Articles: opioid.
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To describe the analgesic treatment of patients with advanced chronic disease (ACD), to determine pain management, and to detect opportunities for improvement. ⋯ In patients with ACD and palliative needs, the use of strong opioids continues to prevail in the hospital setting and oncological disease, although pain is highly prevalent in all EOL trajectories and places of care. The high percentage of negative PMI reveals the opportunity for an individualised analgesic ladder stepping for better pain control. Also, incorporating non-pharmacological approaches could help improve pain in these patients.
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Observational Study
The Incidence and Risk Factors of Persistent Opioid Use After Surgery—a Retrospective Secondary Data Analysis.
The risk of persistent postoperative opioid use (PPOU) and its association with the type of surgery are still unclear in Germany. ⋯ The incidence of PPOU in Germany is low (1.4%). The type of surgery plays an important role in its development.
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Prospective cohort using routinely collected health data. ⋯ Level III.
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Case Reports
Pharmacogenotyping disproves genetic cause of drug-related problems in family history: a case report.
In clinical practice, family medication history is not routinely assessed as part of a patient's family health history (FHH). The information is self-reported and can depend on the individual's subjective perception. To illustrate how pharmacogenetic (PGx) testing results could be used to validate self-reported family medication history on drug-related problems (DRP), as well as to inform medication-related decisions, we herein present a case involving ten members of the same family. ⋯ The original trigger for PGx testing was the self-reported, conspicuous family medication history of DRP reported by the grandmothers. However, the girl's genotype predicted phenotypes of CYP2B6 IM and CYP2D6 PM, differed from the grandmothers'. With this exemplary case, we propose that hereditary concerns based on self-reported information on DRP should be verified by a PGx panel test, when the respective drug exhibits a PGx association. Also, the girl's PGx testing results provided important medication recommendations, which were considered perioperatively by the anesthetist suggesting to use PGx testing results preemptively to inform medication-related decisions.