Prevalence and management of chronic nonmalignant pain in palliative care populations: A systematic review

Kernick, Lucy; Glare, Paul; Hosie, Annmarie; Chiu, Annie; Kissane, David W.

doi:10.1017/s1478951523000378

Cited by 2 publications

(1 citation statement)

References 21 publications

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“…Thus, the palliative care population is quite diverse, as it contains individuals of a broad age range with a wide variety of diseases, complications, and comorbidities. A systematic review found that the estimated prevalence of chronic, nonmalignant pain among patients receiving various types of palliative care ranged from 14% to 34% [8], and in one study, ~22% of individuals receiving palliative home care reported severe daily pain in their last month of life [9].…”

Section: Introductionmentioning

confidence: 99%

Safe Management of Adverse Effects Associated with Prescription Opioids in the Palliative Care Population: A Narrative Review

Zimmerman,

Laitman

2024

JCM

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In the palliative care population, prescription opioids are often considered viable pain relief options. However, in this complex patient population, the adverse effects of opioid medications should be identified and managed without delay. Common adverse effects can include constipation, nausea, somnolence, dizziness, vomiting, and pruritus. Less common adverse effects can include potentially lethal respiratory depression and cardiovascular effects. Critical aspects of safe opioid prescribing are recognition of side effects and knowledge of effective management strategies; prompt management is necessary for uninterrupted pain relief. Most complications are managed with general approaches such as dose reduction, opioid rotation, alternate routes of administration, and symptomatic management. The only opioid-induced complication for which US Food and Drug Administration-approved treatments currently exist is constipation. Treating laxative-refractory opioid-induced constipation (OIC) with peripherally acting mu-opioid receptor antagonists (PAMORAs), which block gastrointestinal opioid receptors, can restore gastrointestinal motility and fluid secretion. This narrative review discusses key complications of prescription opioid treatment and their management in the palliative care setting.

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Section: Introductionmentioning

confidence: 99%

Safe Management of Adverse Effects Associated with Prescription Opioids in the Palliative Care Population: A Narrative Review

Zimmerman,

Laitman

2024

JCM

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Pain prevalence and pain relief in end-of-life care – a national registry study

Hedman,

Fürst,

Strang

et al. 2024

BMC Palliat Care

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Background Despite pain control being a top priority in end-of-life care, pain continues to be a troublesome symptom and comprehensive data on pain prevalence and pain relief in patients with different diagnoses are scarce. Methods The Swedish Register of Palliative Care (SRPC) was used to retrieve data from 2011 to 2022 about pain during the last week of life. Data were collected regarding occurrence of pain, whether pain was relieved and occurrence of severe pain, to examine if pain differed between patients with cancer, heart failure, chronic obstructive pulmonary disease (COPD) and dementia. Binary logistic regression models adjusted for sex and age were used. Results A total of 315 000 patients were included in the study. Pain during the last week of life was more commonly seen in cancer (81%) than in dementia (69%), heart failure (68%) or COPD (57%), also when controlled for age and sex, p < 0.001. Severe forms of pain were registered in 35% in patients with cancer, and in 17–21% in non-cancer patients. Complete pain relief (regardless of pain intensity) was achieved in 73–87% of those who experienced pain, depending on diagnosis. The proportion of patients with complete or partial pain relief was 99.8% for the whole group. Conclusions The occurrence of pain, including severe pain, was less common in patients with heart failure, COPD or dementia, compared to patients with cancer. Compared with cancer, pain was more often fully relieved for patients with dementia, but less often in heart failure and COPD. As severe pain was seen in about a third of the cancer patients, the study still underlines the need for better pain management in the imminently dying. Trial registration No trial registration was made as all patients were deceased and all data were retrieved from The Swedish Register of Palliative Care database.

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Prevalence and management of chronic nonmalignant pain in palliative care populations: A systematic review

Cited by 2 publications

References 21 publications

Safe Management of Adverse Effects Associated with Prescription Opioids in the Palliative Care Population: A Narrative Review

Safe Management of Adverse Effects Associated with Prescription Opioids in the Palliative Care Population: A Narrative Review

Pain prevalence and pain relief in end-of-life care – a national registry study

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