Benzodiazepines for cancer dyspnoea: a nationwide survey of palliative care physicians

2019 ◽  
Vol 10 (2) ◽  
pp. 205-208 ◽  
Author(s):  
Yoshinobu Matsuda ◽  
Ryo Matsunuma ◽  
Kozue Suzuki ◽  
Masanori Mori ◽  
Hiroaki Watanabe ◽  
...  
Keyword(s):  
Palliative Care ◽  
Questionnaire Survey ◽  
Nationwide Survey ◽  
High Baseline ◽  
Future Studies ◽  
Opioid Dose ◽  
Patients With Cancer

ObjectivesIt is unclear whether patients with non-specific dyspnoea are suitable candidates for studies investigating the effectiveness of benzodiazepines against dyspnoea. The objective of this survey was to investigate suitable subjects for studies of benzodiazepines for cancer dyspnoea.MethodsA nationwide questionnaire survey was conducted among 536 Japanese-certified palliative care physicians. We randomly selected 268 physicians and inquired about their approach to dyspnoea management in patients with cancer, with and without anxiety, as follows: (1) Administration of a benzodiazepine. (2) Administration or titration of an opioid. We also asked them to consider their approach in the following situations: (1) Opioid-naïve. (2) Low-to-moderate baseline opioid dose. (3) High baseline opioid dose. We assessed the use of specific benzodiazepines separately.ResultsOverall, 192 physicians responded to the questionnaire (71.6%). For patients without anxiety, the proportion of participants reporting that they frequently or very frequently ‘administer a benzodiazepine’ increased with baseline opioid dose (opioid-naïve: 5.2%, low-to-moderate: 11.5%, high: 26.0%). The proportion of participants reporting that they frequently or very frequently ‘administer or titrate an opioid’ decreased with baseline opioid dose (opioid-naïve: 83.3%, low-to-moderate: 73.4%, high: 41.1%). The pattern was similar for patients with anxiety, although more respondents said they prescribe benzodiazepine for these patients (naïve: 22.4%, low-to-moderate: 34.4%, high: 45.8%) and fewer prescribed an opioid. Alprazolam and lorazepam are frequently used.ConclusionPatients with anxiety or receiving a high baseline opioid dose could be potential candidates for future studies investigating the effectiveness of benzodiazepines against cancer dyspnoea.

Psychologists involved in cancer palliative care in Japan: A nationwide survey

2014 ◽  
Vol 13 (2) ◽  
pp. 327-334 ◽  
Author(s):  
Kasumi Nakajima ◽  
Yumi Iwamitsu ◽  
Mei Matsubara ◽  
Akira Oba ◽  
Kei Hirai ◽  
...  
Keyword(s):  
Palliative Care ◽  
Mental State ◽  
Questionnaire Survey ◽  
Medical Staff ◽  
Nationwide Survey ◽  
Psychological Support ◽  
Knowledge And Skills ◽  
Staff Members ◽  
Adequate Knowledge ◽  
Training Expectations

AbstractObjective:The aim of this study was to clarify, using a nationwide survey, what is perceived as necessary knowledge and skills for psychologists involved in cancer palliative care in Japan, the expectations of medical staff members, and the degree to which these expectations are met.Method:We conducted a questionnaire survey of psychologists involved in cancer palliative care. A total of 419 psychologists from 403 facilities were asked to fill out the questionnaire and return it anonymously. Some 401 psychologists (89 males, 310 females, and 2 unspecified; mean age, 37.2  ±  9.5 years) responded about necessary knowledge and skills for psychologists working in cancer palliative care, the necessity for training, expectations at their current workplace, and the degree to which expectations are met.Results:More than 90% of participants responded that many kinds of knowledge and skills related to the field of cancer palliative care are necessary. Over 80% of participants indicated a necessity for training related to these knowledge and skills. Although more than 50% (range, 50.1–85.8%) of participants responded that such services as “cooperation with medical staff within a hospital,” “handling patients for whom psychological support would be beneficial,” and “assessment of patients' mental state” were expected at their workplace, fewer than 60% (31.4–56.9%) responded that they actually performed these roles.Significance of Results:Our results show that many psychologists in cancer palliative care feel unable to respond to the expectations at their current workplace and that they require more adequate knowledge and skills related to cancer palliative care to work effectively. No other nationwide surveys have generated this type of information in Japan, so we believe that the results of our study are uniquely important.

