Journal of Pain & Palliative Care Pharmacotherapy最新文献_第10页

In-Patient Medication Order Trends of Methadone and Buprenorphine for Chronic Pain and Opioid Use Disorder: A Multi-Center 10-Year Analysis Between 2014 and 2023. 美沙酮和丁丙诺啡治疗慢性疼痛和阿片类药物使用障碍的住院用药趋势：2014 - 2023年多中心10年分析

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub Date: 2025-11-23 DOI: 10.1080/15360288.2025.2588358

Zaid Yousif, Merna A Shammami, Rabia S Atayee

{"title":"In-Patient Medication Order Trends of Methadone and Buprenorphine for Chronic Pain and Opioid Use Disorder: A Multi-Center 10-Year Analysis Between 2014 and 2023.","authors":"Zaid Yousif, Merna A Shammami, Rabia S Atayee","doi":"10.1080/15360288.2025.2588358","DOIUrl":"10.1080/15360288.2025.2588358","url":null,"abstract":"Methadone and buprenorphine are commonly utilized to manage chronic pain and opioid use disorder (OUD), yet data on their prescribing trends remain limited. This multi-center retrospective study examines the use of methadone and buprenorphine in-patient medication orders across three University of California health systems over a 10-year period between the beginning of 2014 and the end of 2023. The analysis included 3,754 hospitalized patients with OUD and 4,990 hospitalized patients with chronic pain. Our study findings suggest that methadone may have been the primary treatment for chronic pain and OUD over the time frame, but buprenorphine use considerably increased over the latter portion of the decade for OUD, especially among younger patients and those with psychiatric comorbidities, reflecting national efforts to expand access. Laboratory findings may highlight the prevalence of comorbidities, particularly among methadone-treated patients. Methadone in-patient medication orders were estimated to have higher morphine equivalent daily doses (MEDDs) compared to buprenorphine. The decline in MEDDs and opioid prescribing for chronic pain over the study period align with broader public health initiatives aimed at reducing opioid-related harm and using non-opioid alternatives for analgesia. Prospective studies are needed to confirm the trends identified in this study.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"44-53"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145587795","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。

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub 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":"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, available upon request. 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":"145-153"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","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 Final Review. 最后的审查。

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub Date: 2025-11-25 DOI: 10.1080/15360288.2025.2586209

Zhaohui Su

引用次数: 0

Evidence Supporting Alternative Parenteral Routes of Opioid Administration for Pain Management in Sickle Cell Disease: A Comprehensive Review. 支持阿片类药物外注射替代途径治疗镰状细胞病疼痛的证据：一项综合综述

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub Date: 2025-10-18 DOI: 10.1080/15360288.2025.2574471

Nkem P Nonyel, Victoria Hannahoe, Earnestradj Porselvame

{"title":"Evidence Supporting Alternative Parenteral Routes of Opioid Administration for Pain Management in Sickle Cell Disease: A Comprehensive Review.","authors":"Nkem P Nonyel, Victoria Hannahoe, Earnestradj Porselvame","doi":"10.1080/15360288.2025.2574471","DOIUrl":"10.1080/15360288.2025.2574471","url":null,"abstract":"Sickle cell disease (SCD) is an autosomal, recessive, genetic disorder that affects the structure and function of the hemoglobin. Pain is the hallmark of SCD, and opioids and nonsteroidal anti-inflammatory drugs are the mainstay of SCD pain control during vaso-occlusive crisis (VOC). Intravenous (IV) access is mostly used for opioid administration in emergency departments. Most people with SCD often need frequent venipuncture for IV access for medications, fluids, and transfusions. The frequent venipuncture sometimes damages their veins, making it difficult to establish or maintain IV access for therapies during VOC, prompting the need for alternative parenteral routes of opioid administration for pain management. This article aims to summarize existing evidence on alternative routes of opioid administration to provide support for their use in acute SCD-related pain. Literature search for human studies was conducted through Pubmed, Ovid, ProQuest, EBSCOHost, Scopus, National Institute of Medicine, Google Scholar, and governmental agency websites. Systematic reviews, randomized control trials, cohort studies, and clinical guidelines published in English between 1984 to 2025 were included. Future clinical research should be conducted on the safety and effectiveness of using alternative routes of opioid administration in individuals with SCD.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"100-111"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145318340","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

Evaluation of Flexible Buprenorphine Dosing in Patients with Chronic Pain. 丁丙诺啡在慢性疼痛患者中灵活给药的评价。

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub Date: 2025-12-13 DOI: 10.1080/15360288.2025.2598012

Sarah Setoudeh, Rebecca Hoss, Aletha Loeb, Christian James Squires, Alicia Agnoli, Mariya Kotova

{"title":"Evaluation of Flexible Buprenorphine Dosing in Patients with Chronic Pain.","authors":"Sarah Setoudeh, Rebecca Hoss, Aletha Loeb, Christian James Squires, Alicia Agnoli, Mariya Kotova","doi":"10.1080/15360288.2025.2598012","DOIUrl":"10.1080/15360288.2025.2598012","url":null,"abstract":"Buprenorphine is a mixed agonist-antagonist, safer for long-term use compared to full agonist opioids. There is no literature to describe utilization of flexible buprenorphine dosing regimens in the chronic pain population. This was a retrospective single center, observational study. Inclusion criteria were age 18 and older, diagnosis of chronic pain, and prescribed buprenorphine. Patients with a diagnosis of opioid use disorder (OUD) were excluded. Buprenorphine regimens analyzed included: scheduled buprenorphine, scheduled plus as needed (PRN) buprenorphine, PRN buprenorphine alone, and scheduled buprenorphine plus PRN full µ-opioid agonist. The primary outcome was the percent of patients on each buprenorphine regimen. The secondary outcome was duration of buprenorphine therapy. Overall, 691 patients were reviewed, with 401 meeting inclusion criteria. Scheduled buprenorphine was prescribed to 340 patients (84.4%), while 37 patients (9.2%) were prescribed scheduled plus PRN buprenorphine. Patients exposed to flexible dosing remained on treatment longer than those on scheduled buprenorphine alone (HR 3.50, CI 2.07-5.92, NNT 9.0). Flexible buprenorphine dosing was utilized for chronic pain. Patients on scheduled plus PRN buprenorphine were on treatment longer than those on scheduled buprenorphine alone. Scheduled plus PRN buprenorphine can be considered for patients with chronic pain.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"72-78"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145751839","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 Journey Toward Effective Pain Management: Tackling the Healthcare Providers Related Barriers. 通往有效疼痛管理的旅程：解决医疗保健提供者相关的障碍。

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub Date: 2025-12-11 DOI: 10.1080/15360288.2025.2599367

Doreen Kher Lee Kiu, Kian Yee Yap, Teck Long King, Pei Jye Voon

{"title":"The Journey Toward Effective Pain Management: Tackling the Healthcare Providers Related Barriers.","authors":"Doreen Kher Lee Kiu, Kian Yee Yap, Teck Long King, Pei Jye Voon","doi":"10.1080/15360288.2025.2599367","DOIUrl":"10.1080/15360288.2025.2599367","url":null,"abstract":"Cancer pain is one of the most frequent and distressing symptoms experienced by patients and remains commonly undertreated. Understanding healthcare provider-related barriers is essential to improving pain management practices. A cross-sectional survey was conducted among healthcare providers in Hospital Umum Sarawak using the Knowledge and Attitudes Survey Regarding Pain (KASRP) questionnaire to assess knowledge and attitudes toward pain management. A total of 136 healthcare providers participated, with an overall mean KASRP score of 60.26%. Doctors achieved the highest mean score (67.69%), followed by pharmacists (62.56%) and nurses (47.69%), with statistically significant interprofessional differences. As a minimum score of 80% is considered adequate, the findings indicate substantial gaps in knowledge and attitude across all groups. Variability in pain management education within professional curricula may explain these differences. Although education and training programs were associated with improved knowledge, their effectiveness varied, highlighting the need for regular, high-quality, and targeted training. Adequate knowledge alone does not ensure high-quality pain management, as inadequate pain assessment remains a persistent barrier. Regular audits, continuous education, and tailored training initiatives are crucial to overcome healthcare provider-related barriers and enhance the quality of cancer pain management.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"162-170"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743071","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

Phenobarbital for Refractory Behavioral Disturbances in Anti-NMDAR and HSV Encephalitis: A Case Report. 苯巴比妥治疗抗nmdar和HSV脑炎难治性行为障碍1例报告。

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub Date: 2025-12-01 DOI: 10.1080/15360288.2025.2594474

