Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2002
ReviewOpioid treatment of chronic pain in patients with addiction.
Patients with a history of drug or alcohol addiction may present to physicians with pain complaints. The medical literature is weak on the treatment of pain with opioids in patients in recovery or active addiction. This is because inconsistent criteria were used to define addiction and the types of chronic pain. ⋯ A way to distinguish between these conditions is by giving the patient appropriate pain medication and observing the pattern of behavior to determine which is causing the drug-seeking behavior. Safe prescribing of medications with abuse potential includes use of a medication agreement, setting goals with the patient, giving appropriate amounts of pain medication, monitoring with pill counts and drug screens, and careful documentation. Even patients with a history of addiction can benefit from opioid pain medications if monitored appropriately.
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J Pain Palliat Care Pharmacother · Jan 2002
Comparative StudyManagement of cancer pain evidence report technology assessment: number 35--management of cancer pain summary.
Under its Evidence-Based Practice Program, the Agency for Healthcare Research and Quality (AHRQ) is developing scientific information for other agencies and organizations on which to base clinical guidelines, performance measures, and other quality improvement tools. Contractor institutions review all relevant scientific literature on assigned clinical care topics and produce evidence reports and technology assessments, conduct research on methodologies and the effectiveness of their implementation, and participate in technical assistance activities.
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This paper introduces a new series in the Journal that will address Outcomes Research and Pharmacoeconomics in Pain & Palliative Care. The goal of the series is to provide an overview of the field of outcomes research that will be geared to clinicians, and to review the outcomes literature in the area of Pain and Palliative Care. ⋯ There are a lot of misconceptions about the field including some who look at outcomes research as not really science and not adding to our knowledge about drugs and drug use. To the contrary, outcomes research is a powerful tool, but like many others it has limitations and it is important to understand both what outcomes research is, and what it isn't.
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J Pain Palliat Care Pharmacother · Jan 2002
Case ReportsMyofascial pain response to topical lidocaine patch therapy: case report.
This is a case from a preliminary open trial to assess the efficacy of topically applied lidocaine patches as an alternative to trigger point injections for myofascial pain. We describe one case in this report that had a dramatic response to the lidocaine patch. Her pain relief increased, pain intensity decreased, and functional capacity increased. ⋯ The response to other patients has varied. The true clinical utility cannot be obtained from this one report, but only after the data have been analyzed from this initial trial. If the data are promising, a randomized, double-blind, crossover trial is planned.
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J Pain Palliat Care Pharmacother · Jan 2002
Case ReportsPain relief from baclofen analgesia in a neuropathic pain patient who failed opioid and pharmacotherapy: case report.
A case report and discussion of a 64-year-old white female who presented with uncontrolled pain in several body areas despite massive oral controlled release morphine use is presented. Her pain was not associated with much spasticity. This patient responded remarkably to intrathecal baclofen even after the opioid was tapered and discontinued. The potential usefulness of baclofen in seemingly opioid-resistant chronic pain is discussed.