How nurses assess breakthrough cancer pain, and the impact of this pain on patients' daily lives – Results of a European survey

2013 ◽  
Vol 17 (4) ◽  
pp. 402-407 ◽  
Author(s):  
Tone Rustøen ◽  
Jenske I. Geerling ◽  
Theodora Pappa ◽  
Carina Rundström ◽  
Isolde Weisse ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Daily Lives ◽  
Breakthrough Cancer Pain ◽  
European Survey ◽  
The Impact

scholarly journals Impact of individualized management of breakthrough cancer pain on quality of life in advanced cancer patients: CAVIDIOPAL study

2021 ◽  
Author(s):  
Albert Tuca Rodríguez ◽  
Miguel Núñez Viejo ◽  
Pablo Maradey ◽  
Jaume Canal-Sotelo ◽  
Plácido Guardia Mancilla ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Advanced Cancer ◽  
Low Doses ◽  
Breakthrough Cancer Pain ◽  
Eortc Qlq C30 ◽  
Eortc Qlq ◽  
Individualized Management ◽  
The Impact

Abstract Purpose The main aim of the study was to assess the impact of individualized management of breakthrough cancer pain (BTcP) on quality of life (QoL) of patients with advanced cancer in clinical practice. Methods A prospective, observational, multicenter study was conducted in patients with advanced cancer that were assisted by palliative care units. QoL was assessed with the EORTC QLQ-C30 questionnaire at baseline (V0) and after 28 days (V28) of individualized BTcP therapy. Data on background pain, BTcP, comorbidities, and frailty were also recorded. Results Ninety-three patients completed the study. Intensity, duration, and number of BTcP episodes were reduced (p < 0.001) at V28 with individualized therapy. Transmucosal fentanyl was used in 93.8% of patients, mainly by sublingual route. Fentanyl titration was initiated at low doses (78.3% of patients received doses of 67 μg, 100 μg, or 133 μg) according to physician evaluation. At V28, mean perception of global health status had increased from 31.1 to 53.1 (p < 0.001). All scales of EORTC QLQ-C30 significantly improved (p < 0.001) except physical functioning, diarrhea, and financial difficulties. Pain scale improved from 73.6 ± 22.6 to 35.7 ± 22.3 (p < 0.001). Moreover, 85.9% of patients reported pain improvement. Probability of no ≥ 25% improvement in QoL was significantly higher in patients ≥ 65 years old (OR 1.39; 95% CI 1.001–1.079) and patients hospitalized at baseline (OR 4.126; 95% CI 1.227–13.873). Conclusion Individualized BTcP therapy improved QoL of patients with advanced cancer. Transmucosal fentanyl at low doses was the most used drug. Trial registration This study was registered at ClinicalTrials.gov database (NCT02840500) on July 19, 2016.

Assessing the impact of breakthrough cancer pain

2011 ◽  
Vol 20 (Sup5) ◽  
pp. S14-S19 ◽  
Author(s):  
Beth Burton ◽  
Giovambattista Zeppetella
Keyword(s):  
Cancer Pain ◽  
Breakthrough Cancer Pain ◽  
The Impact

679 EUROPEAN SURVEY OF BREAKTHROUGH CANCER PAIN

2009 ◽  
Vol 13 (S1) ◽  
Author(s):  
A. Davies ◽  
G. Zeppetella ◽  
S. Andersen ◽  
A. Damkier ◽  
T. Vejlgaard ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Breakthrough Cancer Pain ◽  
European Survey

A European survey of oncology nurse breakthrough cancer pain practices

2013 ◽  
Vol 17 (1) ◽  
pp. 95-100 ◽  
Author(s):  
Tone Rustøen ◽  
Jenske I. Geerling ◽  
Theodora Pappa ◽  
Carina Rundström ◽  
Isolde Weisse ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Breakthrough Cancer Pain ◽  
Oncology Nurse ◽  
European Survey

4176 ORAL A European Survey of Oncology Nurse Breakthrough Cancer Pain Practices

2011 ◽  
Vol 47 ◽  
pp. S302
Author(s):  
T. Rustoen ◽  
Y. Wengström ◽  
B. Zavratnik ◽  
C. Rundström ◽  
I. Weisse ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Breakthrough Cancer Pain ◽  
Oncology Nurse ◽  
European Survey

Breakthrough cancer pain (BTcP) and quality-of-life outcomes.

