Outcomes of a specialized interdisciplinary approach for cancer patients with aberrant opioid-related behavior: A preliminary report.

2017 ◽  
Vol 35 (31_suppl) ◽  
pp. 212-212
Author(s):  
Tonya Edwards ◽  
Joseph Anthony Arthur ◽  
Suresh Reddy ◽  
Kristy Nguyen ◽  
David Hui ◽  
...  
Keyword(s):  
Pain Intensity ◽  
Cancer Patients ◽  
Interdisciplinary Approach ◽  
Clinical Effectiveness ◽  
Median Number ◽  
Control Group ◽  
Team Approach ◽  
Post Intervention ◽  
Care Clinic ◽  
Opioid Dose

212 Background: Data on the development and outcomes of effective interventions to address aberrant opioid-related behavior (AB) in cancer patients is lacking. Our outpatient supportive care clinic developed and implemented a specialized interdisciplinary team approach to manage patients with AB. The purpose of this study was to report clinical outcomes of this novel intervention. Methods: The medical records of 30 consecutive patients with evidence of AB who received the intervention and a random control group of 70 patients without evidence of AB between January 1, 2015 and August 31, 2016 were reviewed. Results: At baseline, pain intensity (p=0.002) and opioid dose (p=0.001) were significantly higher among patients with AB. During the course of the study, the median number of ABs per month significantly decreased from 3 pre-intervention to 0.4 post-intervention (p<0.0001). The median morphine equivalent daily dose decreased from 165mg/day at the first intervention visit to 112mg/day at the last follow up (p=0.018) although pain intensity did not significantly change (p= 0.984). ‘Request for opioid medication refills in the clinic earlier than the expected time’ was the AB with the highest frequency prior to the intervention and the greatest improvement during the study period. Younger age (p<0.0001) and higher ESAS anxiety score (p=0.005) were independent predictors of the presence of AB. Conclusions: The intervention was associated with a reduction in the frequency of AB and opioid utilization among cancer patients receiving chronic opioid therapy. More research is needed to further characterize the clinical effectiveness of this intervention. [Table: see text]

scholarly journals Chronic Non-Malignant Pain in Patients with Cancer Seen at a Timely Outpatient Palliative Care Clinic

Cancers ◽  
2020 ◽  
Vol 12 (1) ◽  
pp. 214
Author(s):  
David Hui ◽  
Eman Abdelghani ◽  
Joseph Chen ◽  
Shiva Dibaj ◽  
Donna Zhukovsky ◽  
...  
Keyword(s):  
Palliative Care ◽  
Cancer Patients ◽  
Task Force ◽  
International Association ◽  
Brief Pain Inventory ◽  
Median Number ◽  
Care Clinic ◽  
Disease Trajectory ◽  
Palliative Care Setting ◽  
Attending Physician

Palliative care is seeing cancer patients earlier in the disease trajectory with a multitude of chronic issues. Chronic non-malignant pain (CNMP) in cancer patients is under-studied. In this prospective study, we examined the prevalence and management of CNMP in cancer patients seen at our supportive care clinic for consultation. We systematically characterized each pain type with the Brief Pain Inventory (BPI) and documented current treatments. The attending physician made the pain diagnoses according to the International Association for the Study of Pain (IASP) task force classification. Among 200 patients (mean age 60 years, 69% metastatic disease, 1-year survival of 77%), the median number of pain diagnosis was 2 (IQR 1–2); 67 (34%, 95% CI 28–41%) had a diagnosis of CNMP; 133 (67%) had cancer-related pain; and 52 (26%) had treatment-related pain. In total, 12/31 (39%) patients with only CNMP and 21/36 (58%) patients with CNMP and other pain diagnoses were on opioids. There was a total of 94 CNMP diagnoses among 67 patients, including 37 (39%) osteoarthritis and 20 (21%) lower back pain; 30 (32%) were treated with opioids. In summary, CNMP was common in the timely palliative care setting and many patients were on opioids. Our findings highlight the need to develop clinical guidelines for CNMP in cancer patients to standardize its management.

scholarly journals Warm Compress Reduced Pain Intensity of Arthritis Rheumatoid for Elderly People; Pre- and Post-test Design Study

2019 ◽  
Author(s):  
Agussalim . ◽  
Josephine Lorica
Keyword(s):  
Pain Intensity ◽  
Elderly People ◽  
T Test ◽  
Control Group ◽  
P Value ◽  
Post Intervention ◽  
Two Samples ◽  
Post Test ◽  
Quasi Experimental ◽  
Arthritis Rheumatoid