A Nationwide Survey of Japanese Palliative Care Physicians' Practice of Corticosteroid Treatment for Dyspnea in Patients With Cancer

2019 ◽  
Vol 58 (6) ◽  
pp. e3-e5 ◽  
Author(s):  
Kozue Suzuki ◽  
Ryo Matsunuma ◽  
Yoshinobu Matsuda ◽  
Masanori Mori ◽  
Hiroaki Watanabe ◽  
...  
Keyword(s):  
Palliative Care ◽  
Nationwide Survey ◽  
Corticosteroid Treatment ◽  
Patients With Cancer

Desirable Information of Opioids for Families of Patients With Terminal Cancer

2016 ◽  
Vol 34 (3) ◽  
pp. 248-253
Author(s):  
Yoshiaki Okamoto ◽  
Satoru Tsuneto ◽  
Tatsuya Morita ◽  
Tatsuya Takagi ◽  
Megumi Shimizu ◽  
...  
Keyword(s):  
Palliative Care ◽  
Life Expectancy ◽  
Nationwide Survey ◽  
Terminal Cancer ◽  
Cross Sectional ◽  
Patients With Cancer ◽  
Patient Will ◽  
Palliative Care Units ◽  
Hospice And Palliative Care ◽  
Care Evaluation

Objective: The aims of this study are to clarify the state of information regarding opioids for families and what kinds of experiences they had with opioids while the patient was followed as an outpatient and inpatient. Participants: This study was part of a cross-sectional nationwide survey of bereaved families of patients with cancer, namely, the Japan Hospice and Palliative Care Evaluation 2 study. The participants in this study comprised 572 bereaved families who had experienced the death of a family member during the period from January 2008 to December 2009 at 1 of 103 certificated palliative care units. Main Outcome Measures: In response to the question of “how much improvement was needed for information regarding opioids,” 41% answered “improvement is not necessary at all,” 43% answered “improvement is slightly necessary,” 14% answered “improvement is necessary,” and 2% answered “improvement is extremely necessary.” Regarding anxiety about the use of opioid, it was found that 14% of respondents indicated “opioids are very safe,” 65% of respondents indicated “opioids are relatively safe,” 19% of respondents indicated “opioids are not so safe,” and 2% of respondents indicated “opioids are not so safe at all.” from the information obtained for opioids. It was found that 90% of families agreed with the item, “I would like to be clearly explained that drugs for medical purposes are safe and that the patient will not develop a drug addiction and their life expectancy will not be reduced.” Conclusion: From this study, it is important for families of patients with cancer to be explained profound and careful information of opioid.

scholarly journals Symptom clusters and their influence on prognosis using EORTC QLQ-C15-PAL scores in terminally ill patients with cancer

2021 ◽  
Author(s):  
Nanako Koyama ◽  
Chikako Matsumura ◽  
Yuuna Tahara ◽  
Morito Sako ◽  
Hideo Kurosawa ◽  
...  
Keyword(s):  
Palliative Care ◽  
Terminally Ill ◽  
Symptom Clusters ◽  
Rank Test ◽  
Appetite Loss ◽  
Patients With Cancer ◽  
Terminally Ill Patients ◽  
Log Rank Test ◽  
Eortc Qlq ◽  
Cluster 2

Abstract Purpose The aims of the present study were to investigate the symptom clusters in terminally ill patients with cancer using the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 15 Palliative Care (EORTC QLQ-C15-PAL), and to examine whether these symptom clusters influenced prognosis. Methods We analyzed data from 130 cancer patients hospitalized in the palliative care unit from June 2018 to December 2019 in an observational study. Principal component analysis was used to detect symptom clusters using the scored date of 14 items in the QLQ-C15-PAL, except for overall QOL, at the time of hospitalization. The influence of the existence of these symptom clusters and Palliative Performance Scale (PPS) on survival was analyzed by Cox proportional hazards regression analysis, and survival curves were compared between the groups with or without existing corresponding symptom clusters using the log-rank test. Results The following symptom clusters were identified: cluster 1 (pain, insomnia, emotional functioning), cluster 2 (dyspnea, appetite loss, fatigue, and nausea), and cluster 3 (physical functioning). Cronbach’s alpha values for the symptom clusters ranged from 0.72 to 0.82. An increased risk of death was significantly associated with the existence of cluster 2 and poor PPS (log-rank test, p = 0.016 and p < 0.001, respectively). Conclusion In terminally ill patients with cancer, three symptom clusters were detected based on QLQ-C15-PAL scores. Poor PPS and the presence of symptom cluster that includes dyspnea, appetite loss, fatigue, and nausea indicated poor prognosis.

