Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Sep 2020
Case ReportsPeripheral Neuropathy Associated with Hypereosinophilic Syndrome: A Clinical Therapeutic Success with Capsaicin 8% Patch.
Neuropathic pain is defined as a direct consequence of an injury or disease that affects the somatosensory system, which may affect 7 to 10% of the world population. Regardless of its origin, it is often described as disabling, chronic, difficult to treat and with a noticeable impact on patients' quality of life. This case report describes a patient with peripheral polyneuropathy associated with hypereosinophilic syndrome, a medical condition scarcely described in literature. Capsaicin 8% patches therapy, never mentioned before in the literature in such clinical cases, proved to be significantly successful, and of major relevance for clinical practice.
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J Pain Palliat Care Pharmacother · Sep 2020
The Clinical Pharmacist's Role in Perioperative Surgical Pain Management.
The purpose of this quality improvement initiative was to demonstrate the value of having a clinical pain pharmacist in transitional perioperative pain management. Patients were referred to the pain pharmacist prior to elective surgery. The pharmacist worked with the patients to develop an individualized perioperative analgesic plan and provided education regarding surgery. ⋯ Greater than 90% of patients reported they were "very appreciative" of the pharmacist talking to them about a pain management plan both before surgery and after discharge. One hundred percent of referring providers who responded to the survey reported they were satisfied with the pharmacist role in perioperative pain management. Pain management pharmacy specialists contribute to positive pain management outcomes for patients and surgical provider satisfaction.
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J Pain Palliat Care Pharmacother · Sep 2020
Healthcare Expenditures Associated with Persistent Opioid use Among Adults with Chronic Non-Cancer Pain Conditions: A Retrospective Cohort Study.
Persistent opioid use in adults with chronic non-cancer pain (CNCP) conditions may lead to high economic burden due to adverse events associated with opioids. The objective of our study was to estimate the healthcare expenditures associated with persistent opioid use among adults with CNCP from both payer and patient perspectives. A retrospective cohort study using data from the Medical Expenditure Panel Survey (2012-2015) was undertaken. ⋯ Moreover, persistent opioid use was associated with high out-of-pocket burden compared to no opioid use (adjusted odds ratio, 1.44; 95% confidence interval, 1.09-1.89). Our study shows that both payers and patients bear the brunt of economic burden of persistent opioid use. Alternative cost-effective strategies for pain management for this group of patients are needed.
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J Pain Palliat Care Pharmacother · Sep 2020
Case ReportsPruritic Manifestation of Peripheral T Cell Lymphoma Effectively Managed with Mirtazapine: A Case Report.
Chronic pruritus associated with underlying malignancy can greatly hinder a patient's quality of life. The severity is variable and patients frequently fail traditional first line therapies. We report a patient with diffuse, chronic pruritus secondary to peripheral T Cell Lymphoma (PTCL) who had same day response to mirtazapine after a litany of other agents were unsuccessful.
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J Pain Palliat Care Pharmacother · Sep 2020
Improving Pain Management with Pharmacogenomics: A General Introduction.
Tailoring an individual patient's pain treatment is paramount to decreasing patient suffering and diminishing morbidity. Performing pharmacogenomic (PGx) testing can help guide prescribing decisions for current and future medication therapy by assisting dosage adjustments to increase therapeutic efficacy, decrease adverse drug reactions and avoid potentially ineffective medications. Pharmacogenomics is the study of inherited genetic information that influences drug response. ⋯ Genes of interest associated with pain medications include cytochrome P450 (CYP) enzymes, OPRM1, COMT, ABCB1, UGT, COX, OPRK1, OPRD1. To properly use PGx results in clinical application requires the healthcare provider to distinguish the difference between types of PGx tests, interpret test results, be familiar with PGx databases to use for prescribing guidance, and evaluate the level of evidence for specific gene-drug associations. This article introduces these concepts to assist the healthcare provider with incorporating PGx into practice to improve pain management.