PROCESSING OF THE CONTROL REGIME OF MEDICINES FOR PHARMACOTHERAPY OF CHRONIC PAIN SYNDROME IN THE FIELD OF PALLIATIVE AID

In the world from 10 to 55% people suffer from chronic pain syndrome. Therefore, timely reduction of pain helps to improve the quality of their life in all areas of activity. To improve the organizational and legal procedure for providing patients with drugs as part of palliative care, a control regime for non-steroidal anti-inflammatory drugs, non-narcotic and narcotic (opioid) analgesics and adjuvant (auxiliary) drugs, which prescribed by doctors for chronic pain syndrome was developed. The research materials were the current regulatory, legislative and instructive documents; statistics of the Ministry of Healthcare of Ukraine; instructions for medical use of medicines, websites of the Verkhovna Rada of Ukraine, the Ministry of Healthcare of Ukraine, the State Expert Center of the Ministry of Healthcare of Ukraine and others. We used documentary, comparative, systemic and regulatory methods of analysis. In the article, based on the analysis of the normative base, analyzed the medical and technological documents concerning the pharmacotherapy of chronic pain syndrome, allocated three classes of medicines. Processed the control regime of non-steroidal medicines, non-narcotic analgesics, narcotic (opioid) analgesics and adjuvant (auxiliary) drugs prescribed by doctors for chronic pain syndrome. Analyzed the normative and legal documents on the procedure for the circulation of narcotic, psychotropic and potent medicines in medical and pharmaceutical healthcare institutions in accordance with the licensed conditions for the conduct of economic activity. Established that the circulation of medicines for pharmacotherapy of chronic pain syndrome within palliative care in medical institutions carried out based on a license for medical practice, and in pharmacy institutions – based on a license for wholesale and retail trade of medicines.

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Analysis of the assortment of narcotic drugs used for the treatment of pain in cancer patients in the palliative care unit

Public health of the Far East Peer-reviewed scientific and practical journal ◽

10.33454/1728-1261-2021-2-93-96 ◽

2021 ◽

Vol 2 (88) ◽

pp. 93-96

Author(s):

N. V. Orlova ◽

◽

N.V. Abrosimova ◽

Yu.A. Melnitskaya ◽

I.V. Kryukova ◽

...

Keyword(s):

Chronic Pain ◽

Palliative Care ◽

Cancer Patients ◽

Pain Syndrome ◽

Opioid Analgesics ◽

Dosage Forms ◽

Palliative Care Unit ◽

Chronic Pain Syndrome ◽

Oncological Center ◽

Narcotic Drugs

A study of the assortment of narcotic drugs for the relief of acute and chronic pain syndrome in cancer patients in the palliative care unit of the Oncological Center was carried out. It has been shown that practically all registered dosage forms of opioid analgesics are used

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Relationship between catechol-o-methyltransferase gene polymorphism and pain syndrome in breast cancer patients

Regional Anesthesia and Acute Pain Management ◽

10.17816/1993-6508-2020-14-2-72-85 ◽

2020 ◽

Vol 14 (2) ◽

pp. 72-85

Author(s):

Arina P. Spasova ◽

I. V. Kurbatova ◽

O. Y. Barysheva ◽

G. P. Tikhova

Keyword(s):

Breast Cancer ◽

Chronic Pain ◽

Postoperative Period ◽

Mutant Allele ◽

Pain Syndrome ◽

Comt Gene ◽

Nucleotide Polymorphisms ◽

Chronic Pain Syndrome ◽

Narcotic Analgesics ◽

Single Nucleotide

The goal of the study was to explore the influence of single-nucleotide polymorphisms of the COMT gene on the formation and features of pain syndrome, the level of anxiety, and the need for narcotic analgesics in patients with breast cancer. Materials and methods. The intensity of pain and opioid consumption in the postoperative period were evaluated in 58 patients who met the inclusion criteria of the study and were operated for breast cancer. The frequency of chronic pain syndrome after mastectomy was studied in the same group of patients after a year by using short pain questionnaires, McGill Pain Questionnaire and PainDetect. The anxiety level was assessed by using the HADS questionnaire. Genotyping was performed for single-nucleotide polymorphisms, rs4680, rs740603, rs2097603 = rs2070577, rs4633, of the COMT gene localized in the 22q11.21 region in the studied group of patients. The relationship between the carrier of different genotypes and the intensity of acute and chronic pain, the severity of the pain rating index for sensory and affective characteristics, the presence of a neuropathic component of pain, and the severity of anxiety were studied in the entire sample. The use of narcotic analgesics was evaluated in the postoperative period (IU/day and IU/course) and for the relief of chronic pain. Results. It is shown that the intensity of postoperative pain and the severity of anxiety do not depend on the presence of a mutant allele for the studied polymorphisms of the COMT gene, while the postoperative consumption of opioids in patients with the rs4680 missense mutation in the exon of this gene is significantly less. The dependence of the intensity of chronic pain syndrome and the severity of anxiety on the presence of a mutant allele for the polymorphic locus rs4680 localized in the exon of the COMT gene was established. No significant relationship was observed between the mutant alleles and the use of opioids for chronic pain relief after mastectomy. Conclusion. Genotyping for the COMT gene polymorphisms can be useful for choosing the optimal tactics of pain management in patients with breast cancer.

