Journal of pain and symptom management
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J Pain Symptom Manage · Feb 2018
Randomized Controlled Trial Multicenter StudyResults of a Double-Blind, Randomized, Placebo-Controlled Study of Nabiximols Oromucosal Spray as Adjunctive Therapy in Advanced Cancer Patients With Chronic Uncontrolled Pain.
Prior Phase 2/3 studies found that cannabinoids might provide adjunctive analgesia in advanced cancer patients with uncontrolled pain. ⋯ Nabiximols might have utility in patients with advanced cancer who receive a lower opioid dose, such as individuals with early intolerance to opioid therapy.
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J Pain Symptom Manage · Feb 2018
Review Practice GuidelineThe development of practice guidelines for a palliative care multidisciplinary case conference.
In Ontario, we identified that few hospitals have developed multi-disciplinary case conferences or forums for discussion of patients with palliative care issues. ⋯ We have described the process of creating the first pMCC guideline. A key component of this guideline is that pMCCs should serve as a link between the hospital and community.
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J Pain Symptom Manage · Feb 2018
Meta AnalysisDrugs for treating opioid-induced constipation: A mixed treatment comparison network meta-analysis of randomized controlled clinical trials.
Opioid-induced constipation is a common problem associated with chronic use of opioid analgesics. ⋯ Subcutaneous methyl naltrexone was found to perform better than other interventions for managing opioid-induced constipation.
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J Pain Symptom Manage · Feb 2018
ReviewA systematic review of the patient and carer related factors affecting the experience of pain for advanced cancer patients cared for at home.
Effective pain management is a priority in the palliative care of advanced cancer patients. A body of research is emerging examining the factors that influence the management and experience of pain for such individuals. Identifying such factors should allow for the development of targeted interventions to improve pain management in the home while ultimately reducing unnecessary suffering for the patient. ⋯ There is a lack of quantitative research in the area of factors influencing the experience of pain for advanced cancer patients cared for at home. Such findings would be useful in developing theories of change that would underpin interventions aimed at improving pain outcomes for this population.
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J Pain Symptom Manage · Feb 2018
Outcomes that Define Successful Advance Care Planning: A Delphi Panel Consensus.
Standardized outcomes that define successful advance care planning (ACP) are lacking. ⋯ A large, multidisciplinary Delphi panel developed an Organizing Framework and rated the importance of ACP outcome constructs. Top rated outcomes should be used to evaluate the success of ACP initiatives. More research is needed to create reliable and valid measurement tools for the highest rated outcomes, particularly "care consistent with goals."