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Cancer Pain Opioid

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2. [Intrathecal opioid infusion pump for chronic cancer and non-cancer pain]

[Intrathecal opioid infusion pump for chronic cancer and non-cancer pain] [Intrathecal opioid infusion pump for chronic cancer and non-cancer pain] [Intrathecal opioid infusion pump for chronic cancer and non-cancer pain] Rey-Ares L, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A, López A Record Status This is a bibliographic record of a published health technology assessment from a member of INAHTA. No evaluation of the quality of this assessment has been (...) made for the HTA database. Citation Rey-Ares L, Bardach A, Pichon-Riviere A, Augustovski F, García Martí S, Alcaraz A, Ciapponi A, López A. [Intrathecal opioid infusion pump for chronic cancer and non-cancer pain] Buenos Aires: Institute for Clinical Effectiveness and Health Policy (IECS). Documentos de Evaluación de Tecnologías Sanitarias, Informe de Respuesta Rapida No 514. 2017 Authors' conclusions Scarce evidence of moderate methodological quality suggests that the use of intrathecal opioids

2017 Health Technology Assessment (HTA) Database.

3. Opioids for cancer-related pain in children and adolescents. (PubMed)

Opioids for cancer-related pain in children and adolescents. Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization (WHO) guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. Views on children's pain have changed over time and relief of pain is now seen as important (...) . In the past, pain was largely dismissed and was frequently left untreated, and it was assumed that children quickly forgot about painful experiences.We designed a suite of seven reviews in chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol) to review the evidence for children's pain using pharmacological interventions.As one of the leading causes of mortality and morbidity for children and adolescents

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2017 Cochrane

4. Interventions for the reduction of prescribed opioid use in chronic non-cancer pain. (PubMed)

Interventions for the reduction of prescribed opioid use in chronic non-cancer pain. This is the first update of the original Cochrane Review published in 2013. The conclusions of this review have not changed from the 2013 publication. People with chronic non-cancer pain who are prescribed and are taking opioids can have a history of long-term, high-dose opioid use without effective pain relief. In those without good pain relief, reduction of prescribed opioid dose may be the desired and shared (...) goal of both patient and clinician. Simple, unsupervised reduction of opioid use is clinically challenging, and very difficult to achieve and maintain.To investigate the effectiveness of different methods designed to achieve reduction or cessation of prescribed opioid use for the management of chronic non-cancer pain in adults compared to controls.For this update we searched CENTRAL, MEDLINE, and Embase in January 2017, as well as bibliographies and citation searches of included studies. We also

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2017 Cochrane

5. High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews. (PubMed)

High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews. Chronic pain is typically described as pain on most days for at least three months. Chronic non-cancer pain (CNCP) is any chronic pain that is not due to a malignancy. Chronic non-cancer pain in adults is a common and complex clinical issue where opioids are routinely used for pain management. There are concerns that the use of high doses of opioids for chronic non-cancer pain lacks evidence of effectiveness and may (...) data on any opioid agent used at high dose for two weeks or more for the treatment of chronic non-cancer pain in adults.We did not identify any reviews or overviews meeting the inclusion criteria. The excluded reviews largely reflected low doses or titrated doses where all doses were analysed as a single group; no data for high dose only could be extracted.There is a critical lack of high-quality evidence regarding how well high-dose opioids work for the management of chronic non-cancer pain

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2017 Cochrane

6. Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews. (PubMed)

Adverse events associated with medium- and long-term use of opioids for chronic non-cancer pain: an overview of Cochrane Reviews. Chronic pain is common and can be challenging to manage. Despite increased utilisation of opioids, the safety and efficacy of long-term use of these compounds for chronic non-cancer pain (CNCP) remains controversial. This overview of Cochrane Reviews complements the overview entitled 'High-dose opioids for chronic non-cancer pain: an overview of Cochrane Reviews (...) '.To provide an overview of the occurrence and nature of adverse events associated with any opioid agent (any dose, frequency, or route of administration) used on a medium- or long-term basis for the treatment of CNCP in adults.We searched the Cochrane Database of Systematic Reviews (the Cochrane Library) Issue 3, 2017 on 8 March 2017 to identify all Cochrane Reviews of studies of medium- or long-term opioid use (2 weeks or more) for CNCP in adults aged 18 and over. We assessed the quality of the reviews

