Abstract:
:Strong opioids are recommended for treating severe cancer pain in the advanced stages of the disease. Few data are available concerning the efficacy of buprenorphine in cancer pain. We compared transdermal buprenorphine 70 microg/h (BUP TDS) to placebo in an enriched design study. Opioid-tolerant patients with cancer pain requiring strong opioids in the dose range of 90-150 mg/d oral morphine equivalents entered a two-week run-in phase, during which they were converted to BUP TDS. Patients who could be stabilized on BUP TDS were randomized to BUP TDS or placebo patch for a two-week maintenance phase. Rescue medication (buprenorphine sublingual tablets 0.2mg) was allowed as required. Response was defined as a mean pain intensity of <5 (0-10 scale) and a mean daily buprenorphine sublingual tablet intake of < or =2 tablets during the maintenance phase. Of 289 patients who entered the run-in phase, 100 discontinued treatment due to lack of efficacy or adverse events; 189 patients continued treatment in the maintenance phase (94 BUP TDS, 95 placebo), of whom 31 discontinued treatment (7 BUP TDS, 24 placebo). A significant difference in the number of treatment responders was observed: 70 BUP TDS (74.5%, 65.7-83.3) vs. 47 placebo (50%, 39.9-60.1) (P=0.0003). This result was supported by a lower daily pain intensity, lower intake of buprenorphine sublingual tablets and fewer dropouts in the BUP TDS group. The incidence of adverse events was slightly higher for BUP TDS. In conclusion, BUP TDS 70 microg/h is an efficacious and safe treatment for patients with severe cancer pain.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Poulain P,Denier W,Douma J,Hoerauf K,Samija M,Sopata M,Wolfram Gdoi
10.1016/j.jpainsymman.2007.09.011subject
Has Abstractpub_date
2008-08-01 00:00:00pages
117-25issue
2eissn
0885-3924issn
1873-6513pii
S0885-3924(08)00104-8journal_volume
36pub_type
杂志文章,多中心研究,随机对照试验abstract::Latin America consumes less than 2.7% of the morphine in the world, as reported by the governments to the International Narcotics Control Board. Methods to improve access to opioids for the treatment of pain have been developed by the Pain & Policy Studies Group (PPSG), a World Health Organization Collaborating Center...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2009.03.007
更新日期:2009-11-01 00:00:00
abstract::More than 2200 subjects were enrolled in the MorphiDex (MS:DM) development program, with a 1:1 (weight:weight) ratio of morphine sulfate (MS) to dextromethorphan hydrobromide (DM). Of the 1400 subjects exposed to MorphiDex, more than 350 subjects were treated for at least 6 months, and over 200 subjects were treated f...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析
doi:10.1016/s0885-3924(99)00131-1
更新日期:2000-01-01 00:00:00
abstract:CONTEXT:Sedation is administered to some palliative care patients at the end of their life. Nurses play an important role in this practice. OBJECTIVES:To systematically review the evidence on nurses' attitudes and practice of end-of-life sedation. METHODS:We searched eight electronic databases, four key palliative ca...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2013.06.011
更新日期:2014-05-01 00:00:00
abstract::The purpose of this randomized, controlled, home care intervention was to test the effectiveness of two nurse-targeted, e-mail-based interventions to increase home care nurses' adherence to pain assessment and management guidelines, and to improve patient outcomes. Nurses from a large urban non-profit home care organi...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2004.08.018
更新日期:2005-05-01 00:00:00
abstract::Patients with advanced cancer often do not receive high-quality pain and symptom management or support with coordination of care, communication, and decision making. Implementing quality indicators that are reflective of the scope of care, feasible to implement, and supported by evidence might help to identify areas a...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2009.04.024
更新日期:2009-12-01 00:00:00
abstract::The relationship of trauma history to physical and emotional functioning in primary care pain patients was examined. Data were drawn from a mailed screening questionnaire for a larger study designed to evaluate an intervention for improving pain management in primary care. Results indicated that 50.4% of the pain pati...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(02)00646-2
更新日期:2003-03-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to assess the characteristics of breakthrough cancer pain (BTcP) in patients with abdominal cancer pain, and the eventual factors associated with its presentation. METHODS:Patients with abdominal visceral cancer presenting BTcP were included in the analysis. Pain intensity, cu...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2019.02.014
