Articles: opioid.
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A Task Force was established by the International Restless Legs Syndrome Study Group (IRLSSG) to develop evidence-based and consensus-based recommendations for the long-term pharmacologic treatment of restless legs syndrome/Willis-Ekbom disease (RLS/WED). The Task Force reviewed the results of all studies of RLS/WED treatments with durations of 6 months or longer presented at meetings over the past 2 years, posted on Web sites of pharmaceutical companies, or published in peer-reviewed journals, asking the questions, "What is the efficacy of this treatment in patients with RLS/WED?" and "What is the safety of this treatment in patients with RLS/WED?" The Task Force developed guidelines based on their review of 61 papers meeting inclusion criteria, and using a modified evidence-grading scheme. Pregabalin has been established as effective for up to 1 year in treating RLS/WED (Level A evidence). ⋯ Other pharmacologic therapies have insufficient evidence to support their long-term use in treating RLS/WED. The IRLSSG Task Force also developed consensus-based strategies for the prevention and treatment of complications (such as augmentation, loss of efficacy, excessive daytime sleepiness, and impulse control disorders) that may develop with the long-term pharmacologic treatment of RLS/WED. The use of either a dopamine-receptor agonist or α2δ calcium-channel ligand is recommended as the first-line treatment of RLS/WED for most patients, with the choice of agent dependent on the patient's severity of RLS/WED symptoms, cognitive status, history, and comorbid conditions.
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J Pain Symptom Manage · Jul 2013
Use of opioid analgesics among older persons with colorectal cancer in two health districts with palliative care programs.
Prescription of opioid analgesics is a key component of pain management among persons with cancer at the end of life. ⋯ PCPs may play an important role in enabling access to end-of-life care within the community.
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The factors associated with successful opioid discontinuation after cancer treatment are not well-known. We determined the proportion of patients with advanced head and neck cancer who continued using opioids 3 months after the completion of radiation therapy with or without chemotherapy. ⋯ CAGE positivity is a risk factor for opioid use beyond 3 months after the completion of radiation therapy and for duration of opioid treatment. Routine CAGE screening and meticulous follow-up are needed for these patients.
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Am J Hosp Palliat Care · Jun 2013
Prevalence and management of pain by different age groups of Korean cancer patients.
The aims of this study were to evaluate the differences in cancer prevalence and pain management between young and elderly patients. The patients were grouped into 3 groups. The prevalence of cancer pain was 50.0% in those younger than 65 years, 55.9% in those aged between 65 and 75, and 58.3% in those older than 75 years. ⋯ Severe cancer pain occurred in 8.0% of the patient and was most prevalent in the advanced stage. Side effects of analgesics were observed in 24.5%. Cancer pain correlates with performance status and cancer stage but not significantly with age.