Pain medicine : the official journal of the American Academy of Pain Medicine
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Randomized Controlled Trial
Personalized oxycodone dosing: using pharmacogenetic testing and clinical pharmacokinetics to reduce toxicity risk and increase effectiveness.
To develop a framework for integrating pharmacogenetics with clinical pharmacokinetics for personalized oxycodone dosing based on a patient's CYP2D6 phenotype. ⋯ Personalized oxycodone dosing is a new tool for a clinician treating chronic pain patients requiring oxycodone. By expressing a patient's CYP2D6 phenotype pharmacokinetically, a clinician (at least theoretically) can improve the safety and efficacy of oxycodone and decrease the risk for iatrogenically induced overdose or death. Pharmacokinomics provides a general framework for the integration of pharmacogenetics with clinical pharmacokinetics into clinical practice for gene-based prescribing.
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Utilities are values of health-related quality of life (HRQoL) based on patient preference for a health status. The purpose of this study was to compare indirect measures to a directly elicited utility. ⋯ This study demonstrates that the EQ-5D overestimates, whereas the paper version of TTO underestimates, the impact of pain on HRQoL compared with the directly elicited FTF TTO utility. Our findings provide preliminary evidence that utilities vary by method, and directly elicited utility values differ from indirectly elicited measures.
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The aim of this study was to investigate the clinical characteristics of primary stabbing headache (PSH) and its prevalence in a neurology outpatient center at a university hospital in China. ⋯ PSH was shown to have an onset at middle age with moderate-to-severe intensity attacks localized predominantly within the first division of the trigeminal nerve. Accompanying phenomena and trigger factors were common and should be noted, implying further research to be conducted.