Abstract:
BACKGROUND:Dyspnea is one of the most distressing symptoms encountered by advanced cancer patients. In this study, we aimed to evaluate the role of opioids in the management of cancer-related dyspnea. METHODS:A systematic review and meta-analysis based on Randomized Controlled Trials was conducted in the databases PUBMED, EMBASE, and Cochrane Central Register of Controlled Trials testing the effect of opioids in relieving cancer-related dyspnea. Subgroup and sensitivity analyses were performed to evaluate various types of opioids in dyspnea management and stabilization of the study respectively. RESULTS:Eleven RCTs fulfilled the eligibility criteria and had a total of 290 participants. Nine of these studies were included in meta-analyses. Compared with control, opioid therapy showed a small positive effect in dyspnea, SMD-0.82 (95%CI = -1.54 to -0.10) and Borg score, WMD-0.95 (95%CI = -1.83 to -0.06); Opioid therapy did not increase the risk of somnolence, OR0.93 (95%CI = 0.34 to 2.58), whereas a negative effect on respiratory rate was observed,WMD-1.89 (95%CI = -3.36 to -0.43); Also, there was no evidence to suggest improved performance of the 6MWT test, WMD6.49 (95%CI = -34.23 to 47.21), or the level of peripheral oxygen saturation, WMD0.33 (95%CI = -0.59 to 1.24) after opioid therapy. Subgroup analysis yielded a small positive effect for morphine on dyspnea, SMD-0.78 (95%CI = -1.45 to -0.10), whereas fentanyl showed no improvement in dyspnea, SMD-0.44 (95%CI = -0.89 to 0.02). Sensitivity analysis showed no changes in the direction of effect when any one study was excluded from the meta-analyses. CONCLUSIONS:Our systematic review and meta-analysis indicated low quality evidence for a small positive effect of opioids in cancer-related dyspnea. Evidence for safety is insufficient as comprehensive adverse events were not adequately reported in studies.
journal_name
J Pain Symptom Managejournal_title
Journal of pain and symptom managementauthors
Luo N,Tan S,Li X,Singh S,Liu S,Chen C,Huang Z,Feng S,Lin Y,Lin Y,Cen H,Liang M,Chen Mdoi
10.1016/j.jpainsymman.2020.07.021subject
Has Abstractpub_date
2021-01-01 00:00:00pages
198-210.e1issue
1eissn
0885-3924issn
1873-6513pii
S0885-3924(20)30632-1journal_volume
61pub_type
杂志文章abstract:CONTEXT:The symptom experience of patients with chronic obstructive pulmonary disease (COPD) is extremely complex. It is characterized by multiple co-occurring symptoms. However, very few studies have described this experience in COPD patients. OBJECTIVES:The aims of this study were to evaluate for differences in symp...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2015.12.324
更新日期:2016-05-01 00:00:00
abstract::The safety and efficacy of intraspinal opioids as therapy for selected patients with cancer pain are well-established. The choice of the appropriate drug is influenced by many variables that are to date incompletely elucidated. The cost of therapy is an increasingly important component of decision-making. This report ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(96)00266-7
更新日期:1997-02-01 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:CONTEXT:Audits have been proposed for estimating possible recruitment rates to randomized controlled trials (RCTs), but few studies have compared audit data with subsequent recruitment rates. OBJECTIVES:To compare the accuracy of estimates of potential recruitment from a retrospective consecutive cohort audit of actua...
