Treatment outcome in a multidisciplinary cancer pain clinic

Pain ◽  
1991 ◽  
Vol 47 (2) ◽  
pp. 129-134 ◽  
Author(s):  
A. Banning ◽  
P. Sjøgren ◽  
H. Henriksen
Keyword(s):  
Treatment Outcome ◽  
Cancer Pain ◽  
Pain Clinic

Non-cancer pain clinic in three English prisons: understanding prisoner needs and prescribing practice in relation to chronic non-cancer pain (CNCP)

2018 ◽  
Vol 14 (4) ◽  
pp. 268-275
Author(s):  
Arun Sondhi ◽  
Tina Garrett
Keyword(s):  
Cancer Pain ◽  
Substance Misuse ◽  
Emotional Health ◽  
Secondary Analysis ◽  
Therapeutic Interventions ◽  
Pain Clinic ◽  
Practical Implementation ◽  
Physical And Mental Health ◽  
Content Type ◽  
Female Patients

Purpose Prisoner access to opiate-based analgesics and gabapentinoids is a concern to prisons through illicit trading. The purpose of this paper is to describe patient needs following introduction of nine pilot chronic non-cancer pain (CNCP) clinics for chronic pain in three prisons (two male and one female) in the South of England. The study evaluated the effectiveness of this model and assessed the wider practical implementation issues. Design/methodology/approach Clinical notes were reviewed for 63 consultations, anonymised and recorded for secondary analysis. Findings Alongside CNCP, high levels of substance misuse, physical and mental health histories were noted, especially for female patients. Amitriptyline, pregabalin, gabapentin were the main frontline analgesics prescribed prior to assessment. A total of 41 per cent of patients did not change their medication following the consultation; 25 per cent had their medication increased or reintroduced (greater for women prisoners); with one-third (33 per cent) of patients reducing the prescription of strong opioids and gabapentinoids. Significant differences were noted between male and female patients. Prisoners were amenable to changes in medication to facilitate access to work and other therapeutic interventions. Social implications The prescribing of analgesics has largely been couched in terms of disruption to the prison regime through illicit trading. This study highlights the need to place CNCP within wider contexts of substance misuse, physical and emotional health. There is an opportunity to develop a rehabilitative rather than palliative approach to pain management. Gender specific approaches for female patients should be considered. Originality/value Few studies of CNCP have been conducted within a prison environment.

Patients— and Physiotherapists— Belief in and Use of Acupuncture for Cancer-Related Symptoms

2017 ◽  
Vol 35 (4) ◽  
pp. 251-258 ◽  
Author(s):  
Anna Enblom
Keyword(s):  
Treatment Outcome ◽  
Cancer Therapy ◽  
Cancer Pain ◽  
Therapeutic Relationships ◽  
Vasomotor Symptoms ◽  
Treatment Expectations ◽  
Patients With Cancer ◽  
Radiotherapy Treatment

Background It is important to investigate attitudes to acupuncture, because therapists’ and patients’ expectations may affect the treatment outcome. Aim To explore the use of and belief in acupuncture among oncological physiotherapists and to explore patients’ interest in receiving acupuncture during cancer therapy and their belief in its effectiveness. Methods 522 patients (80% female, mean age 67 years) reported on their interest in receiving acupuncture for nausea during radiotherapy treatment; a subgroup (n=198) additionally disclosed their belief in the effectiveness of acupuncture. 117 Swedish oncological physiotherapists (96% female, mean age 48 years) answered a questionnaire regarding their use of and belief in acupuncture. Results Of the patients initiating cancer therapy, 359 (69%) were interested in receiving acupuncture. The patients believed acupuncture to be effective for pain (79%), nausea (79%) and vasomotor symptoms (48%). Of the 117 physiotherapists, 66 (56%) practised acupuncture. Physiotherapists generally believed in the effectiveness of acupuncture. For pain, 89% believed that acupuncture was effective and 42% of them practised it. Similar responses were noted for chemotherapy-induced nausea (86% and 38%, respectively) and vasomotor symptoms (80% and 28%, respectively). Younger physiotherapists and patients were more likely to believe in the effectiveness of acupuncture compared with older ones. Conclusions More than two thirds of patients with cancer were interested in receiving acupuncture during therapy. Patients and oncological physiotherapists believed that acupuncture was effective for cancer pain, nausea and vasomotor symptoms. Further studies of acupuncture for cancer-related symptoms and of the effect of patients’ and clinicians’ therapeutic relationships, including treatment expectations, would be welcome.

scholarly journals Episodic Cancer Pain: Patient Reporting, Prevalence, and Clinicodemographic Associations at Initial Cancer Pain Clinic Assessment

2020 ◽  
Vol 2020 ◽  
pp. 1-11
Author(s):  
Paulo Reis-Pina ◽  
Anand Acharya ◽  
Antonio Barbosa ◽  
Peter G. Lawlor
Keyword(s):  
Cancer Pain ◽  
Pain Intensity ◽  
Brief Pain Inventory ◽  
Cross Sectional Study ◽  
Pain Clinic ◽  
Pain Patient ◽  
Cross Sectional ◽  
Pain Location ◽  
Patient Reported ◽  
Average Pain

