Abstract：
CONTEXT:Pain is common among patients with advanced cancer despite the dissemination of clinical pain care guidelines. OBJECTIVES:We sought to assess the quality of pain care among patients with advanced disease. METHODS:We reviewed the records of 85 adult ambulatory patients with advanced breast, lung, and gastrointestinal cancer treated in 2004-2006. Patients' screening pain intensity scores were at least 7 of 10. Nurse reviewers completed medical record reviews of care rendered at the index visit and over the subsequent 30 days based on the 2004 National Comprehensive Cancer Network pain guideline. An expert panel then rated the quality of the evaluation, treatment, and overall pain care. We used a multivariable model to analyze guideline compliance and resolution of severe pain. RESULTS:Among advanced cancer patients with severe pain, clinicians adjusted pain medications only half the time and made few timely referrals for pain-related consultations. By 30 days after the index visit, 34% of patients continued to report severe pain. The expert panel judged the overall quality of pain care as "fair" or "poor" in about two-thirds of cases because more timely and effective intervention could have reduced the severity and duration of pain. Resolution of severe pain was associated with adjustment of pain medications at the index visit (adjusted odds ratio 3.8, 95% CI 1.3-10.6). CONCLUSION:There is room for improvement in the pain care of patients with advanced cancer. Additional research is needed to understand the reasons for poor performance.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Weingart SN,Cleary A,Stuver SO,Lynch M,Brandoff D,Schaefer KG,Zhu J,Berry DL,Block S,Weeks JCdoi
10.1016/j.jpainsymman.2011.06.022subject
Has Abstractpub_date
2012-06-01 00:00:00pages
1072-81issue
6eissn
0885-3924issn
1873-6513pii
S0885-3924(12)00067-Xjournal_volume
43pub_type
杂志文章abstract：:A prospective protocol for treatment of malignant inoperable bowel obstruction was implemented at Grenoble University Hospital Center for 4 years. All 80 episodes of obstruction resulted from peritoneal carcinomatosis and none could expect another treatment cure. The protocol comprised three successive stages. Stage I...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2005.10.009
更新日期：2006-06-01 00:00:00
abstract：:Comparisons of symptom ratings and health-related quality of life between significant others and patients have been the focus of numerous studies during the past decades. Additional studies are needed to assess the discrepancies identified in this work. In the present cross-sectional exploratory study, focus has been ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2006.07.019
更新日期：2007-02-01 00:00:00
abstract：:The article describes the important steps of palliative care development in Moldova, the current status, main achievements and challenges to be addressed in the future. It covers background information, policy development, medicines access and availability, education, and training, as well as services' provision. Pall...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2017.05.013
更新日期：2018-02-01 00:00:00
abstract：:There is little objective data on how cancer and its therapy affect physical activity. The main aims of this pilot study were 1) to compare physical activity in patients receiving palliative chemotherapy and healthy controls, and 2) to explore the relationship between patients' activity, quality of life (QoL), and cli...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2006.09.024
更新日期：2007-06-01 00:00:00
abstract：:Fifty-eight consecutive patients with advanced cancer who required parenteral hydration were treated with hypodermoclysis. A solution of two-thirds 5% dextrose and one-third saline was used in all cases at a rate of 20-100 cc/hr, with 750 units of hyaluronidase per liter, and 20-40 mEq KCl/L were administered in all p...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/0885-3924(90)90014-b
更新日期：1990-08-01 00:00:00
abstract：:In recent years, palliative care and related organizations have increasingly adopted a stance of "studied neutrality" on the question of whether euthanasia should be legalized as a bona fide medical regimen in palliative care contexts. This stance, however, has attracted criticism from both opponents and proponents of...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2011.12.276
更新日期：2012-12-01 00:00:00
abstract：CONTEXT:Cancer-related fatigue (CRF) is one of the most common symptoms experienced by cancer patients after hematopoietic cell transplantation (HCT). Yoga is an approach with supportive evidence to improve CRF in different cancer populations, but to our knowledge, it has not been tested in an adult HCT population. OB...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.11.012
更新日期：2020-03-01 00:00:00
abstract：:To improve assessment and management of pain in nonverbal older adults with dementia, an effective means of recognizing and evaluating pain in this vulnerable population is needed. The purpose of this review is to critically evaluate the existing tools used for pain assessment in this population to provide recommendat...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2005.07.001
更新日期：2006-02-01 00:00:00
abstract：:Pain and symptoms related to palliative care (pain and palliative care [PPC]) are often undertreated. This is largely owing to the complexity in the provision of care and the potential discrepancy in education among the various health care professionals required to deliver care. Pharmacists are frequently involved in ...