Arthritis Rheumatoid (AR) is an autoimmune disease showing erosive of symmetric joint. It sometimes refers to many systems disturbances inside our bodies. The progressivity of AR has chronic fluctuation in daily life. AR can increase mortality risk, especially for chronic disabilities. This study aims to understand the effect of warm compress on the pain intensity of AR cases for elderly people. The method used in this study was a quasi-experimental one. The sampling method used was a purposive technique. The total number of respondents was 10, with 5 as the interventional arm of the study and 5 as the control arm. This study was conducted between February and July 2014. A paired t-test was used to identify whether the sample means for those in the intervention arm was statistically different from the average of the sample means drawn from those drawn from the control group presumed to be from the general elderly population who do not benefit from the particular intervention of a warm compress. What the author wanted to conclude on was whether the two samples at hand actually differ significantly from each other. The intensity of pre- and post-intervention using parametric statistics following the application of warm compress was noted and used as a basis of comparison. The result of the statistics formula showed the effectiveness of warm compress in decreasing the AR pain, the t-test was 6.000 and the p-value was lower than 0.05. It can be summarized that warm compress can be used to decrease pain intensity for elderly people with AR. Discussion – the result of this study can be used as a reference to conduct care among elder people who are affected by AR. People living in the community area should help their family member with AR on first aid.

The Benefits of Platelet-Rich Fibrin in Promoting Post-Extraction Healing

2018 ◽  
Vol 68 (12) ◽  
pp. 2974-2977
Author(s):  
Cherana Gioga ◽  
Edwin Sever Bechir ◽  
Farah Curt Mola ◽  
Carmen Liliana Defta ◽  
Anamaria Bechir ◽  
...  
Keyword(s):  
Wound Healing ◽  
Pain Intensity ◽  
Local Anesthesia ◽  
Control Group ◽  
Analog Scale ◽  
Post Intervention ◽  
Platelet Rich Fibrin ◽  
Healing Period

The aim of this study was to evaluate pain intensity and wound healing of the post-extraction sites after the use of Platelet-Rich Fibrin (PRF). 240 patients which needed difficult or multiple extractions were included in the study. The extractions were realized under local anesthesia, with piezotome and pliers. The patients were divided in two groups, the first group of 120 patients which benefited the application of PRF in the post-extraction alveoli, and the second group of 120 patients represented the control group (without application of PRF). A questionnaire was realized after a VAS analog scale and was used to quantify the post-intervention pain intensity in the postoperative four days. The assessment of the post-extraction sites healing period was performed clinically. According to the obtained results, the healing period of the post-extraction sites was shorter in the patients of first group (PRF), compared to the sites of control group patients. No postextractional healing complications occurred in the patients of first group/PRF. The study demonstrated the benefits of PRF insertion in post-intervention healing.

Do exercises improve back pain in pregnancy?

2017 ◽  
Vol 32 (3) ◽  
Author(s):  
Muhammad Azrai Abu ◽  
Nur Azurah Abdul Ghani ◽  
Lim Pei Shan ◽  
Aqmar Suraya Sulaiman ◽  
Mohd Hashim Omar ◽  
...  
Keyword(s):  
Back Pain ◽  
Pregnant Women ◽  
Pain Intensity ◽  
Functional Limitation ◽  
Intervention Group ◽  
Exercise Program ◽  
Control Group ◽  
Prospective Control Study ◽  
Post Intervention ◽  
Back Care

AbstractObjectiveTo assess the efficacy of an exercise program towards reducing back pain in pregnant women.MethodsIn this prospective control study, 145 low risk pregnant women who scored more than 20 for functional limitation assessment were recruited. The severity of back pain was assessed using the visual analoque scale (VAS) and the functional limitation was assessed using the Oswestry disability questionnaire (ODQ). All participants were informed of back care measures and provided with Paracetamol as an adjunct analgesia. The intervention group will have a session with a trained physiotherapist. Subsequently, all participants will be required to fill in a similar questionnaire regarding pain intensity and functional limitation assessment after 6 weeks post-intervention.ResultsThere was a significant reduction in the VAS score and improvement in functional ODQ score in the intervention group. The median usage of Paracetamol as an analgesia to control back pain in the control group was 500 mg higher than the intervention group. There was a weak association of age, parity, duration of back pain, and body mass index with functional ODQ score at 6 week following intervention.ConclusionThe back pain exercise reducing program was effective in reducing back pain intensity and analgesia usage with a significant improvement in functional ability.

