-in-end-of-life-care-crisis-at-the-end-of-life-which-therapy-is-adequate-and-when-is-redefining-treatment-goals-appropriate
#11
Gesine Benze, Bernd Alt-Epping, Friedemann Nauck
Crisis at the end of life are exceptional challenges for patients, relatives and therapists. With respect to the individual treatment goals and the patients' autonomy, therapeutic action should be commenced in an adequate manner in order to preserve the patients' quality of life as much as possible. Advance care planning for specific critical scenarios may be helpful in order to treat patients according to their wishes and values even if they are not capable to express themselves. Furthermore, a crisis plan can define the scope of action for therapists in emergency situations...
January 2017: Bundesgesundheitsblatt, Gesundheitsforschung, Gesundheitsschutz
https://www.readbyqxmd.com/read/27871265/the-association-between-different-opioid-doses-and-the-survival-of-advanced-cancer-patients-receiving-palliative-care
#12
Anon Sathornviriyapong, Kittiphon Nagaviroj, Thunyarat Anothaisintawee
BACKGROUND: Concerns that opioids may hasten death can be a cause of the physicians' reluctance to prescribe opioids, leading to inadequate symptom palliation. Our aim was to find if there was an association between different opioid doses and the survival of the cancer patients that participated in our palliative care program. METHODS: A retrospective study was conducted at Ramathibodi Hospital, Bangkok between January 2013 and December 2015. All of the cancer patients that were referred to palliative care teams by their primary physicians were included in the study...
November 21, 2016: BMC Palliative Care
https://www.readbyqxmd.com/read/27857517/evaluation-of-the-optimal-positioning-of-subcutaneous-butterfly-when-administering-injectable-opioids-in-cancer-patients
#13
Nicoleta Mitrea, Daniela Mosoiu, Julie Vosit-Steller, Liliana Rogozea
BACKGROUND AND AIMS: The increasing number of cancer patients, together with the development of new palliative care services in Romania, warrants the evaluation of nursing strategies meant to improve the level of comfort of patients who are suffering from advanced cancer. The main objective of the study was to evaluate the optimal positioning of the subcutaneous (sc) butterfly, in accordance with its resistance in the insertion tissue, the local complications that may occur, and the evaluation of the time of resistance at the insertion site (puncture) with the daily frequency of injectable opioid administration...
2016: Clujul Medical (1957)
https://www.readbyqxmd.com/read/27849111/pharmacological-interventions-for-pruritus-in-adult-palliative-care-patients
#14
REVIEW
Waldemar Siemens, Carola Xander, Joerg J Meerpohl, Sabine Buroh, Gerd Antes, Guido Schwarzer, Gerhild Becker
BACKGROUND: This is an update of the original Cochrane review published in 2013 (Issue 6). Pruritus occurs in patients with disparate underlying diseases and is caused by different pathologic mechanisms. In palliative care patients, pruritus is not the most prevalent but is one of the most puzzling symptoms. It can cause considerable discomfort and affects patients' quality of life. OBJECTIVES: To assess the effects of different pharmacological treatments for preventing or treating pruritus in adult palliative care patients...
16, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27826454/pregabalin-prescription-for-terminally-ill-cancer-patients-receiving-specialist-palliative-care-in-an-acute-hospital
#15
Ryo Yajima, Kazuaki Matsumoto, Yuya Ise, Norihito Suzuki, Yuta Yokoyama, Junko Kizu, Shiro Katayama
BACKGROUND: Pregabalin is recommended as an adjuvant analgesic for neuropathic cancer-related pain, and may be taken at all steps of the World Health Organization analgesic ladder. However, unlike opioids, pregabalin treatments are limited to an oral administration route. If patients have oral feeding difficulties, it is not possible to administer any drug as an adjuvant analgesic for neuropathic cancer-related pain. Therefore, the aim of the present study was to clarify the problems of pain control after pregabalin discontinuation in terminally ill cancer patients...
2016: Journal of Pharmaceutical Health Care and Sciences
https://www.readbyqxmd.com/read/27803557/cancer-pain-management-in-developing-countries
#16
REVIEW
Shalini Saini, Sushma Bhatnagar
The World Health Organization estimated that more than 60% of the 14 million new cancer cases worldwide in 2012 were reported in the developing part of the world, including Asia, Africa, Central and South America. Cancer survival rate is poorer in developing countries due to diagnosis at late stage and limited access to timely treatment. Since the disease per se cannot be treated even with the best available treatment modalities, what remains important is symptom management and providing comfort care to these patients...
October 2016: Indian Journal of Palliative Care
https://www.readbyqxmd.com/read/27786538/new-opioid-prescribing-guidelines-released-in-the-us-what-impact-will-they-have-in-the-care-of-older-patients-with-persistent-pain
#17
Fabio Guerriero, M Carrington Reid
No abstract text is available yet for this article.
February 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27764523/benzodiazepines-for-the-relief-of-breathlessness-in-advanced-malignant-and-non-malignant-diseases-in-adults
#18
REVIEW
Steffen T Simon, Irene J Higginson, Sara Booth, Richard Harding, Vera Weingärtner, Claudia Bausewein
BACKGROUND: This is an updated version of the original Cochrane review published in Issue 1, 2010, on 'Benzodiazepines for the relief of breathlessness in advanced malignant and non-malignant diseases in adults'. Breathlessness is one of the most common symptoms experienced in the advanced stages of malignant and non-malignant disease. Benzodiazepines are widely used for the relief of breathlessness in advanced diseases and are regularly recommended in the literature. At the time of the previously published Cochrane review, there was no evidence for a beneficial effect of benzodiazepines for the relief of breathlessness in people with advanced cancer and chronic obstructive pulmonary disease (COPD)...
October 20, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27754744/identifying-factors-that-predict-worse-constipation-symptoms-in-palliative-care-patients-a-secondary-analysis
#19
Katherine Clark, Lawrence T Lam, Nicholas J Talley, Jane L Phillips, David C Currow
OBJECTIVE: The aim of this work was to investigate whether variables identified as likely to impact the experience of constipation in other clinical settings similarly affected the experiences of constipated palliative care patients. BACKGROUND: The majority of palliative care patients with cancer are likely to be bothered by constipation symptoms at some point in their disease trajectory. Despite this, it remains unclear as to which factors predict more severe problems...
October 18, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27742907/the-impact-of-an-educational-program-on-patient-practices-for-safe-use-storage-and-disposal-of-opioids-at-a-comprehensive-cancer-center
#20
Maxine de la Cruz, Akhila Reddy, Vishidha Balankari, Margeaux Epner, Susan Frisbee-Hume, Jimin Wu, Diane Liu, Sriram Yennurajalingam, Hilda Cantu, Janet Williams, Eduardo Bruera
BACKGROUND: Improper use, storage, and disposal of prescribed opioids can lead to diversion or accidental poisoning. Our previous study showed a large proportion of cancer patients have unsafe opioid practices. Our objective was to determine whether an improvement occurred in the patterns of use, storage, and disposal of opioids among cancer outpatients after the implementation of a patient educational program. PATIENTS AND METHODS: Our palliative care (PC) clinic provides every patient with educational material (EM) on safe opioid use, storage, and disposal every time they receive an opioid prescription...
October 14, 2016: Oncologist
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