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Clinicians should use aggressive methods to treat the millions of cancer patients who suffer pain that weakens and debilitates them, according to results of a study by a federal panel co-chaired by Ada K. Jacox, R.N, Ph.D, professor of nursing 67 who holds the Independence Foundation Chair in Health Policy at The Johns Hopkins School of Nursing.
The 26-member private sector panel on pain management, which was set up in 1991, issued a set of 66 guidelines today that are expected to improve pain management in hospitals and clinics throughout the country. The panel's conclusions are contained in a report published by the Agency for Health Care Policy and Research (AHCPR), which sponsored the study.
The conclusions will have profound implications for the management of cancer pain in hospitals and in ambulatory care, according to Jacox. They should help to dispel the myths that prevent good pain management and will provide detailed and practical descriptions of the many methods available for assessing and controlling pain
Among the panel's recommendations:
1. Health-care professionals should receive sufficient training to assess and managed their patients' pain effectively.
2. Pain therapy should begin with the simplest, least invasive method, such as swallowing, transdermal patches, and rectal applications, before injections or intravenous routes.
3. Use opiate drugs if pain persists or increases, and increase the strength or size of the dose, if necessary.
4. Use other techniques, such as relaxation therapy and hypnosis in addition to drug therapy if necessary, but not as substitutes for drugs.
The panel emphasized that clinicians should develop individual pain-management plans for each patient and should discuss pain management with patients with their families. "Since individualized regimens are the most effective, patients and their