Journal of pain and symptom management
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J Pain Symptom Manage · Aug 2012
Attitudes of health care professionals to opioid prescribing in end-of-life care: a qualitative focus group study.
Opioid therapy is central to the management of pain in the field of generalist palliative and end-of-life care, and international guidelines highlight the need for opioids to be used as part of a comprehensive strategy to treat pain. However, evidence suggests that the use of opioids in palliative care is suboptimal, and many patients do not receive adequate pain control at the end of life. ⋯ Significant barriers exist to the appropriate use of opioids in end-of-life care. If international priorities on improving pain management at the end of life are to be achieved, educational opportunities for generalists need to be enhanced, and effective interprofessional working models need to be developed so that pain management for patients at the end of life is optimized.
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J Pain Symptom Manage · Aug 2012
Prognostication in advanced cancer: a study examining an inflammation-based score.
Prognostication in advanced cancer is challenging. Biomarkers of systemic inflammation (C-reactive protein and albumin) combined in the modified Glasgow Prognostic Score (mGPS) have been used to assist prognostication in various cancer types. ⋯ A role for the mGPS in prognostication near the end of life is suggested. Biomarkers (e.g., mGPS) may assist clinical decisions as to whether intensive treatments are appropriate and may facilitate end-of-life care planning.
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J Pain Symptom Manage · Aug 2012
Review Meta AnalysisA systematic evaluation of content, structure, and efficacy of interventions to improve patients' self-management of cancer pain.
Cancer pain continues to be extensively undertreated, despite established guidelines. Although the efficacy of interventions that support patients' self-management of cancer pain has been demonstrated in several studies, the most effective components of these interventions remain unknown. ⋯ This analysis provides researchers and clinicians with a detailed overview of the various structural and content components, as well as various combinations that were tested in intervention studies to improve cancer pain management. However, because of a variety of limitations, the most efficacious intervention components or combination of components remain to be determined in future studies.
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J Pain Symptom Manage · Aug 2012
Consensus building in palliative care: a Europe-wide delphi study on common understandings and conceptual differences.
Throughout Europe, there are major differences in the stages of development and in the types of service delivery of palliative care. Consensus on standards and norms for palliative care in Europe is needed for advocacy and health policy decision making. ⋯ Overall, this study contributed to a higher level of consensus toward the proposed recommendations. Expert comments underlined the need for clearer definitions and specifications of terms and indicated important topics where cultural issues, geographical aspects, and the local health care setting have to be considered in palliative care.
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J Pain Symptom Manage · Aug 2012
Prevalence, characteristics, and factors associated with chronic pain with and without neuropathic characteristics in São Luís, Brazil.
Chronic pain (CP) with and without neuropathic characteristics is a public health problem. This is the first population-based study in South America, and the third in the world, to use the Douleur Neuropathique 4 Questions (DN4) tool in epidemiologic studies. ⋯ CP with and without neuropathic characteristics is a public health problem in Brazil, with high prevalence and great influence on people's daily lives.