scholarly journals Development and pilot test of a new set of good practice indicators for chronic cancer pain management

2014 ◽  
Vol 19 (1) ◽  
pp. 28-38 ◽  
Author(s):  
P.J. Saturno ◽  
I. Martinez-Nicolas ◽  
I.S. Robles-Garcia ◽  
F. López-Soriano ◽  
D. Angel-García
1990 ◽  
Vol 13 (3) ◽  
pp. 176-182 ◽  
Author(s):  
Anna R. Williams ◽  
Kelli E. Beaulaurier ◽  
Debbie L. Seal

2014 ◽  
Vol 44 (6) ◽  
pp. 586-591 ◽  
Author(s):  
J. R. Hardy ◽  
O. Spruyt ◽  
S. J. Quinn ◽  
L. R. Devilee ◽  
D. C. Currow

2012 ◽  
Vol 29 (8) ◽  
pp. 640-646 ◽  
Author(s):  
Sewar S. Salmany ◽  
Sara M. Koopmans ◽  
Imad M. Treish ◽  
Rana El Jaber ◽  
Shorouq Telfah ◽  
...  

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 206-206
Author(s):  
Alison Wiesenthal ◽  
Natalie Moryl ◽  
Paul A. Glare

206 Background: Many cancer patients experience chronic and breakthrough pain necessitating the use of both immediate release (IR) and extended release (ER) opioids. The common strategy in treating chronic cancer pain is using ER opioids with the addition of IR opioids for breakthrough pain. The National Comprehensive Cancer Network recommends IR dosing at 0.1-0.2 times the daily ER dose as needed every 1 hour for breakthrough pain, though data is lacking to validate this recommendation. The aim of this exploratory study was to review the current practice in prescribing IR and ER opioids and the IR/ER ratio used in cancer pain management at one comprehensive cancer center (CCC). Methods: We performed a retrospective chart review of 54 consecutive patients at a CCC over a 6 month period. IR/ER doses, dose adjustments and satisfaction with analgesia were recorded. Adjustments in treatment plans were made based on patients' report of effectiveness and side effects associated with ER and IR opioids. Results: 19 of 54 (35%) patients reported adequate analgesia, with the average daily prescribed IR/ER ratio of 0.6 (range 0 to 3.75). In this group, IR opioids were unchanged during the clinic visit. The ER opioids, on average, were also unchanged, though decreased by 25% and increased by 50% in a few cases over serial clinic visits. Of those patients reporting suboptimal analgesia during the clinic visit (65%), 80% had their ER opioids increased, 6% had IR opioids increased, and 9% had both IR and ER increased. The ER opioids were increased by 40% on average and IR by 11% with the average IR/ER ratio changing from 0.5 (range 0-2) to 0.37 (range 0-1.13). Conclusions: These preliminary data highlight the great variability between patient preferences and clinician decisions in terms of IR/ER opioid ratios. In this retrospective study, analgesia was better in the group using higher IR doses with a higher IR/ER ratio. At the same time, patients with suboptimal analgesia had their ER opioids titrated faster and higher than the IR opioids. More studies are needed to determine best practice in the prescribing of long and short acting opioids for management of chronic cancer pain.


Revista Dor ◽  
2016 ◽  
Vol 17 ◽  
Author(s):  
Anara da Luz Oliveira ◽  
Natália da Palma Sobrinho ◽  
Beatriz Aparecida Silva Cunha

2014 ◽  
Vol 155 (3) ◽  
pp. 93-99
Author(s):  
Péter Heigl

Pain is a significant and alarming symptom of cancer seriously affecting the activity and quality of life of patients. Recent research proved that inadequate analgesia shortens life expectancy. Therefore, pain relief is not only a possibility but a professional, ethical and moral commitment to relieve patients from suffering, as well as ensure their adequate quality of life and human dignity. Proper pain relief can be achieved with medical therapy in most of the cases and the pharmacological alternatives are available in Hungary. Yet medical activity regarding pain relief is far from the desired. This paper gives a short summary of the guidelines on medical pain management focusing particularly on the use of opioids. Orv. Hetil., 2014, 155(3), 93–99.


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