scholarly journals P29-1 The results of the questionnaire survey of oral steroids for patients with cancer-related fatigue

2021 ◽  
Vol 32 ◽  
pp. S347
Author(s):  
Takahiro Yamamura ◽  
Yoshito Komatsu ◽  
Satoshi Yuki ◽  
Yasuyuki Kawamoto ◽  
Kazuaki Harada ◽  
...  
Keyword(s):  
Questionnaire Survey ◽  
Patients With Cancer ◽  
Cancer Related Fatigue ◽  
Oral Steroids

scholarly journals Acupuncture for palliative cancer pain management: systematic review

2021 ◽  
pp. bmjspcare-2020-002638
Author(s):  
Juan Yang ◽  
Dietlind L Wahner-Roedler ◽  
Xuan Zhou ◽  
Lesley A Johnson ◽  
Alex Do ◽  
...  
Keyword(s):  
Systematic Review ◽  
Palliative Care ◽  
Pain Management ◽  
Cancer Pain ◽  
Included Study ◽  
Favourable Effect ◽  
Levels Of Evidence ◽  
Patients With Cancer ◽  
Level 3 ◽  
Randomised Controlled

BackgroundPain is one of the most common and problematic symptoms encountered by patients with cancer. Due to the multifactorial aetiology, pain management of these patients frequently requires multidisciplinary interventions including conventional support and specialty palliative care. Acupuncture has been identified as a possible adjunctive therapy for symptom management in cancer pain, and there is currently no systematic review focused solely on the evidence of acupuncture on cancer pain in palliative care.ObjectiveTo critically analyse currently available publications regarding the use of acupuncture for pain management among patients with cancer in palliative care settings.MethodsMultiple academic databases were searched from inception to 29 October 2020. Randomised controlled trials involving acupuncture in palliative care for treatment of cancer-related pain were synthesised. Data were extracted by two independent reviewers, and methodological quality of each included study was assessed using the Oxford Centre for Evidence-Based Medicine (OCEBM) 2011 Levels of Evidence.ResultsFive studies (n=189) were included in this systematic review. Results indicated a favourable effect of acupuncture on pain relief in palliative care for patients with cancer. According to OCEBM 2011 Levels of Evidence, they were level 2 in one case (20%), level 3 in two cases (40%) and level 4 in the remaining (40%). Low-level evidence adversely affects the reliability of findings.ConclusionsAcupuncture may be an effective and safe treatment associated with pain reduction in the palliative care of patients with cancer. Further high-quality, adequately powered studies are needed in the future.

scholarly journals Concerns of Patients With Cancer on Accessing Cannabis Products in a State With Restrictive Medical Marijuana Laws: A Survey Study

2019 ◽  
Vol 15 (10) ◽  
pp. 531-538 ◽  
Author(s):  
Vinita Singh ◽  
Ali J. Zarrabi ◽  
Kimberly A. Curseen ◽  
Roman Sniecinski ◽  
Justine W. Welsh ◽  
...  
Keyword(s):  
Health Care ◽  
Palliative Care ◽  
Health Care Providers ◽  
Medical Marijuana ◽  
Survey Study ◽  
Care Practice ◽  
Care Providers ◽  
Patients With Cancer ◽  
Medical Marijuana Laws ◽  
Source Of Information

PURPOSE: Several states, particularly in the Southeast, have restrictive medical marijuana laws that permit qualified patients to use specific cannabis products. The majority of these states, however, do not provide avenues for accessing cannabis products such as in-state dispensaries. METHODS: We conducted a survey of patients registered for medical marijuana (low tetrahydrocannabinol [THC] oil cards) in an ambulatory palliative care practice in Georgia (one of the states with restrictive medical marijuana laws). RESULTS: We had a total of 101 responses. Among our sample of patients who use cannabis as part of a state-approved low THC oil program, 56% were male and 64% were older than age 50 years. Advanced cancer was the most common reason (76%) for granting the patients access to a low THC oil card. Although patients reported cannabis products as being extremely helpful for reducing pain, they expressed considerable concerns about the legality issues (64%) and ability to obtain THC (68%). Several respondents were using unapproved formulations of cannabis products. For 48% of the patients, their physician was the source of information regarding marijuana-related products. Furthermore, they believed that their health care providers and family members were supportive of their use of cannabis (62% and 79%, respectively). CONCLUSION: Patients on Georgia’s medical marijuana program are most concerned about the legality of the product and their ability to obtain marijuana-related products. Therefore, we recommend that states with medical marijuana laws should provide safe and reliable access to cannabis products for qualifying patients.

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