scholarly journals Luaran Penggunaan Analgesik Opiat pada Pasien Kanker

2019 ◽  
Vol 9 (4) ◽  
pp. 284
Author(s):  
Salma Fajar Puspita ◽  
Zullies Ikawati, Apt. ◽  
Retno Muliawati
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Disease Status ◽  
Cancer Center ◽  
Transdermal Fentanyl ◽  
Reduction Of Pain

Cancer pain might reduce the quality of life of cancer patients. Opioids are the drug of choice in cancer pain management. Fentanyl and other opioids are often prescribed. This study was aimed to compare the pain intensity reduction and quality of life of patients with cancer pain using transdermal fentanyl and other opioids. This prospective cohort study Oinvolved cancer outpatients with pain at the Tulip International Cancer Center of RSUP Dr. Sardjito, Yogyakarta fulfilling inclusion and exclusion criteria. Follow-up was carried out 2 weeks after recruitment. Pain intensity and quality of life were obtained through interview process using Numerical Rating Scale (NRS) and EORTC QLQ-C30 questionnaire. Patient demographic and disease status were obtained from medical records. Clinical outcomes (reduction in pain intensity and achievement of pain targets) and quality of life in the transdermal fentanyl and oral opioid groups were presented descriptively because of the low research power. Total respondents involved were 111 patients, 13 (11.71%) patients used transdermal fentanyl and 98 (88.29%) patients used oral opiates. The effect of opioid on reduction of pain intensity, achievement of pain targets and quality of life cannot be justified even though descriptively transdermal fentanyl shows better outcomes than oral opioid. The reduction of pain intensity was influenced by age (p = 0,000) and global health status was influenced by the stage of the cancer (p = 0.045).

scholarly journals A Prospective Multicentre Study to Evaluate the Efficacy and Tolerability of Osmotic Release Oral System (Oros®) Hydromorphone in Opioid-Naive Cancer Patients: Results of the Korean South West Oncology Group Study

2015 ◽  
Vol 20 (6) ◽  
pp. 293-299 ◽  
Author(s):  
Eun-Kee Song ◽  
Hyunjeong Shim ◽  
Hye-Suk Han ◽  
DerSheng Sun ◽  
Soon-Il Lee ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Relief ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Pain Control ◽  
Intensity Difference ◽  
Front Line ◽  
Long Acting

BACKGROUND: Osmotic release oral system (OROS®) hydromorphone is a potent, long-acting opioid analgesic, effective and safe for controlling cancer pain in patients who have received other strong opioids. To date, few studies have examined the efficacy of hydromorphone for pain relief in opioid-naive cancer patients.OBJECTIVES: A prospective, open-label, multicentre trial was conducted to determine the efficacy and tolerability of OROS hydromorphone as a single and front-line opioid therapy for patients experiencing moderate to severe cancer pain.METHODS: OROS hydromorphone was administered to patients who had not previously received strong, long-acting opioids. The baseline evaluation (visit 1) was followed by two evaluations (visits 2 and 3) performed two and 14 weeks later, respectively. The starting dose of OROS hydromorphone was 4 mg/day and was increased every two days when pain control was insufficient. Immediate-release hydromorphone was the only accepted alternative strong opioid for relief of breakthrough pain. The efficacy, safety and tolerability of OROS hydromorphone, including the effects on quality of life, and patients’ and investigators’ global impressions on pain relief were evaluated. The primary end point was pain intensity difference (PID) at visit 2 relative to visit 1 (expressed as %PID).RESULTS: A total of 107 patients were enrolled in the present study. An improvement in pain intensity of >50% (≥50% PID) was observed in 51.0% of the full analysis set and 58.6% of the per-protocol set. The mean pain score, measured using a numerical rating scale, was significantly reduced after two weeks of treatment, and most adverse events were manageable. Quality of life also improved, and >70% of patients and investigators were satisfied with the treatment.CONCLUSIONS: OROS hydromorphone provided effective pain relief and improved quality of life in opioid-naive cancer patients. As a single and front-line treatment, OROS hydromorphone delivered rapid pain control.

