Advances in therapy
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Advances in therapy · Feb 2015
ReviewIPF Care: a support program for patients with idiopathic pulmonary fibrosis treated with pirfenidone in Europe.
Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive, and irreversible fibrotic lung disease that requires long-term treatment. Given the importance of adherence to treatment and management of adverse events (AEs), patients with IPF need long-term, high-quality support in living with their condition, and adhering to therapy so they can derive maximum benefit. The IPF Care Patient Support Program (IPF Care) provides support, education, and empowerment to patients receiving pirfenidone for the treatment of IPF in Europe, through the provision of frequent, patient-managed discussions with specialist IPF nurses. ⋯ This highlights the value of the advice and support that patients receive in IPF Care regarding management of AEs and staying on treatment. Patient satisfaction was high in a survey of the UK program, with patients reporting high scores regarding 'feeling in control of their condition', 'knowing what to expect from treatment', and 'feeling confident about how their disease is managed'. IPF Care in Europe will continue to evolve over time, striving to provide individually tailored support and patient-friendly information to improve treatment outcomes and quality of life for patients living with IPF.
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Advances in therapy · Jul 2014
ReviewBreakthrough cancer pain (BTcP): a synthesis of taxonomy, pathogenesis, therapy, and good clinical practice in adult patients in Italy.
Pain presents in 80% of patients with advanced cancer, and 30% have periods of increased pain due to fluctuating intensity, known as breakthrough cancer pain (BTcP). BTcP is high-intensity, short-duration pain occurring in several episodes per day and is non-responsive to treatment. The clinical approach to BTcP is variable. ⋯ Importantly, before choosing a rapid-onset opioid (ROO), it is essential to deeply understand the status of patient and the characteristics of their family unit/caregivers, taking into account the patient's progressive loss of autonomy and/or cognitive-relational functionality. When BTcP therapy is initiated or changed, special attention must be paid to training the patient and family members/caregivers, providing clear instructions regarding the timing of drug administration. The patient must already be treated effectively with opioids before introducing ROOs for control of BTcP.
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Advances in therapy · Apr 2014
ReviewPirfenidone in idiopathic pulmonary fibrosis: expert panel discussion on the management of drug-related adverse events.
Pirfenidone is currently the only approved therapy for idiopathic pulmonary fibrosis, following studies demonstrating that treatment reduces the decline in lung function and improves progression-free survival. Although generally well tolerated, a minority of patients discontinue therapy due to gastrointestinal and skin-related adverse events (AEs). ⋯ The main recommendations to help prevent and/or mitigate gastrointestinal and skin-related AEs include taking pirfenidone during (or after) a meal, avoiding sun exposure, wearing protective clothing, and applying a broad-spectrum sunscreen with high ultraviolet (UV) A and UVB protection. These measures can help optimize AE management, which is key to maintaining patients on an optimal treatment dose.
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Advances in therapy · Mar 2014
ReviewTamper-resistant opioid formulations in the treatment of acute pain.
Pain-including acute or persistent acute pain-is a common condition that is increasingly being treated with opioids in the United States. The acute pain treatment setting may represent a key target for addressing the growing epidemic of prescription drug abuse occurring hand in hand with the rise in opioid prescribing. Balancing the needs of pain treatment with abuse prevention can be challenging for clinicians. ⋯ In order to stem the tide of prescription opioid abuse and preserve the availability of opioids as a much needed analgesic option, a multifaceted approach that includes tamper-resistant opioid formulations-for chronic or acute pain-along with strategies such as improved patient risk assessment, funding for and referral to addiction treatment programs, greater use of PMPs, and raised awareness of prescription opioid abuse is needed.
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Advances in therapy · Feb 2014
ReviewOpioid-induced endocrinopathy in cancer patients: an underestimated clinical problem.
The impact of both endogenous and exogenous opioids on the endocrine system has been known for many years. With the increased use of opioids in chronic pain treatment, the research focuses mainly on their effects on the endocrine system in patients with chronic non-malignant pain. Despite the wide dissemination of cancer, there has been little research on the possible effects of opioids on the endocrine system in cancer patients. ⋯ This article presents the available research on the effects of opioids on the endocrine system and the clinical consequences resulting from opioid use in cancer patients. Clinicians who use opioids in clinical practice should be aware of the existence of the endocrine symptoms of opioid therapy. There is still a need for more research in this area to maintain the best possible quality of life for cancer patients treated with opioid analgesics.