Journal of pain and symptom management最新文献

{"title":"Olanzapine Prophylaxis for Opioid-Induced Nausea and Vomiting: A Single-Arm Exploratory Study.","authors":"Eriko Satomi, Naho Matsubara, Rumi Nishimura, Akiko Abe, Naruaki Kawasaki, Sayaka Arakawa, Hiroto Ishiki, Koji Amano, Naomi Sakiyama, Keisuke Ariyoshi, Kota Kihara, Shouta Kobayashi, Shunsuke Oyamada, Tatsuya Takagi, Akio Mizushima","doi":"10.1016/j.jpainsymman.2026.04.623","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.623","url":null,"abstract":"<p><strong>Introduction: </strong>Opioid-induced nausea and vomiting (OINV) affects 10-45.3% of patients during opioid initiation or dose escalation. Although antiemetics are commonly administered when symptoms occur, their efficacy and safety for prophylactic use remain uncertain. Olanzapine, known for its effectiveness in chemotherapy-induced nausea and vomiting, may be a promising candidate for OINV prophylaxis.</p><p><strong>Aim: </strong>This study aimed to evaluate the efficacy and safety of olanzapine in preventing nausea and vomiting during the initiation of opioid therapy.</p><p><strong>Methods: </strong>This single-arm, single-center exploratory study (jRCT 031220008) assessed the efficacy and safety of administering 5 mg of olanzapine daily for 5 days in cancer patients initiating regular opioid treatment. The primary endpoint was the complete control (CC) rate over 5 days, defined as no emetic episodes, no need for rescue antiemetics, and minimal nausea (≤3 on an 11-point scale). Key secondary endpoints included the complete response (CR) rate defined as no emesis and no rescue antiemetics and adverse events evaluated using CTCAE ver.5.0. Exact binomial tests were conducted, assuming a 65% efficacy threshold based on prior studies.</p><p><strong>Results: </strong>Thirty-five patients were enrolled; 34 received treatment and were analyzed. The mean age was 58.8 years, and 45.7% were male. CC was achieved in 79.4% (95% CI: 64.47-89.92, p=0.0527), and CR in 82.4% (95% CI: 65.47-93.24, p=0.0390). No emetic events occurred in 85.3% of patients. No serious adverse events were reported.</p><p><strong>Conclusion: </strong>Olanzapine may be effective and well tolerated for the prevention of OINV in cancer patients. Further confirmative trials are warranted.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147856515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Humanities Curriculum for Preparing Medical Students to Work with Dying Patients.","authors":"Ryan Jenkins, Sean Eli McCormick, Erin Gentry Lamb","doi":"10.1016/j.jpainsymman.2026.04.621","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.621","url":null,"abstract":"<p><strong>Context: </strong>Medical education literature lacks consensus on how to deliver and measure the efficacy of material about death and dying, a topic medical student learners identify as needing improvement. The humanities offer promising methodologies to address this need as they engage learners via emotion, narrative, and perspective-taking. As part of a research project evaluating using the humanities to teach end-of-life care, we designed a curriculum centered on small-group discussions of pre-assigned readings.</p><p><strong>Objectives: </strong>To detail the implementation of and evaluate student responses to a novel humanities-based elective teaching end-of-life skills to second-year medical students in the interest of broader replicability.</p><p><strong>Methods: </strong>The authors planned the curriculum based on a needs assessment and their professional experience in humanities education. Students (n=42) completed surveys after each session and cumulatively including Likert-scale and free-text items measuring responses to the materials and pedagogy. This analysis includes descriptive statistics and a formal qualitative analysis of written responses.</p><p><strong>Results: </strong>Students overwhelmingly evaluated materials and discussions as valuable for their professional development and comfort, confidence, and anxiety about working with dying patients. Qualitatively, student-identified outcomes included increased knowledge about and comfort with end-of-life care, strong emotional reactions, opportunities for self-reflection, improved emotional understanding, practical skills, and envisioned value for future careers. Course materials contributed to these outcomes through their diversity in type and perspective, and course discussions created a safe space where students could direct the conversation and learn from peers.</p><p><strong>Conclusion: </strong>A humanities-based curriculum can be well-suited to educating preclinical medical students about end-of-life care.