Painful diabetic polyneuropathy and quality of life in Danish type 2 diabetic patients

2017 ◽  
Vol 16 (1) ◽  
pp. 173-173 ◽  
Author(s):  
Sandra Sif Gylfadottir ◽  
Diana Hedevang Christensen ◽  
Sia Kromann Nicolaisen ◽  
Reimar Wernich Thomsen ◽  
Jens Steen Nielsen ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Rating Scale ◽  
Diabetic Polyneuropathy ◽  
Numeric Rating Scale ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Type 2 Diabetic

Abstract Background and aims Painful polyneuropathy (PPN) is a disabling complication of diabetes. This study aims to determine its prevalence and relationship with Quality of Life (QoL) in a nationwide prospective cohort of incident recently diagnosed Danish type 2 diabetic patients. Methods We sent a detailed questionnaire on neuropathy, pain and QoL to 6726 patients prospectively enrolled from general practitioners and hospital specialist outpatient clinics into the Danish Centre for Strategic Research in Type 2 Diabetes (DD2) cohort. Patients who reported pain in both feet and a score ≥3 on the Douleur Neuropathique (DN4) questionnaire were considered to have possible PPN. QoL and pain intensity were measured on a numeric rating scale (NRS, 0–10). The Michigan Neuropathy Screening Instrument (MNSI) was used to assess neuropathy. Results A total of 5371 (79.8%) returned a complete questionnaire. 848 (15.8%) recently diagnosed type 2 diabetic patients reported pain in both feet. Of the 619 patients with pain who completed the DN4 questionnaire, 404 (65.2%) had a DN4 score ≥ 3, corresponding to a prevalence in the total population of possible PPN of 10.3%. Mean pain intensity was 5.2 (SD 2.2) and 89% had a MNSI score ≥ 3. Patients with possible PPN had a substantially lower QoL score than those without PPN (median QoL score 6 versus 8 (p < 0.001)), also when correcting for MNSI score. Conclusions Ten percent of newly diagnosed type 2 diabetic patients in Denmark had possible PPN. Patients with PPN had lower QoL than patients without PPN.

Amitriptyline in Neuropathic Cancer Pain in Patients on Morphine Therapy: A Randomized Placebo-controlled, Double-blind Crossover Study

2002 ◽  
Vol 88 (3) ◽  
pp. 239-242 ◽  
Author(s):  
Sebastiano Mercadante ◽  
Edoardo Arcuri ◽  
Walter Tirelli ◽  
Patrizia Villari ◽  
Alessandra Casuccio
Keyword(s):  
Quality Of Life ◽  
Neuropathic Pain ◽  
Adverse Effects ◽  
Cancer Pain ◽  
Pain Intensity ◽  
Cancer Patients ◽  
Double Blind ◽  
Blind Crossover Study ◽  
Double Blind Crossover Study

Aims and Background Amitriptyline is the most common analgesic adjuvant used in cancer patients with neuropathic pain, even though no specific studies have demonstrated a benefit. A randomized placebo-controlled, double-blind crossover study was designed to evidence the effects of amitriptyline in patients with neuropathic cancer pain. Methods Sixteen advanced cancer patients with neuropathic pain on systemic morphine therapy, no longer receiving oncologic treatment, presenting moderate pain (about 4 or more, but less than 7, on a numerical scale of 0-10) in the last week, and given a stable morphine dose in the last 2 days were admitted to the study. During the first week of study, patients were administered 25 mg of amitriptyline or equivalent drops of placebo at night for 3 days and 50 mg for the following 4 days. Doses for patients aged more than 65 years were 15 mg (first 3 days) and 30 mg (3 days after). After a week, a crossover took place for the second week, with the other treatment at an inverse sequence. Opioid consumption, pain intensity, symptoms and adverse effects, mood, sleep, patient's preference, quality of life before starting the study, the first week after and the second week after were recorded. Results No significant benefits in analgesia were found in the global pain intensity of the previous week of treatment, the least pain intensity or the pain evaluated just after a week of treatment, at the moment of the visit, when amitriptyline was compared with placebo. A significant difference was evidenced for the worst pain (P < 0.035). No differences in opioid doses during the period of study were found. Drowsiness, confusion and dry mouth were significantly more intense with amitriptyline than with placebo (P < 0.036, 0.003, and 0.034, respectively). There were no substantial differences between the two treatments in Spitzer's quality of life score and for each item. No differences in patients' preference for the two treatment periods were found. The analgesic effects of amitriptyline were slight and associated with adverse effects. Conclusions In light of the results obtained in the study, the extensive use of the drug for cancer pain should be questioned.

