Journal of pain and symptom management
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J Pain Symptom Manage · Jan 2024
Multicenter StudyCancer Pain Management in Patients Receiving Inpatient Specialized Palliative Care Services.
Cancer pain is a common complication that is frequently undertreated in patients with cancer. ⋯ SPC achieved cancer pain management over a short period with a high level of patient satisfaction resulting in significant pain reduction and few documented adverse events.
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J Pain Symptom Manage · Dec 2023
ReviewImpact of an Institution-wide Goals of Care Program on the Timing of Referrals to Outpatient Palliative Care.
Palliative care has received increased interest since the COVID-19 pandemic due to its role in guiding goals of care (GOC) discussions. ⋯ There were no significant differences in OS among patients seen in the SCC before and after myGOC, likely related to a ceiling effect. More oncologists had ACP discussions with patients, and patients had lower symptom scores on ESAS after myGOC, likely indicating that more patients were referred for GOC discussions and ACP rather than for symptom distress.
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J Pain Symptom Manage · Dec 2023
ReviewTreatment Effect Estimates from Pilot Trials Are Unreliable.
The CONSORT guideline defines a pilot trial as a small-scale version of a desired future efficacy trial that is intended to answer the key questions of whether and how a larger study should be done. For example, a pilot trial might evaluate different approaches to data collection or outcome measurement. However, pilot trials are unreliable for assessing treatment efficacy due to the statistical phenomenon called sampling variability. ⋯ Treatment effect estimates from pilot trials should not be used to make future development decisions regarding a novel therapy because of the high risk of misleading conclusions.
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J Pain Symptom Manage · Jan 2024
Randomized Controlled TrialImpact of Dosing and Duration of Dexamethasone on Serious Corticosteroid-Related Adverse Events.
Corticosteroids are commonly prescribed in oncology, but few studies have examined its adverse events (AEs) compared to placebo control. ⋯ Greater dexamethasone exposure, even at moderate doses, was associated with more serious AEs. Prescribers should cautiously weigh the risks and benefits of dexamethasone use, especially when considering for palliation of symptoms.
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J Pain Symptom Manage · Jan 2024
ReviewEthical and practical considerations of perimortem gamete procurement for palliative care providers.
Requests for perimortem gamete procurement (PGP) typically arise by a surrogate decision maker after the unexpected death or incapacitation of a reproductive-aged individual. Palliative care clinicians should have a working knowledge of the medical, ethical, and practical considerations pertaining to such requests. ⋯ We review the technologies associated with PGP and posthumous assisted reproduction (PAR) and discuss the ethical and legal issues involved in such cases, including recent position statements from national and international reproductive health groups. Finally, we provider readers with a stepwise approach for considering requests for PGP.