Journal of pain and symptom management
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New effective analgesics are needed for the treatment of pain. Buprenorphine, a partial mu-opioid agonist which has been in clinical use for over 25 years, has been found to be amenable to new formulation technology based on its physiochemical and pharmacological profile. Buprenorphine is marketed as parenteral, sublingual, and transdermal formulations. ⋯ Prolonged use of buprenorphine can result in physical dependence. However, withdrawal symptoms appear to be mild to moderate in intensity compared with those of full mu agonists. Overdoses have primarily involved buprenorphine taken in combination with other central nervous system depressants.
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J Pain Symptom Manage · Mar 2005
Development of a brief assessment scale for caregivers of the medically ill.
Studies have documented high degrees of burden and negative outcomes for caregivers. The present study sought to develop a brief instrument for caregiver burden. An item pool was administered to 102 caregivers of patients with chronic illnesses (cancer, 55%; neurological, 15%; psychiatric 12%), along with measures of caregiver burden and quality of life. ⋯ Construct validity was confirmed by appropriate patterns of intercorrelation with other measures of caregiver burden. Higher burden was found for caregivers expected to have higher levels of distress (adult children caring for parents, P<0.005; female caregivers, P=0.035). These results support the validity of the BASC as a brief instrument for caregiver burden.
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J Pain Symptom Manage · Mar 2005
Multicenter StudyA multicenter study of the revised Edmonton Staging System for classifying cancer pain in advanced cancer patients.
The comparative analysis of analgesic interventions for cancer pain is greatly compromised by the lack of well-validated and clinically acceptable tools, which allow a composite classification of pain and patient population characteristics. Although the Edmonton Staging System (ESS) for cancer pain was developed for this purpose, clinical and research utility has been limited due to problems associated with the assessment of some items, especially in relation to definitions and terminology. To overcome these limitations, we designed a revised ESS (rESS) and conducted a multicenter study to determine its inter-rater reliability and predictive value. ⋯ A comparison of the rESS with the ESS demonstrated the ineffectiveness of the ESS prognostic staging system for predicting achievement of stable pain control. These findings confirm the study hypothesis, suggesting that the rESS appears to have good predictive value and a moderate to high inter-rater reliability. We suggest the rESS should prove to be a useful tool in clinical practice, and in the comparison of cancer pain populations in research studies.