Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2018
Meta AnalysisEffects of Exercise Training on Restless Legs Syndrome, Depression, Sleep Quality, and Fatigue Among Hemodialysis Patients: A Systematic Review and Meta-analysis.
Hemodialysis (HD) patients experience a heavy symptom burden that leads to a decreased quality of life. Pharmacological treatment is effective but costly and has adverse effects. Exercise is a promising approach for symptom management, but the effect of exercise on restless legs syndrome (RLS), depression, sleep quality, and fatigue in HD patients is still uncertain. ⋯ Exercise training may help HD patients to reduce the severity of RLS, depression, and fatigue. More high-quality RCTs with larger samples and comparative RCTs focused on different exercise regimens are needed.
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J Pain Symptom Manage · Apr 2018
Meta AnalysisCharacterizing the Role of U.S. Surgeons in the Provision of Palliative Care: A Systematic Review and Mixed-Methods Meta-Synthesis.
The provision of palliative care varies appropriately by clinical factors such as patient age and severity of disease and also varies by provider practice and specialty. Surgical patients are persistently less likely to receive palliative care than their medical counterparts for reasons that are not clear. ⋯ Among the articles reviewed, surgeons overall demonstrated insight into the benefits of palliative care but reported limited knowledge and comfort as well as a multitude of challenges to introducing palliative care to their patients. These findings indicate a need for wider implementation of strategies that allow optimal integration of palliative care with surgical decision making.
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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 · Nov 2017
Review Meta Analysis Comparative StudyOpioid-Induced Constipation Relief of Fixed-Ratio Combination Prolonged-Release Oxycodone/Naloxone Compared with Oxycodone and Morphine for Chronic Non-malignant Pain: A Systematic Review and Meta-analysis of Randomized Controlled Trials.
Opioid-induced constipation (OIC) is one of the most frequent and severe adverse events (AEs) after treatment with opioids. Recent studies have indicated that fixed-ratio combination prolonged-release oxycodone/naloxone (OXN PR) could decrease OIC with similar pain relief compared with other opioids. ⋯ For people with chronic pain, treatment with OXN PR decreases the incidence of OIC and provides intermediate-term bowel function improvement with clinical importance; in addition, pain relief is not weakened. The OIC after treatment with OXN PR for cancer-related pain and over the long term remains unknown.
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J Pain Symptom Manage · Oct 2017
Review Meta AnalysisThe effectiveness of distraction as procedural pain management technique in paediatric oncology patients: a meta-analysis and systematic review.
Diagnostic tests and treatment regimens for pediatric cancers involve invasive and painful procedures. Effective management of such pain has been shown to be suboptimal in many parts of the world, often because of the cost and limited availability of appropriate medications. Current evidence suggests that distraction (a relatively low-cost technique) is a promising intervention for procedural pain management. There is, however, limited evidence demonstrating its effectiveness in pediatric oncology patients. ⋯ This systematic review demonstrates that distraction is a promising intervention for procedural pain. Future research should assess effectiveness of distraction in varied populations, to explore evidence of cultural influences on pain expression, measurement, and management approaches.