Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2016
Observational StudyPatient-Controlled Therapy (PCT) of Breathlessness in Palliative Care: A New Therapeutic Concept for Opioid Application?
Breathlessness is one of the most distressing symptoms experienced by patients with advanced cancer and noncancer diagnoses alike. Often, severity of breathlessness increases quickly, calling for rapid symptom control. Oral, buccal, and parenteral routes of provider-controlled drug administration have been described. It is unclear whether patient-controlled therapy (PCT) systems would be an additional treatment option. ⋯ Opioid PCT is a feasible and acceptable therapeutic method to reduce refractory breathlessness in palliative care patients.
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J Pain Symptom Manage · Mar 2016
Comparative StudyThe Influence of Low Salivary Flow Rates on the Absorption of a Sublingual Fentanyl Citrate Formulation for Breakthrough Cancer Pain.
Salivary gland hypofunction may affect the absorption of drugs through the oral mucosa, which in turn may affect their clinical efficacy (e.g., onset of action). ⋯ The pharmacokinetics of the sublingual fentanyl orally disintegrating tablet appear to be negatively affected by the presence of salivary gland hypofunction, although the moistening of the oral cavity before dosing results in a pharmacokinetic profile similar to that seen with the giving of pilocarpine hydrochloride.
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J Pain Symptom Manage · Mar 2016
Effective Management of Breathlessness in Advanced Cancer Patients with a Program-Based, Multidisciplinary Approach: The "SOB Program" in Hong Kong.
Breathlessness is common in patients with advanced cancer. Using a multidisciplinary approach for relieving this challenging symptom was believed to be just a theory. The "SOB Program" was implemented in our institution in March 2013. ⋯ A multidisciplinary approach for breathlessness control is both feasible and practical. Similar services can be promoted in other palliative care centers.
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The maintenance of dignity is an important concept in palliative care, and the loss of dignity is a significant concern among patients with advanced cancer. ⋯ The prevalence of a problematic loss of dignity among patients with severe chronic obstructive pulmonary disease is at least as high as among those receiving palliative cancer care. Loss of dignity may represent a concern among people with medical illnesses more broadly, and not just in the context of "death with dignity" at the end of life. Furthermore, interdisciplinary care may help to restore a sense of dignity to those individuals who are able to participate in rehabilitation.