Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2014
Randomized Controlled TrialPalliative radiation before hospice: the long and the short of it.
Randomized data support shorter radiotherapy courses for management of cancer-related symptoms in the palliative setting. ⋯ This study found relatively long courses of radiotherapy before short lengths of survival on hospice. Future research is needed to identify barriers to shorter radiotherapy courses.
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J Pain Symptom Manage · Dec 2014
Multicenter StudyPolypharmacy in patients with advanced cancer and pain: a European cross-sectional study of 2282 patients.
Patients with advanced cancer need multiple drugs to control symptoms and to treat cancer and concomitant diseases. At the same time, the goal of treatment changes as life expectancy becomes limited. This results in a risk for polypharmacy, maintained use of unneeded drugs, and drug-drug interactions (DDIs). ⋯ Patients with cancer treated with a World Health Organization Step III opioid use a high number of drugs. Nonopioid analgesics and corticosteroids are frequently used, but different patterns of use between countries were found. Many patients receive unneeded drugs and are at risk of serious DDIs. These findings demonstrate that drug therapy in these patients needs to be evaluated continuously.
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J Pain Symptom Manage · Dec 2014
ReviewExperience of advanced chronic obstructive pulmonary disease: metasynthesis of qualitative research.
Chronic obstructive pulmonary disease (COPD) is a life-limiting illness. Despite best available treatments, individuals continue to experience symptom burden and have high health care utilization. ⋯ Combining discrete qualitative studies provided a useful perspective of the experience of living with COPD over the past two decades. Further studies into the ongoing needs of individuals with COPD are unlikely to add to this well-established picture. Future research should focus on solutions through the development of interventions that address patients' ongoing needs.
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J Pain Symptom Manage · Dec 2014
Development and validation of a medical chart review checklist for symptom management performance of oncologists in the routine care of patients with advanced cancer.
Oncologists perform a range of pharmacological and nonpharmacological interventions to manage the symptoms of outpatients with advanced cancer. ⋯ Chart review by SyMPeC seems reliable to detect symptom management interventions by oncologists in outpatient clinics. Nonpharmacological interventions were less symptom specific. A template for documentation is needed for standardization.
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J Pain Symptom Manage · Dec 2014
Ethical conduct of palliative care research: enhancing communication between investigators and institutional review boards.
Palliative care has faced moral and ethical challenges when conducting research involving human subjects. There are currently no resources to guide institutional review boards (IRBs) in applying standard ethical principles and terms-in a specific way-to palliative care research. Using as a case study a recently completed multisite palliative care clinical trial, this article provides guidance and recommendations for both IRBs and palliative care investigators to facilitate communication and attain the goal of conducting ethical palliative care research and protecting study participants while advancing the science. Beyond identifying current challenges faced by palliative care researchers and IRBs reviewing palliative care research, this article suggests steps that the palliative care research community can take to establish a scientifically sound, stable, productive, and well-functioning relationship between palliative care investigators and the ethical bodies that oversee their work.