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Undertreated pain

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https://www.readbyqxmd.com/read/29216521/the-use-of-palliative-medications-before-death-from-prostate-cancer-swedish-population-based-study-with-a-comparative-overview-of-european-data
#1
Magdalena Lycken, Linda Drevin, Hans Garmo, Pär Stattin, Jan Adolfsson, Ingela Franck Lissbrant, Lars Holmberg, Anna Bill-Axelson
BACKGROUND: Symptoms of terminal cancer have previously been reported as undertreated. The aim of this study was to assess the use of palliative medications before death from prostate cancer. METHODS: This Swedish register study included men who died from 2009 to 2012 with prostate cancer as the underlying cause of death. We assessed the proportion who collected a prescription of androgen deprivation therapy, non-steroidal anti-inflammatory drugs, paracetamol, opioids, glucocorticoids, antidepressants, anxiolytics and sedative-hypnotics and the differences in treatment related to age, time since diagnosis, educational level, close relatives and comorbidities...
December 4, 2017: European Journal of Cancer
https://www.readbyqxmd.com/read/29189621/predictors-of-nurses-intentions-to-administer-as-needed-opioid-analgesics-for-pain-relief-to-postoperative-orthopaedic-patients-in-the-acute-care-setting
#2
Colleen Y Taylor, Jiunn-Jye Sheu, Huey-Shys Chen, Tavis Glassman, Joseph Dake
BACKGROUND: Patients undergoing orthopaedic surgery experience severe postoperative pain that is frequently undertreated. No study was found that examined the predictors of nurses' intentions to administer as needed (PRN) opioid analgesics for postoperative pain relief. PURPOSE: The purpose of this study was to determine what constructs from the Integrated Behavioral Model (IBM) can predict nurses' intentions to administer PRN opioid analgesics for pain relief to hospitalized postoperative orthopaedic patients...
November 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/29164932/development-of-the-spanish-language-houston-pain-outcome-instrument-for-spanish-speakers
#3
Jeanette McNeill, Gwen Sherwood
PURPOSE: To address reported disparities in pain management among Hispanic patients, this article reports the psychometrics of the newly developed Spanish language Houston Pain Outcome Instrument (HPOI) with postoperative Hispanic patients. METHODS: Findings from qualitative interviews conducted with 35 self-identified Hispanics in Phase 1 of the overall project were used to generate items for a new Spanish language instrument, Cuestionario de Houston Sobre el Dolor (HPOI)...
January 1, 2017: Hispanic Health Care International: the Official Journal of the National Association of Hispanic Nurses
https://www.readbyqxmd.com/read/29155288/investigation-of-the-practices-legislation-supply-chain-and-regulation-of-opioids-for-clinical-pain-management-in-southern-africa-a-multi-sectoral-cross-national-mixed-methods-study
#4
Eve Namisango, Matthew J Allsop, Richard A Powell, Stefan J Friedrichsdorf, Emmanuel Bk Luyirika, Fatia Kiyange, Edward Mukooza, Chris Ntege, Eunice Garanganga, Mavis Ntombifuthi Ginindza-Mdluli, Faith Mwangi-Powell, Lidia Justino Mondlane, Richard Harding
CONTEXT: Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. OBJECTIVES: To identify country-specific and broader regional barriers to access, as well as the administration of opioids, and generate recommendations for advancing pain management in Southern Africa...
November 15, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29153920/pain-assessment-and-management-for-older-patients-with-dementia-in-hospitals-an-integrative-literature-review
#5
REVIEW
I-Pei Tsai, Sarah Yeun-Sim Jeong, Sharyn Hunter
Previous studies have suggested that pain in older people with dementia is often underestimated and undertreated in acute hospitals. Undermanaged pain negatively affects a person's recovery and prolongs hospital stays. However, the issues related to pain assessment and management by nurses for this group have not been fully understood. (1) To synthesize evidence about pain assessment and management for older people with dementia in hospital settings, and (2) to discuss implications for nurses and their practice...
November 16, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29103867/impact-of-analgesics-on-executive-function-and-memory-in-the-alzheimer-s-disease-neuroimaging-initiative-database
#6
Lisa Doan, Daniel Choi, Richard Kline
BACKGROUND AND AIMS: Pain is common in older adults but may be undertreated in part due to concerns about medication toxicity. Analgesics may affect cognition. In this retrospective cohort study, we used the Alzheimer's Disease Neuroimaging Initiative (ADNI) database to examine the interaction of cognitive status and medications, especially non-steroidal anti-inflammatory drugs (NSAIDs). We hypothesized NSAID use would be associated with cognition and that this could be mediated through changes in brain structure...
November 2, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29077871/from-mechanism-to-cure-renewing-the-goal-to-eliminate-the-disease-of-pain
#7
Theodore J Price, Michael S Gold
Objective: Persistent pain causes untold misery worldwide and is a leading cause of disability. Despite its astonishing prevalence, pain is undertreated, at least in part because existing therapeutics are ineffective or cause intolerable side effects. In this review, we cover new findings about the neurobiology of pain and argue that all but the most transient forms of pain needed to avoid tissue damage should be approached as a disease where a cure can be the goal of all treatment plans, even if attaining this goal is not yet always possible...
