Clinical Guideline for Pharmacological Management of Cancer Pain: The Japanese Society of Palliative Medicine Recommendations

Yamaguchi, Takashi; Shima, Yasuo; Morita, Tatsuya; Hosoya, Miki; Matoba, Motohiro

doi:10.1093/jjco/hyt099

Cited by 41 publications

(28 citation statements)

References 74 publications

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“…Initially, the type of opioid and the dose should be determined on an individual basis considering the environment, accompanying diseases, history of opioid medication, purpose of the treatment, medical adverse effects, and degree of pain of each patient [6]. Prescription of opioids typically starts with a short-acting opioid, following a test period [7].…”

Section: Early Opioid Treatmentmentioning

confidence: 99%

Guidelines for prescribing opioids for chronic non-cancer pain in Korea

et al. 2016

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As the treatment of chronic non-cancer pain gradually increases, clinicians have more opportunities to encounter opioid prescription. However, guidelines for prescribing opioids for chronic non-cancer pain have never been published in Korea. The present guidelines were prepared by reviewing various research data. In cases in which the data were insufficient, recommendations were presented following discussion among experts affiliated with the Opioids Research Group in the Korean Pain Society. The present guidelines may need to be continuously revised and amended as more clinical evidence is acquired.

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Section: Early Opioid Treatmentmentioning

confidence: 99%

Guidelines for prescribing opioids for chronic non-cancer pain in Korea

et al. 2016

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“…Opioid switching is a proven approach for reducing intolerable side effects that has also been shown to be effective at improving analgesia for more than 50 % of patients with a poor response to an initial opioid analgesic [6]. The Japanese Society of Palliative Medicine recommends switching the type of opioid used in patients with pain that is inadequately controlled or who experience intolerable side effects (particularly nausea and vomiting) when taking a particular opioid [7]. Improvements in pain intensity and tolerability have been observed following rotation from one opioid analgesic to another in multiple studies in Japanese patients with cancer pain [8–10].…”

Section: Introductionmentioning

confidence: 99%

Ready Conversion of Patients with Well-Controlled, Moderate to Severe, Chronic Malignant Tumor–related Pain on Other Opioids to Tapentadol Extended Release

Imanaka¹,

Tominaga²,

Etropolski

et al. 2014

Clin Drug Investig

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Background and ObjectivesThe effectiveness and tolerability of tapentadol extended release (ER), a centrally acting analgesic with μ-opioid receptor agonist and norepinephrine (noradrenaline) reuptake inhibitor activities, have been demonstrated in patients with chronic pain, including those switching directly from prior opioid therapy. The objective of the current study was to evaluate the effectiveness and safety of conversion to oral tapentadol ER (50–250 mg twice daily) from previous around-the-clock strong opioid therapy in patients with moderate to severe, chronic malignant tumor–related cancer pain that was well-controlled.MethodsThis randomized, open-label, phase III study, which was conducted in Japan, included a 1- to 2-week screening period (on previous opioid) and an 8-week, open-label treatment period. Eligible patients, who were taking a strong opioid analgesic and had a mean pain intensity score <4 during the 3 days prior to randomization (adequate pain control on previous strong opioid), were randomized (1:1) to receive twice-daily treatment with tapentadol ER (100–500 mg/day) or morphine sustained release (SR; 20–140 mg/day; reference for assay sensitivity). Initial doses were estimated based on the conversion ratio of tapentadol ER:oxycodone:morphine:fentanyl = 10:2:3:0.03. The primary effectiveness endpoint was the proportion of patients who maintained pain control [change from baseline in mean pain intensity (11-point numerical rating scale) less than +1.5 for 3 consecutive days and no more than two doses of rescue medication per day for 3 consecutive days) during the first week of open-label treatment.ResultsIn the tapentadol ER group (n = 50), 84.0 % of patients (42/50; 95 % CI, 70.89–92.83) maintained pain control during Week 1. On the Patient Global Impression of Change, 2.1 % (1/48), 2.1 % (1/48), 22.9 % (11/48), and 50.0 % (24/48) of patients in the tapentadol ER group reported that their overall condition was “very much improved,” “much improved,” “minimally improved,” and “not changed,” respectively, at Week 1 compared with 0 %, 10.7 % (3/28), 28.6 % (8/28), and 53.6 % (15/28) reporting these ratings at Week 8. The sensitivity of effectiveness analyses was validated based on results using morphine SR; 98.0 % (49/50; 95 % CI, 89.35–99.95) of patients in the morphine SR group maintained pain control after 1 week of treatment. The overall safety profile was similar to that demonstrated in previous studies; tapentadol ER was associated with a lower incidence of gastrointestinal treatment-emergent adverse events than morphine SR [38.0 % (19/50) vs. 54.0 % (27/50)], including constipation [12.0 % (6/50) vs. 20.0 % (10/50)] and vomiting [6.0 % (3/50) vs. 26.0 % (13/50)].ConclusionsOverall, results indicate that conversion from previous strong opioids to tapentadol ER (50–250 mg twice daily) was successful and resulted in safe and effective pain control with improved gastrointestinal tolerability versus morphine SR in patients with moderate to severe cancer-related pain that was well-controlle...

