Self-reports are not related to objective assessments of cognitive function and sedation in patients with cancer pain admitted to a palliative care unit

2002 ◽  
Vol 16 (6) ◽  
pp. 513-519 ◽  
Author(s):  
Pal Klepstad ◽  
Priscilla Hilton ◽  
Jorunn Moen ◽  
Bjørn Fougner ◽  
Petter C Borchgrevink ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cognitive Function ◽  
Cancer Pain ◽  
Palliative Care Unit ◽  
Patients With Cancer ◽  
Self Reports

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.

Pain and Symptom Management in Palliative Care

1996 ◽  
Vol 3 (3) ◽  
pp. 204-213 ◽  
Author(s):  
Carla Ripamonti ◽  
Eduardo Bruera
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Control Strategy ◽  
Symptom Management ◽  
Pain Control ◽  
Advanced Disease ◽  
Patients With Cancer ◽  
Pharmacologic Management

Background Pain, dyspnea, and anorexia are common symptoms experienced by patients with cancer and often are poorly managed. Methods The incidence and causes of these symptoms are described, as well as factors that exacerbate or ameliorate their impact. Results Pharmacologic management of cancer pain is based on the use of a sequential “ladder” that incorporates nonopioid, opioid, and adjuvant drugs, depending on the severity of the pain. This approach usually is effective. Other symptoms of advanced disease may be more difficult to control. Conclusions Adherence to an adequate pain-control strategy will significantly enhance palliation of pain in patients with cancer.

scholarly journals Number of Unused Medications at the Time of Last Admission: A Prospective Observational Study in a Single Palliative Care Unit

2018 ◽  
Vol 35 (12) ◽  
pp. 1498-1504
Author(s):  
Takahito Omae ◽  
Nobuyuki Yotani ◽  
Akihiro Sakashita ◽  
Yoshiyuki Kizawa
Keyword(s):  
Palliative Care ◽  
Observational Study ◽  
Anticancer Drugs ◽  
Prospective Observational Study ◽  
Low Cost ◽  
Palliative Care Unit ◽  
Opioid Use ◽  
Patients With Cancer ◽  
Unused Medications ◽  
The Cost

Background: Unused medications (UM) are an important issue, with the waste associated with UM a burden to the health-care system. The aims of this study were to clarify the amount and costs of UM in patients with advanced cancer at the time of their last admission to a palliative care unit and to explore the factors contributing to the cost of UM and how patients dealt with UM. Methods: A prospective observational study was conducted in single palliative care unit. Unused medications were classified into 6 categories and the number and cost of UM by category calculated per patient. Patients were classified into 2 cost groups (high and low) based on the total cost of UM, and the number and cost of UM by category were compared between these 2 groups. Results: Of 194 consecutive hospitalized patients, data were analyzed for 90. The mean number and cost of UM per patient was 440 and US$301, respectively. Opioids accounted for 47% of the cost of UM. Comparing costs by UM category, the proportion of opioids (51% vs 21%; P < .0001) and oral anticancer drugs (14% vs 3%; P = .02) was higher in the high- than in the low-cost group. Conclusion: Based on the results of the present study, the estimated annual waste cost of UM for patients with cancer who died in Japan was approximately US$110 million. Interventions to educate patients regarding UM and to eliminate barriers to opioid use may help reduce the cost of UM, particularly opioids and anticancer drugs.

831 ASSESSMENT OF PAIN WITH THE EDMONTON STAGING SYSTEM FOR CANCER PAIN (ESS‐CP) IN A PALLIATIVE CARE UNIT

2009 ◽  
Vol 13 (S1) ◽  
Author(s):  
J. Canal Sotelo ◽  
M. Nabal ◽  
A. Sulhyak ◽  
Có. Palomar ◽  
A. Jimenez ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Staging System ◽  
Palliative Care Unit

scholarly journals Analysis of Severe Pain and its Treatment in a Palliative Care Unit in a Regional Cancer Centre

2017 ◽  
Vol 7 (3) ◽  
pp. 103
Author(s):  
Kannan P ◽  
Gunaseelan K ◽  
Parthasarathy V
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Pain Score ◽  
Cancer Patients ◽  
Severe Pain ◽  
Palliative Care Unit ◽  
Cancer Centre ◽  
Prevalence Of Pain ◽  
Regional Cancer Centre

<p><strong>Objective</strong>: Pain is one of the most common symptoms that troubles cancer patients and precludes satisfactory quality of life. Globally, nearly 80% of the cancer patients receive little or no pain medication and cancer pain is barely controlled. This study was done to analyse the prevalence of pain and pain treatment in patients presenting to palliative care unit in a regional cancer centre.</p><p><br /><strong>Methods</strong>: Palliative care registry and follow-up forms of 2142 patients who got registered in our palliative care unit were analysed to obtain the demographic details, treatment characteristics and to determine the prevalence of pain, its severity, and treatment in cancer patients in our regional cancer centre.</p><p><br /><strong>Results</strong>: Nearly 50% of the cancer population had head and neck and gastrointestinal tract malignancies and received only best supportive care. Stage IV disease was found in 40% of patients, and skeletal metastasis (52%) was most common. This study showed a 92.4% prevalence of cancer pain in our centre. About 40% of patients with pain had a pain score of 7-10 by Numerical rating scale on initial presentation to the palliative care unit. About 65% of the patients with severe pain had a response to treatment withmorphine during their first follow-up to palliative care unit after initial registration. The average overall pain score of the patients per visit decreased from around 7 to 4 at a median follow-up of ten months.</p><p><br /><strong>Significance of results</strong>: Thus, there is a high prevalence of pain in cancer patients and patients with severe pain receive little or no opioid medication at all probably due to the lack of adequate education and training to the primary oncologists and residents regarding prescription of strong opioids. This audit may help in the modification of existing and formulation of new policies in the delivery of palliative care.</p>

scholarly journals Impact of a Comprehensive Ketamine Protocol on Cancer Pain in a Palliative Care Unit

2018 ◽  
Vol 56 (6) ◽  
pp. e63
Author(s):  
Yee Choon Meng ◽  
Provido Mahrley Tanagon ◽  
Low Zhi Jun ◽  
Ang Ching Ching ◽  
Allyn Hum Yin Mei
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
Palliative Care Unit

How Do Hospital Palliative Care Teams Use the WHO Guidelines to Manage Unrelieved Cancer Pain? A 1-Year, Multicenter Audit in Japan

2016 ◽  
Vol 34 (1) ◽  
pp. 92-99 ◽  
Author(s):  
Tetsusuke Yoshimoto ◽  
Shiro Tomiyasu ◽  
Toshinari Saeki ◽  
Tomohiro Tamaki ◽  
Takahiro Hashizume ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Pain ◽  
World Health ◽  
Who Guidelines ◽  
Cancer Pain Management ◽  
Patients With Cancer ◽  
Palliative Care Teams ◽  
Health Organization ◽  
The Individual ◽  
Attention To Detail

It has been reported that pain relief for patients with cancer is suboptimal in Japan. This has been mainly attributed to inadequate dissemination of the World Health Organization (WHO) guidelines for cancer pain management. To better understand this problem, we reviewed how 6 hospital palliative care teams (HPCTs) used the WHO guidelines for unrelieved pain in a 1-year audit that included 534 patients. The HPCT interventions were classified according to the contents of the WHO guidelines. In our study, HPCT interventions involved opioid prescriptions in >80% of referred patients, and “For the Individual” and “Attention to Detail” were the 2 most important principles. Our study indicates which parts of the WHO guidelines should be most heavily emphasized, when disseminating them in Japan.

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