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Notify-Caution: Care Components Missing in Perinatal Palliative Care Notification Laws.","authors":"Meaghann S Weaver, Ambria Williams, Abagail D Cohen, Ashley Kiefer Autrey, DonnaMaria E Cortezzo, Abigail B Wilpers, Lisa C Lindley","doi":"10.1016/j.jpainsymman.2026.04.622","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.622","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Managing Cancer-Related Pain in Patients Receiving Long-Acting Buprenorphine for Opioid Use Disorder.","authors":"Adria Poh-Ming Lam, David Lawrence, Katie Fitzgerald Jones, Michael Spiker","doi":"10.1016/j.jpainsymman.2026.04.617","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.617","url":null,"abstract":"<p><p>Buprenorphine has been shown to significantly reduce opioid related harms, with two injectable extended-release formulations being increasingly used for the management of opioid use disorder (OUD). Palliative care clinicians are encountering more patients with OUD and must familiarize themselves with the unique considerations of the injectable extended-release formulations of buprenorphine. Additionally, the management of cancer-related pain in patients treated with injectable buprenorphine formulations is complex, and guidelines are limited, particularly around the use of full opioid agonists. Here, we explore a composite case study of a 62-year-old man with severe OUD that is well managed on injectable buprenorphine, who is later diagnosed with cancer and develops cancer-related pain, as a basis for a discussion about the management approach in cases similar to this one. Major clinical takeaways are the importance of continuing to prioritize OUD management while also considering the pharmacokinetic profile of extended-release buprenorphine formulations, with particular attention to receptor availability for full opioid agonists and the half-life of buprenorphine formulations. Additionally, it is central to OUD and cancer-related pain management to utilize multimodal analgesia and a multidisciplinary team approach. In light of the lessons learned based on clinical practice and surrounding literature review, we recommend that palliative care teams iteratively balance pain and OUD management needs.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147838858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PC-FACS February 3, 2026.","authors":"","doi":"10.1016/j.jpainsymman.2026.02.001","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.02.001","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":"71 5","pages":"728-733"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147690808","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Generative Artificial Intelligence Use in the Peer Review Process.","authors":"David Hui, Ambereen K Mehta, Daniel Shalev, William E Rosa, Marcin Chwistek, Cara Wallace, Ankita Mehta, Amy Case, Elizabeth Loggers, David Casarett","doi":"10.1016/j.jpainsymman.2026.04.614","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.614","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816498","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Spiritual Well-Being Moderates the Association Between Attachment Insecurity and Death Anxiety in Chinese Patients With Metastatic Breast Cancer: Indirect Pathways Through Distress and Depressive Symptoms.","authors":"Yening Zhang, Miaoning You, Tianye Lin, Fang He, Huiping Li, Lili Tang","doi":"10.1016/j.jpainsymman.2026.04.620","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.620","url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to determine the prevalence of death anxiety and examine its psychological correlates within a hypothesized psycho-social-spiritual framework among Chinese patients with metastatic breast cancer.</p><p><strong>Methods: </strong>Consecutive inpatients with metastatic breast cancer were recruited from the Breast Cancer Department at Peking University Cancer Hospital (Beijing, China) between January 2022 and March 2025. Of 412 consented patients, 400 completed all questionnaires (response rate: 97.1%). Measures included the Chinese Death and Dying Distress Scale (DADDS), Patient Health Questionnaire-9 (PHQ-9), Distress Thermometer (DT), Functional Assessment of Chronic Illness Therapy-Spiritual Well-Being Scale (FACIT-Sp), Brief Experiences in Close Relationships scale (ECR-M16), and Quality of Life at the End of Life in Cancer (QUAL-EC).</p><p><strong>Results: </strong>Death anxiety was common: 37.5% reported mild symptoms and 19.0% reported moderate-to-severe levels. In multivariable ordinal logistic regression, higher death anxiety severity was associated with greater depressive symptoms (PHQ-9), greater general distress (DT), higher attachment insecurity (ECR-M16), and poorer end-of-life preparation (all p<0.001). In a theoretically informed path model, attachment insecurity showed a direct association with death anxiety and an indirect association through distress and depressive symptoms; spiritual well-being moderated the attachment insecurity-death anxiety association after adjusting for distress and depression (interaction p=0.017).</p><p><strong>Conclusion: </strong>In this cross-sectional sample of Chinese patients with metastatic breast cancer, death anxiety was prevalent and was significantly associated with attachment insecurity, distress, depressive symptoms, and poorer end-of-life preparation. Higher spiritual well-being may buffer the association between attachment insecurity and death anxiety among patients with greater attachment vulnerability, highlighting the potential value of targeted psycho-social-spiritual assessment and supportive intervention.