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Biomedical subjects

P J Coyne

Publications and source records attributed to P J Coyne.

10 recordsLinked to original sources
PubMed2005

An implantable drug delivery system (IDDS) for refractory cancer pain provides sustained pain control, less drug-related toxicity, and possibly better survival compared with comprehensive medical management (CMM).

BACKGROUND: The randomized clinical trial of implantable drug delivery systems (IDDS) plus comprehensive medical management (CMM) versus CMM alone showed better clinical success at 4 weeks for IDDS patients. This 'as treated' analysis assessed if improvements in pain control, drug toxicity and survival were maintained over time. PATIENTS AND METHODS: We compared those who received IDDS with those who did not receive IDDS (non-IDDS). All patients had Visual Analogue Scores (VAS) for pain > or =5/10 on at least 200 mg morphine or equivalent daily. RESULTS: At 4 weeks, 46 of 52 (88.5%) IDDS patients achieved clinical success compared with 65 of 91 (71.4%; P=0.02) non-IDDS patients, and more often achieved > or =20% reduction in both pain VAS and toxicity [35 of 52 (67.3%) versus 33 of 91 patients (36.3%); P=0.0003]. By 12 weeks, 47 of 57 (82.5%) IDDS patients had clinical success compared with 35 of 45 (77.8%; P=0.55) non-IDDS patients, and more often had a > or =20% reduction in both pain VAS and toxicity [33 of 57 (57.9%) versus 15 of 45 patients (33.3%); P=0.01]. At 12 weeks the IDDS VAS pain scores decreased from 7.81 to 3.89 (47% reduction) compared with 7.21 to 4.53 for non-IDDS patients (42% reduction; P=0.23). The 12 week drug toxicity scores for IDDS patients decreased from 6.68 to 2.30 (66% reduction), and for non-IDDS patients from 6.73 to 4.13 (37% reduction; P=0.01). All individual drug toxicities improved with IDDS at both 4 and 12 weeks. At 6 months, only 32% of the group randomized to CMM and who did not cross over to IDDS were alive, compared with 52%-59% for patients in those groups who received IDDS. CONCLUSIONS: IDDS improved clinical success, reduced pain scores, relieved most toxicity of pain control drugs, and was associated with increased survival for the duration of this 6 month trial.

Adult↗
PubMed2001

Are nurses adequately prepared for end-of-life care?

PURPOSE: To determine end-of-life (EOL) care core competencies and educational needs from practicing oncology nurses and to describe the characteristics of the respondents that are associated with selection of the leading core competencies. DESIGN AND METHODS: A researcher-developed mailed descriptive survey to members of the Oncology Nursing Society in Georgia, Virginia, Washington, and Wisconsin in late 1999. FINDINGS: Nearly all respondents indicated that EOL care was a part of their practice and that continuing education was important, but one-third of the respondents had less than 2 hours of continuing education in 2 years. How to talk to patients and families about dying was the top-rated core competency, consistent across age, educational level, practice role, and practice setting. Pain control and comfort care were also frequently selected as important EOL care issues about which more education is needed. CONCLUSIONS: Results show guidelines for improving educational curricula and considering characteristics of nurses when planning EOL educational programs.

Adult↗
PubMed1997

International efforts in cancer pain relief.

OBJECTIVES: To provide a review of the problem of cancer pain and cancer pain management around the world. DATA SOURCES: Review articles, World Health Organization reports, guidelines, and personal experience relating to international efforts in the relief of cancer pain. CONCLUSIONS: Cancer pain is a worldwide problem that is not even addressed in most countries of the world because of limited options for cancer treatment and scare resources. Yet pain relief for many patients is possible in developing countries with international assistance and support. IMPLICATIONS FOR NURSING PRACTICE: Oncology nurses have the ability to advocate for the needs of patients with cancer throughout the world. Oncology nurses can work with nurses in developing countries to enhance pain management through support of existing programs, serving as volunteers, and recruitment of resources to assist nurses in these countries.

Global Health↗
PubMed1994

To Dar and back.

Explore the source record for details and available documents.

Humans↗
PubMedDate not supplied

Transcutaneous electrical nerve stimulator for procedural pain associated with intravenous needlesticks.

Venipuncture continues to be considered a painful and unpleasant experience for those receiving medical treatment. A prospective study investigating whether the application of a transcutaneous electrical nerve stimulator (TENS) decreases the complaints of pain and unpleasantness with i.v. needle insertion was conducted using a group of 71 subjects who were double-blinded and randomized to one of three groups: TENS, placebo-TENS, and control. This article gives an overview of this research and describes its findings.

Adult↗