Safety and Efficacy of Buprenorphine Patch in the Management of Chronic Pain

2015 ◽  
Vol 7 ◽  
pp. 1-10 ◽  
Keyword(s):  
Chronic Pain ◽  
Safety And Efficacy

Safety and Efficacy Considerations of Gabapentin as Adjunctive Therapy to Opioids in the Perioperative Setting for Older Adults

2020 ◽  
Vol 35 (10) ◽  
pp. 436-438
Author(s):  
Edgar Garcia ◽  
Justin P. Reinert ◽  
Michael Veronin
Keyword(s):  
Older Adults ◽  
Chronic Pain ◽  
Pain Management ◽  
Adverse Effects ◽  
Older Adult ◽  
Adjunctive Therapy ◽  
Adult Patients ◽  
Opioid Epidemic ◽  
Safety And Efficacy ◽  
Initial Choice

While opioids have historically been the initial choice of analgesic for both acute and chronic pain, legislative and deprescribing trends as a result of the opioid epidemic have demonstrated an increase in the use of adjunctive therapies. These adjunctive agents are being utilized with increased frequency, especially in older adult patients, as a mechanism to mitigate any likelihood of dependency and in an effort to provide multimodal pain management. As this patient population can be more challenging because of comorbidities, the presence of polypharmacy, pharmacokinetic, and pharmacodynamic changes, it is important to evaluate the risk of any relevant adverse effects for opioids and adjuncts that can lead to higher risk of opioid toxicities. Gabapentin is one of the most commonly added adjunctive medications; however, its safety and efficacy in conjunction with opioids has not been exclusively considered in older adult patients in the perioperative setting. This report will summarize available evidence for gabapentin as an adjunctive therapy to opioids in older adult patients undergoing surgery.

Longitudinal trial of a smartphone pain application for chronic pain patients: Predictors of compliance and satisfaction

2016 ◽  
Vol 24 (2) ◽  
pp. 93-100 ◽  
Author(s):  
Robert N Jamison ◽  
Anna Mei ◽  
Edgar L Ross
Keyword(s):  
Chronic Pain ◽  
Future Development ◽  
Activity Monitor ◽  
Safety And Efficacy ◽  
Safety Issues ◽  
Frequent Use ◽  
Chronic Pain Patients ◽  
The Future ◽  
Pain Patients ◽  
Positive Effect

Introduction This study was designed to determine the feasibility, tolerability, safety and efficacy of a smartphone pain application (app) among chronic pain patients over a six-month trial. The app was designed for both Android and iPhone devices and enabled users with chronic pain to assess, monitor, and communicate their status to their providers. Methods We recruited 90 chronic pain patients to use the pain app. All subjects completed baseline measures and were asked to record their progress every day. All participants were supplied an activity monitor. Results Average age of the participants was 46.7 years (range 18–79), 64.4% were female and 31.1% reported multiple pain sites. Satisfaction was rated at three and six months. The app was found to be easily introduced and well tolerated. In general, those who used the app more often were more satisfied with the program ( p < 0.05), although satisfaction ratings of the pain app diminished with time. Greater use of the app and frequent daily assessment entries were found to be related to an overall improvement in mood. However, contrary to our hypotheses, frequent use of the app did not have a positive effect on pain or activity. Those who were more satisfied with the app reported more pain-related disability and were less active than those who were less satisfied with the app. No safety issues were encountered. Discussion Strategies to make the program more engaging and to improve motivation to use the app would be important in the future development and use of a smartphone pain app.

Long-term safety, tolerability, and efficacy of OROS® hydromorphone in patients with chronic pain

2018 ◽  
Vol 5 (2) ◽  
pp. 97 ◽  
Author(s):  
Mark Wallace, MD ◽  
Dwight E. Moulin, MD ◽  
Richard L. Rauck, MD ◽  
Sarita Khanna, PhD ◽  
Iulia Cristina Tudor, PhD ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Plasma Concentrations ◽  
Brief Pain Inventory ◽  
The United States ◽  
Short Term ◽  
Open Label ◽  
Safety And Efficacy ◽  
Analgesic Effects ◽  
N 93