Mycophenolate for persistent complex regional pain syndrome, a parallel, open, randomised, proof of concept trial

2018 ◽  
Vol 18 (1) ◽  
pp. 29-37 ◽  
Author(s):  
Andreas Goebel ◽  
Anu Jacob ◽  
Bernhard Frank ◽  
Paul Sacco ◽  
Guillermo Alexander ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Complex Regional Pain Syndrome ◽  
Rating Scales ◽  
Rating Scale ◽  
Pain Syndrome ◽  
Analysis Of Covariance ◽  
Proof Of Concept ◽  
Numeric Rating

Abstract Background and aims: Current therapies for persistent complex regional pain syndrome (CRPS) are grossly inadequate. With accruing evidence to support an underlying immunological process and anecdotal evidence suggesting potential efficacy of mycophenolate, we wished to explore the feasibility and effectiveness of this treatment in patients with CRPS. Methods: A randomised, open, parallel, proof of concept trial was conducted. Patients with Budapest research criteria CRPS of >2-year duration and moderate or high pain intensity (numeric rating scale score ≥5) were enrolled. Eligible patients were randomised 1:1 to openly receive mycophenolate as add-on treatment, or their usual treatment alone, over 5.5 months. They then switched to the other treatment arm for 5.5 months. The main outcome was average the patients’ average pain intensity recorded over 14 days, between 5.0 and 5.5 months post randomisation, on 11-point (0–10) numeric rating scales, compared between trial arms. Skin sensitivities and additional outcomes were also assessed. Results: Twelve patients were enrolled. Nine provided outcomes and were analysed for the main outcome. Mycophenolate treatment was significantly more effective than control [drug-group mean (SD): pre: 7.4 (1.2)- post: 5.2 (1.3), n=4, control: pre: 7.7 (1.4)- post: 8.1 (0.9), n=5; −2.8 (95% CI: −4.7, −1.0), p=0.01, analysis of covariance]. There were four treatment responders (to mycophenolate treatment either before, or after switch), whose initial exquisite skin hyper-sensitivities, function and quality of life strongly improved. Side effects including itchiness, skin-cryptitis, increased pain, and increased depression caused 45% of the subjects to stop taking mycophenolate. Conclusions: Mycophenolate appears to reduce pain intensity and improve quality of life in a subgroup of patients with persistent CRPS. Implications: These results support the feasibility of conducting a definite trial to confirm the efficacy and effect size of mycophenolate treatment for persistent CRPS (EudraCT 2015-000263-14).

The Development of the Mymop Pictorial Version

2004 ◽  
Vol 22 (2) ◽  
pp. 68-71 ◽  
Author(s):  
Anthony Day
Keyword(s):  
Quality Of Life ◽  
Complementary Therapies ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Life Instrument ◽  
Numerical Rating

The MYMOP is a well accepted quality of life instrument that is particularly suitable for assessing the effect of complementary therapies; however, some groups of patients find it difficult to use. A pictorial version was developed using faces instead of the numerical rating scale – it is called MYMOP pictorial. This version appears to be more acceptable to patients but has not been formally validated.

scholarly journals 12-Month Cohort Study to Investigate Changes in Patient-Reported Outcomes Pain after Intra-articular Injection of Micro-Fragmented Adipose Tissue for Knee Osteoarthritis

2021 ◽  
Vol 3 (1) ◽  
pp. e19-e28
Author(s):  
Nathan Hogaboom ◽  
Ella D'Amico ◽  
Ken Mautner ◽  
Christopher Rogers ◽  
Gerard Malanga
Keyword(s):  
Quality Of Life ◽  
Adipose Tissue ◽  
Knee Osteoarthritis ◽  
Outcome Measures ◽  
Knee Pain ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Symptomatic Knee ◽  
Patient Reported