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.2015.11.022
更新日期:2016-04-01 00:00:00
abstract::Brain death is a traumatic and sudden event following a severe injury to the brain. Most patients with brain death spend the last days of life in an intensive care unit (ICU), where some families will be approached to ask for organ donation. This qualitative study was carried out with relatives of patients who had die...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2008.04.013
更新日期:2009-04-01 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:BACKGROUND:We implemented a systematic multidisciplinary process to engage new outpatients with cancer in selecting and preparing a medical decision-maker. MEASURES:Templated advance care planning notes and medical power of attorney documents were used in the electronic health record by the third office visit. INTERV...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.12.006
更新日期:2020-12-24 00:00:00
abstract::Recent case reports have raised concerns about the potential for methadone to prolong the QTc interval (QT corrected for heart rate) and predispose patients to torsade de pointes (TdP), a life-threatening arrhythmia. We present a case report that describes the successful use of parenteral and oral methadone in a patie...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2007.05.001
更新日期:2007-11-01 00:00:00
abstract:CONTEXT:Aggregates of concurrent symptoms, known as symptom clusters (SxCls), have been described in predominantly cross-sectional samples of lung cancer (LC) patients undergoing treatment. OBJECTIVES:The objective of this study was to delineate SxCls in LC survivors up to five years after diagnosis, investigate their...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2010.10.257
更新日期:2011-08-01 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:CONTEXT:Older adults with advanced cancer face uncertainty related to their disease and treatment. OBJECTIVES:To evaluate the associations of uncertainty with psychological health and quality of life (QoL) in older adults with advanced cancer. METHODS:Secondary cross-sectional analysis of baseline data from a nationa...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2020.08.012
更新日期:2021-02-01 00:00:00
abstract:CONTEXT:Cancer patients have impaired humoral and cellular immunity, and are more susceptible to infections; their immunological response is expected to be less effective than that of healthy people. OBJECTIVES:To assess the immune response to influenza vaccine in terminally ill cancer patients in a home palliative ca...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2010.05.016
更新日期:2011-02-01 00:00:00
abstract:CONTEXT:As most end-of-life care is provided by health care providers who are generalists rather than specialists in palliative care, effective communication skills training for generalists is essential. OBJECTIVES:To determine the effect of communication training interventions for generalist palliative care providers...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,meta分析,评审
doi:10.1016/j.jpainsymman.2017.04.007
更新日期:2017-09-01 00:00:00
abstract::The results of a randomized controlled trial that tested the effects of eight-week, six-contact multidimensional interactive interventions for symptom management are presented. Four hundred and thirty-five cancer patients with solid tumors undergoing chemotherapy were randomized to receive either nurse-assisted sympto...
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.2006.11.018
更新日期:2007-09-01 00:00:00
abstract:CONTEXT:Fatigue is a distressing persistent sense of physical tiredness that is not proportional to a person's recent activity. Fatigue impacts patients' treatment decisions and can limit their self-care activities. Although significant interindividual variability in fatigue severity has been noted, little is known abo...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2015.02.015
更新日期:2015-08-01 00:00:00
abstract::Pain was measured and analgesic treatment examined in 131 children and adolescents, 8-17 years of age, for 5 days after surgery. Analgesic data were converted to 10 mg intramuscular morphine-equivalent doses (IMMSEQ) and were designated appropriate or inappropriate for body weight. Analgesic onset, peak, and duration ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/0885-3924(94)90161-9
更新日期:1994-02-01 00:00:00
abstract::Methylnaltrexone, a peripherally acting mu-opioid receptor antagonist with restricted ability to cross the blood-brain barrier, reverses opioid-induced constipation (OIC) without affecting analgesia. A double-blind study in patients with advanced illness and OIC demonstrated that methylnaltrexone significantly induced...
