Adouble-blind Placebo Contorolled Study Of Subcutaneous Ketamine In The Management Of Cancer Pain
Funder
National Health and Medical Research Council
Funding Amount
$50,000.00
Summary
Palliative care teams are studying an anaesthetic, ketamine, used at low doses for cancer pain which is not responsive to opioid drugs. Clinical experience suggests ketamine may help in neuropathic pain, which is due to nerve damage and is common in cancer. The study involves five days of treatment at three doses of ketamine, to see how well pain is controlled on each dose. The highest dose given will be that which gives good pain control. The study compares ketamine with a placebo, and patients ....Palliative care teams are studying an anaesthetic, ketamine, used at low doses for cancer pain which is not responsive to opioid drugs. Clinical experience suggests ketamine may help in neuropathic pain, which is due to nerve damage and is common in cancer. The study involves five days of treatment at three doses of ketamine, to see how well pain is controlled on each dose. The highest dose given will be that which gives good pain control. The study compares ketamine with a placebo, and patients keep on their usual pain medicines. Participants are randomised to have ketamine or the placebo. The study looks at pain control, quality of life, ketamine side effects, and change in need for usual pain medicines. This is the first national clinical study of a new palliative care research network, the Palliative Care Clinical Trials Collaborative (PaCCSC). It is hoped that if ketamine is proven safe and effective in difficult cancer pain, it will be more easily available for cancer patients.Read moreRead less
An Evaluation Of The Validity Of Measureing Salivary Oxycodone Concentrations For Pharmacokinetic Studies In Patients
Funder
National Health and Medical Research Council
Funding Amount
$49,135.00
Summary
In many countries, oxycodone is replacing morphine as the opioid of first choice for the treatment of moderate to severe pain. Despite this, very little is known about how the drug is processed in the body or how its ability to control pain is affected by such factors as other drugs, age or organ function. Studies to determine this usually require multiple blood tests from individual patients over set time periods. Our team is able to measure drug levels in saliva and has shown this to be a vali ....In many countries, oxycodone is replacing morphine as the opioid of first choice for the treatment of moderate to severe pain. Despite this, very little is known about how the drug is processed in the body or how its ability to control pain is affected by such factors as other drugs, age or organ function. Studies to determine this usually require multiple blood tests from individual patients over set time periods. Our team is able to measure drug levels in saliva and has shown this to be a valid substitute for the measurement of drug levels in blood. Furthermore, one of us has developed a computer modelling system that shows how drugs are handled in the body using only a few samples from each patient. Palliative care patients are generally frail and unwell. We are reluctant to expose them to invasive tests such as repeated blood sampling. If we can prove that saliva sampling is as good as blood sampling, we will have identified a simple non-invasive means of greatly increasing our knowledge of oxycodone and how it behaves in individual patients. This in turn may allow us to tailor drug doses according to the unique characteristics of each patient and to optimise their pain control.Read moreRead less
Developing And Testing A Pain Management Program For Family Caregivers Of Advanced Cancer Patients
Funder
National Health and Medical Research Council
Funding Amount
$119,500.00
Summary
To improve cancer patients' and family carers' knowledge and attitudes about pain management. A secondary aim is to examine the effect of a pain education program (PEP) on patients' actual pain experiences. This study builds on pilot data indicating that a pain education program (PEP) for family carers of cancer patients in a home based palliative service is effective in improving family carers' knowledge of pain management and family carers' attitudes toward managing the patient's pain. The PEP ....To improve cancer patients' and family carers' knowledge and attitudes about pain management. A secondary aim is to examine the effect of a pain education program (PEP) on patients' actual pain experiences. This study builds on pilot data indicating that a pain education program (PEP) for family carers of cancer patients in a home based palliative service is effective in improving family carers' knowledge of pain management and family carers' attitudes toward managing the patient's pain. The PEP will be tested with both patients with progressive or recurrent cancer and their family carers, taking into account three recommendations arising from the pilot study: Both patients and family carers should be included in the education sessions to ensure that they receive the same information because the attitudes and behaviours of those close to the patient can directly influence outcomes; Recruitment should occur at an early stage of the illness rather than the palliative stage so that patients will be well enough to participate in the education sessions and the information provided will be useful for a longer period of time; Education sessions should be short and be delivered in the outpatient oncology settings, which is more cost-effective and typical of the way that the intervention will be delivered in practice, if found to be effective.Read moreRead less
