Ensuring pain relief for children at the end of life
Child; Female; Humans; Male; adolescent; Preschool; infant; Palliative Care/methods; Analgesia/methods; Pain Measurement/methods; Terminal Care/methods; Pain/etiology/psychology/therapy
2006
Gregoire MC; Frager G
Pain Research & Management : The Journal Of The Canadian Pain Society = Journal De La Societe Canadienne Pour Le Traitement De La Douleur
2006
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
A review of the use of methadone for the treatment of chronic noncancer pain
Humans; Canada; Analgesics; Methadone; Non-U.S. Gov't; Research Support; Chronic disease; Pain/drug therapy; Drug; Legislation; Methadone/adverse effects/chemistry/pharmacokinetics/pharmacology/therapeutic use; Opioid/adverse effects/chemistry/pharmacokinetics/pharmacology/therapeutic use
Methadone, although having been available for approximately half a century, is now receiving increasing attention in the management of chronic pain. This is due to recent research showing that methadone exhibits at least three different mechanisms of action including potent opioid agonism, N-methyl-D-aspartate antagonism and monoaminergic effects. This, along with methadone's excellent oral and rectal absorption, high bioavailability, long duration of action and low cost, make it a very attractive option for the treatment of chronic pain. The disadvantages of significant interindividual variation in pharmacokinetics, graduated dose equivalency ratios based on prerotation opioid dose when switching from another opioid, and the requirement for special exemption for prescribing methadone make it more complicated to use. The present review is intended to educate physicians interested in adding methadone to their armamentarium for assisting patients with moderate to severe pain.
2005
Lynch ME
Pain Research & Management : The Journal Of The Canadian Pain Society = Journal De La Societe Canadienne Pour Le Traitement De La Douleur
2005
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1155/2005/286713" target="_blank" rel="noreferrer">10.1155/2005/286713</a>
Data equivalency of an interactive voice response system for home assessment of back pain and function
Female; Humans; Male; Adult; Longitudinal Studies; Disability Evaluation; Telephone; Data Collection/methods; Automation; Back Pain/physiopathology; Evaluation Studies as Topic
BACKGROUND: Interactive voice response (IVR) systems that collect survey data using automated, push-button telephone responses may be useful to monitor patients' pain and function at home; however, its equivalency to other data collection methods has not been studied. OBJECTIVES: To study the data equivalency of IVR measurement of pain and function to live telephone interviewing. METHODS: In a prospective cohort study, 547 working adults (66% male) with acute back pain were recruited at an initial outpatient visit and completed telephone assessments one month later to track outcomes of pain, function, treatment helpfulness and return to work. An IVR system was introduced partway through the study (after the first 227 participants) to reduce the staff time necessary to contact participants by telephone during nonworking hours. RESULTS: Of 368 participants who were subsequently recruited and offered the IVR option, 131 (36%) used IVR, 189 (51%) were contacted by a telephone interviewer after no IVR attempt was made within five days, and 48 (13%) were lost to follow-up. Those with lower income were more likely to use IVR. Analysis of outcome measures showed that IVR respondents reported comparatively lower levels of function and less effective treatment, but not after controlling for differences due to the delay in reaching non-IVR users by telephone (mean: 35.4 versus 29.2 days). CONCLUSIONS: The results provided no evidence of information or selection bias associated with IVR use; however, IVR must be supplemented with other data collection options to maintain high response rates.
2007
Shaw WS; Verma SK
Pain Research & Management : The Journal Of The Canadian Pain Society = Journal De La Societe Canadienne Pour Le Traitement De La Douleur
2007
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1155/2007/185863" target="_blank" rel="noreferrer">10.1155/2007/185863</a>
Physician variability in treating pain and irritability of unknown origin in children with severe neurological impairment
Article #6
BACKGROUND: <⁄span> Pain and irritability of unknown origin (PIUO) is a challenging problem for nonverbal children with severe neurological impairments. PIUO is not associated with an identifiable source of nociceptive-inflammatory or neuropathic pain. OBJECTIVE: <⁄span> To assess how physicians use pharmacotherapy to treat PIUO, and to report a pilot study of a standardized approach to investigating and treating PIUO. METHOD: <⁄span> Part 1 of the present study involved independently presenting a case vignette of a patient with PIUO to six experienced physicians who care for children with neurological impairments. They were asked for medication choices and sequences to empirically treat PIUO. Part 2 was a pilot study of a PIUO protocol. Patients followed a standard pathway for PIUO, referred to as the pathway for unknown pain (PUP). The initial drug sequence for the PUP was based on Part 1. RESULTS: <⁄span> In Part 1, physicians responding to the case vignette listed eight medications (atypical antipsychotics, benzodiazepines, gabapentin, methadone, opioids, selective serotonin reuptake inhibitors, tramadol and tricylic antidepressants) and eight empiric drug sequences. In Part 2, eight children with PIUO (six to 17 years of age; five females, three males) were enrolled in a pilot clinic. Only two had been fully evaluated for nociceptive-inflammatory pain sources before enrollment. At the end of the pilot study, four patients were clinically improved and only three required a study medication. DISCUSSION AND CONCLUSION: <⁄span> Even experienced physicians do not agree on a common approach for medical treatment of PIUO. A standardized pathway is feasible and readily implemented. The proposed PUP has the potential to address PIUO and be the basis for future intervention studies.
2013-10
Siden H; Carleton BC; Oberlander T
Pain Research & Management : The Journal Of The Canadian Pain Society = Journal De La Societe Canadienne Pour Le Traitement De La Douleur
2013
Article information provided for research and reference use only. PedPalASCNET does not hold any rights over the resource listed here. All rights are retained by the journal listed under publisher and/or the creator(s).
Journal Article
<a href="http://doi.org/10.1155/2013/193937" target="_blank" rel="noreferrer">10.1155/2013/193937</a>