Objective Chronic pain is one of the most detrimental symptoms exhibited by cancer patients, being an indication for opioid therapy in up to half of the patients’ receiving chemotherapy and in 90% of advanced cases. Various successful non-pharmacological integrative therapy options have been explored and implemented to improve the quality of life in these patients. This review aims to highlight the mechanisms implicated; assessment tools used for cancer pain and summarize current evidence on non-pharmacological approaches in the treatment of chronic cancer pain. Data sources A review of the literature was conducted using a combination of MeSH keywords including “Chronic cancer pain,” “Assessment,” “Non-pharmacological management,” and “Integrative therapy.” Data summary Data on the approach and assessment of chronic cancer pain as well as non-pharmacological integrative options have been displayed with the help of figures and tables. Of note, non-pharmacological integrative management was divided into three subcategories; physical therapy (involving exercise, acupuncture, massage, and transcutaneous electric nerve stimulation), psychosocial therapy (e.g. mindful practices, supportive therapy), and herbal supplementation. Conclusions The use of non-pharmacological integrative therapy in the management of chronic cancer pain has been grossly underestimated and must be considered before or as an adjuvant of other treatment regimens to ensure appropriate care.
Background: Potentially inappropriate medication (PIM) is defined as the usage of a medication for which the risks surpass the perceived benefits, particularly when more efficient alternatives exist. The focus has now shifted from prescribing to deprescribing, especially with one aging. Methods: Based on the Scale for the Assessment of Narrative Review Articles (SANRA) criteria, we performed a search of articles published in Medline and google scholar databases between 2008 and 2022 using terms such as Deprescribing, Psychogeriatric patients, polypharmacy, psychotropic drugs, benzodiazepines, and potentially inappropriate medication (PIM). The initial search yielded 3058 articles. After review, 53 articles were included for discussion. Discussion: Polypharmacy and multimorbidity are multifaceted interconnected concepts in geriatric care that call for timely intervention and interdisciplinary management across each healthcare and social setting. And although the literature and studies on the benefits are variable, deprescribing appears to be overall efficacious. Conclusion: Further research on the efficacy of strategies and existing guidelines in lowering PIMs in geriatric psychiatry patients is warranted. The purpose of this review is to give an outline of the current evidence to inform effective methods for deprescribing PIMs for older persons, with an emphasis on strategies clinicians can use to address challenges to these approaches
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