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2017 Cochrane

7. Opioids for cancer pain - an overview of Cochrane reviews. (PubMed)

Opioids for cancer pain - an overview of Cochrane reviews. Pain is a common symptom with cancer, and 30% to 50% of all people with cancer will experience moderate to severe pain that can have a major negative impact on their quality of life. Opioid (morphine-like) drugs are commonly used to treat moderate or severe cancer pain, and are recommended for this purpose in the World Health Organization (WHO) pain treatment ladder. The most commonly-used opioid drugs are buprenorphine, codeine (...) , fentanyl, hydrocodone, hydromorphone, methadone, morphine, oxycodone, tramadol, and tapentadol.To provide an overview of the analgesic efficacy of opioids in cancer pain, and to report on adverse events associated with their use.We identified systematic reviews examining any opioid for cancer pain published to 4 May 2017 in the Cochrane Database of Systematic Reviews in the Cochrane Library. The primary outcomes were no or mild pain within 14 days of starting treatment, withdrawals due to adverse

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2017 Cochrane

8. Ketamine as an adjuvant to opioids for cancer pain. (PubMed)

Ketamine as an adjuvant to opioids for cancer pain. This is an update of a review first published in 2003 and updated in 2012.Ketamine is a commonly used anaesthetic agent, and in subanaesthetic doses is also given as an adjuvant to opioids for the treatment of refractory cancer pain, when opioids alone or in combination with appropriate adjuvant analgesics prove to be ineffective. Ketamine is known to have psychomimetic (including hallucinogenic), urological, and hepatic adverse effects.To (...) determine the effectiveness and adverse effects of ketamine as an adjuvant to opioids for refractory cancer pain in adults.For this update, we searched MEDLINE (OVID) to December 2016. We searched CENTRAL (CRSO), Embase (OVID) and two clinical trial registries to January 2017.The intervention considered by this review was the addition of ketamine, given by any route of administration, in any dose, to pre-existing opioid treatment given by any route and in any dose, compared with placebo or active

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2017 Cochrane

9. Opioids for chronic non-cancer pain in children and adolescents. (PubMed)

Opioids for chronic non-cancer pain in children and adolescents. Pain is a common feature of childhood and adolescence around the world, and for many young people, that pain is chronic. The World Health Organization guidelines for pharmacological treatments for children's persisting pain acknowledge that pain in children is a major public health concern of high significance in most parts of the world. While in the past, pain was largely dismissed and was frequently left untreated, views (...) on children's pain have changed over time, and relief of pain is now seen as importantWe designed a suite of seven reviews on chronic non-cancer pain and cancer pain (looking at antidepressants, antiepileptic drugs, non-steroidal anti-inflammatory drugs, opioids, and paracetamol as priority areas) in order to review the evidence for children's pain utilising pharmacological interventions in children and adolescents.As the leading cause of morbidity in children and adolescents in the world today, chronic

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2017 Cochrane

10. Chronic Opioid Therapy for Chronic Non-Cancer Pain

Chronic Opioid Therapy for Chronic Non-Cancer Pain ? 2010 Kaiser Foundation Health Plan of Washington. All rights reserved. 1 Patients on Chronic Opioid Therapy for Chronic Non-Cancer Pain Safety Guideline Major Changes as of September 2016 2 Guideline Scope 2 Preventing Conversion from Acute to Chronic Opioid Therapy 3 Washington State Law 4 Expectations for Kaiser Foundation Health Plan of Washington Providers 4 Managing Chronic Opioid Therapy (COT) 5 Contraindications to opioid therapy 5 (...) medication for all patients taking = 40 mg MED and their families is now recommended. • It is now recommended that COT patients be screened for opioid use disorder using the Substance Use Disorder Checklist. • Principles to prevent conversion from acute to chronic opioid therapy have been added, with links to an external guideline. This guideline is in compliance with the State of Washington regulations WAC 296-919-850–863 on the use of opioids in the treatment of patients with chronic non-cancer pain

2016 Kaiser Permanente Clinical Guidelines

11. What processes decrease the risk of opioid toxicity following interventional procedures for uncontrolled pain in palliative care or cancer patients?