更新日期:2019-05-01 00:00:00
abstract::Assessing quality of care at the end of life involves measurements in several domains-use of evidence-based guidelines, patient and family satisfaction, quality of life, and incidence of adverse events, among others. There are several different data sources from which to calculate quality measures. Each data source ha...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(01)00329-3
更新日期:2001-09-01 00:00:00
abstract:CONTEXT:Conflicts between families and clinicians in pediatric end-of-life (EOL) care cause distress for providers, dissatisfaction for patients' families, and potential suffering for terminally ill children. OBJECTIVES:We hypothesized that family factors might influence clinician decision making in these circumstance...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2012.05.005
更新日期:2013-05-01 00:00:00
abstract:CONTEXT:Trends in symptoms and functional ability are known toward the end of life, but less is understood about quality of life, particularly prospectively following service referral. OBJECTIVES:This study compares quality of life trajectories of people with and without cancer, referred to volunteer-provided palliati...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2018.07.020
更新日期:2018-11-01 00:00:00
abstract:CONTEXT:This article presents the results of a pivotal Phase 3 study that assesses a new treatment for the management of chronic low back pain: a transdermal patch containing the opioid buprenorphine. In this randomized, placebo-controlled study with an enriched enrollment design, the buprenorphine transdermal system (...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,随机对照试验
doi:10.1016/j.jpainsymman.2011.04.006
更新日期:2011-12-01 00:00:00
abstract:CONTEXT:Coronavirus disease 2019 (COVID-19) led to increased attention nationally on advance care planning. OBJECTIVES:To describe the impact COVID-19 had on advance care planning based on changes in the calls to the West Virginia Center for End-of-Life Care (center) and in the volume and types of documents requested ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.09.021
更新日期:2020-12-01 00:00:00
abstract:CONTEXT:In 2010, California launched Partners for Children (PFC), a pediatric palliative care pilot program offering hospice-like services for children eligible for full-scope Medicaid delivered concurrently with curative care, regardless of the child's life expectancy. OBJECTIVES:We assessed the change from before PF...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2016.02.020
更新日期:2016-09-01 00:00:00
abstract::The coronavirus disease 2019 (COVID-19) pandemic presents unique challenges to those who work with the seriously ill population, including both health care providers and the family caregivers providing unpaid care. We rely on this lay workforce as health care routinely transitions care to the home, and now more than e...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.04.006
更新日期:2020-07-01 00:00:00
abstract::Continuing the transition to competency-based education, Hospice and Palliative Medicine (HPM) fellowship programs began using context-free reporting milestones (RMs) for internal medicine subspecialties in 2014 but quickly recognized that they did not reflect the nuanced practice of the field. This article describes ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.01.008
更新日期:2020-07-01 00:00:00
abstract:CONTEXT:Individuals from low socioeconomic (SE) groups have less resources and poorer health outcomes. Understanding the nature of access to appropriate end-of-life care services for this group is important. OBJECTIVES:To evaluate the literature in the developed world for barriers to access for low SE groups. METHODS...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2010.10.265
更新日期:2011-07-01 00:00:00
abstract:CONTEXT:Although many family members who make surrogate decisions report problems with communication, there is no validated instrument to accurately measure surrogate/clinician communication for older adults in the acute hospital setting. OBJECTIVES:The objective of this study was to validate a survey of surrogate-rat...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2016.08.010
更新日期:2017-01-01 00:00:00
abstract::Inadequate nursing education is a major impediment to effective pain relief for cancer patients throughout the world. This study was conducted to identify the level of cancer pain knowledge among baccalaureate student nurses and to determine whether specific activities affect this level of knowledge. Two questionnaire...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(92)90134-4
更新日期:1992-11-01 00:00:00
abstract::The purpose of this study was to examine the predictors of perceived success in addressing the end-of-life care needs of low-income older adults and their family members. Perceived success is defined as the clinician's subjective assessment of the extent to which end-of-life care needs of the patient and family have b...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2010.04.017
