Emerging PRC/EAPC RN study [Новость добавлена - 24.03.2010]

Emerging PRC/EAPC RN study

The PRC and the EAPC RN are in the process of planning several new studies. One of these is: “A European symptom palliative care study, a prospective data collection in cancer patients during the palliative care disease trajectory”.

It is generally agreed that there is a need to conduct an international prospective data collection in large representative patient samples, in order to:

· Gain a better understanding of the symptom prevalence and symptoms variations over time in palliative cancer patients

· Build on results from previous studies and further validate the assessment and classification systems for pain, cachexia, dyspnoea and other symptoms

· Identify biomarkers and predictive factors for treatment selection and effect

· Gain knowledge about the organization and delivery of palliative care and the variability across nations and institutions

· Arrive at a basic set of indicators for assessment of patient characteristics and symptoms, endorsed by the EAPC RN, to be included in future palliative care studies

· … reach other possible objectives

The upcoming study will probably have a “modular design” meaning that all centres need to include a minimum amount of data (the basic dataset), while other centres can collect more data, also supplemented with biobanking according to specific research objectives. According to the timeline, the plan is to finalise the protocol and obtain ethical approval before the summer in order to include the first patients in medio September 2010.

By this note we would like to inform you about one of the ongoing activities. We kindly ask you to take part in the study, give input and feedback about the study plan, design as well as practical issues. Please contact Stein Kaasa (stein.kaasa@ntnu.no) or Lotte Rogg (lotte.rogg@ntnu.no). We would also like your participation in the inclusion at a later stage.

The EAPC recommendations on opioids in cancer pain are about to be revised

In association with the EAPC and the EPCRC the University of Bristol recently held the 5th Bristol opioid conference; “Revising the EAPC recommendations on opioids in cancer pain”.

Key speakers at the conference were Henry McQuay, Geoffrey Hanks, Franco de Conno, Stein Kaasa and Augusto Caraceni, and the main discussion sessions were lead by experts from outside Europe, Kathy Foley and Jim Cleary.

A consistent message that came from many speakers was that there is still a relative lack of good quality evidence to support day-to-day clinical practice in the use of opioids in cancer pain.

The EPCRC opioid guidelines project group presented the ongoing process for development of revised guidelines, and presented a number of specific issues that should be addressed.

The issues which reviewed and discussed were:

· Step III opioid of first choice and methods for dose titration.

· The use of alternative step III opioids: Oxycodone, methadone, hydromorphone, transdermal fentanyl, transdermal buprenorphine and opioid combinations

· Special considerations for patients with renal and hepatic impairment

· Breakthrough pain

· Opioid rotation and equianalgesic dose ratios

· Routes of administration and spinal opioids

· The use of non-opioids: NSAIDS, ketamine, antidepressants and anticonvulsants

· Opioid side-effects; gastrointestinal and central

One important outcome of the enormous amount of work that has gone into undertaking the systematic reviews is that a clear research agenda is outlined for the future. Based upon the presentations and discussions at the conference and the ongoing process on guidelines development, revised recommendations on opioids in cancer pain will be proposed. When these new guidelines will be updated in five year’s time it may be expected to find much more high quality evidence to support clinical practice.

On the PRC website you will find a more detailed summary from the conference, in addition to a downloadable version of the abstract book.

With the best wishes for improvement for palliative care,

The European Palliative Care Research Centre (PRC) and the European Association for Palliative Care Research Network (EAPC RN)
 

For updates on the PRC, research projects, events and seminars, etc, please visit the PRC website: www.ntnu.no/prc
To contact the PRC, please send an email to: prc@ntnu.no
To unsubscribe, click here.