2016 ◽  
Vol 34 (26_suppl) ◽  
pp. 61-61
Author(s):  
Valeria Stati ◽  
Gian Paolo Spinelli ◽  
Elisa Gozzi ◽  
Belardino Rossi ◽  
Silverio Tomao
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Nasal Spray ◽  
Qualitative Evaluation ◽  
Solid Cancer ◽  
Breakthrough Cancer Pain ◽  
Valid Instrument ◽  
Buccal Tablets ◽  
The Impact

61 Background: Breakthrough cancer pain (BTcP) is frequent in patients with advance solid tumors and is always associated with worsening of the quality of life (QoL). There are few studies in the literature on the effect of BTcP treatment on QoL. The aim of this analysis was to provide a qualitative evaluation of the effect of BTcP therapies considering different fentanyl formulation(nasal spray, lollipop or buccal tablets) on the QoL of treated patients. Methods: In our study, we enrolled patients with different advanced solid cancer treated with active and/or palliative therapies. All patients included have a baseline analgesis therapy and showed frequent BTcP episodes during the day. The patients were evaluated with a simultaneous care control (medical oncologist, palliativist, psychologist and nurse) every week for four consecutively weeks after initiating treatment with BtcP medicaments. A questionary about BtcP and QoL evaluation (QoL-BTcP scale) was administered. It was also completed by an interview during periodic visit. The main parameters investigated were frequency of BTcP, cancer pain value (NRSscale), fentanyl formulation for BTcP (nasal spray, lollipop or buccal tablets), time of onset of cancer pain relief and adverse events correlated with use of BTcP medicaments. At each simultaneuous care evaluation the authors evaluated the impact of BTcP medicaments on psychologic aspects using a validated Anxiety, Depression and health status Scale integrated to QoL-BTcP questionary (QoL-BTcP scale). Results: A total of 35 patients with > 2 BTcP episodes/die were enrolled (50% from 2 to 4 episodes, 45% from 5 to 6 episodes and 5% for those patients with more than 6 episodes). QoL-BTcP scores showed significant improvement in the QoL in terms of depression and other psychologic aspects in the first two subgroups (from 2 to 6BTcP episodes). The QoL-BTcP scale was worse in more depressed patients and in those patients at the end of life. Conclusions: QoL-BTcP scale is a reliable and valid instrument for measuring QoL correlated to efficacy and tolerability of BTcP drugs. Results provide some suggestions for the development of programs to evaluate QoL in patient with cancer pain and implement BTcP interventions among cancer survivors.

scholarly journals Emotional and Mental Wellbeing Following COVID-19 Public Health Measures on People Living With Dementia and Carers

2021 ◽  
pp. 089198872199681
Author(s):  
Kerry Hanna ◽  
Clarissa Giebel ◽  
Hilary Tetlow ◽  
Kym Ward ◽  
Justine Shenton ◽  
...  
Keyword(s):  
Public Health ◽  
Mental Health ◽  
Social Support ◽  
Support Services ◽  
Mental Wellbeing ◽  
Daily Lives ◽  
Health Measures ◽  
Social Support Services ◽  
The Uk ◽  
The Impact

Background: To date, there appears to be no evidence on the longer-term impacts caused by COVID-19 and its related public health restrictions on some of the most vulnerable in our societies. The aim of this research was to explore the change in impact of COVID-19 public health measures on the mental wellbeing of people living with dementia (PLWD) and unpaid carers. Method: Semi-structured, follow-up telephone interviews were conducted with PLWD and unpaid carers between June and July 2020. Participants were asked about their experiences of accessing social support services during the pandemic, and the impact of restrictions on their daily lives. Results: 20 interviews were conducted and thematically analyzed, which produced 3 primary themes concerning emotional responses and impact to mental health and wellbeing during the course of the pandemic: 1) Impact on mental health during lockdown, 2) Changes to mental health following easing of public health, and 3) The long-term effect of public health measures. Conclusions: The findings from this research shed light on the longer-term psychological impacts of the UK Government’s public health measures on PLWD and their carers. The loss of social support services was key in impacting this cohort mentally and emotionally, displaying a need for better psychological support, for both carers and PLWD.