A Randomised Clinical Trial To Test A Pain Education Program For Patients With Cancer And Their Family Carers
Funder
National Health and Medical Research Council
Funding Amount
$150,000.00
Summary
This study seeks to improve cancer patients' and family carers' knowledge and attitudes toward pain management. A pain education program will be offered to patients with recurrent or progressive cancer and their primary family carers. The study addresses a palliative care concern that impacts upon a large number of Australians each year. The study has the potential to provide a brief, standardised protocol that could be taught and integrated into usual practice and to reduce health care costs fo ....This study seeks to improve cancer patients' and family carers' knowledge and attitudes toward pain management. A pain education program will be offered to patients with recurrent or progressive cancer and their primary family carers. The study addresses a palliative care concern that impacts upon a large number of Australians each year. The study has the potential to provide a brief, standardised protocol that could be taught and integrated into usual practice and to reduce health care costs for advanced cancer patients.Read moreRead less
Pall Care Approaches For Pain Management Education Among Care Assistants Residential Aged Care Hostels: A Feasiblity Stu
Funder
National Health and Medical Research Council
Funding Amount
$25,000.00
Summary
Pain is a devastating symptom that seriously diminishes quality of life1, yet few care assistants in residential aged care hostels are familiar with the principles of palliative care2. This project seeks to explore the feasibility of palliative approaches as a framework for developing a pain education program for these workers. The study will identify: required levels of knowledge; appropriate educational strategies; barriers to learning; best methods for evaluating programs; and cost implicatio ....Pain is a devastating symptom that seriously diminishes quality of life1, yet few care assistants in residential aged care hostels are familiar with the principles of palliative care2. This project seeks to explore the feasibility of palliative approaches as a framework for developing a pain education program for these workers. The study will identify: required levels of knowledge; appropriate educational strategies; barriers to learning; best methods for evaluating programs; and cost implications of providing pain management education in the hostel settings.Read moreRead less
Using N-of-1 Trials To Determine Effectiveness Of Paracetamol In Advanced Cancer Patients On Opioids
Funder
National Health and Medical Research Council
Funding Amount
$49,996.00
Summary
In advanced cancer, the prevalence of pain is very high (70-90%). Chronic pain is the most feared symptom and is not controlled in a large proportion of cancer patients. The impact on function (physical, mental, social and spiritual) and quality of life (QOL) is very significant. The role of paracetamol in the management of pain in patients with advanced cancer on opioids needs to be defined. Managing pain with treatment supported by the best possible evidence for individual patients and produci ....In advanced cancer, the prevalence of pain is very high (70-90%). Chronic pain is the most feared symptom and is not controlled in a large proportion of cancer patients. The impact on function (physical, mental, social and spiritual) and quality of life (QOL) is very significant. The role of paracetamol in the management of pain in patients with advanced cancer on opioids needs to be defined. Managing pain with treatment supported by the best possible evidence for individual patients and producing any improvement in pain will improve patients’ functional status, and will greatly improve QOL for patients and carers. N-of-1 trials are randomized, double-blind cross-over comparisons of active drug with placebo or another drug. The patient is their own control. N-of-1 trials provide objective means of testing effectiveness of medicines in individuals, providing evidence stronger than randomised controlled trial evidence for the efficacy of that drug in that individual. We will pilot N-of-1 trials of paracetamol for pain in 10 patients. If feasible, this will be a new method of obtaining strong evidence in a difficult to research population: palliative care patients.Read moreRead less