Background. Better understanding of the episodic cancer pain (CP) spectrum, including pains that occur in addition to its conventionally defined breakthrough CP (BTcP) and incident CP (IcP) components, may inform CP assessment and management. This study aimed to determine the prevalence of episodic patient-reported CP and the prevalence and associations of study-defined BTcP (S-BTcP) and IcP (S-IcP) in patients with CP. Methods. In a cross-sectional study at their first CP clinic attendance, participants with CP had the following assessments: Brief Pain Inventory (BPI); Pain Management Index (PMI), with PMI-negative status indicating undertreatment; standardized neuropathic pain component (NPC) status; S-BTcP (no trigger identified) and S-IcP (trigger identified) status, based on a preceding 7-day history of transitory pain flares distinct from background pain, and BPI-Worst or BPI-Now pain intensity ≥ 4. Clinicodemographic variables’ association with S-BTcP and S-IcP was examined in logistic regression analyses. Results. Of 371 participants, 308 (83%) had episodic CP by history alone; 140 (37.7%) and 181 (48.8%) had S-BTcP and S-IcP, respectively. Multivariable analyses demonstrated significant (p<0.05) associations (odds ratios: 95% CIs) for 6 variables with S-BTcP: head and neck pain location (2.53; 1.20–5.37), NPC (2.39; 1.34–4.26), BPI average pain (1.64; 1.36–1.99), abdominal pain (0.324; 0.120–0.873), S-IcP (0.207; 0.116–0.369), and PMI-negative status (0.443; 0.213–0.918). Similar independent associations (p<0.05) occurred for S-IcP with NPC, BPI average pain, and PMI-negative status, in addition to radiotherapy, S-BTcP, soft tissue pain, and sleep interference. Conclusions. Episodic or transient patient-reported CP flares often do not meet the more conventional criteria that define BTcP and IcP, the principal episodic CP types. Both BTcP and IcP occur frequently and both are associated with a NPC, higher pain intensity, and less opioid underuse in the management of CP. Further studies are warranted to both better understand the complex presentations of episodic CP and inform its classification.

Computerized Quality-of-Life Screening in a Cancer Pain Clinic

2001 ◽  
Vol 17 (1) ◽  
pp. 46-52 ◽  
Author(s):  
Linda E. Carlson ◽  
Michael Speca ◽  
Neil Hagen ◽  
Paul Taenzer
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Pain Clinic

scholarly journals Sex Differences in the Adequacy of Pain Management Among Patients Referred to a Multidisciplinary Cancer Pain Clinic

2008 ◽  
Vol 36 (2) ◽  
pp. 167-172 ◽  
Author(s):  
Kristine A. Donovan ◽  
Lindsay A. Taliaferro ◽  
Charles W. Brock ◽  
Sadaf Bazargan
Keyword(s):  
Sex Differences ◽  
Pain Management ◽  
Cancer Pain ◽  
Pain Clinic

scholarly journals (386) The influence of age and gender on opioid dosage in cancer pain clinic patients

2016 ◽  
Vol 17 (4) ◽  
pp. S71
Author(s):  
N. Moryl ◽  
V. Dave ◽  
P. Glare ◽  
V. Malhotra ◽  
A. Gulati ◽  
...  
Keyword(s):  
Cancer Pain ◽  
Pain Clinic ◽  
Age And Gender ◽  
And Gender

Pain clinic treatment outcome in low-back pain: A follow-up study

Pain ◽  
1990 ◽  
Vol 41 ◽  
pp. S342
Author(s):  
J. Robson ◽  
C.C. Spanswick ◽  
C.J. Main
Keyword(s):  
Low Back Pain ◽  
Treatment Outcome ◽  
Back Pain ◽  
Pain Clinic ◽  
Low Back ◽  
Follow Up Study

scholarly journals Combinations of Low-Dose Antidepressants and Low-Dose Pregabalin as Useful Adjuvants to Opioids for Intractable, Painful Bone Metastases

2013 ◽  
Vol 5;16 (5;9) ◽  
pp. E547-E552
Author(s):  
Masahiko Ikeuchi
Keyword(s):  
Cancer Pain ◽  
Bone Metastases ◽  
Low Dose ◽  
Controlled Trial ◽  
Pain Clinic ◽  
Key Words Cancer ◽  
Total Pain ◽  
Key Words Cancer Pain ◽  
Antidepressant Combination ◽  
Painful Bone Metastases

Background: Systemic analgesics would not provide good enough pain relief for some kinds of cancer pain. Metastatic bone pain is characteristic of one of the refractory cancer pains, since the pain is not only nociceptive but also neuropathic. A low-dose antiepileptic-antidepressant combination with opioids is effective in the management of neuropathic cancer pain. Objective: The aim was to see whether a low-dose antiepileptic-antidepressant combination is effective in the treatment of bone metastases. Study Design: Randomized, controlled trial Setting: Pain Clinic in Japan. Methods: Thirty-seven cancer patients, confirmed to have bone metastases, were allocated into 3 groups: P group took pregabalin 50 mg every 8 hours orally; P-I group took pregabalin 25 mg every 8 hours orally and imipramine 5 mg every 12 hours orally; P-M group took pregabalin 25 mg every 8 hours orally and mirtazapine 7.5 mg every 12 hours orally. Pain assessments were performed for 2 weeks. Results: The total pain score significantly decreased in all 3 groups even one day after the start of the medication. The decreases in the P-I and P-M groups were significantly greater than those in the P group from Day 2. Also, the daily paroxysmal pain episodes significantly decreased in all 3 groups at Day 1. The decreases in the P-M groups were significantly greater than those in the P group from Day 1. The decreases in the P-I group were significantly greater than those in the P group from Day 3. Conclusion: Low-dose pregabalin-antidepressant combinations with opioids were effective in the management of painful bone metastases. Key words: Cancer pain, painful bone metastases, antidepressant and anticonvulsants, pregabalin, mirtazapin

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