What processes decrease the risk of opioid toxicity following interventional procedures for uncontrolled pain in palliative care or cancer patients? Review Methods Search Strategy: A systematic search was conducted across a wide-ranging set of data- bases: Ovid Medline, including In-Process & Other Non-Indexed Citations, Ovid Embase, Ebsco CINAHL and Cochrane Library. The preliminary search strategy was devel- oped on Ovid Medline using both text words and Medical subject headings from January (...) reviews were checked for any relevant studies. The search- es generated 288 citations after removing duplicates and irrelevant records. Figure 1 represents the flow of information through the different phases of the review. Inclusion: Studies reporting Palliative care or cancer patients on opioid analgesics who have been referred and had interventional procedures as an adjunct to pain manage- ment. Studies published in English from 2006 to current. Exclusion: Studies set in a non-Organization

2017 Palliative Care Evidence Review Service (PaCERS)

12. Mu-opioid antagonists for opioid-induced bowel dysfunction in people with cancer and people receiving palliative care. (PubMed)

Mu-opioid antagonists for opioid-induced bowel dysfunction in people with cancer and people receiving palliative care. Opioid-induced bowel dysfunction (OIBD) is characterised by constipation, incomplete evacuation, bloating, and gastric reflux. It is one of the major adverse events of treatment for pain in cancer and in palliative care, resulting in increased morbidity and reduced quality of life.This is an update of two Cochrane reviews. One was published in 2011, Issue 1 on laxatives (...) and methylnaltrexone for the management of constipation in people receiving palliative care; this was updated in 2015 and excluded methylnaltrexone. The other was published in 2008, Issue 4 on mu-opioid antagonists (MOA) for OIBD. In this updated review, we only included trials on MOA (including methylnaltrexone) for OIBD in people with cancer and people receiving palliative care.To assess the effectiveness and safety of MOA for OIBD in people with cancer and people receiving palliative care.We searched

2018 Cochrane

13. Is as needed opioid usage superior to around the clock (ATC) opioid usage for cancer pain?

Is as needed opioid usage superior to around the clock (ATC) opioid usage for cancer pain? Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability for the content of this registration record, any associated files or external websites

2019 PROSPERO

14. A systematic review of the prevalence of prescription opioid dependence in patients with chronic non-cancer pain (CNCP) receiving treatment with opioid painkillers

A systematic review of the prevalence of prescription opioid dependence in patients with chronic non-cancer pain (CNCP) receiving treatment with opioid painkillers Print | PDF PROSPERO This information has been provided by the named contact for this review. CRD has accepted this information in good faith and registered the review in PROSPERO. The registrant confirms that the information supplied for this submission is accurate and complete. CRD bears no responsibility or liability

2019 PROSPERO

15. Pain: Assessment, Non-Opioid Treatment Approaches and Opioid Management

Pain: Assessment, Non-Opioid Treatment Approaches and Opioid Management Pain; Assessment, Non-Opioid Treatment Approaches and Opioid Management | ICSI The MN Health Collaborative includes physicians and other representatives from major healthcare organizations working together to address major health topics affecting Minnesota communities today. ICSI has been developing evidence-based clinical practice guidelines to improve patient care since 1993. ICSI helps forward-focused Minnesota health (...) organizations find ways to redefine and redesign systems and the market. Together, we aim to improve care and reduce costs for our patients, families and communities. e Guidelines Pain; Assessment, Non-Opioid Treatment Approaches and Opioid Management REVISION DATE: AUGUST 2017 / EIGHTH EDITION GUIDELINE SUMMARY This guideline, Pain: Assessment, Non-Opioid Treatment Approaches and Opioid Management guideline, is a combination of ICSI’s Acute Pain Assessment/Opioid Prescribing Protocol and the Assessment

2017 Institute for Clinical Systems Improvement

16. Naldemedine (Rizmoic) - treating constipation caused by opioid pain relief medicines

3 times a week during treatment. Rizmoic EMA/21684/2019 Page 2/2 In two of the studies, involving 1095 patients taking opioids for chronic (long-term) pain caused by a condition other than cancer, 50% of patients taking Rizmoic for 12 weeks achieved the desired outcome, compared with 34% of patients taking placebo. In two other studies, involving 307 patients taking opioids for cancer pain, 74% of patients taking Rizmoic for two weeks achieved the desired outcome compared with 36% of patients (...) in patients with a blocked or perforated bowel or patients at high risk of bowel blockage. For the full list of side effects and restrictions, see the package leaflet. Why is Rizmoic authorised in the EU? Constipation is the most common side effect of opioid pain medicines and many standard laxatives are not effective in treating the condition. Rizmoic has been shown to improve bowel movement in patients taking opioids pain medicines for long-term pain (including cancer pain). Furthermore, the side

