Pharmacological Pain Treatment in Older Persons.

Pharmacological pain treatment in older persons is presented by a multi-disciplinary group of European pain experts. Drugs recommended for acute or chronic nociceptive pain, also for neuropathic pain and the routes of administration of choice are the same as those prescribed for younger persons but comorbidities and polypharmacy in older persons increase the risk of adverse effects and drug interactions. Not all drugs are available or authorised in all European countries.

Spirituality in people with advanced chronic obstructive pulmonary disease - challenge for more effective interventions, support, and healthcare education: Mini-review.

More recently there has been a growing interest in spirituality in medicine, especially in the field of palliative care, oncology, intensive care, and cardiology. However, according to literature, it seems to be a limited number of researches on how healthcare professionals should provide spiritual care (SC) for people with non-malignant lung diseases and what kind of education for them enables them to do it efficiently. This mini-review aims to provide an overview of current knowledge of an area of spirituality and SC for people with advanced chronic obstructive pulmonary disease, including spiritual well-being and religious/spiritual coping, their relations with the quality of life and symptom burden, exercise capacity and daily functioning, mental health, or medication adherence.

Current status of academic palliative medicine in Poland: a nationwide study.

Aim: To assess the current status of palliative medicine (PM) education in medical students in Poland.

Methods: Data on PM teaching were obtained from a 16-item questionnaire sent to the heads of PM and palliative care (PC) departments at universities or university authorities. In cases in which there was no PM or PC department, the questionnaire was sent to authorities of a given University.

Less Well-Known Consequences of the Long-Term Use of Opioid Analgesics: A Comprehensive Literature Review.

Background: The adverse effects of short-term opioid analgesics are well known and acknowledged; however, the spectrum of the sequelae of long-term use seems less clear. Some effects may remain undetected but still have the potential to cause harm and reduce patients' quality of life.

Objective: To review the literature on the adverse effects of long-term opioid therapy.

Psychometric validation and cross-cultural adaptation of the Integrated Palliative care Outcome Scale in Polish (IPOS-Pol).

Objective: The study aimed to assess the reliability and validity of the IPOS-Pol for patient self-reporting.

Method: Patients (>18 years of age) with advanced cancer admitted to three palliative care centers (inpatient units and home-based) were recruited to a multicenter, cross-sectional, observational, prospective study. Participants provided responses to the IPOS-Pol Patient version and the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire - Core 15 - Palliative Care (EORTC QLQ-C15-PAL) Polish version at baseline (T1) and four to seven days later (T2).

Medical Students' and Internal Medicine Trainees' Knowledge of Drug Prescribing Recommendations in Older Patients with Impaired Kidney Function.

Background: Numerous medications used in older adults require dose modification or should be avoided in individuals with impaired kidney function.

Purpose: To assess medical students' and physicians' knowledge of drug prescribing recommendations in older patients with estimated glomerular filtration rate (eGFR) < 30 mL/min/1.73m.

Clinically Significant Drug-Drug Interactions Involving Medications Used for Symptom Control in Patients With Advanced Malignant Disease: A Systematic Review.

Context: Most patients with advanced malignant disease need to take several drugs to control symptoms. This treatment raises risks of serious adverse effects and drug-drug interactions (DDIs).

Objectives: To identify studies reporting clinically significant DDIs involving medications used for symptom control, other than opioids used for pain management, in adult patients with advanced malignant disease.

Pharmacotherapy of pain in cancer patients - recommendations of the Polish Association for the Study of Pain, Polish Society of Palliative Medicine, Polish Society of Oncology, Polish Society of Family Medicine, Polish Society of Anaesthesiology and Intensive Therapy and Association of Polish Surgeons.

