Current medical research and opinion
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Randomized Controlled Trial Multicenter Study Comparative Study
Randomized trial comparing polymer-coated extended-release morphine sulfate to controlled-release oxycodone HCl in moderate to severe nonmalignant pain.
To assess the long-term efficacy, tolerability and safety of polymer-coated extended-release morphine sulfate (P-ERMS) (KADIAN) compared with controlled-release oxycodone HCl (CRO) (OxyContin) in treating chronic, nonmalignant, moderate to severe pain in a community-based outpatient population. ⋯ P-ERMS and CRO both relieved chronic nonmalignant pain in this community-based population; however, patients taking P-ERMS dosed in accordance with FDA-approved frequencies (QD/BID); 44% of those taking CRO dosed more frequently (TID/QID).
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Multicenter Study Comparative Study
Development and testing of a neuropathic pain screening questionnaire: ID Pain.
To develop a patient-completed screening tool to help differentiate nociceptive and neuropathic pain. ⋯ ID Pain appeared to accurately indicate the presence of a neuropathic component of pain. As a brief, self-administered screening tool, it could be useful in primary care settings.
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Multicenter Study
A Phase III study to assess the clinical utility of low-dose fentanyl transdermal system in patients with chronic nonmalignant pain.
The transdermal fentanyl delivery system (fentanyl TTS; Duragesic) is currently widely available in patch strengths of 25, 50, 75, and 100 microg/h. However, a lower dose of 12 microg/h would allow optimal titration and fine tuning of the analgesic effect, and may be beneficial in certain patient populations such as the elderly or opioid-naïve. A 12 microg/h fentanyl TTS patch has been developed, and the clinical efficacy and safety tested in this single-arm, non-randomized, open-label, multicenter, 28-day trial in opioid-exposed and -naïve patients with moderate to severe pain for at least 6 months. ⋯ This trial demonstrated that the lower 12 microg/h dose of fentanyl TTS provided a therapeutic benefit in non-malignant chronic pain, with a similar AE rate but a lower drop-out rate than that seen in trials at higher doses. This lower dose may, therefore, be of particular benefit to elderly or opioid-naïve patients.
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Multivariate models of health-related utility and the fear of hypoglycaemia in people with diabetes.
The aim was to statistically model the degree of fear of hypoglycaemia experienced by people with diabetes, and then model the resulting change in health-related utility associated with differing severity and frequency of hypoglycaemia. ⋯ While controlling for other factors, the fear of hypoglycaemia was an important determinant of health-related utility. The magnitude of fear of hypoglycaemia was associated with the severity and frequency of hypoglycaemia. Hypoglycaemia was associated with a considerable decrement in health-related utility as a function of increased fear. Measures should be taken to minimise the severity and frequency of hypoglycaemia.
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This study describes the clinical management of type 2 diabetes among a cohort of patients receiving oral antidiabetic monotherapy. ⋯ Despite the known benefits of glycemic control among patients with diabetes, the time between elevated HbA(1c) results and pharmacotherapy change exceeds 12 months for those with HbA(1c) test results between 7-10% and 9 months for those with results over 10%.