| Abstract [eng] |
Master thesis of Austėja Strakšytė, scientific supervisor doc. dr. J. Grincevičius. