Journal of Pain & Palliative Care Pharmacotherapy最新文献

Patient and Clinician Views on Risk Prediction for Chemotherapy-Induced Peripheral Neuropathy. 患者和临床医生对化疗诱导周围神经病变风险预测的看法。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-10-17 DOI: 10.1080/15360288.2025.2571532

Katherine J Holzer, Simon Haroutounian, Lesley A Colvin, Karen A Frey, Justin J Stout, Joanna Abraham

{"title":"Patient and Clinician Views on Risk Prediction for Chemotherapy-Induced Peripheral Neuropathy.","authors":"Katherine J Holzer, Simon Haroutounian, Lesley A Colvin, Karen A Frey, Justin J Stout, Joanna Abraham","doi":"10.1080/15360288.2025.2571532","DOIUrl":"https://doi.org/10.1080/15360288.2025.2571532","url":null,"abstract":"Chemotherapy-induced peripheral neuropathy (CIPN) is a common, often debilitating side effect of oxaliplatin, a standard treatment for colorectal cancer. CIPN can cause pain, functional impairment, and cold hypersensitivity, frequently leading to treatment modifications that impact both quality of life and clinical outcomes. Although risk factors are known, no validated tools exist to predict an individual's CIPN risk, limiting opportunities for proactive management. This study explored patient and clinician perspectives on CIPN risk, its effects on treatment and daily life, and the potential value of risk prediction. Semi-structured interviews were conducted with six patients with colorectal cancer treated with oxaliplatin and six clinicians (four oncologists, two nurse practitioners) from an academic hospital. Thematic analysis identified shared concerns and needs related to CIPN. Clinicians consistently described neuropathy as oxaliplatin's most concerning side effect and reported that it often necessitated dose modifications. Patients reported sensory disturbances, functional limitations, and significant lifestyle disruption. Both groups expressed strong interest in tools to predict CIPN risk, with clinicians emphasizing the importance of clinically actionable, accurate, and workflow-integrated approaches. Findings highlight the potential of CIPN risk prediction to improve care and support treatment decisions, while demonstrating the need for strategies that balance efficacy with quality-of-life considerations.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145313195","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Establishing a Health System Policy for Proportionate Palliative Sedation. 建立比例缓和镇静的卫生系统政策。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-10-03 DOI: 10.1080/15360288.2025.2564538

Alec Rutherford, Trinh Bui, Jaya Gupta, Alex Choi, Leah Tenenbaum, Benjamin Tolchin, Laura Morrison, Karen Jubanyik, Richard Gelb, Allison Pinney, L Scott Sussman, Rohit B Sangal, Elizabeth Prsic

{"title":"Establishing a Health System Policy for Proportionate Palliative Sedation.","authors":"Alec Rutherford, Trinh Bui, Jaya Gupta, Alex Choi, Leah Tenenbaum, Benjamin Tolchin, Laura Morrison, Karen Jubanyik, Richard Gelb, Allison Pinney, L Scott Sussman, Rohit B Sangal, Elizabeth Prsic","doi":"10.1080/15360288.2025.2564538","DOIUrl":"https://doi.org/10.1080/15360288.2025.2564538","url":null,"abstract":"Proportionate palliative sedation (PPS) is an important therapeutic option for patients at the end of life who experience intractable suffering despite use of all conventional interventions. Clinical guidelines for PPS differ between institutions, often tailored to local practice patterns and the regulatory environment. While professional organizations encourage institutions to develop tailored PPS guidelines, the literature lacks robust discussion of the development process. In this article, we present two cases from Yale New Haven Hospital, and explore the associated practical and ethical challenges, in the absence of clear institutional guidelines. We then describe the policy development process that followed these cases and discuss how defined PPS guidelines not only ensure patient comfort and autonomy but also mitigate decisional fatigue and moral distress among clinicians. As further guidance, we offer an ethical analysis and our own institution's PPS policy. We encourage other institutions that are similarly committed to patient-centered care and the moral support of clinicians and caregivers to develop PPS guidelines.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2025-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145225143","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

The Risk of Chronic Opioid Utilization with Tramadol: A Narrative Review of the Literature. 曲马多慢性阿片类药物使用的风险：文献综述。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-10-01 DOI: 10.1080/15360288.2025.2562033

Eric P Borrelli

{"title":"The Risk of Chronic Opioid Utilization with Tramadol: A Narrative Review of the Literature.","authors":"Eric P Borrelli","doi":"10.1080/15360288.2025.2562033","DOIUrl":"https://doi.org/10.1080/15360288.2025.2562033","url":null,"abstract":"Tramadol is a prescription opioid analgesic which was first approved in the U.S. in 1995. Tramadol was not a controlled substance on the federal level until August 2014 when it was classified as a Schedule-IV controlled substance. Even with it becoming a controlled substance, its utilization increased in the following years and is the second most prescribed opioid in the U.S. behind hydrocodone products. Recent research highlights tramadol's potential for psychological or physical dependence. Therefore, the objective of this article was to review all studies assessing the impact of tramadol on chronic opioid utilization and/or opioid misuse compared to other therapies. Ten published studies showed tramadol had comparable or higher risk of chronic opioid utilization and/or opioid misuse compared to other opioids, while six studies showed tramadol had a significantly lower risk. This article intends to review these findings, providing rationale and potential policy implications. While there may be some residual confounding, confounding by indication, or unmeasured biases contributing to the results seen showing higher risks, it is still concerning given the number of studies that demonstrated these findings.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-13"},"PeriodicalIF":1.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199438","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Administration of Intrathecal Ketamine in the Treatment of Refractory Cancer Pain: A Case Series. 鞘内氯胺酮治疗难治性癌性疼痛：一个病例系列。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-09-26 DOI: 10.1080/15360288.2025.2564697

Laura Hanssen Textor, William S Rosenberg

{"title":"Administration of Intrathecal Ketamine in the Treatment of Refractory Cancer Pain: A Case Series.","authors":"Laura Hanssen Textor, William S Rosenberg","doi":"10.1080/15360288.2025.2564697","DOIUrl":"https://doi.org/10.1080/15360288.2025.2564697","url":null,"abstract":"Objectives: Intrathecal opioids may not be effective for severe refractory pain associated with cancer. Intrathecal ketamine may be effective in reducing pain in these cases, however, there is legitimate concern regarding ketamine neurotoxicity. We present our experience using intrathecal ketamine in 17 consecutive patients in one clinic, as well as, a case report of one patient who received intrathecal ketamine for 36 wk.Materials and methods: A retrospective case review included all patients treated with intrathecal ketamine at one center. The primary outcome was dosing required to change pain intensity and signs of neurotoxicity.Results: Seventeen patients received intrathecal ketamine, data was available on 11. Mean ketamine concentration was 794 mcg/ml. Mean basal dose was 341 mcg/day. All 11 experienced pain reduction. One experienced auditory hallucinations.Conclusion: This study provides more data supporting the safety and efficacy of intrathecal ketamine in this population. While neurotoxicity is a concern, our experience has been positive.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-6"},"PeriodicalIF":1.0,"publicationDate":"2025-09-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176156","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Characteristics and Economic Outcomes of Treated and Untreated Patients Diagnosed with Opioid Use Disorder. 经治疗和未治疗的阿片类药物使用障碍患者的特征和经济结果

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-09-25 DOI: 10.1080/15360288.2025.2558745

Howard Weston Schmutz, Connor Willis, Emeka Elvis Duru, Cathy Guo, Fulton Velez, Diana Brixner

