Integration of pain management into comprehensive cancer care

Lévy, Michaël

doi:10.1002/1097-0142(19890601)63:11<2328::aid-cncr2820631143>3.0.co;2-5

Cited by 15 publications

(3 citation statements)

References 23 publications

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“…[23,24] In addition, a large proportion of opioid users in our sample appeared to be receiving these drugs post-surgery (among opioid users, nearly 30% had surgery). Opioid use for post-surgical pain, in particular, may not be indicative of a patient’s engagement with other aspects of supportive care.…”

Section: Discussionmentioning

confidence: 99%

Early supportive medication use and end-of-life care among Medicare beneficiaries with advanced breast cancer

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Rosenstein

Dusetzina

2016

Support Care Cancer

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Purpose A randomized controlled trial of cancer patients has linked early supportive care with improved hospice use and less aggressive end-of-life care. In practice, the early use of supportive interventions and potential impact on end-of-life care are poorly understood. We sought to describe early use of medications to treat common breast cancer symptoms (pain, insomnia, anxiety, and depression) and to assess the relationship between early use of these treatments and end-of-life care. Methods Secondary analysis of 2006–2012 SEER-Medicare data. Women included had stage IV breast cancer and died within the observation period. We used modified Poisson regression to assess the relationship between supportive medication use in the 90 days post-diagnosis and several end-of-life care measures (hospice use, in-hospital death, chemotherapy receipt within 14 days of death, ICU admission or >1 hospitalization or emergency department/ED visit 30 days before death). Results Among the 947 women included, 68% of women used at least one supportive medication in the 90 days following their diagnosis: 60.3% used opioid pain medications, and 28.3% received non-opioid psychotropic medications. Early use of any supportive medications was not associated with end-of-life care. Similarly, we found no differences in end-of-life care between opioid pain medication users and non-users. However, we found that non-opioid psychotropic medication users were less likely to receive chemotherapy in the last 14 days of life (aRR: 0.33, 95% CI: 0.12–0.88). Conclusions Non-opioid psychotropic use was associated with some aspects of end-of-life care. Future research should consider alternative measures of palliative and supportive care use using administrative data sources.

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Section: Discussionmentioning

confidence: 99%

Early supportive medication use and end-of-life care among Medicare beneficiaries with advanced breast cancer

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Rosenstein

Dusetzina

2016

Support Care Cancer

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“…An adequate control of pain is reached through three basic strategies: modifying the source of the pain, altering the central perception of pain, and blocking the transmission of the pain to the central nervous system. [71] The optimal use of these strategies in the control of cancer pain requires a thorough assessment of patient's pain, cancer features, concurrent medical problems, and psychosocial status. [72,73] An individualized plan of care must be established, implemented, reassessed, and then modified on a regular basis in order to maximize both the quality and duration of life.…”

Section: The Management Of Cancer Painmentioning

confidence: 99%

Cancer Pain — The Role of an Integrated, Comprehensive Rehabilitation Program in Its Management

Saggini¹,

Fulle²,

Carmignano³

et al. 2015

Updates on Cancer Treatment

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there appears to be a deficiency in the training of physicians and nurses. Both physicians and nurses indicated that "inability to properly assess the pain" and "inadequate knowledge about pain management" ranked among the most relevant barriers preventing a multidisciplinary approach to pain treatment and adequate cancer pain management. [8] Despite the increasing availability of pain medications, pain continues to be deemed as moderate-to-severe in more than 50% of cancer patients. According to a recent population-based study, investigating cancer pain in eleven European countries and Israel, 56% of patients suffered from moderate to severe pain in the previous months, and 69% reported pain-related difficulties hindering everyday activities. [9] A systematic review completed in 2007 showed that cancer pain is present in 64% of patients with metastatic, advanced disease, in 59% of subjects undergoing cancer-related therapies. Despite effective, curative treatment, a moderate-to-severe pain intensity being reported in more than one third of all cancer patients. Pain is present in over 50% of cancer patients, reaching higher percentages in patients with cancer at specific sites, such as stomach, uterus, lung, prostate, cervico-facial district, biliary tract, breast, colon, brain, pancreas, cervix, and ovary. [10] 2. Cancer pain The diagnosis of cancer is typically traumatic and full of uncertainties, due to its prognostic implications and the need for demanding treatment regimens. The word "cancer" still remains synonymous of "pain" and "death". Therefore, both mental and physical pain, in all the aspects and intensity of their clinical expression, characterize every stage of the disease. [11] Cancer can cause pain at any time during its course, with frequency and intensity of pain tending to increase in the advanced stages. Indeed, roughly 75-95% of patients with metastatic cancer will experience significant amounts of cancer-induced pain. According to the International Association for the Study of Pain (IASP), pain is defined as "an unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage." Pain occurring to cancer patients is defined as "total pain" (or "global suffering"), since people with cancer tend to manifest a wide array of functional needs (at a psychological, social, spiritual and existential level) that ought to be recognized and addressed in their complexity. Relief of pain should, therefore, be seen as part of a comprehensive strategy of care addressing physical, psychological, social, and spiritual aspects of suffering. Physical aspects of pain cannot be treated separately from psychological aspects, whereas patients' anxieties cannot be effectively addressed while patients are physically suffering. Therefore, all various components of cancer pain should be addressed simultaneously. Knowledge of the mechanisms of pain has improved considerably over the past few years. We now know that physical injuries, pain pathways, and th...

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“…Αν και δεν υπάρχει ακριβής, αντικειμενικός, οικουμενικά αποδεκτός ορισμός για την ποιότητα ζωής (Padilla et al 1990, αναμφισβήτητα η ανακούφιση του πόνου για τον ογκολογικό ασθενή σημαίνει ποιότητα ζωής (Ferrell et al 1989, Ferren and.Ανεξάρτητα από το αίτιο πρόκλησης, ο πόνος επιδρά στον τρόπο ζωής, την κινητικότητα, τον ύπνο και στη δραστηριότητα του ασθενούς.Έχει δε σαν αποτέλεσμα φυσική και ψυχική καταπόνηση, κοινωνική απομόνωση και αυξημένη ζήτηση νοσοκομειακών κλινών (Foley 1986, WHO 1986, Dorrepaal et al 1989, Cleeland 1984, Levy 1989, Portenoy 1990, Miller and Walsh 1991.…”

Section: γενικο μερος εισαγωγηunclassified

Νοσηλευτικη Αξιολογηση Του Πονου Αρρωστων Με Καρκινο

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Integration of pain management into comprehensive cancer care

Cited by 15 publications

References 23 publications

Early supportive medication use and end-of-life care among Medicare beneficiaries with advanced breast cancer

Early supportive medication use and end-of-life care among Medicare beneficiaries with advanced breast cancer

Cancer Pain — The Role of an Integrated, Comprehensive Rehabilitation Program in Its Management

Νοσηλευτικη Αξιολογηση Του Πονου Αρρωστων Με Καρκινο

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