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Topics
- Access to Care (1)
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- Cancer: Lung Cancer (1)
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- Care Management (1)
- Children/Adolescents (2)
- Chronic Conditions (1)
- Comparative Effectiveness (2)
- Education: Patient and Caregiver (1)
- Hospitalization (1)
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- Opioids (2)
- (-) Pain (7)
- (-) Palliative Care (7)
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AHRQ Research Studies
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Research Studies is a compilation of published research articles funded by AHRQ or authored by AHRQ researchers.
Results
1 to 7 of 7 Research Studies DisplayedMarcus KL, Kao PC, Ma C
Symptoms and suffering at end of life for children with complex chronic conditions.
The objective of this study was to evaluate symptoms and suffering at end of life for children with noncancer, noncardiac complex chronic conditions (CCCs), as well as parental distress related to their child’s suffering. Nearly one-third of bereaved parents of children with CCCs who completed the survey reported high suffering in their child's final days of life. Parental preparedness was associated with lower perceived suffering. The authors concluded that future research should target symptoms contributing to parent and child distress and assess whether enhancing parent preparedness reduces perceived child suffering.
AHRQ-funded; HS022986.
Citation: Marcus KL, Kao PC, Ma C .
Symptoms and suffering at end of life for children with complex chronic conditions.
J Pain Symptom Manage 2022 Jan; 63(1):88-97. doi: 10.1016/j.jpainsymman.2021.07.010..
Keywords: Children/Adolescents, Chronic Conditions, Palliative Care, Pain
Enzinger AC, Ghosh K, Keating NL
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
This study looked at trends in opioid prescriptions for cancer patients near the end-of-life (EOL) defined as the 30 days before death or hospice enrollment. The authors looked at Medicare part D data from 2007 to 2017 for 270,632 Medicare fee-for-service decedents with poor prognosis cancers. During that time, the proportion of decedents with poor prognosis cancers receiving 1 or greater opioid prescriptions near EOL declined 15.5% and the proportion receiving 1 or greater long-acting opioid prescriptions declined 36.5% to 18.1%. The mean daily dose fell from 24.5%, from 85.6 morphine milligram equivalents per day (MMED) to 64.6. The total amount of opioids prescribed fell from 1,075 morphine milligram equivalents per decedent to 666 morphine milligram equivalents per decedents. At the same time, the proportion of patients with pain-related ED visits increase 50.8% from 13.2% to 19.9%.
AHRQ-funded; HS024072.
Citation: Enzinger AC, Ghosh K, Keating NL .
US trends in opioid access among patients with poor prognosis cancer near the end-of-life.
J Clin Oncol 2021 Sep 10;39(26):2948-58. doi: 10.1200/jco.21.00476..
Keywords: Cancer, Opioids, Palliative Care, Pain, Access to Care, Medication, Practice Patterns
Perone JA, Riall TS, Olino K
Palliative care for pancreatic and periampullary cancer.
This article summarizes surgical, endoscopic, and other palliative techniques for relief of obstructive jaundice, relief of duodenal or gastric outlet obstruction, and relief of pain due to invasion of the celiac plexus. It also introduces the utility of the palliative care triangle in clarifying a patient's and family's goals to guide decision making.
AHRQ-funded; HS022134.
Citation: Perone JA, Riall TS, Olino K .
Palliative care for pancreatic and periampullary cancer.
Surg Clin North Am 2016 Dec;96(6):1415-30. doi: 10.1016/j.suc.2016.07.012.
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Keywords: Cancer, Palliative Care, Pain, Shared Decision Making
Wysham NG, Cox CE, Wolf SP
Symptom burden of chronic lung disease compared with lung cancer at time of referral for palliative care consultation.
The authors compared the symptom burden of chronic lung disease with that of lung cancer at the time of initial palliative care consultation. They found that patients with chronic lung disease have symptom burdens similar to those of patients with lung cancer at the time of the first palliative care encounter. They concluded that, given the population burden of chronic lung disease and limitations in the palliative care workforce, attention should be focused on ensuring that pulmonologists are prepared to assess and manage the common palliative care needs of patients with chronic lung disease.
AHRQ-funded; HS023681.
Citation: Wysham NG, Cox CE, Wolf SP .
Symptom burden of chronic lung disease compared with lung cancer at time of referral for palliative care consultation.
Ann Am Thorac Soc 2015 Sep;12(9):1294-301. doi: 10.1513/AnnalsATS.201503-180OC.
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Keywords: Respiratory Conditions, Cancer: Lung Cancer, Pain, Palliative Care, Patient-Centered Outcomes Research
Ragsdale L, Zhong W, Morrison W
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
The researchers conducted a retrospective study in which they examined the prescribing patterns of opioid and sedation medications among 37,459 children who died in 430 hospitals in the US 2007-2011. Their study reveals an overall high prevalence of exposure to opioid and sedation medications among pediatric terminal hospitalizations, yet with slightly less than one-half of patients receiving both opioids and sedatives daily near the end of life.
AHRQ-funded; HS018425.
Citation: Ragsdale L, Zhong W, Morrison W .
Pediatric exposure to opioid and sedation medications during terminal hospitalizations in the United States, 2007-2011.
J Pediatr 2015 Mar;166(3):587-93.e1. doi: 10.1016/j.jpeds.2014.10.017..
Keywords: Children/Adolescents, Hospitalization, Medication, Opioids, Pain, Palliative Care
Cagle JG, Zimmerman S, Cohen LW
EMPOWER: an intervention to address barriers to pain management in hospice.
The researchers tested the preliminary efficacy of the Effective Management of Pain: Overcoming Worries to Enable Relief (EMPOWER) intervention. At two weeks, caregivers in the intervention group reported better knowledge about pain management, fewer concerns about pain and pain medications, lower patient pain over the past week, and trended toward improvement in most other areas under study. EMPOWER had a greater effect for black subjects vs. whites on reducing concern about stigma. At three months, the intervention group trended better on most study outcomes. The researchers concluded that EMPOWER is a promising model to reduce barriers to pain management in hospice.
AHRQ-funded; HS019068.
Citation: Cagle JG, Zimmerman S, Cohen LW .
EMPOWER: an intervention to address barriers to pain management in hospice.
J Pain Symptom Manage 2015 Jan;49(1):1-12. doi: 10.1016/j.jpainsymman.2014.05.007.
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Keywords: Care Management, Caregiving, Comparative Effectiveness, Education: Patient and Caregiver, Medication, Pain, Palliative Care
Martinez KA, Aslakson RA, Wilson RF
A systematic review of health care interventions for pain in patients with advanced cancer.
The authors sought to synthesize the evidence on the effectiveness of pain-focused interventions in patients with advanced cancer. In nineteen studies, they found moderate strength of evidence that pain management in advanced cancer can be improved using health care interventions, particularly nurse-led patient-centered interventions.
AHRQ-funded; 290200710061.
Citation: Martinez KA, Aslakson RA, Wilson RF .
A systematic review of health care interventions for pain in patients with advanced cancer.
Am J Hosp Palliat Care 2014 Feb;31(1):79-86. doi: 10.1177/1049909113476129.
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Keywords: Cancer, Comparative Effectiveness, Pain, Palliative Care, Quality Improvement