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• W2029042369 abstract "There continue to exist serious deficiencies in the analgesic therapy of elderly patients and patients with polypathia and severe pain. Orally administered controlled-release hydromorphone (see Note 1) appears to be particularly suitable for this patient group due to its pharmacological and metabolic benefits. The aim of the present prospective, multicentre study was to analyse the effects of hydromorphone therapy on quality of analgesia and potential side effects. Patients and methods. 567 elderly patients with severe, predominantly tumour-related or musculoskeletal pain were included in this study. The majority of these patients had received prior analgesic therapy. The following parameters were measured before initiating treatment with orally administered controlled-release hydromorphone and at three further assessments during the therapy: the daily dose required, intensity of pain (measured on the Numeric Rating Scale: 0 = no pain to 10 = worst pain imaginable); typical opioid-related side effects such as tiredness, nausea, vomiting, constipation, pruritus; and severe adverse events, e.g. hospitalisation due to tumour therapy, dyspnoea, urinary retention. Pain-related interferences were assessed in seven spheres of life: general activity, mobility, social relationships, enjoyment of life, mood, resilience, sleep. Furthermore, the quality of life was assessed by means of the 'Brief Pain Inventory' developed by Cleeland as well as in diaries. A differentiated final assessment with regard to efficacy, tolerability and compliance was performed by the physician on completion of the study using a 5-point scale. Results. Within three weeks of therapy with controlled-release hydromorphone, intensity of pain was reduced by 65.7% on average, from 7.0 at the beginning to 2.4 at the final assessment. Typical opioid-related side effects frequently present at the beginning of the study decreased during therapy with hydromorphone by 88.6% on average. Therapy resulted in a reduction in pain-related interference by 50.7% and thus in a marked improvement in quality of life. In the final assessment by the physician both, efficacy and tolerability, as well as compliance were rated as 'very good' or 'good' in more than 80% of patients. Conclusion. The advantages of controlled-release hydromorphone offer an appropriate analgesic therapy even for elderly patients and patients with polypathia in the clinical and outpatient setting. Hydromorphone was well tolerated and effective in the treatment of severe pain. Quality of life improves substantially as a result of a marked decrease in opioid-related side effects and interferences in daily life. Prior to inclusion in this study, only a few patients with severe pain were treated with WHO-level III opioids indicating that blatant inadequacies in tumour pain therapy continue to exist." @default.
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• W2029042369 date "2006-10-01" @default.
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• W2029042369 title "Hydromorphone in elderly patients with polypathia and with severe pain" @default.
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• W2029042369 doi "https://doi.org/10.1179/016911106779498993" @default.
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