scholarly journals Nutritional Intervention Improves Nutrition Outcomes in Stomach and Colon Cancer Patients Receiving Chemotherapy: Finding from a Quasi-Experiment in Vietnam

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 843
Author(s):  
Le Thi Huong ◽  
Duong Thi Phuong ◽  
Dang Kim Anh ◽  
Phung Lam Toi ◽  
Nguyen Le Tuan Anh ◽  
...  
Keyword(s):  
Colon Cancer ◽  
Cancer Patients ◽  
Muscle Mass ◽  
Intervention Group ◽  
Nutritional Intervention ◽  
Control Group ◽  
Post Intervention ◽  
Nutritional Interventions ◽  
And Control ◽  
Quasi Experiment

Background: Evidence on the effects of nutritional interventions on gastrointestinal cancer patients receiving chemotherapy is not well documented. This study aims to assess the effects of nutritional intervention in patients diagnosed with stomach and colon cancer receiving chemotherapy in Vietnam. Methods: A quasi-experiment with intervention and control groups for pre- and post-intervention was carried out in cancer patients receiving chemotherapy in a university hospital in Vietnam. Patients in the intervention group were provided nutritional counseling, personalized specific dietary advice, and received oral nutrition supplements (ONSs) while patients in the control group only received nutrition counseling. Results: The weight in the intervention and control group after 2 months increased significantly by 1.4 ± 2.6 kg and 0.4 ± 2.3 kg, respectively. Muscle mass increased by 1.2 ± 4.1 cm in the intervention group, while those in the control group decreased by 0.55 ± 2.77 cm. There was no statistical significance between two groups after intervention in terms of Mid–Upper Arm Circumference (MUAC) and percentage of fat. The percentage of malnutrition based on the Scored Patient-Generated Subjective Global Assessment (PG-SGA) and Body Mass Index (BMI) declined after the intervention in both groups. According to the average treatment effect on the treated (ATT) using the propensity score matching and DiD method, participants receiving the intervention were more likely to have a higher score of weight (Coef = 0.84; 95%CI = 0.47; 2.16) and muscle mass (Coef = 1.08; 95%CI = 0.09; 2.06) between pre- and post-intervention. By contrast, the PG-SGA scores on treated participants were more likely to decrease after the intervention (Coef = −1.28; 95%CI = −4.39; −0.84). After matching, being female, living in rural areas, or having stomach cancer were still positively related to being moderately/severely malnourished by the PG-SGA, and these findings were statistically significant (p < 0.05). Conclusion: The nutritional interventions had a positive effect on weight gain, muscle mass, and reduced malnutrition. Further studies with a longer follow-up duration are needed to confirm the effects of the intervention.

scholarly journals The effect of warm compress intervention on post herniotomy pain

2020 ◽  
Vol 1 ◽  
pp. 146-150
Author(s):  
Ika Cahyaningsih ◽  
Wenny Savitri ◽  
R. Anggono Joko Prasojo
Keyword(s):  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Intervention Group ◽  
Nursing Intervention ◽  
Rank Test ◽  
Control Group ◽  
Post Intervention ◽  
Control Group Design ◽  
Post Surgery

The most complaint symptom for post herniotomy patients is pain on the surgical site. Pain may affect patients' ability to mobilize and may attribute to prolonged length of stay in the hospital. Many complementary therapies have been used to decrease pain intensity for patients post-surgery, but warm compress intervention on post herniotomy pain has not been explored significantly. To investigate the effect of warm compress intervention on post herniotomy pain. The study used a pre-post test quasi-experimental with control group design. Sixteen post herniotomy adult patients of Wates Kulon Progo District General Hospital of Yogyakarta were recruited for each group. The intervention group was given warm compress interventions two times per day for two days. Pain intensity was assessed pre and post-intervention with the Numerical Rating Scale, while the control group only received regular analgetic. The researchers used the Wilcoxon Signed-Rank Test and Mann-Whitney U Test to compare pain intensity in each group and between groups.Fifteen out of 16 patients who received warm compress intervention rated decreased pain intensity as the rest did not experience any differences after the intervention (Z=-3.354, p=.001). Unlike the control group, only 3 out of 16 patients experienced declined pain intensity after two days of herniotomy when the rest did not encounter any changes (Z=-1.732, p=.083). The mean rank between intervention and control groups were significantly different (U=20.000, p=.000). Warm compress intervention is a non-invasive nursing intervention which is effective in reducing the pain intensity of post herniotomy patients.