scholarly journals Evaluation of an Educational Outreach Campaign (IMPACT) on Pain Management Delivered to General Practices in Walsall

2021 ◽  
Vol 29 (Supplement_1) ◽  
pp. i48-i49
Author(s):  
S Visram ◽  
J Saini ◽  
R Mandvia
Keyword(s):  
Data Analysis ◽  
Pain Management ◽  
Cancer Pain ◽  
Educational Intervention ◽  
Opioid Analgesics ◽  
Educational Outreach ◽  
Opioid Prescribing ◽  
Prescribing Trends ◽  
The Impact

Abstract Introduction Opioid class drugs are a commonly prescribed form of analgesic widely used in the treatment of acute, cancer and chronic non-cancer pain. Up to 90% of individuals presenting to pain centres receive opioids, with doctors in the UK prescribing more and stronger opioids (1). Concern is increasing that patients with chronic pain are inappropriately being moved up the WHO ‘analgesic ladder’, originally developed for cancer pain, without considering alternatives to medications, (2). UK guidelines on chronic non-cancer pain management recommend weak opioids as a second-line treatment, when the first-line non-steroidal anti-inflammatory drugs / paracetamol) ineffective, and for short-term use only. A UK educational outreach programme by the name IMPACT (Improving Medicines and Polypharmacy Appropriateness Clinical Tool) was conducted on pain management. This research evaluated the IMPACT campaign, analysing the educational impact on the prescribing of morphine, tramadol and other high-cost opioids, in the Walsall CCG. Methods Standardised training material was delivered to 50 practices between December 2018 and June 2019 by IMPACT pharmacists. The training included a presentation on pain control, including dissemination of local and national guidelines, management of neuropathic, low back pain and sciatica as well as advice for prescribers on prescribing opioids in long-term pain, with the evidence-base. Prescribing trends in primary care were also covered in the training, and clinicians were provided with resources to use in their practice. Data analysis included reviewing prescribing data and evaluating the educational intervention using feedback from participants gathered via anonymous questionnaires administered at the end of the training. Prescribing data analysis was conducted by Keele University’s Medicines Management team via the ePACT 2 system covering October 2018 to September 2019 (two months before and three months after the intervention) were presented onto graphs to form comparisons in prescribing trends of the Midland CCG compared to England. Results Questionnaires completed at the end of sessions showed high levels of satisfaction, with feedback indicating that participants found the session well presented, successful at highlighting key messages, and effective in using evidence-based practice. 88% of participants agreed the IMPACT campaign increased their understanding of the management and assessment of pain, and prescribing of opioids and other resources available to prescribers. The majority (85%) wished to see this form of education being repeated regularly in the future for other therapeutic areas. Analysis of the prescribing data demonstrated that the total volume of opioid analgesics decreased by 1.7% post-intervention in the Midlands CCG in response to the pharmacist-led educational intervention. As supported by literature, the use of educational strategies, including material dissemination and reminders as well as group educational outreach was effective in engaging clinicians, as demonstrated by the reduction in opioid prescribing and high GP satisfaction in this campaign. Conclusion The IMPACT campaign was effective at disseminating pain-specific guidelines for opioid prescribing to clinicians, leading to a decrease in overall prescribing of opioid analgesics. Educational outreach as an approach is practical and a valuable means to improve prescribing by continuing medical education. References 1. Els, C., Jackson, T., Kunyk, D., Lappi, V., Sonnenberg, B., Hagtvedt, R., Sharma, S., Kolahdooz, F. and Straube, S. (2017). Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews. Cochrane Database of Systematic Reviews. This provided the statistic of percentage receiving opioids that present to pain centres. 2. Heit, H. (2010). Tackling the Difficult Problem of Prescription Opioid Misuse. Annals of Internal Medicine, 152(11), p.747. Issues with prescriptions and inappropriate moving up the WHO ladder.

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