Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2015
Sickle cell disease patients with and without extremely high hospital use: pain, opioids, and coping.
Patients with sickle cell disease (SCD) and extremely high hospital use (EHHU) encounter significant challenges in pain management because of opioid medication use for pain and providers' concerns about addiction. ⋯ The prescription of opioid medications for SCD pain management exacerbates issues of distrust in the patient-provider relationship. Such issues dominate patient care in patients with EHHU. Patients with EHHU and providers may learn from the proactive nature of LHU patients' engagement with the health care system as further research and interventions are designed for EHHU.
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J Pain Symptom Manage · Mar 2015
Fatigue is associated with serum interleukin-6 levels and symptoms of depression in patients on chronic hemodialysis.
Little is known about activated immune-inflammatory pathways and interleukin-6 (IL-6) in the development of fatigue and/or depression in patients with end-stage renal disease on chronic hemodialysis (HD). ⋯ Fatigue was significantly associated with symptoms of depression and serum IL-6 levels in patients receiving chronic HD.
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J Pain Symptom Manage · Mar 2015
Avoidable and unavoidable visits to the emergency department among patients with advanced cancer receiving outpatient palliative care.
Admissions to the emergency department (ED) can be distressing to patients with advanced cancer receiving palliative care. There is limited research about the clinical characteristics of these patients and whether these ED visits can be categorized as avoidable or unavoidable. ⋯ Nearly one-fourth of ED visits by patients with advanced cancer receiving palliative care were potentially avoidable. Proactive efforts to improve communication and support between scheduled appointments are needed.