更新日期:2011-01-01 00:00:00
abstract::Many painful disorders, including joint dysfunctions such as rheumatoid arthritis (RA) or temporomandibular joint disorders (TMD), are associated with hyperthermia of the overlying skin. The same is true of certain intractable chronic pain conditions, such as chronic orofacial pain, which may be associated with TMD. W...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/s0885-3924(97)00178-4
更新日期:1997-10-01 00:00:00
abstract::US health-care policy and recent literature are reviewed to examine whether there are reimbursement barriers to acute and cancer pain management. The available evidence suggests that lack of coverage and uneven reimbursement policies for health care including prescription drugs, medical equipment, and professional ser...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/0885-3924(94)90101-5
更新日期:1994-05-01 00:00:00
abstract::A 39-year-old woman with breast cancer metastatic to bone presented with acute hip pain marginally responsive to escalating doses of opioid analgesics. Pathologic pelvic fractures were present and there were minimal clinical indicators of infection, but the severity and intractable nature of the pain prompted further ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(95)00065-7
更新日期:1995-10-01 00:00:00
abstract::Infection is common among advanced cancer patients. This study was undertaken to review the pattern of use of antibiotics and to identify potential factors that could affect outcomes after infection. The medical records of all patients with advanced cancer who were enrolled into the palliative care service of a distri...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2005.06.005
更新日期:2005-12-01 00:00:00
abstract:CONTEXT:Breast cancer morbidity and mortality disproportionately affect medically underserved women. Most studies of the experience of living with advanced breast cancer do not focus on this population. A deeper understanding of racial/ethnic minorities' and low-income patients' experiences is needed to reduce breast c...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.08.006
更新日期:2019-12-01 00:00:00
abstract:CONTEXT:Intermountain Healthcare, in collaboration with Cerner Corporation, developed a hospital-based electronic palliative care algorithm. OBJECTIVES:This study aims to improve identification of patients who would benefit from palliative care services, and calculate palliative care penetration rates. METHODS:This s...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2017.09.013
更新日期:2018-02-01 00:00:00
abstract:BACKGROUND:Dying patients whose implantable cardioverter defibrillators (ICDs) continue to deliver shocks may experience significant pain, and the National Quality Forum has endorsed routine deactivation of ICDs when patients near the end of life. The overarching goal of this quality improvement project was to increase...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2013.09.010
更新日期:2014-09-01 00:00:00
abstract::Clinical trials of investigational therapy in patients with advanced cancer may not pay sufficient attention to quality of life (QOL) and supportive care issues, resulting in an adverse impact on the quality of care (QOC). We hypothesized that the simultaneous delivery of investigational therapy and a structured progr...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpainsymman.2004.03.002
更新日期:2004-12-01 00:00:00
abstract::Celiac plexus blockade with ethanol is a widely accepted modality of pain control for adults with cancer pain. The role of interventional strategies in children is less well established. A 7-year-old child with abdominal pain secondary to a Wilms tumor was treated with neurolytic celiac plexus blockade. This resulted ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(95)00014-P
更新日期:1995-05-01 00:00:00
abstract:CONTEXT:Measuring What Matters (MWM) prioritizes quality measures in palliative care practice. Hematologic malignancy patients are less likely to access palliative care, yet little is known about their unique needs. Differences in MWM adherence may highlight opportunities to improve palliative care in hematology. OBJE...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2016.09.004
更新日期:2016-12-01 00:00:00
abstract:CONTEXT:Previous surveys have suggested that pain in hospitalized patients remains undertreated. However, little is known about those with persistently high pain scores. OBJECTIVES:To document the distribution of scores and analyze the clinical characteristics of outliers with persistently high pain scores. METHODS:W...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2014.01.006
更新日期:2014-11-01 00:00:00