Pain Education for Underserved Minority Cancer Patients: A Randomized Controlled Trial

2004 ◽  
Vol 22 (24) ◽  
pp. 4918-4925 ◽  
Author(s):  
Karen O. Anderson ◽  
Tito R. Mendoza ◽  
Richard Payne ◽  
Vicente Valero ◽  
Guadalupe R. Palos ◽  
...  
Keyword(s):  
Quality Of Life ◽  
African American ◽  
Pain Management ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Control Group ◽  
Pain Education ◽  
Perceived Pain

Purpose Previous studies found that African American and Hispanic cancer patients are at risk for undertreatment of pain. We evaluated the efficacy of a pain education intervention for underserved minority patients. Patients and Methods Ninety-seven underserved African American and Hispanic outpatients with cancer-related pain were enrolled onto a randomized clinical trial of pain management education. The patients in the education group received a culture-specific video and booklet on pain management. The control group received a video and booklet on nutrition. A research nurse met with each patient to review the materials. We measured changes in pain intensity and pain-related interference 2 to 10 weeks after the intervention, as well as changes in quality of life, perceived pain control, functional status, analgesics, and physician pain assessments. Results Physicians underestimated baseline pain intensity and provided inadequate analgesics for more than 50% of the sample. Although the ratings for pain intensity and pain interference decreased over time for both groups, there was no statistically significant difference between groups. Pain education did not affect quality of life, perceived pain control, or functional status. African American patients in the education but not the control group reported a significant decrease in pain worst ratings from baseline to first follow-up (P < .01), although this decrease was not maintained at subsequent assessments. Conclusion Brief education had limited impact on pain outcomes for underserved minority patients, suggesting that more intensive education for patients and interventions for physicians are needed.

The use of intravenous morphine for breakthrough pain in terminal cancer patients admitted to hospice center.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20621-e20621
Author(s):  
Ik-Joo Chung ◽  
Sang-Hee Cho ◽  
Jun-Eul Hwang ◽  
Jae-Sook Ahn ◽  
Won-young Choi ◽  
...  
Keyword(s):  
Adverse Effects ◽  
Pain Intensity ◽  
Breakthrough Pain ◽  
Terminal Cancer ◽  
Care Clinic ◽  
Opioid Dose ◽  
Study Results ◽  
Intravenous Morphine ◽  
The Mean ◽  
Moderate Nausea

e20621 Background: The adequate opioid dose to be administered for breakthrough pain(BTP) is still controversial. Dosing recommendations are based on patient’s(pts) total daily opioid dose. Intravenous morphine(IV-M) has been found to be effective and safe for the management of BTP. However, physicians are often reluctant in using large doses of IV-M because of the possible adverse events in terminal cancer pts. The aim of this study was to evaluate whether pts were treated appropriately for their BTP in hospice setting. Methods: A total of 94 consecutive terminal cancer pts who were admitted in the Hospice and Palliative Care Clinic at Jeonnam Regional Cancer Center from June 2012 to Nov 2012 were analyzed in this study. Results: In total, 1,213 BTP events treated by IV-M were recorded and the mean number of events per pts was 13.6 (95% confidence interval (CI) 10.5-15.4). The mean dose of IV-M was 13.9mg (95% CI 12.5-14.5mg, range 3-90mg) and was equivalent to 7.1% of the total daily opioid dose. For each episode, pain intensity and opioid-related symptoms were recorded at the base (T0) and within 30 minutes after (T1). Pain intensity decreased from a mean of 5.1(on a 0-10 numeric scale) at base to 1.8 at T1. A decrease in pain of more than 30%, 50% and 70% was observed in 1179 (97.2%), 958 (78.9%) and 460 (37.9%) BTP events, respectively. In 21 episodes, no changes in pain intensity were observed and a further dose of IV-M was given. Doses of more than 10mg, 30mg and 50mg of IV-M were given for 456 (37.6%), 200 (16.5%) and 104(8.6%). No differences in age, sex and pain location were found. Adverse effects were uncommon, moderate nausea/vomiting in 32 episodes, drowsiness in 15 episodes, and confusion in one episode. Conclusions: In the current study, IV-M was safe and effective for almost all episodes of BTP. This study shows that IV-M did not result in life-threatening adverse effects in terminal cancer pts, including older pts and those requiring relatively large doses.

