Journal of pain and symptom management
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J Pain Symptom Manage · Dec 2024
Optimizing the Dosing Regimen During Rotation From Subcutaneous to Transdermal Administration of Fentanyl.
Subcutaneous (SC) administration of fentanyl allows for rapid dose titration to treat urgent cancer-related pain. After establishing the optimal fentanyl dose, patients typically rotate towards transdermal (TD) fentanyl patches. Continuing the SC fentanyl up to 12h after application of the patch led to elevated fentanyl concentrations and fentanyl-related toxicities. Based on these findings, and simulations using a pharmacokinetic (PK) model, SC fentanyl administration was discontinued immediately following the application of the patch. ⋯ The updated rotation scheme, implying a 1:1 dose conversion and discontinuation of SC fentanyl directly after rotation, resulted in equivalent fentanyl exposure pre and post-rotation. Moreover, the dosing regimen showed to be safe and efficacious during rotation. The new dosing regimen when rotating from SC to TD fentanyl can be effectively and safely implemented in routine palliative care.
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J Pain Symptom Manage · Dec 2024
Identifying palliative care needs in patients with heart failure using patient reported outcomes.
Heart failure (HF) is considered a multifaceted and life-threatening syndrome characterized by high symptom-burden and significant mortality. ⋯ Patients with HF have a high prevalence of symptoms and, thus, potential palliative care needs. Predominantly, women, older patients, and those with higher severity of disease have the highest symptom burden. PROMs can help cardiologists address the palliative care needs and systematic assessment may be a prerequisite to integrate symptom-modifying and palliative care interventions.
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J Pain Symptom Manage · Dec 2024
Machine learning for targeted advance care planning in cancer patients: a quality improvement study.
Prognostication challenges contribute to delays in advance care planning (ACP) for patients with cancer near the end of life (EOL). ⋯ Identifying patients with cancer and high mortality risk via machine learning elicited a substantial increase in documented ACP conversations but did not impact EOL care. Our intervention showed promise in changing clinician behavior. Further integration of this model in clinical practice is ongoing.
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J Pain Symptom Manage · Dec 2024
Review Meta AnalysisEffects of aromatherapy on quality of life and pain in patients with cancer: A meta-analysis.
Cancer has become a chronic disease to which new therapeutic approaches are being applied and many patients are interested in the long-term consequences of these approaches. Aromatherapy is one approach that has been used as a safe and comfortable method to alleviate symptoms in patients with cancer, and its effects on various aspects of life have been reported. ⋯ The findings indicate statistically significant improvements in QoL when combining aromatherapy and massage, but it was not possible to disentangle the individual effects of each. Considering the characteristics of cancer patients, aromatherapy has beneficial effects as a non-pharmacological method. Further research is needed to investigate the effect of aromatherapy on symptom management, considering factors such as the duration of cancer development and type of cancer.
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J Pain Symptom Manage · Dec 2024
ReviewUtilizing Digital Tools for Self-Report Symptom Assessment and Management in Pediatric Oncology: A Systematic Review.
The evaluation of digital tools for measuring self-reported symptoms in children and adolescents undergoing cancer treatment is a critical area of research with significant implications for clinical practice and patient outcomes. ⋯ It shows that studies have generally focused on developing digital tools to address pain, nausea, vomiting, and other symptoms commonly experienced by pediatric oncology patients. While the quality of the included studies ranged from low to high, the overall findings show promise for the effectiveness and usability of these digital tools for symptom assessment and management in pediatric oncology care.