Buprenorphine in long-term control of chronic pain in cancer patients

10.2741/2147 ◽  
2007 ◽  
Vol 12 (1) ◽  
pp. 1291 ◽  
Author(s):  
Maria Caterina Pace
Keyword(s):  
2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Michael Brinkers ◽  
Giselher Pfau ◽  
Anne-Marie Toepffer ◽  
Frank Meyer ◽  
Moritz A. Kretzschmar

Background. It is well known that cancer patients more seldom have a psychiatric disorder than noncancer patients with chronic pain. Conversely, earlier studies have suggested that, at the psychiatric level, long-term cancer survivors (LCSs) have more in common with noncancer patients affected by chronic pain. Materials and Methods. We investigated 89 cancer patients with acute pain (Acute Cancer Pain Patients, ACPPs) treated at a university outpatient chemotherapy department and compared these with 61 LCSs (living >5 yr after the first diagnosis) admitted by general practitioners for the treatment of noncancer pain. Upon administration, each patient was psychiatrically assessed by a liaison-psychiatrist conducting a semistructured interview. In a second step, we compared the LCS patients with hitherto treated noncancer patients suffering from chronic pain and ACPPs with data published by Derogatis in 1983. Results. In a comparison of LCSs with ACPPs, LCSs have more patients with brain organic disorders and more addictions. The largest cancer group within the LCSs is patients with urogenital (Uro) cancer (44.3%), while within the ACPPs, these are patients with cancer of the gastrointestinal (GI) tract (ACPP-GI, 57.2%). As far as the distribution of mental disorders is concerned, long-term cancer survivors show some similarities to noncancer patients. The data of ACPPs are similar to those of cancer patients, published by Derogatis. Discussion. The higher values of addiction and brain organic disorders, in particular, and the slight differences for psychic disorders in general of LCSs vs. ACPPs may result from the different cancer types and a longer survival time for urogenital tract cancer compared to GI cancer. In an additional examination, we compared patients with acute cancer of the GI tract (ACPP-GI, n = 50) with those of the urogenital tract (ACPP-Uro, n = 43). ACPP-Uro had the lowest percentage of patients with psychiatric disorders in general (ACPP-Uro 37.2%, ACPP-GI 50.0%, all LCSs 65.6%, and LCS-Uro 74.1%) and addiction, in particular (ACPP-Uro 2.3%, ACPP-GI 4.0%, and LCSs 13.1%). Conclusion. Cancer patients can develop a process of chronification with an increase in the prevalence of mental disorders. For urogenital cancer, an increase in the probability to develop mental disorders is a function of time.


2004 ◽  
Vol 171 (4S) ◽  
pp. 194-195
Author(s):  
Kyoichi Tomita ◽  
Haruki Kume ◽  
Keishi Kashibuchi ◽  
Satoru Muto ◽  
Shigeo Horie ◽  
...  

2012 ◽  
Vol 03 (03) ◽  
pp. 121-125
Author(s):  
I. Pabinger ◽  
C. Ay

SummaryCancer is a major and independent risk factor of venous thromboembolism (VTE). In clinical practice, a high number of VTE events occurs in patients with cancer, and treatment of cancerassociated VTE differs in several aspects from treatment of VTE in the general population. However, treatment in cancer patients remains a major challenge, as the risk of recurrence of VTE as well as the risk of major bleeding during anticoagulation is substantially higher in patients with cancer than in those without cancer. In several clinical trials, different anticoagulants and regimens have been investigated for treatment of acute VTE and secondary prophylaxis in cancer patients to prevent recurrence. Based on the results of these trials, anticoagulant therapy with low-molecular-weight heparins (LMWH) has become the treatment of choice in cancer patients with acute VTE in the initial period and for extended and long-term anticoagulation for 3-6 months. New oral anticoagulants directly inhibiting thrombin or factor Xa, have been developed in the past decade and studied in large phase III clinical trials. Results from currently completed trials are promising and indicate their potential use for treatment of VTE. However, the role of the new oral thrombin and factor Xa inhibitors for VTE treatment in cancer patients still has to be clarified in further studies specifically focusing on cancer-associated VTE. This brief review will summarize the current strategies of initial and long-term VTE treatment in patients with cancer and discuss the potential use of the new oral anticoagulants.


