Articles: analgesics.
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The aim of the study is showing the results of the experience of "Hospital without pain" in the Lazio Region, in order to plan a specific regional project. This was a cross-sectional study conducted through the administration of a questionnaire during the month of October 2007, sent by the Social Department of the Regional Direction Health Planning to the General Directors of Local Health units, Hospital Trusts and Teaching Hospitals. 24 hospitals entered the study (response rate 80%). 37.5% of responders declare that pain level is routinely controlled by a trained health professional, mainly in smaller hospitals (50% vs. 20% in larger ones). In most hospitals (62.5%), pain monitoring is based on the use of the Visual analogue scale (VAS), whereas other scales are less frequently used (20.8%). ⋯ In the last case, these protocols are predominant in the roman (76.9%; p = 0.045), larger (80%; p = 0.069) and teaching hospitals (100%; p = 0.064). The management of pain in the Lazio Region shows a high heterogeneity, both in terms of geographical and dimensional issues. This study highlighted critical elements to be considered for the improvement of the situation at the regional level.
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Multicenter Study
Determinants of medication underuse and medication overuse in patients with chronic non-malignant pain: a multicenter study.
In chronic non-malignant pain, medication is often used as an important cornerstone of the treatment. Medication non-adherence is a frequent problem in chronic conditions. In patients with chronic non-malignant pain, medication non-adherence ranges between 8% and 53%. Two types of non-adherence can be identified: underuse and overuse of pain medication. ⋯ Patients underusing or overusing their medication do have a different risk profile. The set of determinants of non-adherence, proposed by WHO, is suitable to study determinants of underuse, but the framework is less suitable to study determinants of medication overuse.
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Randomized Controlled Trial Multicenter Study
A multicenter, randomized, double-blind, controlled dose finding study of NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia.
Postherpetic neuralgia (PHN) is a painful complication of acute herpes zoster. This multicenter, double-blind, controlled study randomized 299 PHN patients to receive either NGX-4010, a high-concentration capsaicin (8%) patch, or a low-concentration capsaicin (0.04%) control patch for 30, 60, or 90 minutes. The mean percent reductions in NPRS score from baseline to weeks 2 through 8 were significantly greater in the total NGX-4010 group (26.5%, P = .0286) and the 90-minute NGX-4010 group (27.8%, P = .0438) compared to the pooled control group (17.3%). After review of the data suggested a difference between genders in reporting of pain scores and a higher proportion of males (61%) in the 60-minute NGX-4010 group, post hoc gender-stratified analyses were performed and showed that the 60-minute NGX-4010 group also had a significantly larger mean percent reduction in average pain scores (28.0%, P = .0331). Pain reduction in the 30-minute NGX-4010 group, although similar in magnitude to the other doses, was not significantly different from control in either of these analyses. Similar results were observed during weeks 2 through 12. Most treatment-emergent adverse events were application-site specific, transient and mostly mild to moderate in severity. ⋯ This article reports the safety and efficacy of NGX-4010 applied for 3 different durations (30, 60, or 90 minutes) in patients with PHN. The results identified the 60-minute duration as the dose to be evaluated in subsequent studies and identified a gender effect on reported changes in pain.
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Expert Opin Pharmacother · Oct 2010
Randomized Controlled Trial Multicenter StudyTreatment response to pregabalin in fibromyalgia pain: effect of patient baseline characteristics.
The objective of this study was to evaluate the effect of patients' characteristics at baseline on the magnitude of pain response to pregabalin in patients with fibromyalgia. ⋯ The magnitude of response to pregabalin in terms of changes in pain may depend on age, pain, and sleep levels at baseline in patients with fibromyalgia.
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Randomized Controlled Trial Multicenter Study
Efficacy and safety of prucalopride in patients with chronic noncancer pain suffering from opioid-induced constipation.
Opioid-induced constipation (OIC) has negative effects on quality of life (QOL). Prucalopride is a new, selective 5-HT(4) agonist and enterokinetic with strong clinical data in chronic constipation. This study investigated the efficacy, safety, and tolerability of prucalopride in patients with noncancer pain and OIC. ⋯ In this population with OIC, prucalopride improved bowel function and was safe and well tolerated.