2019 European Medicines Agency - EPARs

17. Fentanyl (Actiq and other brands) and other opioids: risk of increased pain

Fentanyl (Actiq and other brands) and other opioids: risk of increased pain Prescrire IN ENGLISH - Spotlight ''Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain'', 1 July 2019 {1} {1} {1} | | > > > Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain Spotlight Every month, the subjects in Prescrire’s Spotlight. 100 most recent :  |   |   |   |   |   |   |   |   |  Spotlight (...) Fentanyl (Actiq° and other brands) and other opioids: risk of increased pain Paradoxically, fentanyl, like other opioids, can exacerbate the pain it is intended to relieve. In 2018, the European Medicines Agency (EMA) reported 16 cases of hyperalgesia (severe pain) in patients taking transmucosal fentanyl. Hyperalgesia is a known adverse effect of opioids. The key symptom is an increase in the intensity of pain felt, an increase associated with the effects of the opioid. It is difficult to distinguish

2019 Prescrire

18. Traditional opioids for chronic non-cancer pain: untidy, unsatisfactory, and probably unsuitable

Traditional opioids for chronic non-cancer pain: untidy, unsatisfactory, and probably unsuitable Traditional opioids for chronic non-cancer pain: untidy, unsatisfactory, and probably unsuitable - Evidently Cochrane Search and hit Go By September 23, 2016 // In this guest blog, Consultant in Pain Medicine Cathy Stannard and pain researcher Andrew Moore discuss some unpalatable truths about traditional opioids for chronic non-cancer pain. What are opioids? There are two main types of opioids (...) . Traditional opioids, which we discuss here, are drugs that work only on opioid receptors in the nervous system; they include morphine, hydromorphone, codeine, hydrocodeine, methadone, oxycodone, fentanyl, and buprenorphine. Some opioids (tramadol, tapentadol) have additional methods of action, and need to be considered separately on another occasion. What is chronic non-cancer pain? If you ignore pain lasting less than three months, and headache, and cancer pain, then what you have left is chronic pain

2016 Evidently Cochrane

19. Are opioids effective in the treatment of chronic low back pain?

Are opioids effective in the treatment of chronic low back pain? Are Opioids Effective in the Treatment of Chronic Low Back Pain? – Clinical Correlations Search Are Opioids Effective in the Treatment of Chronic Low Back Pain? April 17, 2019 4 min read By Anna Hirsch Peer Reviewed The use of opioid medications for chronic low back pain, or for any chronic non-cancer pain complaint, is still a source of controversy in the medical community, with a large divide between the recommendations (...) of professional societies and actual physician prescribing data. In the , 1 the 2 and the 3 have all issued guidelines urging caution with the use of opioids for chronic back pain, specifically emphasizing the poor-to-moderate quality of the evidence demonstrating benefit from this therapeutic modality. All three organizations reinforce that opioids should only be used after failure of other non-opioid and non-pharmacologic treatment options and recommend that if physicians choose to prescribe opioids

2019 Clinical Correlations

20. Cancer pain management and the opioid crisis in America: How to preserve hard-earned gains in improving the quality of cancer pain management. (PubMed)

Cancer pain management and the opioid crisis in America: How to preserve hard-earned gains in improving the quality of cancer pain management. Cancer pain remains a feared consequence of the disease and its treatment. Although prevalent, cancer pain can usually be managed through the skillful application of pharmacologic and nonpharmacologic interventions. Unfortunately, access to these therapies has been hampered by interventions designed to contain another serious public health problem (...) : the opioid misuse epidemic. This epidemic and the unintended consequences of efforts to control this outbreak are leading to significant barriers to the provision of cancer pain relief. Oncologists and other professionals treating those with cancer pain will require new knowledge and tools to provide safe and effective pain control while preventing additional cases of substance use disorders (SUDs), helping patients in recovery to maintain sobriety, and guiding those not yet in recovery to seek treatment

2018 Cancer

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