Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2003
ReviewSymptom management in cancer: pain, depression and fatigue: State-of-the-Science Conference Statement.
NIH Consensus Statements are prepared by a nonadvocate, non-Federal panel of experts, based on (1) presentations by investigators working in areas relevant to the consensus questions during a 2 day public session; (2) questions and statements from conference attendees during open discussion periods that are part of the public session; and (3) closed deliberations by the panel during the remainder of the second day and morning of the third. This statement is an independent report of the panel and is not a policy statement of the NIH or the Federal Government. ⋯ Thus, it provides a "snapshot in time" of the state of knowledge on the conference topic. When reading the statement, keep in mind that new knowledge is inevitably accumulating through medical research.
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J Pain Palliat Care Pharmacother · Jan 2003
Comparative StudyA one year health economic model comparing transdermal fentanyl with sustained-release morphine in the treatment of chronic noncancer pain.
A Markov model was constructed to simulate the resource use and health outcomes of one year of treatment comparing the fentanyl transdermal therapeutic system (fentanyl-TTS) with oral sustained-release (SR) morphine in outpatients with noncancer pain in Denmark. Effectiveness was assessed in terms of days of good pain control and days on initial treatment. ⋯ Patients treated with fentanyl-TTS remained considerably longer on initial treatment compared with those treated with SR-morphine (166 days vs. 117 days, respectively). The results of this study suggest that fentanyl-TTS is a competitive therapeutic and economic choice for the treatment of chronic noncancer pain.
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J Pain Palliat Care Pharmacother · Jan 2003
Pain and palliative care in the Cochrane Library: Issue Number 4 for 2002.
The Cochrane Library of systematic reviews is published quarterly. Issue 4 for 2002 contains 2655 reviews of which 1519 are completed and in full text. Nine of those are directly relevant to pain management and palliative care. Annotated bibliographies for those nine reviews are provided.
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Cost-of-illness studies measure the overall economic impact of a disease on society. Such studies are important in setting public health priorities and for economic evaluation of new treatments. ⋯ Often indirect costs exceed direct costs. Comparison of cost-of-illness studies from different countries is difficult because of differences in population, currency, the way health care is provided, and other social and political factors.
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J Pain Palliat Care Pharmacother · Jan 2003
Palliative care in developing countries: why research is needed.
Contemporary medical knowledge is sufficient to control the suffering of most of the millions of terminally patients in the world if applied appropriately. However, palliative care is still unavailable to most patients in developing countries. Effective models of palliative care delivery that have been tested in developed countries seldom apply to the developing world where poverty, extended families, and insufficient health infrastructure require the adaptation of such care to local cultures and circumstances. ⋯ Palliative care research shares most of the obstacles common to health research in the developing world. Additional obstacles include a lack of consideration of palliative care as part of cancer control strategies and the low political acceptability of such care because it involves the use of opioid analgesics. Coordinated research efforts through active networking and common protocols would increase the visibility of the discipline, provide answers relevant to the local contexts, and assist in expanding palliative care services across the developing world.