Journal of pain and symptom management
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J Pain Symptom Manage · Nov 2006
Letter Case ReportsEfficacy of pregabalin in the management of cetuximab-related itch.
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Elderly people are commonly considered more susceptible to opioid effects. However, no data regarding the need for opioid escalation in patients already receiving opioids for the management of chronic pain are available. The purpose of this study was to evaluate the differences between younger and older patients during the crucial phase of opioid titration. ⋯ Although the elderly require lower doses, opioid effects do not appear to vary with age in this population. However, the group of patients over 75 was relatively small and data should be interpreted with caution. Careful titration based on the individual response seems appropriate irrespective of age.
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J Pain Symptom Manage · Nov 2006
Multicenter Study Comparative StudyMeasuring fatigue in Parkinson's disease: a psychometric study of two brief generic fatigue questionnaires.
This study evaluated and compared the measurement properties of the 13-item Functional Assessment of Chronic Illness Therapy-Fatigue Scale (FACIT-F) and the 9-item Fatigue Severity Scale (FSS) in 118 consecutive Parkinson's disease (PD) patients, using traditional and Rasch measurement methodologies. Both questionnaires exhibited excellent data quality and reliability (coefficient alpha>or=0.9), and acceptable rating scale functionality, and both discriminated between fatigued and nonfatigued patients. ⋯ These results support the measurement validity of both questionnaires in PD, although the FACIT-F displayed better measurement precision and modest psychometric advantages over the FSS. Availability of psychometrically sound fatigue measures that are applicable across disorders provides a sound basis for advancing the understanding of this common and distressing complaint.
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J Pain Symptom Manage · Nov 2006
Hospice care in the nursing home: changes in visit volume from enrollment to discharge among longer-stay residents.
Our objective was to describe the pattern of visits made to longer-stay hospice patients in nursing homes with different diagnoses over the course of their hospice stay. This was a retrospective cohort study in which we used administrative data from a large hospice provider. Longer-stay was defined as hospice enrollment for 12-24 weeks. ⋯ During the penultimate month, aides had the highest visit rates. Visit rates were similar for all diagnostic groups until the final week of care, when residents with cancer received more visits than others. These patterns of visit volume and configuration confirm that care is most expensive in the earliest and the latest days.
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J Pain Symptom Manage · Nov 2006
You won't know if you're improving unless you measure: recommendations for evaluating Hospice-Veteran Partnerships.
Growing evidence indicates that there are abundant opportunities to improve the care that patients receive near the end of life. Hospice care has been associated with improvements in these and other outcomes, but hospice is underused by most patient populations. ⋯ In addition to committing funding for hospice care, the VA has also established a national network of Hospice-Veteran Partnerships (HVPs) whose goal is to improve access to hospice for veterans. This article describes the results of a nationwide consensus project to develop measures of the success of HVPs and recommends key measures that should be used to track improvements and to identify opportunities for highly successful collaborative strategies.