Abstract:
:The burden of constipation from the patient's perspective has been well described. The aim of this study was to evaluate the cost of managing constipation in patients taking opioids in a specialist palliative care inpatient unit. A retrospective review of the medical records of 58 patients (70 admissions) who died during a six-month period was undertaken to identify prescribing patterns for opioids and oral laxatives and tasks associated with managing constipation in these patients. A prospective time and motion study also was undertaken, whereby staff recorded the time and resources required to perform each task. These data were then applied to the actual frequency recorded in the retrospective review to calculate the direct cost of managing constipation in those 70 admissions during that six-month period. There was no discernable pattern in oral laxative prescribing. The mean cost of managing constipation was 29.81 pounds (48.74 USD) per admission, with staff time accounting for 85% of the cost. The most time-consuming activity was staff discussion about bowel management, which occurred at least once daily for doctors and twice for nurses and involved up to eight members of staff at a time. The cost of managing constipation is skewed in that it costs 30 pounds (49 USD) or less in 71% of admissions but exceeded 100 pounds (163 USD) in 5%. In the latter group, earlier and/or more effective intervention for constipation could lead to clinical and economic benefits.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Wee B,Adams A,Thompson K,Percival F,Burslem K,Jobanputra Mdoi
10.1016/j.jpainsymman.2009.09.007subject
Has Abstractpub_date
2010-04-01 00:00:00pages
644-54issue
4eissn
0885-3924issn
1873-6513pii
S0885-3924(10)00080-1journal_volume
39pub_type
杂志文章abstract:CONTEXT:Being diagnosed with incurable cancer can be a life-changing experience, evoking different spiritual questions and needs. Confronting a serious life-threatening event occurs not only often unexpected but also can disrupt a person's self-image and ideals of their personhood. This confrontation makes it difficult...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2017.11.007
更新日期:2018-03-01 00:00:00
abstract::Accurate pain assessment is considered essential for effective management of cancer pain. The aim of this study was to evaluate the compliance of hospitalized patients with chronic cancer pain, referred to an inpatient palliative care consultation service, with self-assessment of pain intensity by means of a daily pai...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/j.jpainsymman.2004.01.002
更新日期:2004-05-01 00:00:00
abstract::Accumulation of active (toxic) metabolites of opioids might explain cases of opioid toxicity when high doses are used for long periods of time. Other mechanisms of late toxicity of opioids may be found at the receptor level. Whatever the cause, a change of opioids using equianalgesic doses can be expected to improve s...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(95)90924-c
更新日期:1995-07-01 00:00:00
abstract:CONTEXT:Osteoarthritis (OA) is a common cause of chronic pain, particularly in the older population. Modern approaches to the management of OA pain recommend tailoring treatment to the individual. This study examines treatment options for OA pain in the form of low-dose transdermal and sublingual opioid analgesia. OBJ...
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.2010.01.013
更新日期:2010-08-01 00:00:00
abstract:CONTEXT:Cancer patients with cachexia may suffer from significant burden of symptoms and it can severely impair patients' quality of life. However, only few studies have targeted the symptom burden in cancer cachexia patients, and whether the symptom burden differed in different cachexia stages is still unclear. OBJEC...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2016.12.325
更新日期:2017-05-01 00:00:00
abstract:CONTEXT:Although sporadic male predominance in hiccup patients has been reported, the association between gender differences and triggering factors has rarely been evaluated in patients with hiccups. OBJECTIVES:The aim of this study was to investigate whether gender differences exist in hiccup patients by analyzing al...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpainsymman.2015.09.013
更新日期:2016-02-01 00:00:00
abstract:CONTEXT:Does octreotide reduce vomiting in cancer-associated bowel obstruction? OBJECTIVES:To evaluate the net effect of adding octreotide or placebo to standardized therapies on the number of days free of vomiting for populations presenting with vomiting and inoperable bowel obstruction secondary to cancer or its tre...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1016/j.jpainsymman.2014.09.013
更新日期:2015-05-01 00:00:00
abstract:CONTEXT:This scoping review maps the existing literature on narrative interventions within a palliative care and end-of-life context. OBJECTIVES:A scoping review was performed to address the following research question: What observational or randomized controlled trials have been performed to evaluate narrative interv...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2019.06.009
更新日期:2019-10-01 00:00:00
abstract::The purposes of this study were 1) to assess and describe the occurrence, frequency, severity, and distress of symptoms reported by Taiwanese pediatric cancer patients who were between 10 and 18 years of age, and 2) to use statistical analysis to determine whether the multiple dimensions (i.e., frequency, severity, or...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2009.04.023
更新日期:2009-11-01 00:00:00
abstract::Although pain is an extremely common symptom presenting to primary care physicians, it frequently is not optimally managed. The purpose of this feasibility study was to develop and pilot-test an efficient, rapid assessment and management approach for pain in busy community practices. The intervention utilized the Dart...