October 25, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29030932/a-prospective-audit-of-pain-profiles-following-general-and-urological-surgery-in-children
#8
Caroline A Wilson, David Sommerfield, Thomas F E Drake-Brockman, Claudia Lagrange, Anoop Ramgolam, Britta S von Ungern-Sternberg
BACKGROUND: Postoperative pain is frequently undertreated in children both in hospital and at home following discharge. Pain has both short- and long-term consequences for children, their families, and the healthcare system. A greater understanding of procedure-specific postoperative pain trajectories is required to improve pain management. AIM: To determine the duration and severity of acute postoperative pain experienced by children undergoing 8 different general and urological procedures (primary outcomes)...
November 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29019634/pain-assessment-in-newborns-infants-and-children
#9
Alexandra Beltramini, Kolia Milojevic, Dominique Pateron
Pain in children is underestimated and undertreated because of lack of pain assessment tools. Pain assessment depends on the cognitive development of the child being tested, clinical context, and pain typology. For children older than age 6 years, pain assessment is based on a self-report. For children younger than age 6 years, behavioral pain scales are needed to assess pain. Numerous pain scales exist. Many are reliable and some are recommended, but all have specific conditions for their use. In this article, we review the available pain scales for children from birth to adolescence...
October 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/28980440/self-report-pain-assessment-tools-for-cognitively-intact-older-adults-integrative-review
#10
Youjeong Kang, George Demiris
BACKGROUND: Pain is common in older adults, but it is often underreported or undertreated partly because many consider pain to be a normal consequence of ageing. Among the plethora of available self-report pain assessment tools, there is no synthetised evidence which tools are indicated for use among cognitively intact older adults. PURPOSE OF THE STUDY: To understand documented self-report pain assessment tools that have been used among cognitively intact older adults, and to describe their characteristics including overall performance as well as studies demonstrating their use...
October 5, 2017: International Journal of Older People Nursing
https://www.readbyqxmd.com/read/28975575/oncologist-s-knowledge-and-implementation-of-guidelines-for-breakthrough-cancer-pain-in-spain-conoce-study
#11
R López López, C Camps Herrero, P Khosravi-Shahi, V Guillem Porta, A Carrato Mena, J Garcia-Foncillas, J J Cruz Hernández, P Gascón Vilaplana, A Antón Torres, E Diaz-Rubio, M Feyjoo Saus, E Aranda Aguilar
PURPOSE: Breakthrough cancer pain (BTcP) has been shown to be a prevalent and poor prognostic factor for oncologic patients, which remain under diagnosed and undertreated. In 2012, the Spanish Society of Medical Oncology (SEOM) published a clinical practice guideline (CPG) for the treatment of cancer pain which specifically addressed the management of BTcP. METHODS: Fundación ECO designed a qualitative study using an Internet-based survey to investigate the attitudes toward, compliance with, and use of SEOM Guideline...
October 3, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28918691/measuring-musculoskeletal-pain-in-infants-children-and-adolescents
#12
Zoe A Michaleff, Steven J Kamper, Jennifer N Stinson, Lise Hestbaek, Christopher M Williams, Paul Campbell, Kate M Dunn
Synopsis Accurate, reliable, and timely assessment of pain is critical for effective management of musculoskeletal pain conditions. The assessment of pain in infants, children, and adolescents with and without cognitive impairment can be particularly challenging to clinicians for a number of reasons, including factors related to the consultation (eg, heterogeneous patient population, time constraints), the clinician (eg, awareness/knowledge of available pain scales), standardized assessment scales (eg, availability, psychometric properties, and application of each scale), the patient (eg, developmental stage, ability to communicate), and the context in which the interaction took place (eg, familiarity with the setting and physiological and psychological state)...
October 2017: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/28831272/pain-reporting-and-analgesia-management-in-270-children-with-a-progressive-neurologic-metabolic-or-chromosomally-based-condition-with-impairment-of-the-central-nervous-system-cross-sectional-baseline-results-from-an-observational-longitudinal-study
#13
Stefan J Friedrichsdorf, Andrea C Postier, Gail S Andrews, Karen Es Hamre, Rose Steele, Harold Siden
Little is known about the prevalence, characterization and treatment of pain in children with progressive neurologic, metabolic or chromosomal conditions with impairment of the central nervous system. The primary aims of this study were to explore the differences between parental and clinical pain reporting in children with life-limiting conditions at the time of enrollment into an observational, longitudinal study and to determine if differences in pain experiences were associated with patient- or treatment-related factors...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28821396/the-new-hdac1-inhibitor-lg325-ameliorates-neuropathic-pain-in-a-mouse-model
#14
Maria Domenica Sanna, Luca Guandalini, Maria Novella Romanelli, Nicoletta Galeotti
Current analgesic therapies for treatment of neuropathic pain are unsatisfactory. Neuropathic pain is, therefore, undertreated and there is a significant need for a better pharmacotherapy. Increasing evidence indicate that histone deacetylation is a critical step in nerve injury pain. To obtain an innovative treatment for the management of neuropathic pain, we investigated the pharmacological effects produced by the new histone deacetylase (HDAC)-1 selective inhibitor, LG325, in a mouse model of trauma-induced peripheral mononeuropathy provoked by spared nerve injury (SNI)...