2020 ◽  
Vol 70 (suppl 1) ◽  
pp. bjgp20X711581
Author(s):  
Charlotte Greene ◽  
Alice Pearson

BackgroundOpioids are effective analgesics for acute and palliative pain, but there is no evidence base for long-term pain relief. They also carry considerable risks such as overdose and dependence. Despite this, they are increasingly prescribed for chronic pain. In the UK, opioid prescribing more than doubled between 1998 and 2018.AimAn audit at Bangholm GP Practice to understand the scale of high-strength opioid prescribing. The aim of the audit was to find out if indications, length of prescription, discussion, and documentation at initial consultation and review process were consistent with best-practice guidelines.MethodA search on Scottish Therapeutics Utility for patients prescribed an average daily dose of opioid equivalent ≥50 mg morphine between 1 July 2019 and 1 October 2019, excluding methadone, cancer pain, or palliative prescriptions. The Faculty of Pain Medicine’s best-practice guidelines were used.ResultsDemographics: 60 patients (37 females), average age 62, 28% registered with repeat opioid prescription, 38% comorbid depression. Length of prescription: average 6 years, 57% >5 years, 22% >10 years. Opioid: 52% tramadol, 23% on two opioids. Indications: back pain (42%), osteoarthritis (12%), fibromyalgia (10%). Initial consultation: 7% agreed outcomes, 35% follow-up documented. Review: 56% 4-week, 70% past year.ConclusionOpioid prescribing guidelines are not followed. The significant issues are: long-term prescriptions for chronic pain, especially back pain; new patients registering with repeat prescriptions; and no outcomes of treatment agreed, a crucial message is the goal is pain management rather than relief. Changes have been introduced at the practice: a patient information sheet, compulsory 1-month review for new patients on opioids, and in-surgery pain referrals.


1998 ◽  
Vol 3 (3) ◽  
pp. 241-247
Author(s):  
Rowan T. Chlebowski ◽  
James Sayre ◽  
Linda M. Lillington

2020 ◽  
Author(s):  
Juqing Zhao ◽  
Pei Chen ◽  
Guangming Wan

BACKGROUND There has been an increase number of eHealth and mHealth interventions aimed to support symptoms among cancer survivors. However, patient engagement has not been guaranteed and standardized in these interventions. OBJECTIVE The objective of this review was to address how patient engagement has been defined and measured in eHealth and mHealth interventions designed to improve symptoms and quality of life for cancer patients. METHODS Searches were performed in MEDLINE, PsychINFO, Web of Science, and Google Scholar to identify eHealth and mHealth interventions designed specifically to improve symptom management for cancer patients. Definition and measurement of engagement and engagement related outcomes of each intervention were synthesized. This integrated review was conducted using Critical Interpretive Synthesis to ensure the quality of data synthesis. RESULTS A total of 792 intervention studies were identified through the searches; 10 research papers met the inclusion criteria. Most of them (6/10) were randomized trial, 2 were one group trail, 1 was qualitative design, and 1 paper used mixed method. Majority of identified papers defined patient engagement as the usage of an eHealth and mHealth intervention by using different variables (e.g., usage time, log in times, participation rate). Engagement has also been described as subjective experience about the interaction with the intervention. The measurement of engagement is in accordance with the definition of engagement and can be categorized as objective and subjective measures. Among identified papers, 5 used system usage data, 2 used self-reported questionnaire, 1 used sensor data and 3 used qualitative method. Almost all studies reported engagement at a moment to moment level, but there is a lack of measurement of engagement for the long term. CONCLUSIONS There have been calls to develop standard definition and measurement of patient engagement in eHealth and mHealth interventions. Besides, it is important to provide cancer patients with more tailored and engaging eHealth and mHealth interventions for long term engagement.


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