BackgroundTo evaluate changes in pain, function, and quality of life after treatment with injected micro-fragmented adipose tissue (MFAT) for knee osteoarthritis in a large cohort of individuals treated at multiple centers. MethodsOne hundred ten individuals were recruited from three private outpatient clinics. Participants had to be diagnosed with symptomatic knee OA (defined by persistent knee pain associated with clinical symptoms of OA and/ or classic imaging findings) and who had not received prior knee surgery or treatment with platelet-rich plasma, cortisone, or hyaluronic acid within the previous 6 weeks. Data from 120 knees were included in the analysis. Outcome measures included Knee Injury and Osteoarthritis Outcome Score (KOOS) subscales (pain, symptoms, activities of daily living [ADL], sports and recreation, quality of life [QOL]) and an 11-point Numerical Rating Scale (NRS) for average knee pain over the past week. Outcomes were collected at baseline and 3, 6, and 12 months. ResultsSignificant increases and decreases in KOOS subscale and NRS scores were observed, respectively, in the cohort as a whole (p< .05). Lower BMI was associated with more significant improvements in pain, sports/recreation, and ADL KOOS subscale scores (p< .05). Greater age was associated with more significant improvements in symptoms and QOL subscale scores (p< .05). ConclusionsA single injection of MFAT improved pain, function, and QOL outcome measures up to 12 months in this cohort for more than half of the participants. Greater BMI and lower age negatively influenced outcomes. It is not known whether improvements continue after this timeframe or why many participants reported little-to-no improvement.

scholarly journals Careful Breakthrough Cancer Pain Treatment through Rapid-Onset Transmucosal Fentanyl Improves the Quality of Life in Cancer Patients: Results from the BEST Multicenter Study

2020 ◽  
Vol 9 (4) ◽  
pp. 1003
Author(s):  
Arturo Cuomo ◽  
Marco Cascella ◽  
Cira Antonietta Forte ◽  
Sabrina Bimonte ◽  
Gennaro Esposito ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cancer Pain ◽  
Cancer Patients ◽  
Rating Scale ◽  
Assessment System ◽  
P Value ◽  
Breakthrough Cancer Pain ◽  
Pain Clinics ◽  
Eortc Qlq

Objectives: To explore the effect of breakthrough cancer pain (BTcP) treatment on quality of sleep and other aspects of the health-related quality of life (HRQoL) in patients with cancer pain. Methods: In an observational, multicenter, cohort study, cancer patients from palliative care units, oncology departments, and pain clinics and affected by BTcP were included. Enrolled patients were assessed at the four visits: T0 (baseline), T7, T14, and T28. Stable chronic background pain (numeric rating scale, NRS ≤ 4) during the whole study period was mandatory. BTcP was treated through transmucosal fentanyl. Three questionnaires were used to measure the HRQoL: EORTC QLQ-C15-PAL, Pittsburgh Sleep Quality Index (PSQI), and the Edmonton Symptom Assessment System (ESAS). RESULTS: In 154 patients, the HRQoL showed a significant improvement for all physical and emotional characteristics in the EORTC QLQ-C15-PAL, except for nausea and vomiting (linear p-value = 0.1) and dyspnea (Linear p-value = 0.05). The ESAS and PSQI questionnaires confirmed these positive results (p < 0.0001 and p = 0.002, respectively). Conclusions: This prospective investigation by an Italian expert group, has confirmed that careful management of BTcP induces a paramount improvement on the HRQoL. Because in cancer patients there is a high prevalence of BTcP and this severe acute pain has deleterious consequences, this information can have an important clinical significance.

scholarly journals Can Naloxegol Therapy Improve Quality of Life in Patients with Advanced Cancer?

