Journal of pain and symptom management
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J Pain Symptom Manage · Jul 2013
Randomized Controlled TrialInternet-based dyspnea self-management support for patients with chronic obstructive pulmonary disease.
People with chronic obstructive pulmonary disease experience dyspnea with activities despite optimal medical management. ⋯ The DSMPs did not significantly reduce dyspnea with activities compared with attention control. However, the high participant satisfaction with the DSMPs combined with positive changes in other outcomes, including self-efficacy for managing dyspnea and exercise behavior, highlight the need for additional testing of individually tailored technology-enabled interventions to optimize patient engagement and improve clinically relevant outcomes.
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J Pain Symptom Manage · Jul 2013
Randomized Controlled TrialLife-sustaining treatment preferences: matches and mismatches between patients' preferences and clinicians' perceptions.
Better clinician understanding of patients' end-of-life treatment preferences has the potential for reducing unwanted treatment, decreasing health care costs, and improving end-of-life care. ⋯ Clinicians erred more often about patients' wishes when patients did not want treatment than when they wanted it. Treatment decisions based on clinicians' perceptions could result in costly and unwanted treatments. End-of-life care could benefit from increased clinician-patient discussion about end-of-life care, particularly if discussions included patient education about risks of treatment and allowed clinicians to form and maintain accurate impressions of patients' preferences.
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J Pain Symptom Manage · Jul 2013
Randomized Controlled TrialOnce-weekly transdermal buprenorphine application results in sustained and consistent steady-state plasma levels.
Transdermal formulations of buprenorphine offer controlled delivery of buprenorphine for sustained analgesic efficacy with reduced adverse events (AEs) compared with the other modes of administration. A buprenorphine transdermal system (BTDS) delivering 5, 10, or 20 mcg/hour for seven days is now marketed in the U.S. as Butrans(®) (Lohmann Therapie-System AG, Andernach Germany), a Schedule III single-entity opioid analgesic indicated for the management of moderate and chronic pain in patients requiring continuous around-the-clock analgesia for an extended period. ⋯ Three consecutive once-weekly applications of BTDS 10 provided consistent and sustained delivery of buprenorphine. Steady-state plasma concentrations were reached within 48 hours of the first application of BTDS 10. Patch adhesion analysis confirmed the appropriateness of the seven-day application period. Overall, BTDS 10 was safe and well tolerated.
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J Pain Symptom Manage · Jun 2013
Randomized Controlled TrialBupropion for control of hot flashes in breast cancer survivors: a prospective, double-blind, randomized, crossover, pilot phase II trial.
Hot flashes (HFs) and sexual dysfunction often affect breast cancer (BC) survivors and compromise their quality of life. Bupropion is an antidepressive medication used for smoking cessation and also has been previously studied for the treatment of sexual dysfunction. ⋯ Compared with placebo, bupropion did not control HFs in this group of BC survivors.
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J Pain Symptom Manage · Jun 2013
Randomized Controlled TrialChanges over time in occurrence, severity, and distress of common symptoms during and after radiation therapy for breast cancer.
Little is known about changes over time in multiple dimensions of the symptom experience in patients with breast cancer undergoing radiation therapy (RT). ⋯ Findings from this study provide a more complete picture of the symptom experience of women who undergo RT for breast cancer. These findings can be used to identify patients at higher risk for more severe symptoms before, during, and after RT.