journal_title：Journal of pain and symptom management
pub_type： 共识发展会议,杂志文章
doi：10.1016/j.jpainsymman.2011.05.021
更新日期：2012-05-01 00:00:00
abstract：:Despite decades of research, national mandates, and widespread implementation of guidelines, recent reports suggest that the quality of pain assessment and management in hospitalized children remains suboptimal. The mismatch between what is advocated and what is done in practice has led experts to argue for a conceptu...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/j.jpainsymman.2011.09.005
更新日期：2012-09-01 00:00:00
abstract：CONTEXT:Palliative care interventions have shown promise in improving quality of life and reducing health-care utilization among patients with chronic organ failure. OBJECTIVES:To evaluate the effect of a palliative care intervention for adults with end-stage liver disease. METHODS:A randomized controlled trial of pa...
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.2019.06.023
更新日期：2019-10-01 00:00:00
abstract：:Spirituality is about what is of utmost value; it is a values lens that asks "what really matters most to me, my family, our community, our country, and our world." This personal reflection comes from a New Zealand academic who works in the spirituality and health care research field. Although largely biographical, th...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2018.12.331
更新日期：2019-05-01 00:00:00
abstract：:Technology is making the routine screening of symptoms and the measurement of quality of life (QoL) more feasible at the point of care. However, most existing symptom screening scales and QoL measures were not developed for clinical use and were not formatted and validated for administration through computerized mediu...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2003.04.003
更新日期：2003-12-01 00:00:00
abstract：CONTEXT:Development of pharmacological and behavioral interventions for cancer-related fatigue (CRF) requires adequate measures of this symptom. A guidance document from the Food and Drug Administration offers criteria for the formulation and evaluation of patient-reported outcome measures used in clinical trials to su...
journal_title：Journal of pain and symptom management
pub_type： 指南,杂志文章,评审
doi：10.1016/j.jpainsymman.2010.02.006
更新日期：2010-06-01 00:00:00
abstract：:Despite several advances in treatment, idiopathic pulmonary fibrosis (IPF) remains a progressive, symptomatic, and terminal disease in patients not suitable for lung transplantation. With disease progression, IPF often leads to a constellation of symptoms, including dyspnea, cough, anxiety, and depression. Palliative ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2019.12.364
更新日期：2020-06-01 00:00:00
abstract：CONTEXT:Observer-based sedation scales have been used to provide a measurable estimate of the comfort of nonalert patients in palliative sedation. However, their usefulness and appropriateness in this setting has not been demonstrated. OBJECTIVES:To study the reliability and validity of observer-based sedation scales ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2011.11.010
更新日期：2012-11-01 00:00:00
abstract：CONTEXT:The Eastern Cooperative Oncology Group performance status (ECOG PS) is one of the most commonly used assessments in oncology and palliative care (PC). However, the interobserver differences between medical oncologists and PC specialists have never been reported. OBJECTIVES:To determine the interobserver differ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2014.10.015
更新日期：2015-06-01 00:00:00
abstract：CONTEXT:Since Canada decriminalized medical assistance in dying (MAID) in 2015, clinicians and organizations have developed policies and protocols to implement assisted dying in clinical practice. Five years on, there is little consensus as to what constitutes high-quality care in MAID. OBJECTIVES:To describe MAID cli...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2020.08.018
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abstract：:The purpose of this randomized controlled community trial is to evaluate the effects of a community intervention utilizing opinion leaders and educational strategies on the cancer pain management knowledge, attitudes, and the practices of physicians and nurses, and cancer pain reported by patients. Six Minnesota commu...