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.2009.02.234
更新日期:2009-11-01 00:00:00
abstract:CONTEXT:High body mass index (BMI) is linked to an increased risk of developing pancreatic cancer (PC). However, in patients with advanced PC (APC), especially those receiving palliative chemotherapy, the impact of BMI on survival has not been investigated fully. OBJECTIVES:To assess changes in BMI during the course o...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2013.08.017
更新日期:2014-07-01 00:00:00
abstract::Palliative care services provided to patients and families vary substantially across hospices. Literature suggests regulation can act as a standardizing force in health care delivery. However, little is known about the effect of regulation on the delivery of palliative care in hospice and whether its effect differs fo...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2007.09.014
更新日期:2008-08-01 00:00:00
abstract:CONTEXT:Patients with lung cancer who undergo chemotherapy (CTX) experience multiple symptoms. Evaluation of how these symptoms cluster together and how these symptom clusters change over time are salient questions in symptom clusters research. OBJECTIVES:The purposes of this analysis, in a sample of patients with lun...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.02.002
更新日期:2019-05-01 00:00:00
abstract::Cancer is one of the major causes of death in Cuba, and in current practice, patients are not usually informed of their diagnosis. Palliative care is an emerging discipline in this country. Cuban cancer patients with advanced disease completed the Palliative Outcome Scale (POS), and the researcher elicited patients' k...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2008.02.015
更新日期:2009-03-01 00:00:00
abstract::The technology of telemedicine has been used for over 20 years, involving different areas of medicine, providing medical care for the geographically isolated patients, and uniting geographically isolated clinicians. Today audio-visual technology may be useful in palliative care for the patients lacking access to medic...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/s0885-3924(01)00402-x
更新日期:2002-02-01 00:00:00
abstract:CONTEXT:Chronic pain (CP) is a major concern in cancer survivors. Often under-reported by patients, it is both underassessed and undertreated by care providers. OBJECTIVES:To assess CP prevalence and related treatment in cancer survivors five years after diagnosis and to identify factors associated with prescribing op...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2019.10.027
更新日期:2020-04-01 00:00:00
abstract:CONTEXT:Over the history of palliative care provision in Ireland, services have predominantly provided care to those with cancer. Previous estimates of palliative care need focused primarily on specialist palliative care and included only a limited number of nonmalignant diseases. OBJECTIVES:The primary aim of this st...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2014.09.011
更新日期:2015-04-01 00:00:00
abstract:CONTEXT:Unfinished business often causes psychological issues after bereavement. Providing care for families of terminally ill patients with cancer to prevent unfinished business is important. OBJECTIVES:To clarify the prevalence and types of unfinished business in families of end-of-life patients with cancer admitted...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章
doi:10.1016/j.jpainsymman.2017.04.013
更新日期:2017-12-01 00:00:00
abstract:CONTEXT:Standardized outcomes that define successful advance care planning (ACP) are lacking. OBJECTIVE:The objective of this study was to create an Organizing Framework of ACP outcome constructs and rate the importance of these outcomes. METHODS:This study convened a Delphi panel consisting of 52 multidisciplinary, ...
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.2017.08.025
更新日期:2018-02-01 00:00:00
abstract::We describe self-reported strategies used by persons living with HIV/AIDS in Botswana, Lesotho, South Africa, and Swaziland to manage common HIV-related symptoms. A questionnaire asked participants to list three to six symptoms they had recently experienced, the care strategies they had used to make them better, where...
journal_title:Journal of pain and symptom management
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2004.05.007
更新日期:2005-02-01 00:00:00
abstract::Advanced dementia patients may be at substantial risk for undetected or undertreated pain. To examine the treatment of pain following hip fracture, a prospective cohort study was conducted in an academic teaching hospital. Fifty-nine cognitively intact elderly patients with hip fracture and 38 patients with hip fractu...
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(00)00113-5
更新日期:2000-04-01 00:00:00
abstract:CONTEXT:Efforts in developing useful tools to properly identify the end-of-life trajectory of patients with advanced medical diseases have been made, but the calibration and/or discriminative power of these tools has not been optimal. OBJECTIVES:Our objective was to develop a new, reliable prognostic tool to identify ...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/j.jpainsymman.2013.04.011
更新日期:2014-03-01 00:00:00
abstract::The aim of this study was to evaluate the prevalence, severity, and management of pain in Korean patients with advanced cancer, and to identify the predictors of inadequate management of cancer pain in Korea. From 8 university hospitals, 655 patients with advanced cancer were surveyed. Information concerning analgesic...
journal_title:Journal of pain and symptom management
pub_type: 杂志文章,多中心研究
doi:10.1016/s0885-3924(03)00103-9
更新日期:2003-05-01 00:00:00