Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Can patient coaching reduce racial/ethnic disparities in cancer pain control? Secondary analysis of a randomized controlled trial.
Minority patients with cancer experience worse control of their pain than do their white counterparts. This disparity may, in part, reflect more miscommunication between minority patients and their physicians. Therefore, we examined whether patient coaching could reduce disparities in pain control in a secondary analysis of a randomized controlled trial. ⋯ Patient coaching offers promise as a means of reducing racial/ethnic disparities in pain control. Larger studies are needed to validate these findings and to explore possible mechanisms.
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To review strategies for treating patients with breakthrough pain (BTP). ⋯ Breakthrough pain can often be successfully treated by tailoring opioid therapy based on the subtype of BTP. These characteristics of BTP will determine the most appropriate opioid compound (i.e., hydrophilic vs lipophilic) and most effective mode of drug delivery.
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Randomized Controlled Trial Clinical Trial
Effect of local administration of transdermal fentanyl on peripheral opioid analgesia.
Transdermal fentanyl is a commonly used analgesic for the treatment of severe chronic pain. Recent investigations have shown the presence of mu-opioid receptors in the skin and opioid analgesic efficacy with alternative routes of administration of narcotics. This placebo-controlled, double-blind prospective study assessed whether transdermal fentanyl administration produces local peripheral opioid analgesia at the site of application. ⋯ These results suggest that the application of transdermal fentanyl patch for a period of 2 h does not produce local peripheral opioid analgesia at the site of patch application.
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To review major clinical issues related to recognition and diagnosis of breakthrough pain. ⋯ Greater knowledge and awareness of BTP in cancer and nonmalignant conditions will lead to improved recognition and diagnosis of BTP and ultimately to more effective treatment and enhanced quality of life for these patients.
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This study of patients with a diagnosis of fibromyalgia (FM) was conducted to test the hypothesis that immediate posttreatment measures of psychosocial functioning, health attributes, negative pain-related emotions, and depressive symptoms improve significantly during multidisciplinary pain rehabilitation while concurrently withdrawing analgesic medications. ⋯ The results of this study support the hypothesis that immediate posttreatment measures of physical and emotional functioning are favorable for patients with FM following multidisciplinary pain rehabilitation that incorporates withdrawal of analgesic medications.