Journal of pain & palliative care pharmacotherapy
-
J Pain Palliat Care Pharmacother · Jan 2011
Awareness and utilization of a prescription monitoring program among physicians.
In 2011, 5 years after the implementation of a statewide prescription monitoring program (PMP) in Ohio, a survey was distributed to physicians in five specialty areas. During the study period, 95 of 156 surveys were returned, for a 61% response rate. The purpose of the questionnaire was to assess utilization rates as well as reasons for accessing the PMP database and any influence the database may have had on prescribing practices. ⋯ However less than 59% of the respondents who were aware of the program had ever used it. Medical specialty was found to have a significant impact on both awareness and utilization of the system, with pediatric physicians least likely, and emergency physicians most likely, to be aware of and utilize the state PMP. Recommendations based on the authors' survey results include targeting pediatric and internal medicine providers for increased education regarding awareness and benefits of PMP utilization.
-
A young man with acute maxillofacial injuries and a tracheotomy in intense pain was denied pain relief for several days. Intermittent suctioning of the trachea was agonizing. He became psychologically affected to such an extent that he was totally focused on his pain and suffering and unable to make intelligent decisions regarding his future treatment. ⋯ A doctor called in to counsel him found that pain was his predominant problem and treated it. The patient was magically transformed to a sensible person, now thinking straight and promptly consenting for surgery. The author, a doctor himself, learned from this experience what a devastating experience pain can have on the person, that one should look for pain to find it, that most of the time pain can be relieved by simple means, and that relief from pain changes the whole attitude of the sufferer.
-
J Pain Palliat Care Pharmacother · Jan 2011
Multicenter Study Clinical TrialMethylnaltrexone for opioid-induced constipation in patients with advanced illness: a 3-month open-label treatment extension study.
Methylnaltrexone is a methylated form of the mu-opioid antagonist naltrexone that blocks peripheral effects of opioids without affecting centrally mediated analgesia. The authors conducted a 3-month open-label extension trial of methylnaltrexone in patients with advanced illness and opioid-induced constipation (OIC). Following completion of a 2-week double-blind (DB) trial, 82 patients with OIC who did not respond to laxatives received subcutaneous (SC) methylnaltrexone as needed for up to 3 months. ⋯ There were minimal changes in pain scores and opioid withdrawal symptoms. Adverse events included abdominal pain and nausea, mostly mild or moderate in severity. SC methylnaltrexone administered PRN (as needed) for up to 3 months continued to rapidly induce laxation in advanced illness patients with OIC.
-
J Pain Palliat Care Pharmacother · Jan 2011
Ensuring patient access to essential medicines while minimizing harmful use: a revised World Health Organization tool to improve national drug control policy.
In 2011, the World Health Organization (WHO) published a series of 21 guidelines to assist governments in improving their national drug control laws, regulations, and administrative procedures to promote the availability of controlled medicines for pain relief and for a variety of acute and chronic diseases and conditions. These guidelines ultimately are designed to encourage the development of policies designed to fulfill a country's dual obligation concerning these medicines: to prevent their abuse, diversion and trafficking while ensuring access for medical and scientific purposes. This article summarizes each guideline and outlines the constituents who can actively participate in making controlled medicines available to the patients who need them. It is hoped that representatives of governments and medical institutions, as well as health care professionals, will commonly and effectively use the revised WHO guidelines as a policy change tool.
-
J Pain Palliat Care Pharmacother · Jan 2011
Declaration of Montréal: declaration that access to pain management is a fundamental human right.
At the conclusion of the 13th World Congress on Pain in Montreal, Quebec, Canada, the International Association for the Study of Pain (IASP) hosted an International Pain Summit on September 3, 2010, to address the tragedy of unrelieved pain in the world. At the conclusion of the Summit, the delegates adopted a Declaration that Access to Pain Management is a Fundamental Human Right. That Declaration is presented.