Efficacy of analgesics in chronic pain: a series of N-of-1 studies.

Abstract:

:Rational drug treatment of chronic musculoskeletal pain remains a challenge. Although commonly prescribed, the true efficacy of opioid analgesics or of nonsteroidal antiinflammatory drugs remains to be established. Using an N-of 1 design, eight patients with regional cervicobrachial pain received ibuprofen 800 mg/day, codeine 120 mg/day, or placebo during six 2 week periods. Clinical outcomes were assessed by pain diary, VAS of pain and change in pain, and uptime/downtime estimates. In none of the five subjects who completed the 12-week trial was analgesic efficacy of either drug shown. Major psychosocial and other medical influences on the subjects' status were encountered. The N-of 1 methodology is appropriated for evaluating true efficacy of pharmacotherapy in patients with regional musculoskeletal pain.

journal_name

J Pain Symptom Manage

authors

Sheather-Reid RB,Cohen M

doi

10.1016/s0885-3924(98)00369-8

subject

Has Abstract

pub_date

1998-04-01 00:00:00

pages

244-52

issue

4

eissn

0885-3924

issn

1873-6513

pii

S0885392498003698

journal_volume

15

pub_type

临床试验,杂志文章
  • Rethinking hopelessness and the role of spiritual care when cure is no longer an option.

    abstract::Increasingly in the U.S., health care clinicians fail to recognize and accept when curative goals are no longer realistic. At this point, futile efforts at cure can fuel false hopes in patients and their loved ones. The clinician's need to be "doing something" may result in treatment that violates the dignity and well...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2012.07.010

    authors: Taylor C

    更新日期:2012-10-01 00:00:00

  • Meaninglessness in terminally ill cancer patients: a validation study and nurse education intervention trial.

    abstract::Recent empirical studies revealed that fostering patients' perception of meaning in their life is an essential task for palliative care clinicians. However, few studies have reported the effects of training programs for nurses specifically aimed at improving skills to relieve the meaninglessness of terminally ill canc...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2006.10.021

    authors: Morita T,Murata H,Hirai K,Tamura K,Kataoka J,Ohnishi H,Akizuki N,Kurihara Y,Akechi T,Uchitomi Y,Japanese Spiritual Care Task Force.

    更新日期:2007-08-01 00:00:00

  • Lack of muscle contractile property changes at the time of perceived physical exhaustion suggests central mechanisms contributing to early motor task failure in patients with cancer-related fatigue.

    abstract:CONTEXT:Fatigue is one of the most common symptoms reported by cancer survivors, and fatigue worsens when patients are engaged in muscle exertion, which results in early motor task failure. Central fatigue plays a significant role, more than muscle (peripheral) fatigue, in contributing to early task failure in cancer-r...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2011.08.007

    authors: Kisiel-Sajewicz K,Davis MP,Siemionow V,Seyidova-Khoshknabi D,Wyant A,Walsh D,Hou J,Yue GH

    更新日期:2012-09-01 00:00:00

  • Artificial hydration therapy for terminally ill cancer patients: a nurse-education intervention.

    abstract::The Japanese Society of Palliative Medicine has developed a clinical guideline to minimize the large variation in clinical practice of artificial hydration therapy for terminally ill cancer patients. The primary aim of this preliminary study was to explore the effects of a five-hour interactive workshop based on the g...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2008.10.007

    authors: Yamagishi A,Tanaka F,Morita T

    更新日期:2009-09-01 00:00:00

  • An Integrated Approach to Selecting a Prepared Medical Decision-Maker.

