Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2008
The national agenda for quality palliative care: promoting the National Consensus Project's domain of physical care and the National Quality Forum's preferred practices for physical aspects of care.
The National Consensus Project (NCP) 2004 Clinical Practice Guidelines for Quality Palliative Care defines eight domains of care essential for palliative care clinical practice. The National Quality Forum (NQF) 2006 document entitled A National Framework and Preferred Practices for Palliative and Hospice Care Quality: A Consensus Report is based on the NCP Guidelines. The NQF document identifies 38 evidence-based preferred practices for palliative care. This paper demonstrates how the Guidelines and Preferred Practices may be operationalized by pharmacotherapists to better treat symptoms of debilitating or chronic illnesses falling under Domain 2 of the Guidelines, "Physical Care." Specifically, dementia and dyspnea are used as illustrative examples.
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Queries from European physicians about analgesic pharmacotherapy and responses from the author are presented. The topics addressed are tolerance to opioid side-effects, use of botulinum toxin A in pain management, use of ketamine in pain management, opioid addicts' perception of pain, intra-articular injections following joint surgery, and opioid rescue doses for breakthrough pain.