Journal of pain and symptom management
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J Pain Symptom Manage · Mar 2018
ReviewInvestigation of the practices, legislation, supply chain and regulation of opioids for clinical pain management in Southern Africa: A multi-sectoral, cross-national, mixed methods study.
Sub-Saharan Africa faces an increasing incidence and prevalence of life-limiting and life-threatening conditions. These conditions are associated with a significant burden of pain linked to high morbidity and disability that is poorly assessed and undertreated. Barriers to effective pain management partly relate to lack of access to opioid analgesia and challenges in their administration. ⋯ Policies and relevant laws should be updated to ensure that the legislative environment supports opioid access for pain management. Action plans for improving pain treatment for patients suffering from HIV or non-communicable diseases should address barriers at the different levels of the supply chain that involve policymakers, administrators, and service providers.
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J Pain Symptom Manage · Mar 2018
Randomized Controlled TrialMeasuring the psychosocial dimensions of quality of life in advanced cancer patients: Psychometrics of the German Quality of Life at the End of Life-Cancer-Psychosocial (QUAL-EC-P) Questionnaire.
Quality of life (QoL) is a central focus of care in advanced cancer. Specialized instruments, such as the Quality of Life at the End of Life-Cancer (QUAL-EC), may be useful to assess psychosocial issues associated with QoL unique to this population. ⋯ The QUAL-EC-P questionnaire may be used to assess the psychosocial aspects of QoL and promote their clinical discussion in patients with advanced cancer.
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J Pain Symptom Manage · Mar 2018
Observational StudyDoes modality matter? Palliative care units associated with more cost-avoidance than consultations.
Inpatient palliative care (PC) is associated with reduced costs, but the optimal model for providing inpatient PC is unknown. ⋯ Both PCU and PCC are associated with lower hospital costs than UC. PCU is associated with a greater cost-avoidance effect than PCC, except where both interventions are provided early in the hospitalization. Both timely provision of PC for appropriate patients and creation of more PCUs may decrease hospital costs.
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J Pain Symptom Manage · Mar 2018
Clinical TrialAcute pain perception during different sampling methods for respiratory culture in cystic fibrosis patients.
Reliable identification of lower respiratory tract pathogens is crucial in the management of cystic fibrosis (CF). The multitude of treatments and clinical procedures are a considerable burden and are potentially provoking pain. ⋯ A relatively large range of pain experiences was observed in patients with CF during respiratory culture sampling, which underlines the importance of individual pain assessment. Nevertheless, clinicians can confidently choose the sampling method based on validity over patients' preference.