August 15, 2017: Pharmacology, Biochemistry, and Behavior
https://www.readbyqxmd.com/read/28811049/marijuana-and-cannabinoids-in-esrd-and-earlier-stages-of-ckd
#15
Joshua L Rein, Christina M Wyatt
Marijuana is the most commonly used recreational drug in the United States, and legal recreational and medicinal use has gained public acceptance during the last decade. Twenty-nine US states have established medical marijuana programs, 8 of which have also legalized recreational marijuana, and Canada is expected to legalize recreational marijuana in 2018. Advanced chronic kidney disease (CKD) and end-stage renal disease (ESRD) are chronic conditions with significant associated morbidity and mortality. Patients experience substantial symptom burden that is frequently undertreated due to adverse medication side effects...
August 12, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28769555/naloxegol-in-opioid-induced-constipation-a-new-paradigm-in-the-treatment-of-a-common-problem
#16
REVIEW
Stephanie C Yoon, Heather C Bruner
Opioid-induced constipation (OIC) imposes a significant burden for patients taking pain medications, often resulting in decreased quality of life. Treatment of OIC with traditional medications for functional constipation can be incompletely effective, leading to nonadherence with opioid treatment and undertreated pain. An emerging class of medications that counteract the adverse effects of opioids in the gastrointestinal tract while preserving central nervous system-based pain relief may represent a paradigm shift in the prevention and treatment of OIC...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28764789/exploring-how-nurses-assess-monitor-and-manage-acute-pain-for-adult-critically-ill-patients-in-the-emergency-department-protocol-for-a-mixed-methods-study
#17
Wayne Varndell, Margaret Fry, Doug Elliott
BACKGROUND: Many critically ill patients experience moderate to severe acute pain that is frequently undetected and/or undertreated. Acute pain in this patient cohort not only derives from their injury and/or illness, but also as a consequence of delivering care whilst stabilising the patient. Emergency nurses are increasingly responsible for the safety and wellbeing of critically ill patients, which includes assessing, monitoring and managing acute pain. How emergency nurses manage acute pain in critically ill adult patients is unknown...
August 1, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28743558/the-association-of-nurses-assessment-and-certainty-to-pain-management-and-outcomes-for-nursing-home-residents-in-jordan
#18
Mohammad Rababa
Despite advances in dementia care, pain in people with dementia is still undertreated due to poor assessment, poor treatment, and factors relating to nurses' critical thinking and decision-making skills. The purpose of the study is to examine temporally based relationships between change in behavior, the nurses' level of certainty regarding pain, assessment scope, and outcomes of pain. The findings of the study were consistent with the Response to Certainty of Pain model. This study found high percentage of variances accounted for by nurses' level of certainty due to potential unexpected confounding variables...
July 22, 2017: Geriatric Nursing
https://www.readbyqxmd.com/read/28729010/evaluation-of-emergency-department-management-of-opioid-tolerant-cancer-patients-with-acute-pain
#19
Pina M Patel, Lauren F Goodman, Sheri A Knepel, Charles C Miller, Asma Azimi, Gary Phillips, Jillian L Gustin, Amber Hartman
CONTEXT: There are no previously published studies examining opioid doses administered to opioid-tolerant cancer patients during emergency department (ED) encounters. OBJECTIVES: To determine if opioid-tolerant cancer patients presenting with acute pain exacerbations receive adequate initial doses of as needed (PRN) opioids during ED encounters based on home oral morphine equivalent (OME) use. METHODS: We performed a retrospective cohort study of opioid-tolerant cancer patients who received opioids in our ED over a two-year period...
October 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28727709/transforaminal-percutaneous-endoscopic-discectomy-and-foraminoplasty-after-lumbar-spinal-fusion-surgery
#20
Jian-Jun Wu, Hui-Zhen Chen, Changkun Zheng
BACKGROUND: The most common causes of pain following lumbar spinal fusions are residual herniation, or foraminal fibrosis and foraminal stenosis that is ignored, untreated, or undertreated. The original surgeon may advise his patient that nothing more can be done in his opinion that the nerve was visually decompressed by the original surgery. Post-operative imaging or electrophysiological assessment may be inadequate to explain all the reasons for residual or recurrent symptoms. Treatment of failed lumbar spinal fusions by repeat traditional open revision surgery usually incorporates more extensive decompression causing increased instability and back pain...
July 2017: Pain Physician
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