Objective: To assess the safety and efficacy of long-term repeated dosing of OROS® hydromorphone in chronic pain patients.Design: This multicenter, open-label extension trial enrolled patients from three short-term OROS® hydromorphone trials.Setting: Fifty-six centers in the United States and Canada.Patients: Adults with chronic cancer pain or chronic nonmalignant pain who were receiving stable doses of OROS® hydromorphone (≥8 mg/day). Three hundred and eighty-eight patients were enrolled, 106 patients completed at least 12 months of therapy.Interventions: OROS® hydromorphone (individualized doses) was administered once daily.Main outcome measures: Safety and efficacy (Brief Pain Inventory and patient and investigator global evaluations) were assessed at monthly visits.Results: The median duration of extended OROS® hydromorphone therapy was 274 days. The median daily dose of study medication was 32.0 mg at extension-study baseline, 40.0 mg at month 3, and 48.0 mg at months 6, 9, and 12, respectively. The most frequently reported adverse events were nausea (n = 93, 24.0 percent) and constipation (n = 75, 19.3 percent). The analgesic effects of OROS® hydromorphone, assessed using the Brief Pain Inventory, were maintained throughout the extension. At 12 months, 72.4 percent of patients and 75.9 percent of investigators rated overall treatment as good, very good, or excellent.Conclusions: Once-daily OROS® hydromorphone is an osmotically driven, controlled-release preparation that may be particularly well suited to long-term use, because it provides consistent plasma concentrations and sustained around-the-clock analgesia. In this study, the benefits of OROS® hydromorphone attained in short-term studies were maintained in the long-term when daily administration was continued.

scholarly journals Buprenorphine buccal film for chronic pain management

2020 ◽  
Vol 10 (4) ◽  
pp. 213-223 ◽  
Author(s):  
Martin Hale ◽  
Joseph Gimbel ◽  
Richard Rauck
Keyword(s):  
Chronic Pain ◽  
Pain Relief ◽  
Review Article ◽  
Chronic Pain Management ◽  
First Line ◽  
Safety And Efficacy ◽  
Safety Risks ◽  
Pharmacokinetic Properties ◽  
Film Formulation ◽  
Effective Analgesia

Buprenorphine is a Schedule III opioid with unique pharmacodynamic and pharmacokinetic properties that contribute to effective analgesia and fewer safety risks than other opioids. This review article focuses on the buccal film formulation, which is preferable to other buprenorphine formulations on the basis of bioavailability, safety and efficacy. The clinical studies reviewed here confirm that buprenorphine buccal film offers effective and continuous pain relief that is generally well tolerated, with no cases of respiratory depression reported in any of the studies. On the basis of these clinical data and individual patient risk/benefit assessments, clinicians should consider utilizing buprenorphine buccal film as a first-line opioid treatment for chronic pain over other buprenorphine formulations or other opioids.

Safety and efficacy of intranasal ketamine for the treatment of breakthrough pain in patients with chronic pain: a randomized, double-blind, placebo-controlled, crossover study

Pain ◽  
2004 ◽  
Vol 108 (1) ◽  
pp. 17-27 ◽  
Author(s):  
Daniel B Carr ◽  
Leonidas C Goudas ◽  
William T Denman ◽  
Daniel Brookoff ◽  
Peter S Staats ◽  
...  
Keyword(s):  
Chronic Pain ◽  
Crossover Study ◽  
Breakthrough Pain ◽  
Double Blind ◽  
Safety And Efficacy ◽  
Double Blind Placebo

Safety and efficacy of spinal cord stimulation for the treatment of chronic pain: a 20-year literature review

2004 ◽  
Vol 100 (3) ◽  
pp. 254-267 ◽  
Author(s):  
Tracy Cameron
Keyword(s):  
Spinal Cord ◽  
Chronic Pain ◽  
Literature Review ◽  
Spinal Cord Stimulation ◽  
Exclusion Criteria ◽  
Safety And Efficacy ◽  
Content Type ◽  
Long Term Effect ◽  
Fine Print

Object. The purpose of this report was to examine the available literature to determine the safety and efficacy of spinal cord stimulation (SCS) for the treatment of chronic pain of the trunk and limbs. Methods. The author identified 68 studies that fulfilled the efficacy inclusion/exclusion criteria, grouped on the basis of pain indication, with an overall population of 3679 patients. Fifty-one studies fulfilled all safety inclusion/exclusion criteria. Based on the literature review, the author found that SCS had a positive, symptomatic, long-term effect in cases of refractory angina pain, severe ischemic limb pain secondary to peripheral vascular disease, peripheral neuropathic pain, and chronic low-back pain, and that, in general, SCS was a safe and effective treatment for a variety of chronic neuropathic conditions. Conclusions. Despite the positive findings, there is an urgent need for randomized, controlled, long-term studies on the efficacy of SCS involving larger patient sample sizes.

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