Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Mar 2023
Evaluation of Pain Scales and Outcome in Critically Ill Patients of a Greek ICU.
The purpose of the study was to evaluate painful procedures in ICU patients and to investigate their effect as well as the role of analgesia in the outcome. We measured pain level and vital signs before, during and after potentially painful procedures by using the Behavioral Pain Scale (BPS) and the Critical Care Pain Observation Tool (CPOT). We analyzed the correlation of these measurements and of analgesia with the outcome. ⋯ The higher change in BPS was correlated with more days of mechanical ventilation [B (95% CI) = 3.640 (1.001-6.280), p = 0.007] and of ICU stay [B (95% CI) = 3.645 (1.035-6.254), p = 0.006]. The higher change in CPOT and the nonuse of extra analgesia were related to increased mortality [OR (95% CI) = 1.492 (1.107-2.011), p = 0.009 and OR (95% CI) = 2.626 (1.013-6.806), p = 0.047]. Increased pain in ICU patients was successfully assessed by the BPS and CPOT and correlated to worse outcomes, which the administration of extra analgesia might improve.
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J Pain Palliat Care Pharmacother · Mar 2023
Case ReportsCase Reports of Transdermal Fentanyl Patch Administration Difficulties in Cancer Patients with Excess Sweating.
(Case 1) A 45-year-old male was diagnosed with prostate cancer. Treatment was administered using bicalutamide and leuprorelin acetate, while a transdermal fentanyl (TDF) was applied for pain relief. However, TDF continued to peel off owing to excessive sweating, even when reinforced by a protective layer. ⋯ During this period, full body sweating began to occur to a large extent due to unknown causes, and it was thought that the absorption of fentanyl decreased. When using a TDF, it is necessary to monitor patients for any sweating during treatment, while also considering changes in medication in some cases. This should promote the maintenance and improvement of the quality of life of the affected patients.
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J Pain Palliat Care Pharmacother · Mar 2023
Case ReportsThe Impact of Provider Communication on Prescription Opioid Use: A Case Report.
Over the past few decades, prescription opioids have greatly impacted our society, providing much needed relief for those in severe pain while simultaneously leading many to develop opioid use disorder. Although the scientific community has made great progress in combating this epidemic, there is still much work to be done. ⋯ In this piece, we describe the case of a 62-year-old woman who experienced debilitating, cyclic opioid withdrawals after years of inappropriate prescription opioid use and how much of her suffering could have been avoided. Her case highlights the importance of patient-provider communication and the willingness of many patients to discontinue opioids.
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J Pain Palliat Care Pharmacother · Mar 2023
Observational StudyEvaluation of Naloxone Co-Prescribing Rates for Older Adults Receiving Opioids via a Meds-to-Beds Program.
Over 10,000 older adults died from opioid overdose in 2019. Naloxone is an underutilized antidote that could prevent many opioid overdose-related deaths. There is a paucity of literature evaluating naloxone prescribing through meds-to-beds programs and in older adults. ⋯ Two patients were prescribed naloxone (1.4%), one of whom was ultimately dispensed naloxone (0.7%). Of the 65 prescribers included in our study, the incidence of naloxone co-prescribing (2/65, 3.1%) was no different from a previously-reported rate among prescribers (3/179, 1.7%), p = 0.61. Naloxone co-prescribing for older adults receiving opioid prescriptions through a meds-to-beds program was low and opportunities for program enhancement exist.