{"title":"Characteristics and Economic Outcomes of Treated and Untreated Patients Diagnosed with Opioid Use Disorder.","authors":"Howard Weston Schmutz, Connor Willis, Emeka Elvis Duru, Cathy Guo, Fulton Velez, Diana Brixner","doi":"10.1080/15360288.2025.2558745","DOIUrl":"https://doi.org/10.1080/15360288.2025.2558745","url":null,"abstract":"Opioid Use Disorder (OUD) imposes significant burdens on healthcare systems, leading to increased costs and utilization. Limited real-world data exist on the healthcare resource use, charges, and impact of medications for OUD (MOUD). This study aimed to characterize healthcare use and costs in treated and untreated OUD patients. Adult patients diagnosed with OUD from January 2017, until April 2022, with at least 1 year of follow-up within the University of Utah Healthcare System (UHealth) were included. Patients were identified using ICD codes and data was extracted from electronic health record data system. Of 6,059 OUD patients, 3,474 (57%) received MOUD. Treated patients were younger (median age: 38.7 vs. 50.9 years), more often male (53% vs. 46%), and insured by Medicaid (40%). MOUD initiation was highest in emergency medicine (32%) and psychiatry (25%). Adjusted all-cause charges were similar for treated and untreated patients ($11,192.23 vs. $14,744.20, p = 0.964). Treated mothers had lower rates of spontaneous abortions/miscarriages (6% vs. 16%, p < 0.0005). The initiation of MOUD is influenced by demographic and clinical factors. While treatment with MOUD did not significantly impact all-cause healthcare charges, improvement in clinic outcomes such as improved maternal and newborn health outcomes were observed.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-12"},"PeriodicalIF":1.0,"publicationDate":"2025-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145137963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Safety and Efficacy of Dexmedetomidine in Spinal Fusion: A Systematic Review and Meta-Analysis Dexmedetomidine in Spinal Fusion Surgery. 右美托咪定在脊柱融合术中的安全性和有效性：一项系统评价和荟萃分析。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-09-08 DOI: 10.1080/15360288.2025.2548903

María Jesús Rodríguez, Alfonso Vázquez, Víctor Rodriguez-Domínguez, Pedro Ramon Mata, Gonzalo Mariscal

{"title":"Safety and Efficacy of Dexmedetomidine in Spinal Fusion: A Systematic Review and Meta-Analysis Dexmedetomidine in Spinal Fusion Surgery.","authors":"María Jesús Rodríguez, Alfonso Vázquez, Víctor Rodriguez-Domínguez, Pedro Ramon Mata, Gonzalo Mariscal","doi":"10.1080/15360288.2025.2548903","DOIUrl":"https://doi.org/10.1080/15360288.2025.2548903","url":null,"abstract":"Dexmedetomidine (DEX) has been proposed as an opioid-sparing adjunct after spinal fusion, but its efficacy across age groups is unclear. We conducted a systematic review and meta-analysis following PRISMA and registered in International Prospective Register of Systematic Reviews (PROSPERO) (CRD42024531252). Twelve studies (RCTs and cohorts; n=1,644) were included. Outcomes were postoperative pain (VAS), opioid consumption, and adverse events. DEX significantly reduced postoperative nausea and vomiting (OR 0.55; 95% CI 0.39-0.77) and respiratory adverse events (OR 0.13; 95% CI 0.04-0.39). Among adults, effects on VAS and opioid consumption were not significant; pediatric cohorts showed a trend toward lower morphine use. Certainty of evidence was appraised with GRADE; risk of bias with RoB 2.0 and MINORS. Heterogeneity for opioid-related outcomes was high (I²=96%). In summary, DEX appears to be a safe adjunct for postoperative analgesia after spinal fusion, with clearer benefits on adverse-effect profiles and potential opioid-sparing effects in pediatric patients. Its impact on adult pain and opioid outcomes is limited. Further adequately powered trials should clarify optimal dosing, timing, and administration routes and explore age-specific effects.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"1-18"},"PeriodicalIF":1.0,"publicationDate":"2025-09-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145015647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Patient-Reported Paresthesia After Administration of Suzetrigine: A Case Report. 患者报告服用舒三嗪后感觉异常：1例报告。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-09-04 DOI: 10.1080/15360288.2025.2555215

Daniel Adams, Mary Bailey

引用次数: 0

A Stepwise Approach to Transitioning from Methadone to Buprenorphine for Cancer-Related Pain in an Outpatient Setting: A Novel Opioid Rotation Without Clinically Evident Withdrawal Symptoms. 逐步从美沙酮过渡到丁丙诺啡治疗门诊癌症相关疼痛：一种无临床明显戒断症状的新型阿片类药物轮换。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-09-03 DOI: 10.1080/15360288.2025.2555214

Sushma Shivananda, Pushpa V H, Tayyaba Irshad

引用次数: 0

Intravenous Ketamine Infusion for Managing Chronic Postoperative Pain After Inguinal Herniorrhaphy: A Case Report. 氯胺酮静脉输注治疗腹股沟疝修补术后慢性疼痛1例报告。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-09-01 Epub Date: 2025-04-30 DOI: 10.1080/15360288.2025.2496522