Guidelines for the pharmacotherapy of pain in cancer patients were developed by a group of 21 experts of the Polish Association for the Study of Pain, Polish Society of Palliative Medicine, Polish Society of Oncology, Polish Society of Family Medicine, Polish Society of Anaesthesiology and Intensive Therapy and Association of Polish Surgeons. During a series of meetings, the experts carried out an overview of the available literature on the treatment of pain in cancer patients, paying particular attention to systematic reviews and more recent randomized studies not included in the reviews. The search was performed in the EMBASE, MEDLINE, and Cochrane Central Register of Controlled Trials databases using such keywords as "pain", "cancer", "pharmacotherapy", "analgesics", and similar.

How Do Experienced Professors Teach Palliative Medicine in European Universities? A Cross-Case Analysis of Eight Undergraduate Educational Programs.

Background: In Europe in recent decades, university teaching of palliative medicine (PM) has evolved. In some countries it has been introduced as a compulsory subject in all medical schools, but in a majority of countries it remains an isolated subject at few universities.

Objective: To explore how PM has been introduced into the curricula and how it is currently being taught at different European universities.

Prescribing Non-Opioid Drugs in End-Stage Kidney Disease.

Therapeutic Reviews aim to provide essential independent information for health professionals about drugs used in palliative and hospice care. Additional content is available on www.palliativedrugs.

Assessment of renal function in geriatric palliative care patients - comparison of creatinine-based estimation equations.

Background: Renal function impairment is common in geriatric palliative care patients. Accurate assessment of renal function is necessary for appropriate drug dosage. Several equations are used to estimate kidney function.

Clinically significant drug-drug interactions involving opioid analgesics used for pain treatment in patients with cancer: a systematic review.

Background: Opioids are the most frequently used drugs to treat pain in cancer patients. In some patients, however, opioids can cause adverse effects and drug-drug interactions. No advice concerning the combination of opioids and other drugs is given in the current European guidelines.

Prevalence of Renal Impairment in Palliative Care Inpatients: A Retrospective Analysis.

Background And Objective: Multiple drugs used in palliative care, including most opioids or their active metabolites may accumulate in patients with abnormal renal function, leading to serious adverse effects. The incidence and severity of renal impairment in palliative care inpatients has not been evaluated. The aim of the study was to investigate the incidence and severity of renal impairment in palliative care inpatients.

Bupivacaine administered intrathecally versus rectally in the management of intractable rectal cancer pain in palliative care.

Background: Unacceptable adverse effects, contraindications to and/or ineffectiveness of World Health Organization step III "pain ladder" drugs causes needless suffering among a population of cancer patients. Successful management of severe cancer pain may require invasive treatment. However, a patient's refusal of an invasive procedure necessitates that clinicians consider alternative options.

Polypharmacy in patients with advanced cancer and pain: a European cross-sectional study of 2282 patients.

Context: Patients with advanced cancer need multiple drugs to control symptoms and to treat cancer and concomitant diseases. At the same time, the goal of treatment changes as life expectancy becomes limited. This results in a risk for polypharmacy, maintained use of unneeded drugs, and drug-drug interactions (DDIs).

The pilot study assessing efficacy and versatility of novel therapy for neoplastic ulceration: clinical and microbiological aspects.

Introduction: Neoplastic ulcers are chronic and, most often, irreversible lesions caused by proliferation of tumor cells infiltrating and damaging skin tissues. The treatment of neoplastic ulcers is a very difficult and time-consuming process. So, is very important to find methods of controlling this type of chronic wounds.

Lumbar paravertebral blockade as intractable pain management method in palliative care.

Optimal symptoms control in advanced cancer disease, with refractory to conventional pain treatment, needs an interventional procedure. This paper presents coadministration of local anesthetic (LA) via paravertebral blockade (PVB) as the alternative to an unsuccessful subcutaneous fentanyl pain control in a 71-year old cancer patient with pathological fracture of femoral neck, bone metastases, and contraindications to morphine. Bupivacaine in continuous infusion (0.

A comparison of attitudes toward euthanasia among medical students at two Polish universities.

The aim of the study conducted upon completion of obligatory palliative medicine courses among 588 medical students at two universities was to compare their attitudes toward euthanasia. Four hundred ninety-two (84.97 %) students were Catholics; 69 (11.