    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

    authors: Zhukovsky DS,Haider A,Williams JL,Naqvi S,Joshi N,Mills S,Soliman PT,Mathew B,Bodurka D,Meyer LA,Westin S,Frumovitz M,Nowitz MB,Archie L,Fenton S,Lang K,Boving V,Bruera E

    更新日期:2020-12-24 00:00:00

  • Changes in Nurses' Knowledge, Difficulties, and Self-reported Practices Toward Palliative Care for Cancer Patients in Japan: An Analysis of Two Nationwide Representative Surveys in 2008 and 2015.

    abstract:CONTEXT:The Cancer Control Act was passed in Japan in 2007, and various additional programs on palliative care have been implemented to improve quality of life and relieve pain and suffering in patients with cancer. However, how clinical settings have changed remains unclear. OBJECTIVES:The primary aim of the present ...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2017.08.034

    authors: Nakazawa Y,Kato M,Miyashita M,Morita T,Kizawa Y

    更新日期:2018-02-01 00:00:00

  • Objective physical activity and self-reported quality of life in patients receiving palliative chemotherapy.

    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

    authors: Dahele M,Skipworth RJ,Wall L,Voss A,Preston T,Fearon KC

    更新日期:2007-06-01 00:00:00

  • Factors that affect quality of dying and death in terminal cancer patients on inpatient palliative care units: perspectives of bereaved family caregivers.

    abstract:CONTEXT:There is an increasing use of palliative care units (PCUs) for the treatment of terminally ill cancer patients. Thus, it is important to evaluate the care and quality of life of terminally ill cancer patients treated in PCUs so that improvements can be made. Limited research has investigated the quality of dyin...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2012.04.010

    authors: Choi JY,Chang YJ,Song HY,Jho HJ,Lee MK

    更新日期:2013-04-01 00:00:00

  • The Effect of Communication Skills Training for Generalist Palliative Care Providers on Patient-Reported Outcomes and Clinician Behaviors: A Systematic Review and Meta-analysis.

    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

    authors: Selman LE,Brighton LJ,Hawkins A,McDonald C,O'Brien S,Robinson V,Khan SA,George R,Ramsenthaler C,Higginson IJ,Koffman J

    更新日期:2017-09-01 00:00:00

  • A double-blind, randomized, crossover comparison between single-dose and double-dose immediate-release oral morphine at bedtime in cancer patients.

    abstract::The European Association for Palliative Care guidelines for treatment of cancer pain recommend a double dose (DD) of immediate-release morphine at bedtime instead of single doses (SD) repeated every four hours throughout the night. A previous open controlled study reported more side effects after DD than after SD. The...

    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.2007.12.016

    authors: Dale O,Piribauer M,Kaasa S,Moksnes K,Knobel H,Klepstad P

    更新日期:2009-01-01 00:00:00

  • Palliative Care in Rwanda: Aiming for Universal Access.

    abstract::In 2011, Rwanda's Ministry of Health set a goal of universal access to palliative care by 2020. Toward this audacious egalitarian and humanitarian goal, the Ministry of Health worked with partners to develop palliative care policies and a strategic plan, secure adequate supplies of opioid for the country, initiate pal...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2017.03.037

    authors: Krakauer EL,Muhimpundu MA,Mukasahaha D,Tayari JC,Ntizimira C,Uhagaze B,Mugwaneza T,Ruzima A,Mpanumusingo E,Gasana M,Karamuka V,Nkurikiyimfura JL,Park P,Barebwanuwe P,Tapela N,Elmore SN,Bukhman G,Leng M,Grant L,Binag

    更新日期:2018-02-01 00:00:00

  • Effects of a brief coping skills training intervention on nociceptive flexion reflex threshold in patients having osteoarthritic knee pain: a preliminary laboratory study of sex differences.

    abstract::Studies have documented the efficacy of coping skills training (CST) for managing pain, distress, and disability in persons with arthritis. However, no laboratory studies have examined the effects of CST on descending modulation of nociception. This study used the nociceptive flexion reflex (NFR) to document pain and ...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2005.07.008

    authors: Emery CF,Keefe FJ,France CR,Affleck G,Waters S,Fondow MD,McKee DC,France JL,Hackshaw KV,Caldwell DS,Stainbrook D

    更新日期:2006-03-01 00:00:00

  • Perceptions of specialized inpatient palliative care: a population-based survey in Japan.

