Journal of pain and symptom management
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J Pain Symptom Manage · Oct 2019
Randomized Controlled Trial Multicenter StudyToward Understanding the Relationship between Prioritized Values and Preferences for Cardiopulmonary Resuscitation Among Seriously Ill Adults.
Prioritizing among potentially conflicting end-of-life values may help patients discriminate among treatments and allow clinicians to align treatments with values. ⋯ Clinicians face challenges as they clarify patient values and align treatments with values. Patients' values predicted CPR preferences, but a substantial proportion of patients expressed CPR preferences that appeared potentially inconsistent with their primary value. Clinicians should question assumptions about relationships between values and CPR preferences. Further research is needed to identify ways to use values to guide treatment decisions.
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J Pain Symptom Manage · Oct 2019
Randomized Controlled TrialEffect of opioid exposure on efficacy and tolerability of sublingual fentanyl and subcutaneous morphine for severe cancer pain episodes. Secondary analysis from a double-blind double-dummy, randomized trial.
Few studies have addressed the impact of previous opioid exposure on the effect of opioids for the treatment of severe cancer pain episodes. ⋯ In this study, we could not demonstrate an effect of previous opioid exposure, from 20 to 120 mg oral morphine equivalent daily dose, on the absolute and relative efficacy and tolerability of 100 μg FST and 5 mg SCM for severe cancer pain episodes.
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J Pain Symptom Manage · Oct 2019
Randomized Controlled TrialAcceptance and Commitment Therapy for Symptom Interference in Advanced Lung Cancer and Caregiver Distress: A Pilot Randomized Trial.
Advanced lung cancer patients typically have a poor prognosis and many symptoms that interfere with functioning, contributing to high rates of emotional distress in both patients and family caregivers. There remains a need for evidence-based interventions to improve functional outcomes and distress in this population. ⋯ Findings suggest that telephone-based ACT is feasible for many advanced lung cancer patients and caregivers, but may not substantially reduce symptom interference and distress. Low baseline levels of certain symptoms may have contributed to null findings. Next steps include applying ACT to specific, clinically meaningful symptom interference and varying intervention dose and modality.
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J Pain Symptom Manage · Oct 2019
Randomized Controlled TrialCOMPASS: A Pilot Trial of an Early Palliative Care Intervention for Patients with End Stage Liver Disease.
Palliative care interventions have shown promise in improving quality of life and reducing health-care utilization among patients with chronic organ failure. ⋯ Logistical obstacles hindered completion of the trial as originally designed. Nevertheless, a preemptive palliative care intervention resulted in increased time to first readmission and more days alive outside the hospital in the first six months after study entry.
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J Pain Symptom Manage · Sep 2019
Randomized Controlled Trial Multicenter StudyAssociation between Plasma Brain Natriuretic Peptide and Overall Survival in Patients with Advanced Cancer: Preliminary Findings.
Atrial and brain natriuretic peptides (ANP and BNP) are established diagnostic and prognostic markers in heart failure, but their utility in patients with advanced cancer is unclear. ⋯ Our preliminary findings suggest that BNP or Pro-BNP may be a novel objective prognostic marker in cancer patients without heart failure. Further research is needed to confirm these findings.