BMJ supportive & palliative care
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BMJ Support Palliat Care · Sep 2016
Pharmacovigilance in hospice/palliative care: net effect of pregabalin for neuropathic pain.
Real-world effectiveness of many medications has been poorly researched, including in hospice/palliative care. Directly extrapolating findings from other clinical settings may not yield robust clinical advice. Pharmacovigilance studies provide an opportunity to understand better the net impact of medications. The study aimed to examine immediate and short-term benefits and harms of pregabalin in routine practice for neuropathic pain in hospice/palliative care. ⋯ Pregabalin delivered benefit to many patients, with 4 of 10 experiencing pain reductions by 21 days. Harms, occurring in 1 in 3 patients, may be difficult to detect in clinical practice, as they mostly involve worsening of symptoms prevalent at baseline.
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BMJ Support Palliat Care · Sep 2016
Pharmacovigilance in hospice/palliative care: the net immediate and short-term effects of dexamethasone for anorexia.
Loss of appetite is prevalent in palliative care and distressing for patients and families. Therapies include corticosteroids or progestogens. This study explores the net effect of dexamethasone on anorexia. ⋯ This study shows positive and negative effects of 7 days of dexamethasone as an appetite stimulant in patients with advanced life-limiting illnesses. Identifying clinicodemographic characteristics of people most at risk of harms with no benefit is a crucial next step. Longer term follow-up will help to understand longer term and cumulative harms.
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BMJ Support Palliat Care · Sep 2016
The effectiveness of buprenorphine for treating cancer pain: an abridged Cochrane review.
To assess the effectiveness and tolerability of buprenorphine for cancer pain in adults and children. ⋯ Buprenorphine might be considered as a fourth-line option compared with the more standard therapies of morphine, oxycodone and fentanyl, and even then it would only be suitable for some patients.