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/s0885-3924(01)00301-3
更新日期:2001-07-01 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::For cancer patients, fatigue is a disturbing symptom caused by many factors. Since fatigue is the most common side effect of localized radiation to the breast, this treatment provides a unique opportunity to follow patients prospectively as they develop one type of fatigue. We evaluated the effect of radiation treatme...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(92)90106-r
更新日期:1992-01-01 00:00:00
abstract::Actigraphy has become a valuable clinical and research tool to objectively evaluate sleep, daytime activity, and circadian activity rhythms in healthy individuals as well as persons with primary and comorbid insomnia. However, procedures used for sampling, data processing, and analysis are not consistently reported in...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2007.10.008
更新日期:2008-08-01 00:00:00
abstract::To explore the factors that patients with malignant and nonmalignant pain consider when deciding whether to enroll in pain research studies, determine whether their views are different, and determine whether willingness to enroll in research is associated with pain severity, semi-structured interviews were conducted w...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(02)00527-4
更新日期:2002-11-01 00:00:00
abstract::Previous studies have shown that acupressure bands can reduce chemotherapy-related nausea. Patients' expectations of efficacy account for part of this outcome. We conducted a three-arm randomized clinical trial to investigate the effectiveness of acupressure bands in controlling radiation therapy-induced nausea and to...
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.2008.09.006
更新日期:2009-09-01 00:00:00
abstract::This study examined the relationship between patient and partner ratings of self-efficacy for symptom control and quality of life (QOL) among 40 African American prostate cancer survivors and their intimate partners. Data analyses revealed that cancer survivors who had rated their self-efficacy for symptom control hig...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2004.02.020
更新日期:2004-11-01 00:00:00
abstract::The results of a novel approach to the use of ketamine in refractory cancer pain are reported. In this prospective, multicenter, unblinded, open-label audit, 39 patients (with a total of 43 pains) received a short duration (3 to 5 days) ketamine infusion. The initial dose of 100 mg/24 hr was escalated if required to 3...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/s0885-3924(01)00340-2
更新日期:2001-10-01 00:00:00
abstract::Patient-controlled analgesia (PCA) has been incorporated into the management of chronic pain in cancer patients despite limited evidence of safety and efficacy. Potential benefits of PCA include decreased delay in the administration of opioids from the time requested, rapidity and ease of dose titration, and adaptabil...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2010.11.020
更新日期:2011-08-01 00:00:00
abstract::The effects of opioids usually parallel the plasma concentrations but with a temporal shift. This temporal shift differs between opioids. It is small with alfentanil or remifentanil and very long with the active metabolite of morphine, morphine-6-glucuronide (M6G). The mathematical and experimental techniques for mode...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2005.01.012
更新日期:2005-05-01 00:00:00
abstract::A significant proportion of health care resources are consumed at end of life. As a result, decision and policy makers seek cost savings to enhance program planning. Most literature, however, combines the cost of all dying patients and, subsequently, fails to recognize the variation between trajectories of functional ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2009.04.007
更新日期:2009-07-01 00:00:00
abstract:CONTEXT:Knowledge is limited regarding pain assessment and management practices, as well as pain-related outcomes in hospice care. OBJECTIVES:To generate national estimates of pain assessment and management practices and outcomes of pain control among patients 65 years or older receiving hospice care in the U.S. and i...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2016.05.020
更新日期:2016-11-01 00:00:00
abstract:CONTEXT:Autonomic nervous system dysfunction (AD) is a common syndrome in patients with advanced cancer. It is associated with decreased survival in several patient populations, including diabetes mellitus, heart failure, and neurological diseases. Based on this evidence, we hypothesized that autonomic dysfunction is a...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2009.06.014
更新日期:2010-02-01 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:Palliative sedation is used to relieve end-of-life refractory symptoms. OBJECTIVE:The objective of this study was to describe the use of palliative sedation in patients who die in internal medicine departments. METHODS:An observational, cross-sectional, retrospective, and multicenter clinical audit study was ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.10.013
更新日期:2020-02-01 00:00:00
abstract:CONTEXT:Hospitalized patients with advanced cancer often face complex, preference-sensitive decisions. How clinicians and patients engage in shared decision-making during goals-of-care discussions is not well understood. OBJECTIVE:The objective of this study was to explore decision-making by patients and clinicians du...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.05.002
更新日期:2019-08-01 00:00:00
abstract:CONTEXT:Hospice care is traditionally used for patients with advanced cancer, but it is increasingly considered for patients with end-stage heart failure. OBJECTIVES:We compared enrollment patterns and clinical events of hospice patients with end-stage heart failure with those of patients with advanced cancer. METHOD...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2012.03.006
更新日期:2013-03-01 00:00:00
abstract::Assessing for the presence of addiction in the chronic pain patient receiving chronic opioid analgesia is a challenging clinical task. This paper presents a recently developed screening tool for addictive disease in chronic pain patients, and pilot efficacy data describing its ability to do so. In a small sample of pa...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章
doi:10.1016/s0885-3924(98)00110-9
更新日期:1998-12-01 00:00:00
abstract::Studies applying exercise, relaxation training, and psychoeducation have each indicated a positive impact on physical performance and/or psychological factors in patients diagnosed with cancer. We explored the longitudinal effect of a combination of these interventions on treatment-related symptoms in patients undergo...
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.2008.09.005
更新日期:2009-08-01 00:00:00
abstract::This report describes a pharmacokinetic study and a clinical study of three different formulations of oral tramadol: once-daily tramadol tablets 150 and 200 mg, and normal release tramadol capsules 50 mg 8-hourly. The randomized, open-label, crossover pharmacokinetic study included 22 subjects. The three treatments sh...
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/s0885-3924(02)00642-5
更新日期:2003-02-01 00:00:00
abstract:CONTEXT:Despite the recognized distressing symptom of fatigue in children with cancer, little information is available to assist in the selection of an instrument to be used to measure fatigue. OBJECTIVES:The objectives of this study were to 1) describe the instruments that have been used to measure cancer-related fat...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,评审
doi:10.1016/j.jpainsymman.2012.02.010
更新日期:2013-01-01 00:00:00