Cancers ◽  
2021 ◽  
Vol 13 (22) ◽  
pp. 5736
Author(s):  
Rita Ostan ◽  
Giuseppe Gambino ◽  
Italo Malavasi ◽  
Gianluca Ronga ◽  
Maria Solipaca ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Advanced Cancer ◽  
Rating Scale ◽  
Numerical Rating Scale ◽  
Bowel Function ◽  
Advanced Cancer Patients ◽  
Background Pain ◽  
Bowel Movements ◽  
Numerical Rating

This observational study aims to evaluate the efficacy of naloxegol therapy in resolving opioid-induced constipation (OIC) and in improving the quality of life in a home palliative care cancer setting. Advanced cancer patients with OIC (Rome IV criteria) not relieved by laxatives started a naloxegol therapy 25 mg/day for 4 weeks. Quality of life was evaluated by Patient Assessment of Constipation Quality-of-Life (PAC-QoL) at day 0 and day 28; background pain by Numerical Rating Scale, number of weekly spontaneous bowel movements and Bowel Function Index (BFI) were evaluated at day 0 and every week. Seventy-eight patients who completed the 4-week study improved all four PAC-QoL dimensions (physical and psychological discomfort, worries/concerns and satisfaction level). Weekly spontaneous bowel movements increased and BFI improved. Background pain reduced after seven days and remained lower during the following weeks. Seventy-two patients dropped out the study before day 28 with a reduced survival compared to patients completing the study. Even in these patients, an improvement of bowel function was observed after two weeks. Naloxegol was effective in improving the quality of life, resolving OIC and reducing overall pain in patients with advanced cancer.

scholarly journals A Role of Complementary Medicine in Rehabilitation of Military Traumatic Brain Injuries

Pain medicine ◽  
2018 ◽  
Vol 3 (2/1) ◽  
pp. 8-8
Author(s):  
T Shitikov ◽  
O Shayrin ◽  
L Danilko
Keyword(s):  
Quality Of Life ◽  
Pain Intensity ◽  
Outcome Measures ◽  
Rating Scale ◽  
Case Series ◽  
Manual Therapies ◽  
Pain Rating ◽  
Post Concussion Syndrome ◽  
Pain Rating Scale

Background: Military service members and veterans face health issues related to traumat-ic brain injury (TBI), especially during combat, use of heavy equipment, and exposures to environmental hazards and explosives. There were 1.000 TBIs reported in deployed Ukra-nian troops during Russian-Ukranian war in 2014–2017. Studies have indicated that some manual therapies could be helpful for treating patients who have post-concussive syndrome. Objective: This case series report de-scribes the effects of CranioSacral Therapy (CST), Visceral Manipulation (VM), and Neu-ro-muscular Manipulation (NM) modalities for treating patients who have post-concussion syndrome. The goal of this study was to evalu-ate these effects on immobility, pain intensity, quality of life, sleep disorders, and cognition in these patients. Materials and Methods: This single-blind-ed case series was conducted at the Volunteer rehabilitation center, Dnipro, Ukraine. The pa-tients were 45 male participationers of Ukra-nian military forces who had been medically diagnosed with post-concussion syndrome. Each participant received a morning and af-ternoon 1-hour session of these three spe-cific manual therapies, which were capable of accessing and addressing the structural, vascular, and neuro-muscular tissues of the Cranium, Neck, Diafragm, Peritoneal bag and brain-as well addressing far-reaching ramifi-cations throughout the body following trauma. The main outcome measures were scores on the: Impact Neurocognitive Test; Blood Oxigen Saturation Test; Short Form-36 Quality of Life Survey, Headache Impact Test, a numeric pain rating scale; orthopedic range of motion tests (ROM); and vestibular testing. Hours of sleep were also checked. These outcome measures were registered at baseline, after treatment, and after a 3–6-month follow up. Results: Statistically significant differenc-es were seen with a decrease in overall pain rating scale scores (P = 0.034), and cranio-cer-vicogenic pain levels decreased (P = 0.047). There were statistically significant increases of blood oxigen saturation (P = 0.033), Mem-ory Test (P = 0.017) scores, and cervical ROM scores (P = 0.036). Hours of sleep averaged 1 hours on the first day of treatment and in-creased to 2.0 hours at the end of treatment. Results were continuing to increase, as noted at a 5-month evaluation. Conclusions: Six sessions of specific CST/VM/NM therapy resulted in statistically great-er improvements in pain intensity, ROM, mem-ory, cognition, blood oxigen saturation and breathing in concussed patients.

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