Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2004
Evidence-based pain management and palliative care in issues three and four for 2003 of The Cochrane Library.
The Cochrane Library of systematic reviews is published quarterly. Issue 3 for 2003 of the library was published in May 2003. That issue contains 3058 reviews of which 1754 are in full text. ⋯ Annotated bibliographies for those seven reviews are provided. Issue 4 for 2003 of The Cochrane reviews and 1344 protocols. The Cochrane trials database now stands at over at over 378,000 records with an additional 4626 summaries of non-Cochrane systematic reviews published in the general medical literature [(Database of abstracts of reviews of effectiveness (DARE)].
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J Pain Palliat Care Pharmacother · Jan 2004
ReviewA systematic review of oxygen and airflow effect on relief of dyspnea at rest in patients with advanced disease of any cause.
Oxygen is used frequently to relieve dyspnea in patients with advanced illness. The objective of this study was to critically appraise the scientific basis for oxygen therapy as a therapeutic intervention to manage dyspnea at rest in patients with advanced disease. A systematic search of all relevant databases was done using MeSH terms and appropriate key words. ⋯ This systematic review and critical appraisal found low-grade scientific evidence that oxygen and airflow improve dyspnea in some patients with advanced disease at rest. However, there is no evidence to identify which patients will benefit from airflow or supplemental oxygen or to determine when to use airflow versus supplemental oxygen. Further research is required to provide scientific evidence to evaluate oxygen and airflow effectiveness and determine the place of oxygen and airflow in the management of dyspnea at rest in patients with advanced disease.
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J Pain Palliat Care Pharmacother · Jan 2004
Multicenter StudyKnowledge and attitudes in pain management: Hong Kong nurses' perspective.
Effective pain management requires accurate knowledge, attitudes and assessment skills. To determine the current knowledge level and attitudes of nurses in pain management, 1,604 registered nurses working in three different hospitals in Hong Kong were invited to participate in this study. The sample consisted of 601 registered nurses, 63 nursing officers, and 14 nursing specialists (N = 678). ⋯ There was statistical significant in educational preparation and clinical experiences with correct scores. The findings of our study support the concern of inadequate knowledge and attitudes in relation to pain management. Further intensive continuing education and staff development is highly indicated for nurses in Hong Kong.
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J Pain Palliat Care Pharmacother · Jan 2004
ReviewOpioid insights:opioid-induced hyperalgesia and opioid rotation.
Opioid analgesics are an irreplaceable component of pharmacotherapy of numerous pain-producing conditions. Clinicians and patients must contend with the imperfect nature of this class of drugs, trying to balance benefits and burdens on a continual basis. New literature related to evidence-based selection of opioids and the neurobiological phenomenon of opioid induced hyperalgesia are reviewed. A matrix describing critical elements in the selection of opioid analgesics, both for initial therapy and for opioid rotation, is presented.
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J Pain Palliat Care Pharmacother · Jan 2004
Patterns of opioid analgesic prescription among patients with osteoarthritis.
This study describes patterns of opioid analgesic prescription during a one-year period among a sample of patients with osteoarthritis (OA). The study sample included 3,061 patients with prior ICD-9 codes indicating a diagnosis of OA who were treated at a federal Veterans Affairs Medical Center. Specific opioid variables included: any opioid prescription, number of specific opioid drugs prescribed, total number of opioid prescriptions, total number of days supply of opioids, and daily opioid doses. ⋯ Daily opioid doses were, on average, below recommended daily doses for the treatment of OA. Findings of this study suggest that opioids are frequently prescribed to individuals with OA and that these drugs may be gaining acceptability for the treatment of chronic musculoskeletal pain. Additional research is needed to examine reasons for racial differences in opioid prescribing, as well as the prescription of these medications at fairly low doses.