journal_title：Journal of pain and symptom management
pub_type： 临床试验,杂志文章,随机对照试验
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更新日期：1997-04-01 00:00:00
abstract：CONTEXT:Clinicians often rely on documentation to relay information, and this remains the mainstay of interprofessional communication regarding patient care. However, there has been scant research focused on clinicians' documentation of dying in hospital and how this is communicated to other team members in patient cha...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2018.05.013
更新日期：2018-09-01 00:00:00
abstract：CONTEXT:Infants of age less than one year have the highest mortality rate in pediatrics. The American Academy of Pediatrics published guidelines for palliative care in 2013; however, significant variation persists among local protocols addressing neonatal comfort care at the end-of-life (EOL). OBJECTIVES:The purpose o...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2017.10.023
更新日期：2018-03-01 00:00:00
abstract：CONTEXT:Increasing numbers of patients with advanced cancer are receiving anticancer and/or palliative treatment in outpatient settings, and palliative care for outpatients with advanced cancer is being recognized as one of the most important areas for comprehensive cancer treatment. OBJECTIVES:The aim of this study w...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
doi：10.1016/j.jpainsymman.2011.04.025
更新日期：2012-03-01 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
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journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2003.11.002
更新日期：2004-07-01 00:00:00
abstract：CONTEXT:One palliative care approach that is increasingly being used at home for relieving intolerable suffering in terminally ill patients is continuous sedation until death. Its provision requires a multidisciplinary team approach, with adequate collaboration and communication. However, it is unknown how general prac...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2014.05.012
更新日期：2015-01-01 00:00:00
abstract：CONTEXT:Chronic pain impacts one-third of the U.S. population, and its effects are debilitating for individuals and costly to the medical system. Although opioids are commonly prescribed to address chronic pain, they confer risk for misuse and addiction in some patients and may not fully restore life function-particula...
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.2014.03.006
更新日期：2014-12-01 00:00:00
abstract：CONTEXT:Oxaliplatin-induced peripheral neuropathy (OIPN) is a dose-limiting toxicity of oxaliplatin and affects most colorectal cancer patients. OIPN is commonly evaluated by patient symptom report, using scales to reflect impairment. They do not discriminate between unique grouping of symptoms and signs, which impedes...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,多中心研究
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更新日期：2017-11-01 00:00:00
abstract：:Safety and efficacy data from a study of slow intrathecal (IT) ziconotide titration for the management of severe chronic pain are presented. Patients randomized to ziconotide (n = 112) or placebo (n = 108) started IT infusion at 0.1 microg/hour (2.4 microg/day), increasing gradually (0.05-0.1 microg/hour increments) o...
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.2005.10.003
更新日期：2006-05-01 00:00:00
abstract：:Alternative routes of drug delivery have particular relevance for use in chronic pain. When the pain experience is constant or nearly constant, a continuous infusion of drug is an ideal way to achieve effective pain relief. Early experience with the transdermal application of fentanyl in chronic cancer pain suggests t...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章,评审
doi：10.1016/0885-3924(92)90051-i
更新日期：1992-04-01 00:00:00
abstract：:Within aging European populations, the need to progress end-of-life and palliative care policy is becoming increasingly important. PRISMA, a European Commission-funded project, aimed to identify and coordinate research priorities, measurement, and practice in end-of-life care for Europe. PRISMA conducted a three-year ...
journal_title：Journal of pain and symptom management
pub_type： 杂志文章
doi：10.1016/j.jpainsymman.2011.06.006
更新日期：2011-10-01 00:00:00
