Cancer Pain Management, Cancer-Related Breakthrough Pain, Therapy

2012 ◽  
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Pain Therapy ◽  
Breakthrough Pain ◽  
Cancer Pain Management

Long- and short-acting opioids in cancer pain management: What is the best ratio?

2014 ◽  
Vol 32 (31_suppl) ◽  
pp. 206-206
Author(s):  
Alison Wiesenthal ◽  
Natalie Moryl ◽  
Paul A. Glare
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Breakthrough Pain ◽  
Retrospective Chart Review ◽  
Clinic Visit ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Cancer Pain Management ◽  
Short Acting ◽  
Chronic Cancer Pain

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.

The effect of pain self-management based on pain control diary on breakthrough pain.

2017 ◽  
Vol 35 (15_suppl) ◽  
pp. 10107-10107
Author(s):  
Zu-Yan Fan ◽  
Jin-Xiang Lin ◽  
Xing Li ◽  
Xiang-Wei Chen ◽  
Xiu-Yan Huang
Keyword(s):  
Pain Management ◽  
Cancer Pain ◽  
Pain Control ◽  
Breakthrough Pain ◽  
Medication Compliance ◽  
Intervention Group ◽  
Life Quality ◽  
Self Management ◽  
Control Group ◽  
Cancer Pain Management

10107 Background: Most patients suffer from cancer pain, especially breakthrough pain. The overall incidence of breakthrough pain is estimated to be 65%. Self-management makes patients actively participating in the use of drugs, transforming their roles and adjusting their moods in order to better cure their own diseases. Therefore, the aim of the study is to discuss the effect of reducing cancer pain patients' breakthrough pain through self-management based on pain control diary. Methods: From October, 2015 to October, 2016, a total of 200 patients treated with opioids for cancer pain were randomly divided into groups. Patients in the control group were given general management including the Standard "the three steps analgesic ladder treatment for cancer pain", the traditional form of health education and psychological care; While the intervention group in addition to conventional cancer pain management, self-management based on pain control diary was applied. Through repeated intensive training, patients learned how to do self-assessment, to master the feature of their own pain, problem-solving skills and formal report to their oncologists in charge. Results: After six weeks of intervention , 10% patients in the intervention group had suffer breakthrough pain compared with 54% patients in the control group (P < 0.05). The whole processing management model is a whole process, specialization and humanization Care model for patients with advanced cancer pain management, can effectively improve patient medication compliance, reduce the cancer breakthrough pain's incidence, improve the patients,s life quality with cancer pain. The medication compliance of the intervention group was significantly higher than that of the control group(X2= 46.606, P<0.001), and in intervention group the incidence of breakthrough pain was significantly lower than that of the control group (X2= 44.148, P<0.001) Conclusions: The self management based on pain control diary is a whole process, specialization and humanization Care model for patients with advanced cancer pain management, can effectively improve patient medication compliance, reduce the cancer breakthrough pain's incidence, improve the patients's life quality with cancer pain.

Review of the Role of Opioids in Cancer Pain

2010 ◽  
Vol 8 (9) ◽  
pp. 1087-1094 ◽  
Author(s):  
Andrea M. Trescot
Keyword(s):  
Pain Management ◽  
Side Effects ◽  
Cancer Pain ◽  
Pain Therapy ◽  
Cancer Pain Management ◽  
Treatment Knowledge

Cancer pain is unfortunately very prevalent, with opioids the mainstay of treatment. Knowledge of the types of pain caused by cancer and the effects of various opioids would be expected to improve pain therapy. This article addresses the use, side effects, formulations, and metabolism of the most commonly used opioids in cancer pain management, including morphine, codeine, hydrocodone, hydromorphone, fentanyl, and methadone. The role of opioid conversion and equipotent dosing when changing from one opioid to another is also described.

Cancer pain management

2014 ◽  
Vol 155 (3) ◽  
pp. 93-99
Author(s):  
Péter Heigl
Keyword(s):  
Quality Of Life ◽  
Pain Management ◽  
Pain Relief ◽  
Life Expectancy ◽  
Cancer Pain ◽  
Cancer Pain Management ◽  
Medical Activity ◽  
Short Summary ◽  
Adequate Quality

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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