    abstract::This study aimed to clarify and compare the awareness and perceptions of the specialized inpatient palliative care service. A cross-sectional questionnaire survey was performed on the general population selected by stratified two-stage random sampling (n=2,548) and bereaved families who actually received specialized i...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2007.04.021

    authors: Sanjo M,Miyashita M,Morita T,Hirai K,Kawa M,Ashiya T,Ishihara T,Miyoshi I,Matsubara T,Nakaho T,Nakashima N,Onishi H,Ozawa T,Suenaga K,Tajima T,Hisanaga T,Uchitomi Y

    更新日期:2008-03-01 00:00:00

  • Measuring outcomes in randomized prospective trials in palliative care.

    abstract::Palliative care aims to improve the quality of life of patients and their families and reduce suffering from life-threatening illness. In assessing palliative care efficacy, researchers must consider a broad range of potential outcomes, including those experienced by the patient's family/caregivers, clinicians, and th...

    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.2007.04.004

    authors: Mularski RA,Rosenfeld K,Coons SJ,Dueck A,Cella D,Feuer DJ,Lipscomb J,Karpeh MS Jr,Mosich T,Sloan JA,Krouse RS

    更新日期:2007-07-01 00:00:00

  • A survey of practice in management of malignant ascites.

    abstract::The purpose of this study was to determine physicians' attitudes toward and preferences for palliative management of malignant ascites. A random sample of eighty physicians practicing in Canada was selected from the memberships of the Canadian Association of Medical Oncologists, the Canadian Association of Gastroenter...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/s0885-3924(98)00037-2

    authors: Lee CW,Bociek G,Faught W

    更新日期:1998-08-01 00:00:00

  • Validation of single-item linear analog scale assessment of quality of life in neuro-oncology patients.

    abstract::Assessment of patient quality of life (QOL) requires balancing the details provided by multi-item assessments with the reduced burden of single-item assessments. In this project, we investigated the psychometric properties of single-item Linear Analog Scale Assessments (LASAs) for patients with newly diagnosed high-gr...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2007.01.016

    authors: Locke DE,Decker PA,Sloan JA,Brown PD,Malec JF,Clark MM,Rummans TA,Ballman KV,Schaefer PL,Buckner JC

    更新日期:2007-12-01 00:00:00

  • Factors correlated with fatigue in terminally ill cancer patients: a longitudinal study.

    abstract::Fatigue is among the most distressing symptoms experienced by terminally ill cancer patients. It is necessary to clarify factors correlated with fatigue to develop effective management strategies. A consecutive sample of cancer patients newly registered in the Palliative Care Unit (PCU) was assessed on three occasions...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2007.06.014

    authors: Okuyama T,Akechi T,Shima Y,Sugahara Y,Okamura H,Hosaka T,Furukawa TA,Uchitomi Y

    更新日期:2008-05-01 00:00:00

  • Psychometric properties of instruments used to measure fatigue in children and adolescents with cancer: a systematic review.

    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

    authors: Tomlinson D,Hinds PS,Ethier MC,Ness KK,Zupanec S,Sung L

    更新日期:2013-01-01 00:00:00

  • Implantable cardioverter defibrillator deactivation: a hospice quality improvement initiative.

    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

    authors: Kraynik SE,Casarett DJ,Corcoran AM

    更新日期:2014-09-01 00:00:00

  • Palliative sedation: a review of the research literature.

    abstract::The overall aim of this paper is to systematically review the following important aspects of palliative sedation: prevalence, indications, survival, medication, food and fluid intake, decision making, attitudes of physicians, family experiences, and efficacy and safety. A thorough search of different databases was con...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章,评审

    doi:10.1016/j.jpainsymman.2007.10.004

    authors: Claessens P,Menten J,Schotsmans P,Broeckaert B

    更新日期:2008-09-01 00:00:00

  • Symptoms in the month before death for stage 5 chronic kidney disease patients managed without dialysis.

    abstract:CONTEXT:There is little evidence on the symptoms experienced by those with advanced (Stage 5) chronic kidney disease (CKD), managed without dialysis, as they approach death. As palliative care extends to noncancer illnesses, understanding symptom prevalence and severity close to death will clarify which symptom interve...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2010.01.021

    authors: Murtagh FE,Addington-Hall J,Edmonds P,Donohoe P,Carey I,Jenkins K,Higginson IJ

    更新日期:2010-09-01 00:00:00

  • "Burst" ketamine for refractory cancer pain: an open-label audit of 39 patients.

