Journal of pain and symptom management
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J Pain Symptom Manage · Sep 2015
Randomized Controlled TrialThe Effect of Methylphenidate on Fatigue in Advanced Cancer: An Aggregated N-of-1 Trial.
Fatigue is common in life-limiting cancer. Methylphenidate (MPH), a psychostimulant, may be a useful therapy. Gathering evidence in patients with advanced cancer can be challenging. ⋯ MPH does not improve fatigue in the population of patients with end-stage cancer. Aggregated N-of-1 trial methodology is feasible and produces population-based sample estimates with less than half the sample size required for the equivalent parallel-group RCT. It also identified individuals who did and did not respond to MPH, which is a feature difficult to achieve in a standard RCT. The study was registered with the Australian Clinical Trials Registry (12609000794202).
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J Pain Symptom Manage · Jul 2015
Randomized Controlled TrialAn Educational Intervention to Reduce Pain and Improve Pain Management for Malawian People Living With HIV/AIDS and Their Family Carers: A Randomized Controlled Trial.
Advances being made in improving access to HIV drugs in resource-poor countries mean HIV patients are living longer, and, therefore, experiencing pain over a longer period of time. There is a need to provide effective interventions for alleviating and managing pain. ⋯ A short pain education intervention is effective in reducing pain and improving pain management for Malawian people living with HIV/AIDS and their family carers.
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J Pain Symptom Manage · Jun 2015
Randomized Controlled Trial Multicenter StudyFeasibility of Conducting a Palliative Care Randomized Controlled Trial in Children With Advanced Cancer: Assessment of the PediQUEST Study.
Pediatric palliative care randomized controlled trials (PPC-RCTs) are uncommon. ⋯ A PPC-RCT in children with advanced cancer was feasible, post-inclusion retention adequate; many families participated for altruistic reasons. Strategies that may further PPC-RCT feasibility include: increasing target population through large multicenter studies, approaching sicker patients, preventing exclusion of certain patient groups, and improving data collection at end of life.
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J Pain Symptom Manage · Jun 2015
Randomized Controlled TrialAdvance Care Planning Does Not Adversely Affect Hope or Anxiety Among Patients With Advanced Cancer.
Many physicians avoid advance care planning (ACP) discussions because they worry such conversations will lead to psychological distress. ⋯ Engaging in ACP with online planning tools increases knowledge without diminishing hope, increasing hopelessness, or inducing anxiety in patients with advanced cancer. Physicians need not avoid ACP out of concern for adversely affecting patients' psychological well-being.
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J Pain Symptom Manage · May 2015
Randomized Controlled TrialValidation of a fentanyl transdermal adhesion scoring tool for use in clinical practice.
The therapeutic efficacy of a transdermal system (TDS) is directly related to the adhesion of TDS, with partial adhesion resulting in lower plasma concentration. Currently there is no TDS adhesion scoring tool available for use in the clinical setting. ⋯ Overall, the TDS adhesion score determined by the participants visually in this study corresponded well to those generated by photo editing software, thus rendering the scoring system highly valid. The FDA scoring system is an adequate tool for assessing fentanyl TDS adhesion in clinical practice.