Journal of pain and symptom management
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J Pain Symptom Manage · Apr 2004
ReviewThe cost effectiveness of spinal cord stimulation in the treatment of pain: a systematic review of the literature.
In this systematic review, we identified and evaluated studies of the cost effectiveness of spinal cord stimulation (SCS) for the treatment of chronic pain. Published reports were identified from a systematic search of a number of general medical electronic databases (Medline, CINAHL, and EMBASE), and specialist economic databases (NHS Centre for Reviews and Dissemination Economic Evaluation Database, and Health Economics Evaluation Database). ⋯ We found that across a range of medical indications, the initial healthcare acquisition costs of SCS implantation are consistently offset by a reduction in post-implant healthcare resource demand and costs. Further research is required to formally examine the cost effectiveness of SCS.
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J Pain Symptom Manage · Apr 2004
Validation study of the Chinese version of the Brief Fatigue Inventory (BFI-C).
A cross-sectional study was conducted among 249 Chinese cancer patients with multiple diagnoses to validate a Chinese version of the Brief Fatigue Inventory (BFI-C). Cronbach's coefficient alpha was 0.92 for fatigue severity items and 0.90 for fatigue interference items. Construct validity was explored by principal factor analysis and suggested a two-factor solution: fatigue severity and fatigue interference. ⋯ Known-group validity was examined by comparing fatigue severity in patients having different scores on the Eastern Cooperative Oncology Group Performance Status Scale. Approximately 60% of patients experienced moderate to severe fatigue (4 or greater on the 0-10 scale of the BFI-C "fatigue worst" item). The BFI-C is a valid, reliable instrument to measure the severity and impact of cancer-related fatigue among Chinese patients.
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J Pain Symptom Manage · Apr 2004
Safety and effectiveness of intravenous morphine for episodic (breakthrough) pain using a fixed ratio with the oral daily morphine dose.
Breakthrough pain is normally severe in intensity and has a rapid onset. The availability of supplemental doses of opioids (rescue medication) in addition to the continuous analgesic medication is the main treatment suggested to manage these pain flares. The intravenous (i.v.) route may provide analgesia fast enough, but has never been assessed in clinical studies. ⋯ Morphine concentration significantly increased at the time of pain intensity reduction, and then decreased. These observations suggest that i.v.-M at a dose equivalent to 20% of the basal oral dosage is safe and effective in the majority of patients experiencing pain exacerbation. This treatment is inexpensive and can be used at little risk to patients.
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J Pain Symptom Manage · Apr 2004
The adequacy of the minimum data set assessment of pain in cognitively impaired nursing home residents.
This paper examines the validity of the Minimum Data Set (MDS), a comprehensive functional assessment used in most United States nursing homes, for recognizing pain in cognitively impaired nursing home residents. Eighty nursing home residents participated in the study. They were initially divided into four groups, along two dimensions: severe vs. mild/moderate cognitive impairment, and pain-medicated vs. non-medicated for pain. ⋯ The findings reveal that the MDS underreports pain in cognitively impaired residents. Given the centrality of the MDS in the U. S. as a tool for clinical decision-making in long-term care, there seems to be an urgent need to improve either the MDS pain assessment tools or the procedures used for completing them.
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J Pain Symptom Manage · Apr 2004
Controlled-release oxycodone for the management of pediatric postoperative pain.
Studies addressing pain management after pediatric spinal fusion surgery have focused on the use of patient-controlled or epidural analgesia during the immediate postoperative period. Controlled-release (CR) analgesics have been found to be safe and effective in adults. The purpose of this study was to describe the use of oxycodone-CR in pediatric patients after the immediate postoperative period. ⋯ Common side effects included dizziness, constipation, and nausea. Oxycodone-CR was used for an average of 13.3 days, which included an average wean time of 6 days. Results of this study demonstrate safe and effective use of oxycodone-CR in the pediatric spinal fusion population.