Palliative medicine
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Palliative medicine · Apr 2010
Randomized Controlled Trial Multicenter StudySublingual administration of fentanyl to cancer patients is an effective treatment for breakthrough pain: results from a randomized phase II study.
In this study we evaluated the efficacy and tolerability of sublingual fentanyl (SLF) for breakthrough pain (BTP) in adult opioid-tolerant cancer patients. Patients received one dose of placebo, SLF 100, 200 and 400 microg in random order at four pain episodes. The primary efficacy endpoint was pain intensity difference (PID) from baseline. ⋯ Reduced use of rescue medication (p < 0.001, SLF 400 microg) and improved global assessment of treatment (p = 0.0146, SLF 400 microg) confirmed these differences as clinically important. Nausea and dizziness were the most common treatment-related adverse effects. SLF appears to be a fast, effective and well-tolerated treatment for BTP.
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Palliative medicine · Apr 2010
Multicenter StudyHow do nurses assess and manage breakthrough pain in specialist palliative care inpatient units? A multicentre study.
The aim of this qualitative study was to gain a better understanding of how nurses working on inpatient specialist palliative care units assess and manage breakthrough pain. Thematic analysis of semi-structured interviews with fifteen nurses from five different specialist palliative care units in the UK was undertaken. ⋯ Nurses had difficulty defining breakthrough pain as a distinct pain subtype and were often unable to differentiate it from poorly controlled background pain. This study highlights significant training needs and suggests that the theoretical work and recently published consensus recommendations around breakthrough pain now need to be translated into day-to-day clinical practice.
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Palliative medicine · Apr 2010
ReviewReview: the use of proteomics as a research methodology for studying cancer-related fatigue: a review.
There is an increasing emphasis on using translational research to examine mechanisms and increase our understanding of disease. Translational research involves the use of basic science techniques to generate new treatments for use in a clinical setting - the so called 'bench to bedside' approach. ⋯ This review will examine specifically the potential role of the science of protein structure and function (proteomics) as a technique to improve our knowledge in this area. This will include an explanation of the specific methods used in this research in order to increase our understanding of the mechanisms of cancer-related fatigue and discuss potential directions for future research with the development of more targeted therapies.
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National experts have recognized a need for increased research in pediatric palliative care. However, when conducting research it is important to use rigorous methods, report significant and non-significant findings, and include information on responders and non-responders. Most studies do not present information on non-responders, yet this is critical as the results many not be generalizable if there are inherent differences between the two groups. ⋯ However, we also found that of the Black, non-Hispanic parents who did not participate, their primary reason for doing so was that they had non-working or disconnected phone numbers. Only 3% of the Black, non-Hispanic parents who did not participate flatly refused. Information from this study can be used to design interventions aimed at increasing minority participation in pediatric palliative care research.