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Electronic educational course for medical specialists training in diagnostics of chronic pain syndrome in adult patients requiring palliative care

Medical news of the North Caucasus ◽

10.14300/mnnc.2021.16015 ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Nevzorova Diana ◽

Prirodova Olga Fedorovna ◽

Sidorov Alexander ◽

Guzel Rafailovna Abuzarova ◽

Oksana Yurievna Kudrina ◽

...

Keyword(s):

Chronic Pain ◽

Palliative Care ◽

Pain Syndrome ◽

Adult Patients ◽

Chronic Pain Syndrome ◽

Medical Specialists ◽

Educational Course

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Duloxetine Added to Tramadol in Chronic Pain Syndrome

European Psychiatry ◽

10.1016/j.eurpsy.2016.01.1844 ◽

2016 ◽

Vol 33 (S1) ◽

pp. S500-S501

Author(s):

M. Domijan ◽

Z. Lončar ◽

S. Udovičić

Keyword(s):

Quality Of Life ◽

Chronic Pain ◽

Sleep Disturbances ◽

Short Form ◽

Pain Syndrome ◽

Mcgill Pain Questionnaire ◽

Chronic Pain Syndrome ◽

Reduction Of Pain ◽

Competing Interest

IntroductionAbout 15–20% of the population suffering from the chronic pain. Over time, chronic pain can result in different emotional problems, social isolation, sleep disturbances, which reduce the quality of life. Chronic pain syndrome (CPS) indicates persistent pain, subjective symptoms in excess of objective findings, associated dysfunctional pain behavious and self-limitation in activities of daily living. Duloxetine is a potent antidepressant approved by the Food and Drug Administration for the chronic musculoskeletal disorder, diabetic neuropathic pain, fibromyalgia, generallized anxiety disorder and major depressive disorder.ObjectiveTo determine the effect of duloxetine on the reduction of pain and psychosocial suffering.AimsThe goal of the treatment should be to effectively reduce pain while improving function and reducing psychosocial suffering.MethodsThirty-six adult, nondepressed patients, already on tramadol therapy were included. Patients with VAS (visual analogue scale) ≥ 4were treated with duloxetine for 13 weeks. We measured pain intensity with the McGill Pain Questionnaire-Short Form (MPQ-SF) and compared VAS before starting the treatment with duloxetine and weekly for 13 weeks.ResultsPain response was defined as a 30%decrease in the MPQ-SF. A total of 62.5% of the sample met these criteria for response. Among them, 13.8% of patients were discontinued because of adverse effects. Duloxetine significantly improved functioning and the quality of life in patients with CPS.ConclusionsBecause of it is analgesic properties, duloxetine in the lower antidepressant doses (60 mg taken ones daily) combined with tramadol (another analgesic agent) can be useful in CPS for patients who do not respond satisfactory to monotherapy.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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Strong opioid analgesics in therapy for chronic pain syndrome. Which drug should be preferred?

Onkologiya Zhurnal imeni P A Gertsena ◽

10.17116/onkolog20176662-71 ◽

2017 ◽

Vol 6 (6) ◽

pp. 62 ◽

Cited By ~ 1

Author(s):

G. R. Abuzarova ◽

R. R. Sarmanaeva ◽

S. E. Lapina ◽

S. V. Kuznetsov

Keyword(s):

Chronic Pain ◽

Pain Syndrome ◽

Opioid Analgesics ◽

Chronic Pain Syndrome ◽

Strong Opioid

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Automation of the regional register of persons needing palliative medical care in Krasnodar region

10.37690/1811-0193-2020-s1-6-14 ◽

2020 ◽

pp. 6-14

Author(s):

N. V. Kardashova ◽

◽

M. A. Korogod ◽

A. A. Koshkarov ◽

R. A. Murashko ◽

...

