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Pearls for opioid use in seriously ill patients.
J Pain Palliat Care Pharmacother 2019 Mar - Jun; 33(1-2):54-58JP

Abstract

Opioids are often the foundation of pain management in seriously ill patients. Unfortunately, even experienced providers carry with them information that they consider "fact", when this information is not based on scientific evidence, but on "myth". Several topics were elicited based on common beliefs and misconceptions in clinical practice. These were identified via a survey of pharmacist pain and palliative care providers. Pearls from these topics were chosen that were based on evidence and would have the greatest bearing on clinical practice. The pearls address topics such as not using opioids as first-line analgesics for all types of pain, opioid-induced hyperalgesia, opioid risk management in cancer patients, use of buprenorphine in hospice and palliative care settings and use of naloxone in seriously ill patients. The pearls are supported by clinical evidence extracted from several references. They are intended to make readers give thought to opioid therapy which is strictly evidence-based, and not historical or anecdote-based. Practical recommendations are provided to give readers a starting point to base clinical decisions going forward. Readers may discover that "facts" they once learned about opioid use in seriously ill patients are actually "myths" that are a figment of the past.

Authors

No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

31592735

Citation

Kral, Lee, et al. "Pearls for Opioid Use in Seriously Ill Patients." Journal of Pain & Palliative Care Pharmacotherapy, vol. 33, no. 1-2, 2019, pp. 54-58.
Kral L, Ku J, Kematick BS, et al. Pearls for opioid use in seriously ill patients. J Pain Palliat Care Pharmacother. 2019;33(1-2):54-58.
Kral, L., Ku, J., Kematick, B. S., & Fudin, J. (2019). Pearls for opioid use in seriously ill patients. Journal of Pain & Palliative Care Pharmacotherapy, 33(1-2), pp. 54-58. doi:10.1080/15360288.2019.1650870.
Kral L, et al. Pearls for Opioid Use in Seriously Ill Patients. J Pain Palliat Care Pharmacother. 2019;33(1-2):54-58. PubMed PMID: 31592735.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pearls for opioid use in seriously ill patients. AU - Kral,Lee, AU - Ku,Jennifer, AU - Kematick,Benjamin S, AU - Fudin,Jeffrey, Y1 - 2019/10/08/ PY - 2019/10/9/pubmed PY - 2019/10/9/medline PY - 2019/10/9/entrez KW - buprenorphine KW - cancer KW - hyperalgesia KW - naloxone KW - opioids KW - palliative SP - 54 EP - 58 JF - Journal of pain & palliative care pharmacotherapy JO - J Pain Palliat Care Pharmacother VL - 33 IS - 1-2 N2 - Opioids are often the foundation of pain management in seriously ill patients. Unfortunately, even experienced providers carry with them information that they consider "fact", when this information is not based on scientific evidence, but on "myth". Several topics were elicited based on common beliefs and misconceptions in clinical practice. These were identified via a survey of pharmacist pain and palliative care providers. Pearls from these topics were chosen that were based on evidence and would have the greatest bearing on clinical practice. The pearls address topics such as not using opioids as first-line analgesics for all types of pain, opioid-induced hyperalgesia, opioid risk management in cancer patients, use of buprenorphine in hospice and palliative care settings and use of naloxone in seriously ill patients. The pearls are supported by clinical evidence extracted from several references. They are intended to make readers give thought to opioid therapy which is strictly evidence-based, and not historical or anecdote-based. Practical recommendations are provided to give readers a starting point to base clinical decisions going forward. Readers may discover that "facts" they once learned about opioid use in seriously ill patients are actually "myths" that are a figment of the past. SN - 1536-0539 UR - https://www.unboundmedicine.com/medline/citation/31592735/Pearls_for_opioid_use_in_seriously_ill_patients L2 - http://www.tandfonline.com/doi/full/10.1080/15360288.2019.1650870 DB - PRIME DP - Unbound Medicine ER -