https://ogma.newcastle.edu.au/vital/access/ /manager/Index en-au 5 https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:25789 Thu 17 Feb 2022 09:28:02 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:31109 Thu 13 Jan 2022 10:29:16 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:46810 Thu 01 Dec 2022 10:31:07 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:16027 Sat 24 Mar 2018 08:21:16 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:20537 Sat 24 Mar 2018 08:02:43 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:17972 Sat 24 Mar 2018 07:56:41 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:21354 n=1402) were pain free. Of those with pain, mean score was 2 (range 0-10). The majority had cancer (90%), with no significant difference between the severity of reported pain scores between cancer and nonmalignant diagnoses (P=0.27). A significant gender difference was noted, with females statistically more likely to report severe pain (χ²(3026)=5.61, p=0.018). Similarly, those <60 years were more likely to report pain χ²(3025)=3.07; p=0.022). Longitudinal changes in pain revealed the pain scores of people admitted with pain <7 always reported lower pain scores than those with severe pain on admission (90 days, F(1, 654)=55.72, p<0.001; 60 days, F(1, 1008)=48.62, p<0.001; 30 days, F(1, 1522)=60.36, p<0.001; 7 days, F(1, 1897)=15.4, p<0.001). However, pain scores of those with pain <7 on admission rose as death approached compared with those who reported severe pain. Conclusion: Even in the context of expert delivery of palliative care where pain is most likely to be optimally managed, pain continues to be a problem. Work such as this suggests that the different mechanisms that contribute to pain may influence patients' experiences even when analgesia is optimized in a specialist setting. Particular attention is needed in the future to explore the relationship between severe pain and mobility.]]> Sat 24 Mar 2018 07:51:28 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:18781 Sat 24 Mar 2018 07:51:10 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:28795 15% reduction over their own baseline breathlessness intensity. Results: Eleven people had trial medication (eight males, median age 78 years (68 to 89); all had COPD; median Karnofsky 70 (50 to 80); six were on long-term home oxygen. Ten people completed day four. One person withdrew because of unsteadiness on day four. Five participants reached the 15% reduction, but only three went on to the extension study, all completing without toxicity. Conclusion: This study was safe, feasible and there appears to be a group who derive benefits comparable to titrated opioids. Given the widespread use of benzodiazepines for the symptomatic treatment of chronic refractory breathlessness and its poor evidence base, there is justification for a definitive phase III study.]]> Sat 24 Mar 2018 07:38:22 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:28133 underestimate services' benefits. Observational symptom prevalence studies reported in hospice/palliative care to date have not accounted for people with long-term refractory symptoms, potentially systematically overestimating symptoms attributed to life-limiting illnesses. Cross-sectional community prevalence rates of key chronic refractory symptoms largely unrelated to their life-limiting illness reflect the likely prevalence on referral to hospice/palliative care: fatigue (up to 35%); pain (12%–31%); pain with neuropathic characteristics (9%); constipation (2%–29%); dyspnea (4%–9%); cognitive impairment (>10% of people >65 years old; >30% of people >85 years old); anxiety (4%); and depression (lifetime incidence 2%–15%; one year prevalence 3%). Prospective research is needed to establish (1) the prevalence and severity of chronic symptoms that pre-date the diagnosis of a life-limiting illness in people referred to hospice/palliative care services, comparing this to whole-of-population estimates; and (2) whether this group is disproportionately represented in people with refractory symptoms.]]> Sat 24 Mar 2018 07:24:54 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:24383 Sat 24 Mar 2018 07:16:18 AEDT ]]> https://ogma.newcastle.edu.au/vital/access/ /manager/Repository/uon:23460 Sat 24 Mar 2018 07:13:01 AEDT ]]>