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“…The performance of previous or current oncological treatments, analytical and imaging data was related to the etiology of pain. This aspect is considered fundamental in a comprehensive analysis of the person with cancer pain [10,22,23,24]. The nonpharmacological strategies are the person-centered care, which emphasizes the individualization and inclusion of a significant person that increases health outcomes.…”

Section: Discussionmentioning

confidence: 99%

Control of Pain and Dyspnea in Patients with Oncologic Disease in Acute Care: Non-Pharmacological Interventions

Fonseca¹

2017

MOJYPT

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Objective: To identify non-pharmacological strategies in the control of pain and dyspnea in patient with oncological disease in acute care. (2011, 2014) and Cancer Care Ontario (2010) resulting in a total of 15 articles. Results:The gold standard to an adequate symptom control is a systematized assessment. Non-pharmacological measures psycho-emotional support, hypnosis, counseling, training, instruction, therapeutic adherence, music therapy, massage, relaxation techniques, telephone support, functional and respiratory reeducation increase health gains. Conclusion:The control of oncologic pain and dyspnea require a comprehensive and multimodal approach.Keywords: Oncologic pain; Dyspnea; Nursing interventions; Acute care IntroductionGlobally more than 14 million new cases of cancer will occur each year and the number of people with this disease expected to triple by 2030 as a result of survival [1,2]. Survivors continue to experience significant limitations compared to those without a history of cancer [3]. The presence of symptoms persists permanently resulting from the direct adverse effects of cancer, treatment, exacerbation and onset of new ones associated with recurrence or second tumor [4,5].Pain, dyspnea, fatigue, emotional distress arises simultaneously and is interdependent. In this way the term cluster symptoms comes to light when two or more symptoms are interrelated since they can share the same etiology and produce a cumulative effect on the person's functioning [6]. Richards et al. [7] found that patients with a high prevalence of pain were more likely to be treated with high-dose pain relief than those who did not. The incidence of pain at the onset of the disease pathway is estimated at 50% and is increased to approximately 75% at advanced stages which means that the survivor does not experience it only as an immediate treatment outcome [6]. In an advanced stage of the oncological disease dyspnea is one of the symptoms that assumes particular relevance often arises associated with pain (about 45%) represented a cluster symptoms inducer of greater anxiety and fatigue. That is responsible for the demand for health care so it is fundamental a serious investment in their control [8]. The objective of this systematic review of the literature is to identify non-pharmacological strategies in the control of pain and dyspnea of the patients with oncological disease in acute care. Research StrategyWas formulated a question in PI[C]O format: What are the non-pharmacological strategies (Intervention) for the control of pain and dyspnea (Outcomes) in the patients with oncology (Population) in acute care (Setting)? The electronic database used was based on EBSCO (MEDLINE with Full TEXT, CINAHL, Plus with Full Text, British Nursing Index) and descriptors were searched in the following order (guideline or evidence based practice or randomized controlled trial) and (symptoms control or dyspnea or tachypnea or Cheyne stokes respiration or respiratory symptoms or chronic pain or cancer pain or (oncology nu...

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Clinical Guideline for Pharmacological Management of Cancer Pain: The Japanese Society of Palliative Medicine Recommendations

Cited by 41 publications

References 74 publications

Guidelines for prescribing opioids for chronic non-cancer pain in Korea

Guidelines for prescribing opioids for chronic non-cancer pain in Korea

Ready Conversion of Patients with Well-Controlled, Moderate to Severe, Chronic Malignant Tumor–related Pain on Other Opioids to Tapentadol Extended Release

Control of Pain and Dyspnea in Patients with Oncologic Disease in Acute Care: Non-Pharmacological Interventions

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