    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

    authors: Jackson K,Ashby M,Martin P,Pisasale M,Brumley D,Hayes B

    更新日期:2001-10-01 00:00:00

  • Hospice and palliative care development in Africa: a multi-method review of services and experiences.

    abstract::There is a paucity of information on hospice and palliative care provision in Africa and only a weak evidence base upon which to build policy and practice development. We set out to assess the current state of provision across the continent, mapping the existence of services country by country and exploring the perspe...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章,评审

    doi:10.1016/j.jpainsymman.2006.09.033

    authors: Clark D,Wright M,Hunt J,Lynch T

    更新日期:2007-06-01 00:00:00

  • Integrating Supportive Care Principles Into Dialysis Decision Making: A Primer for Palliative Medicine Providers.

    abstract::Despite advances in predialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy, and substantial physical, emotional, and spiritual suffering. Patients with acute ki...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2016.10.371

    authors: Moss AH

    更新日期:2017-03-01 00:00:00

  • Documentation quality of inpatient code status discussions.

    abstract:CONTEXT:Accurate documentation of inpatient code status discussions (CSDs) is important because of frequent patient care handoffs. OBJECTIVES:To examine the quality of inpatient CSD documentation and compare documentation quality across physician services. METHODS:This was a retrospective study of patients hospitaliz...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2013.11.014

    authors: Thurston A,Wayne DB,Feinglass J,Sharma RK

    更新日期:2014-10-01 00:00:00

  • Clinitron therapy and pain management in advanced cancer patients.

    abstract::Many patients with advanced malignancy develop bone metastases, pathologic fractures, and skin breakdown, all of which compromise comfort and interfere with the delivery of patient care. In 1986, 38 Clinitron beds were utilized at Calvary Hospital, a specialty hospital for advanced cancer, for patients who were immobi...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/s0885-3924(05)80009-0

    authors: Walsh M,Brescia FJ

    更新日期:1990-02-01 00:00:00

  • The Alberta Breakthrough Pain Assessment Tool for cancer patients: a validation study using a delphi process and patient think-aloud interviews.

    abstract::Breakthrough pain is a prevalent cancer pain syndrome, and research is needed to identify more effective interventions to manage it. A validated tool to assess breakthrough pain in a standard and reliable manner is urgently needed to support the conduct of clinical trials in breakthrough pain. To address this need, we...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2007.03.016

    authors: Hagen NA,Stiles C,Nekolaichuk C,Biondo P,Carlson LE,Fisher K,Fainsinger R

    更新日期:2008-02-01 00:00:00

  • Improving availability of and access to opioids in Colombia: description and preliminary results of an action plan for the country.

    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

    authors: Leon MX,De Lima L,Florez S,Torres M,Daza M,Mendoza L,Agudelo N,Guerra L,Ryan K

    更新日期:2009-11-01 00:00:00

  • Creating computable algorithms for symptom management in an outpatient thoracic oncology setting.

    abstract:CONTEXT:Adequate symptom management is essential to ensure quality cancer care, but symptom management is not always evidence based. Adapting and automating national guidelines for use at the point of care may enhance use by clinicians. OBJECTIVES:This article reports on a process of adapting research evidence for use...

    journal_title:Journal of pain and symptom management

    pub_type: 杂志文章

    doi:10.1016/j.jpainsymman.2013.01.016

    authors: Cooley ME,Lobach DF,Johns E,Halpenny B,Saunders TA,Del Fiol G,Rabin MS,Calarese P,Berenbaum IL,Zaner K,Finn K,Berry DL,Abrahm JL

    更新日期:2013-12-01 00:00:00

  • Influenza vaccination for terminally ill cancer patients receiving palliative care: a preliminary report.

    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

    authors: Sasson M,Mandelboim M,Shvartzman P

    更新日期:2011-02-01 00:00:00