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Optimizing Approaches in Advance Care Planning in Dementia as Perceived by General Practitioners.","authors":"Jenny T van der Steen, Xu Jingyuan, Willemijn Tros, Jeanet W Blom","doi":"10.1016/j.jpainsymman.2026.04.618","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.618","url":null,"abstract":"<p><strong>Context: </strong>. Feasible, person-centered advance care planning (ACP) approaches for persons with dementia and their care partners are needed, and the optimal approach may differ depending on the situation. Two contrasting approaches involve a highly scripted medical order-setting approach to decide on specific treatments in advance versus a flexible goal-eliciting, more psychosocially-oriented coping-based approach.</p><p><strong>Objectives: </strong>. To distinguish situations in which either approach is preferred in dementia from the perspective of general practitioners.</p><p><strong>Methods: </strong>. We interviewed thirteen practitioners participating in the CONT-END program in the Netherlands. Seven were trained in the order-setting approach and six in the goal-eliciting approach for an ACP trial. Twelve other practitioners participated in a video vignette study showing the two approaches, and we triangulated findings. Inductive qualitative content analyses of interviews aimed at elucidating for whom and when an approach was preferred.</p><p><strong>Results: </strong>. Four attributes distinguished situations in which either approach is preferred: understanding, trust, readiness and momentum. For the order-setting approach, understanding, trust, and readiness of person and care partner were prerequisites for momentum (time right to express preferences), when not triggered for urgent medical reasons. In contrast, the goal-eliciting approach would help understand the person, foster trust and create readiness from a first conversation. Without a clear trigger, however, momentum would need to be created.</p><p><strong>Conclusion: </strong>. Skill in employing various approaches to ACP conversations each with specific benefits could help tailor ACP to the individual and their situation. Further theoretical and empirical research including in other populations and settings may inform person-centered ACP.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816439","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Caring for Muslim Children at the End of Life: Faith-Informed Guidance for Pediatric Clinicians.","authors":"Mashal Z Naqvi, Fadumo Warsame, Zach W Lovig, Megan Thorvilson","doi":"10.1016/j.jpainsymman.2026.04.610","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.610","url":null,"abstract":"","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies to Engage Diverse Population in Home-based Palliative Care: A Qualitative Study in Hawaii.","authors":"Susan Enguidanos, Rae Seitz, Yujun Zhu, Valeria Cardenas, Alexis Coulourides Kogan, Zachary Song","doi":"10.1016/j.jpainsymman.2026.04.619","DOIUrl":"https://doi.org/10.1016/j.jpainsymman.2026.04.619","url":null,"abstract":"<p><strong>Context: </strong>Several studies have documented racial and cultural inequities in the receipt of palliative care. With expanding home-based palliative care programs spreading across the United States and in other countries, understanding barriers to enrollment of diverse populations and promising practices to overcome these barriers is critical.</p><p><strong>Objectives: </strong>To identify barriers enrolling diverse patients in home-based palliative care; and to elicit successful strategies and best practices in engaging and communicating with diverse populations about palliative care.</p><p><strong>Methods: </strong>We conducted a qualitative study employing nine focus groups with staff from nine home-based palliative care agencies in Hawaii. Interviews were conducted via video conferencing and audio recorded. Using thematic analysis, we identified core themes related to challenges and best practices of engaging minorities in palliative care services.</p><p><strong>Results: </strong>Barriers to care acceptance included perceptions of 'giving up', lack of knowledge of palliative care, cultural values and attitudes, language barriers, and issues of healthcare accessibility and equity. In response, we identified facilitators and recommendations to care which highlighted the importance of community leader involvement, respect for patient and family-centered care, building trust and ensuring continuity in care, having staff and materials in diverse languages, in-person conversation about palliative care services, and the active engagement of family in healthcare decision-making.</p><p><strong>Conclusions: </strong>These findings highlight the importance of considering cultural factors in the provision of care and underscore the necessity for culturally sensitive, patient-centered approaches to hospice and palliative care.</p>","PeriodicalId":16634,"journal":{"name":"Journal of pain and symptom management","volume":" ","pages":""},"PeriodicalIF":3.5,"publicationDate":"2026-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147816450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}