Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2014
Factors associated with survival after opioid rotation in cancer patients presenting to an outpatient supportive care center.
Data on cancer outpatients undergoing opioid rotation (OR) are limited. Understanding the characteristics of patients who do not follow up after OR could facilitate optimization of OR. ⋯ Our preliminary study suggests that patients with advanced cancer, poorer performance status, opioid-induced neurotoxicity, and higher MDAS scores are less likely to follow up after OR and may have shorter overall survival and, therefore, require closer follow-up. Patients with unsuccessful OR also may have a shorter overall survival. Further studies are warranted.
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J Pain Symptom Manage · Jul 2014
Testing the factorial validity of scores from the caregiver pain medicine questionnaire.
The Caregiver Pain Medicine Questionnaire is designed to measure caregiver agreement with statements regarding pain management. However, little testing has been done to determine its reliability and validity. ⋯ The theoretical model hypothesized by the original study authors was not confirmed. Results lead us to conclude that the instrument is poor and should not be used. Further research is needed to define content domains and validate the items developed to assess them.
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J Pain Symptom Manage · Jul 2014
Comparative StudySymptoms and problem clusters in cancer and non-cancer patients in specialized palliative care-is there a difference?
In clinical practice, some symptoms and problems frequently occur in combination, which may have consequences for symptom management. ⋯ As symptom clusters do not significantly differ between cancer and non-cancer patients, specific frequent symptoms in non-cancer patients should be assessed. Identification of symptom clusters may help to target therapies and focus the use of medications to improve patients' quality of life.
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J Pain Symptom Manage · Jul 2014
Comparative StudyA single institution's effort to translate codeine knowledge into specific clinical practice.
Codeine is an unpredictable analgesic because of its variable pharmacokinetic, pharmacodynamic, and pharmacogenetic properties. This variability may lead to ineffective analgesia in some and respiratory depression in others. Despite this, codeine is still widely used. At a pediatric tertiary medical institution, codeine was prescribed despite efforts to inform prescribers of the potentially unpredictable analgesia and serious side effects. ⋯ This quality improvement initiative was successful in eliminating codeine from the hospital formulary. Although education decreased codeine orders, understanding and addressing the barriers to change and directly changing the ordersets were the most effective and efficient for knowledge translation.
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J Pain Symptom Manage · Jul 2014
Comparative StudyPatterns of hospice care among military veterans and non-veterans.
Historically, hospice use by veterans has lagged behind that of non-veterans. Little is known about hospice use by veterans at a population level. ⋯ Although veteran and non-veteran hospice users were similar on most demographic measures, important differences in hospice referral patterns and utilization exist.