Lorin J Fisher, Bryan Struck, James B Ray

{"title":"Phenobarbital for Refractory Behavioral Disturbances in Anti-NMDAR and HSV Encephalitis: A Case Report.","authors":"Lorin J Fisher, Bryan Struck, James B Ray","doi":"10.1080/15360288.2025.2594474","DOIUrl":"10.1080/15360288.2025.2594474","url":null,"abstract":"Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune-mediated disorder with neuropsychiatric manifestations, frequently following herpes simplex virus (HSV) encephalitis. The management of associated behavioral disturbances is challenging, complicated by poor response and tolerability to antipsychotics. This case report describes the use of oral phenobarbital for refractory behavioral disturbances in a patient with concurrent anti-NMDA and HSV encephalitis. A 65-year-old female with a two-year history of anti-NMDAR and HSV encephalitis presented with severe behavioral disturbances, including paranoia, insomnia, hypersexuality, compulsive behaviors, and aggression. Disease-modifying therapies, including IV acyclovir, IV immunoglobulin, prednisone, and rituximab, were ineffective. Multiple psychotropic medications, including fluoxetine, quetiapine, olanzapine, and trazodone, failed to relieve behavioral symptoms. Given previous ineffective pharmacotherapies, oral phenobarbital was initiated at 30 mg every 12 hours and later titrated to 60 mg every 12 hours. Four weeks after phenobarbital dose escalation, behavioral improvements were observed, with reductions in obsessive behaviors, elopement, and insomnia. After 20 weeks of phenobarbital therapy, notable improvements in agitation, redirection, and verbal aggression were documented. No adverse effects were reported. This case suggests that low-dose oral phenobarbital may be a viable option for managing refractory behavioral disturbances in patients and improving quality of life with anti-NMDAR and HSV encephalitis.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"128-134"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145654250","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

Effect of Long-Term Opioid Therapy on Sexual Dysfunction in Pain Patients. 长期阿片类药物治疗对疼痛患者性功能障碍的影响。

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub Date: 2025-12-11 DOI: 10.1080/15360288.2025.2599362

Morgan Streett, Michael Chandler, Lisa Luciani, Anne Cetto, Jennifer Kathol, Jacob Painter

{"title":"Effect of Long-Term Opioid Therapy on Sexual Dysfunction in Pain Patients.","authors":"Morgan Streett, Michael Chandler, Lisa Luciani, Anne Cetto, Jennifer Kathol, Jacob Painter","doi":"10.1080/15360288.2025.2599362","DOIUrl":"10.1080/15360288.2025.2599362","url":null,"abstract":"This single-center, retrospective chart review aims to estimate the incidence of opioid-induced hypogonadism (OIH) among chronic pain patients treated with long-term opioid therapy and determine whether the incidence differs between patients receiving buprenorphine versus those receiving full-agonist opioid agents. The primary endpoint was a composite of plasma testosterone less than 300 ng/dL, initiation of medications for testosterone replacement therapy or erectile dysfunction (ED), or a new diagnosis of ED or hypogonadism. Adult male Veterans were included if they received at least 90 d' supply of an opioid during the study period with a preceding 90-d opioid-free interval. Forty-five patients were included in the buprenorphine group and 55 in the full-agonist opioid group. There was no significant difference between groups in baseline characteristics. Fewer patients in the buprenorphine group met the primary composite endpoint as compared to the full-agonist opioid group (13.3% vs. 29.1%, p = 0.058), and patients in the buprenorphine group had fewer diagnoses of ED or hypogonadism post-treatment initiation (0% vs. 12.7%, p = 0.013). These findings support the use of buprenorphine as a treatment option when endocrine-related side effects are a concern.","PeriodicalId":16645,"journal":{"name":"Journal of Pain & Palliative Care Pharmacotherapy","volume":" ","pages":"79-86"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145743106","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

Innovation Versus Consolidation: Critical Reflections on Suzetrigine and the Tramadol-Celecoxib Co-Crystal. 创新与整合：对苏泽三嗪和曲马多-塞来昔布共晶的批判性反思。

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub Date: 2025-12-12 DOI: 10.1080/15360288.2025.2600077

A Alcántara Montero

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。

IF 1

Journal of Pain & Palliative Care Pharmacotherapy Pub Date : 2026-03-01 Epub 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":"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":"87-99"},"PeriodicalIF":1.0,"publicationDate":"2026-03-01","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