Effect of chamomile oil on cesarean section pain in primiparous women: a randomized clinical trial

2020 ◽  
Vol 15 ◽  
Author(s):  
Roghayeh Zardosht ◽  
Ameneh Basir ◽  
Amirhossein Sahebkar ◽  
Seyed Ahmad Emami
Keyword(s):  
Clinical Trial ◽  
Cesarean Section ◽  
Pain Intensity ◽  
Intervention Group ◽  
Control Group ◽  
Post Intervention ◽  
Chi Square ◽  
Double Blind ◽  
The Difference ◽  
Primiparous Women

Background: Pain after cesarean section can turn the pleasant event of childbirth into an unpleasant experience for the mother. Pain relief through non-pharmaceutical methods, such as aromatherapy, could potentially be a useful intervention. In this study, the analgesic effect of chamomile oil was studied. Purpose: The current research was conducted to study the effect of chamomile oil on cesarean section pain in primiparous women. Materials and methods: This was a randomized double blind clinical trial wherein 128 primiparous pregnant women (who willingly selected cesarean section) took part. In the aromatherapy group, the subjects inhaled one drop of 5% chamomile oil, and in the control group the subjects inhaled one placebo drop. In both groups the subjects inhaled for 15-20 minutes at a distance of 5 cm from the nose at 4, 8, and 12 hours after surgery, and pain intensity was measured before and after half an hour after inhalation using the visual analog scale (VAS). For data analysis, the software SPSS (version 25) and descriptive statistics (frequency, frequency percentage, mean, and standard deviation) were used. In order to determine the significance, inferential statistics (Mann-Whitney, Wilcoxon, independent t-test, and Chi-square) were used. Findings: Data indicated that the intervention and placebo groups were homogeneous in terms of demographic variables. The average weights and heights of women in the intervention group were 86/5± 5/9 and 163/7 ±5/1, respectively. Corresponding values women in the control group were 84/5± 5/7 kg and 163/4± 5/8 cm. The finding of the current research indicates that the intervention and placebo groups showed no significant statistical difference in terms of baseline pain before intervention (p=0.08), while the difference between the two groups was significant in terms of pain 4, 8, and 12 hours after intervention (p<0.01). Therefore, inhalation of chamomile oil reduced pain intensity significantly compared to post-intervention. Conclusion: According to the results of the present study, inhalation of chamomile oil following caesarean section in primiparous women reduced pain and also the need for analgesics. Therefore, the use of aromatherapy with chamomile oil as a simple way without any side effects for the reduction of pain in mothers after cesarean section is recommended.

The Effect of Logotherapy on Death Anxity, Pain Catastrophizing, Pain Acceptance, and Pain Intensity in Patients With Prostate Cancer

2021 ◽  
Vol 20 (3) ◽  
pp. 216-225
Author(s):  
Mohammad Reza Haghdoost ◽  
◽  
Naser Saraj Khoami ◽  
Behnam Makvandi ◽  
◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Death Anxiety ◽  
Pain Catastrophizing ◽  
Treatment Center ◽  
Control Group ◽  
Pain Acceptance ◽  
Experimental Group

Background and Objectives: This study investigated the effectiveness of logotherapy on death anxiety, pain catastrophizing, pain acceptance, and severity of pain in prostate cancer patients. Subjects and Methods : The research design was an experimental pretest-posttest with a control group. At first, 40 hospitalized men in a treatment center were selected by using the purposive sampling method. The experimental group was treated for eight 45-minute sessions by training logotherapy. All subjects completed the questionnaire at the beginning of the study, immediately after the intervention, and one month after the treatment (one-month follow-up). For data analysis, 1-way analysis of variance was used. Results The results indicated that logotherapy in the experimental group was more effective than the control group in reducing death anxiety, pain catastrophizing, pain acceptance, and severity of pain in prostate cancer patients. The follow-up results also showed that the effect of logotherapy was sustained on death anxiety, pain catastrophizing, pain acceptance, and severity of pain in prostate cancer patients. Conclusion The results showed that Logotherapy has an effect on death anxiety, pain catastrophe, pain acceptance and pain intensity in patients with prostate cancer

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