Keyword(s):

Chronic Pain ◽

Palliative Care ◽

Medical Care ◽

Pain Syndrome ◽

Orphan Diseases ◽

Chronic Pain Syndrome ◽

Health Authorities ◽

Public Health Authorities ◽

Krasnodar Region ◽

Palliative Medical Care

The relevance of improving the management of the palliative care system in the Krasnodar region, the direct provision of medical care and the interaction of public health authorities is due to the processing of large amounts of data on the need for pain relief and equipment. In each municipality of the Territory, registers of patients suffering from chronic pain syndrome are maintained. The purpose of the article is to develop a methodology for integration municipal registers into a single register of people needed palliative care, and automation of management at the regional level. The paper discusses approaches to create a unified database (registers) of patients suffering from chronic pain syndrome receiving palliative care in order to assess the compliance of medical care with modern clinical guidelines. The possibilities of a unified information system for extracting and dispensing preferential recipes for the implementation of the technology for automated management of the regional registry along with the registers of federal and regional beneficiaries, orphan diseases are shown.

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ENSURING ACCESS TO PAIN RELIEF AS HUMAN RIGHTS

Inter Collegas ◽

10.35339/ic.5.1.10-18 ◽

2018 ◽

Vol 5 (1) ◽

pp. 10-18

Author(s):

K. Shapoval-Deinega K. ◽

A. Rokhanskiy ◽

O. Riga ◽

A. Penkov

Keyword(s):

Chronic Pain ◽

Palliative Care ◽

Human Rights ◽

Pain Relief ◽

Professional Training ◽

Pain Syndrome ◽

Chronic Pain Management ◽

Chronic Pain Syndrome ◽

Long Time

ENSURING ACCESS TO PAIN RELIEF AS HUMAN RIGHTSK. Shapoval-Deinega, A. Rokhanskiy, O. Riga, A. PenkovThe article presents the results of a selective study on the access to anesthesia. It has been determined that in most cases the goal of chronic pain management has not been achieved for a long time, the expected level of successful anesthesia has not been achieved in 80-90% of those in need, anesthesia is prescribed formally (“any prescription is a good prescription”), without taking into account clinical recommendations and clinical guidelines, that is doctors do not adhere to the principles of the WHO regarding the prescription of analgesics, approved by the Order of the Ministry of Health No. 311 as of 15 April 2012 “On the approval and implementation of medical and technological documents for standardization of palliative care in chronic pain syndrome”. The authors believe that professional training of doctors requires changes regarding the quality of palliative care in accordance with WHO standards, wide implementation of modern scientific concepts of anesthesia in all areas of medical staff training.Key words: palliative care, anesthesia, human rights. ЗАБЕЗПЕЧЕННЯ ДОСТУПУ ДО ЗНЕБОЛЕННЯ ЯК ПРАВА ЛЮДИНИК. Шаповал-Дейнега, А. Роханський, О. Ріга, А. Пеньков У статті наведено результати вибіркового дослідження щодо забезпечення людини до знеболення. Визначено, що у більшості випадків не досягнута мета лікування хронічного больового синдрому протягом тривалого часу, не досягнуто очікуваного рівня успішного знеболення у 80–90 % осіб, що цього потребують, знеболення призначається формально («щось призначили – і гаразд»), без урахування клінічних рекомендацій та клінічних настанов, тобто лікарі не дотримуються принципів ВООЗ щодо призначення знеболюючих засобів, які містяться у наказі МОЗ № 311від 25.04.2012 "Про затвердження та впровадження медико-технологічних документів зі стандартизації паліативної медичної допомоги при хронічному больовому синдромі". Автори вважають, що ротребує змін фахова підготовка лікарів щодо якості надання паліативної допомоги відповідно до стандартів ВООЗ, широкої імплементації сучасних наукових уявлень про знеболення в усі ланки підготовки медичних працівників.Ключові слова: паліативна допомога, знеболення, права людини. ОБЕСПЕЧЕНИЕ ДОСТУПА К ОБЕЗБОЛИВАНИЮ КАК ПРАВО ЧЕЛОВЕКАК. Шаповал-Дейнега, А. Роханский, О. Рига, А. ПеньковВ статье приведены результаты выборочного исследования по обеспечению человека к обезболиванию. Определено, что в большинстве случаев не достигнута цель лечения хронического болевого синдрома в течение длительного времени, не достигнуто ожидаемого уровня успешного обезболивания в 80-90% лиц, нуждающихся, обезболивания назначается формально ( «что-то назначили - и ладно»), без учета клинических рекомендаций и клинических руководств, то есть врачи не соблюдают принципы ВОЗ по назначению обезболивающих средств, которые содержатся в приказе Минздрава № 311вид 25.04.2012 "Об утверждении и внедрении медико-технологических документов по стандартизации паллиативной медицинской помощи при хроническом болевом синдроме ". Авторы считают, что ротребуе изменений профессиональная подготовка врачей по качеству оказания паллиативной помощи в соответствии со стандартами ВОЗ, широкой имплементации современных научных представлений о обезболивания во все звенья подготовки медицинских работников.Ключевые слова: паллиативная помощь, обезболивание, права человека.

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