Journal of palliative medicine
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Case Reports
Oral transmucosal fentanyl citrate for dyspnea in terminally ill patients: an observational case series.
To evaluate the efficacy and safety of oral transmucosal fentanyl citrate (OTFC) in terminally ill patients experiencing dyspnea. ⋯ OTFC appears to be safe and effective for dyspnea in terminally ill patients. The study population is limited to four cases, however, the initial findings are promising and merit further research.
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Comparative Study
Symptom clusters in patients with cancer with metastatic bone pain.
The primary objective was to explore how patients' worst pain clustered together with functional interference items. Secondary objectives were to determine whether symptom clusters change with palliative radiotherapy (RT) and to compare the difference between responders and nonresponders to radiation. ⋯ Symptom clustering has proved to be therapeutically important because treatment of one symptom may affect others within the same cluster. The significant correlations between worst pain and the functional interference items reaffirm the importance of pain reduction as a treatment goal for palliative radiotherapy. By treating a patient's symptom of worst pain, it would subsequently ease their response burden on their daily functional activities by decreasing symptom severity, increasing function, and improving overall quality of life.
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Comparative Study
A comparison of sennosides-based bowel protocols with and without docusate in hospitalized patients with cancer.
Constipation is a common and distressing condition in patients with cancer, especially those taking opioid analgesics. Many institutions prevent and treat constipation with titrated laxatives, which is known as a bowel protocol. An effective and well-tolerated bowel protocol is a very important component of cancer care, and there is little evidence on which to base selection of the most appropriate agents. This study compares a protocol of the stimulant laxative sennosides alone with a protocol of sennosides plus the stool softener docusate, in hospitalized patients at an oncology center. The docusate-containing protocol had an initial docusate-only step for patients not taking opioids, and four to six 100-mg capsules of docusate sodium in addition to the sennosides for the rest of the protocol. ⋯ The addition of the initial docusate-only step and adding docusate 400-600 mg/d to the sennosides did not reduce bowel cramps, and was less effective in inducing laxation than the sennosides-only protocol. Further research into the appropriate use of docusate and into the details of bowel protocol design are required.