André Luis Vieira Drumond, Lucas Nunes Bandeira de Melo, Marina Ayres Delgado

{"title":"Intravenous Ketamine Infusion for Managing Chronic Postoperative Pain After Inguinal Herniorrhaphy: A Case Report.","authors":"André Luis Vieira Drumond, Lucas Nunes Bandeira de Melo, Marina Ayres Delgado","doi":"10.1080/15360288.2025.2496522","DOIUrl":"10.1080/15360288.2025.2496522","url":null,"abstract":"Chronic postsurgical pain (CPSP) is a debilitating condition that affects up to 50% of patients after procedures like inguinal herniorrhaphy, significantly impairing quality of life. This case report describes a 63-year-old male who experienced refractory CPSP for 5 years following inguinal hernia repair. The patient reported persistent pain despite multiple pharmacological treatments, including amitriptyline, gabapentin, and codeine, as well as nerve blocks and nonpharmacological interventions like acupuncture. Periodic intravenous ketamine infusions (30 mg every 30 days) were introduced, resulting in substantial pain relief, improved mobility, and enhanced functionality. Ketamine, a noncompetitive NMDA receptor antagonist, has shown promise in modulating central sensitization in chronic pain, with minimal adverse effects at low doses. This case aligns with the 2018 consensus guidelines on ketamine use in chronic pain and contributes to the growing body of evidence supporting its efficacy in CPSP management. While this therapy demonstrated remarkable clinical benefits, further research is essential to establish optimal protocols and long-term outcomes for ketamine use in chronic postoperative pain.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"403-407"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Comparison of Effectivity and Safety of Olanzapine and Mirtazapine on Cancer-Associated Anorexia and Cachexia in Advanced Oral Cavity Cancer Patients: Prospective, Comparative, Interventional Study. 奥氮平和米氮平治疗晚期口腔癌患者癌症相关性厌食症和恶病质的有效性和安全性比较：前瞻性、对比性、介入性研究。

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Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2025-09-01 Epub Date: 2025-05-01 DOI: 10.1080/15360288.2025.2492801

Yogendra Singhal, Surendra Kumar Pingoliya, Pavan Gaurav R, Sreeharsh Saji, Amit Sharma

{"title":"Comparison of Effectivity and Safety of Olanzapine and Mirtazapine on Cancer-Associated Anorexia and Cachexia in Advanced Oral Cavity Cancer Patients: Prospective, Comparative, Interventional Study.","authors":"Yogendra Singhal, Surendra Kumar Pingoliya, Pavan Gaurav R, Sreeharsh Saji, Amit Sharma","doi":"10.1080/15360288.2025.2492801","DOIUrl":"10.1080/15360288.2025.2492801","url":null,"abstract":"Cancer-associated cachexia-anorexia syndrome (CACS) significantly affects patients' quality of life, leading to weight loss, muscle wasting, and reduced treatment response. This prospective study aimed to evaluate effectiveness of olanzapine versus mirtazapine in managing CACS. Primary objective was to assess their impact on body weight and appetite, while the secondary objective focused on psychological distress and sleep. A total of 152 patients were randomly allocated into two groups of 76 patients each. Group O received Tablet Olanzapine 5 mg/day orally; Group M received Tablet Mirtazapine 15 mg/day orally at bed time. All patients were assessed by using Simplified Nutritional Appetite Questionnaire (SNAQ) score and weight at time of first visit then follow-up visit at 2nd and 4th weeks. At 2nd week, the mean change in SNAQ score was 3.14 in Group M compared to 2.04 in Group O (p = 0.035). By the 4th week, it was 3.86 in Group M and 2.87 in Group O (p = 0.006). Weight changes increased from 45.57 to 46.81 kg in Group M and from 45.97 to 46.90 kg in Group O by 4th week (p ≥ 0.5). Both mirtazapine and olanzapine significantly increased appetite without notable weight gain. Mirtazapine showed stronger effects on appetite, sleep, anxiety, and depression.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"432-441"},"PeriodicalIF":1.0,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025853","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0