Search Results (3)

Background and Aim: Neuropathic pain leads to a significant deterioration in health-related quality of life (HRQOL). Treating neuromusculoskeletal pain is especially important to prevent and improve physical frailty and the locomotive syndrome. Varied pharmacotherapies could be applicable for neuropathic pain patients, but evidence has been limited for a wide range of neuropathic pain conditions with different etiologies. The aim of this review was to highlight mirogabalin, a novel calcium channel α2δ ligand which was first approved in Japan, and which is effective for various types of neuropathic pain diseases. Methods: We conducted a narrative review of the recent evidence that mirogabalin has significant analgesic potency for varied types of neuropathic pain conditions. Futher, this review highlighted specific advantages over other calcium channel ligands. Results: Analgesic potency of mirogabalin could cover peripheral neuropathic pain conditions including post-herpetic neuralgia, diabetic peripheral neuropathy, cauda equina syndrome caused by lumbar spinal stenosis, radiculopathy caused by cervical spondylosis, and also central neuropathic pain conditions like spinal cord injury. Mirogabalin consistently demonstrated daytime sleepiness and dizziness as adverse effects, but most of these were mild. Conclusions: Mirogabalin is recommended as the first-line drug against most molecular mechanisms that cause neuropathic pain regardless of whether they have a peripheral or central origin. Mirogabalin demonstrates relatively less daytime sleepiness, making it age-friendly in the current global situation where population aging is accelerated. Considering the epidemic of ‘opiophobia’ in Japan and other countries, pharmacotherapy using mirogabalin could treat neuropathic pain associated with cancer and its treatment (e.g., chemotherapy-induced peripheral neuropathy), as well as non-cancer etiologies worldwide. Full article

Opiophobia contributes to oligoanalgesia in the emergency department (ED), but its definition varies, and its association to healthcare providers’ personality traits has been scantly explored. Our purpose was to study the different definitions of opiophobia and their association with two personality traits of doctors and nurses working in EDs, namely the stress from uncertainty and risk-taking. We used three online questionnaires: the ‘Attitude Towards Morphine Use’ Score (ATMS), the Stress From Uncertainty Scale (SUS) and the Risk-Taking Scale (RTS). Doctors and nurses from nine hospital EDs in francophone Switzerland were invited to participate. The ATMS score was analyzed according to demographic characteristics, SUS, and RTS. The response rate was 56%, with 57% of respondents being nurses and 63% women. Doctors, less experienced and non-indigenous participants had a significantly higher ATMS (all p ≤ 0.01). The main contributors of the ATMS were the fear of side effects and of addiction. In multivariate analysis, being a doctor, less experience and non-indigenous status were predictive of the ATMS; each point of the SUS increased the ATMS by 0.24 point. The fear of side effects and of addiction were the major contributors of opiophobia among ED healthcare providers; opiophobia was also associated with their personality traits. Full article

There is a great need for paediatric palliative care (PPC) services globally, but access to services is lacking in many parts of the world, particularly in resource-poor settings. Globally it is estimated that 21.6 million children need access to palliative care, with 8.2 needing specialist services. PC has been identified as important within the global health agenda e.g., within universal health coverage, and a recent Lancet commission report recognised the need for PPC. However, a variety of challenges have been identified to PPC development globally such as: access to treatment, access to medications such as oral morphine, opiophobia, a lack of trained health and social care professionals, a lack of PPC policies and a lack of awareness about PPC. These challenges can be overcome utilising a variety of strategies including advocacy and public awareness, education, access to medications, implementation and research. Examples will be discussed impacting on the provision of PPC in resource-poor settings. High-quality PPC service provision can be provided with resource-poor settings, and there is an urgent need to scale up affordable, accessible, and quality PPC services globally to ensure that all children needing palliative care can access it. Full article