Journal of pain and symptom management
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J Pain Symptom Manage · Jun 2024
Review Meta AnalysisEffectiveness of dyadic advance care planning: a systematic review and meta-analysis.
Making decisions regarding end-of-life care is particularly challenging for patients and their family caregivers. Studies have advocated that family involvement in advance care planning is important to provide goal-concordant care and to increase family caregivers' preparation for surrogate decision-making. However, there is a lack of evidence to examine the effectiveness of advance care planning using the patient-caregiver dyadic approach. ⋯ This review supports that dyadic advance care planning is a promising approach to preparing patients and their family caregivers for end-of-life communication and decision-making. Given that this multifaceted process is influenced by multiple factors within the socio-cultural context, future studies are warranted to identify the barriers and facilitators to implement dyadic advance care planning in real-world settings.
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J Pain Symptom Manage · May 2024
Review Meta AnalysisPatient and family preferences about place of end-of-life care and death: An umbrella review.
The place where people are cared towards the end of their life and die is a complex phenomenon, requiring a deeper understanding. Honoring preferences is critical for the delivery of high-quality care. ⋯ These findings are a crucial starting point to address gaps and enhance strategies to align care with patient and family preferences. To accurately identify patient and family preferences is an important opportunity to change their lives positively.
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J Pain Symptom Manage · Apr 2024
Review Meta AnalysisThe Management of Opioid-Induced Constipation in Cancer and Advanced Illness: A Meta-Analysis.
Constipation is a common problem among patients with cancer. By some accounts, about 60% of cancer patients experience constipation. There is limited empirical evidence of the clinical effectiveness of pharmacologic agents in opioid-induced constipation in advanced diseases. ⋯ Methylnatrexone and Naldemedine have currently shown promise in randomized trials concerning opioid-induced constipation in cancer and advanced illness. It is imperative that future research ascertain not just the relative therapeutic efficacy but also the cost-benefit analyses of these newer regimens with more commonly used and accessible laxatives.
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J Pain Symptom Manage · Mar 2024
Review Meta AnalysisEfficacy and safety of ketamine to treat cancer pain in adult patients: A systematic review.
Ketamine is a well-characterized anesthetic agent, and subanesthetic ketamine possesses analgesic effects in both acute and chronic pain. ⋯ Ketamine may be used as an effective therapy to relieve cancer pain. However, more rigorously designed RCTs with larger sample sizes are required to verify the above conclusions.
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J Pain Symptom Manage · Mar 2024
Review Meta AnalysisUnmet supportive care needs among cancer patients in Sub-Saharan African countries: a mixed method systematic review and meta-analysis.
Supportive cancer care is vital to reducing the current disparities in cancer outcomes in Sub-Saharan Africa (SSA), including poor survival and low quality of life, and ultimately achieving equity in cancer care. This is the first review aimed to evaluate the extent of unmet supportive care needs and identify their contributing factors among patients with cancer in SSA. ⋯ In SSA, optimal cancer care provision was low, up to two-thirds of patients reported unmet needs for one or more domains. Strengthening efforts to develop comprehensive and integrated systems for supportive care services are keys to improving the clinical outcome, survival, and quality of life of cancer patients in SSA.