Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2011
Multicenter StudyErrors in managing postsurgical pediatric pain in Mexico.
Postoperative pain is a subjective symptom that has been extensively studied in adults, but only minimally in children. In children, use of low analgesic doses and failure to document the pain and its management are common concerns. In newborns and infants pain is difficult to interpret. ⋯ Nurses and doctors in training did not have the skills needed to evaluate pain. The study revealed errors in pain management and fear among staff in using high doses of common analgesics. The study results document patterns of care in most Mexican hospitals today and indicate a need for pain management training for Mexican doctors and nurses.
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J Pain Palliat Care Pharmacother · Jan 2011
Computational opioid prescribing: a novel application of clinical pharmacokinetics.
We implemented a pharmacokinetics-based mathematical modeling technique using algebra to assist prescribers with point-of-care opioid dosing. We call this technique computational opioid prescribing (COP). ⋯ We conclude that COP is a new technique for the quantitative assessment of opioid dosing regimen design evaluation and adjustment, which may help prescribers to manage acute and chronic pain at the point-of-care. Potential benefits include opioid dose optimization and minimization of adverse opioid drug events, leading to potential improvement in patient treatment outcomes and safety.
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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.
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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.
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J Pain Palliat Care Pharmacother · Jan 2011
A first comparison between the consumption of and the need for opioid analgesics at country, regional, and global levels.
The objective of this study was to propose a rough but simple method for estimating the total population need for opioids for treating all various types of moderate and severe pain at the country, regional, and global levels. We determined per capita need of strong opioids for pain related to three important pain causes for 188 countries. These needs were extrapolated to the needs for all the various types of pain by using an adequacy level derived from the top 20 countries in the Human Development Index. ⋯ Only the populations of some industrialized countries have good access. Policies should seek a balance between maximizing access for medical use and minimizing abuse and dependence. Countries should aim to increase the medical consumption to the magnitude needed to address the totality of moderate and severe pain.