Journal of pain and symptom management
-
J Pain Symptom Manage · Feb 2011
Randomized Controlled Trial Multicenter StudyConsistency of efficacy, patient acceptability, and nasal tolerability of fentanyl pectin nasal spray compared with immediate-release morphine sulfate in breakthrough cancer pain.
We recently reported that fentanyl pectin nasal spray (FPNS) provides superior pain relief from breakthrough cancer pain (BTCP) compared with immediate-release morphine sulfate (IRMS), with significant effects by five minutes and clinically meaningful pain relief from 10 minutes postdose. ⋯ This study demonstrates that FPNS is efficacious, well accepted, and well tolerated by patients with BTCP.
-
J Pain Symptom Manage · Feb 2011
Randomized Controlled TrialThe association of depression and preferences for life-sustaining treatments in veterans with chronic obstructive pulmonary disease.
Depressive symptoms are common among patients with chronic obstructive pulmonary disease (COPD) and may modify patients' preferences for life-sustaining therapy. Examining the relationship between patient preferences for life-sustaining treatments and depressive symptoms is important for clinicians engaging in end-of-life care discussions. ⋯ Depressive history and active symptoms among veterans with severe COPD were not associated with their decisions for life-sustaining treatments. Clinicians caring for patients with COPD should understand the importance of assessing and treating patients with depressive symptoms, yet recognize that depressive symptoms may not be predictive of a patient declining life-sustaining treatments.
-
J Pain Symptom Manage · Jan 2011
Randomized Controlled TrialCaregiver-assisted coping skills training for lung cancer: results of a randomized clinical trial.
Lung cancer is one of the most common cancers in the United States and is associated with high levels of symptoms, including pain, fatigue, shortness of breath, and psychological distress. Caregivers and patients are adversely affected. However, previous studies of coping skills training (CST) interventions have not been tested in patients with lung cancer nor have systematically included caregivers. ⋯ Taken together with the broader literature in this area, results from this study suggest that psychosocial interventions can lead to improvements in a range of outcomes for cancer patients. Suggestions for future studies include the use of three-group designs (e.g., comparing two active interventions with a standard-care control) and examining mechanisms of change.
-
J Pain Symptom Manage · Dec 2010
Randomized Controlled Trial Multicenter StudyHydroxyurea and acute painful crises in sickle cell anemia: effects on hospital length of stay and opioid utilization during hospitalization, outpatient acute care contacts, and at home.
Exploratory findings from the randomized, double-blind, placebo-controlled, multicenter study of hydroxyurea (MSH) in sickle cell anemia (SS). Recurrent acute painful crises may be mild, moderate, or severe in nature and often require treatment at home, in acute care facilities as outpatients, and in the hospital with oral and/or parenteral opioids. ⋯ Beneficial effects of HU include shortening the duration of hospitalization because of acute painful episodes and reducing the net amount of opioid utilization.
-
J Pain Symptom Manage · Nov 2010
Randomized Controlled TrialThe deliverability, acceptability, and perceived effect of the Macmillan approach to weight loss and eating difficulties: a phase II, cluster-randomized, exploratory trial of a psychosocial intervention for weight- and eating-related distress in people with advanced cancer.
Up to 80% of people with cancer will develop weight loss and anorexia during the advanced stages of the disease. The Macmillan Weight and Eating Studies (2000-2009) have used the Medical Research Council complex interventions framework to develop the first psychosocial intervention for weight- and eating-related distress (WRD and ERD) in people with advanced cancer and their carers: The Macmillan Approach to Weight and Eating (MAWE). ⋯ A follow-on randomized controlled trial of MAWE is warranted but should be of a revised design.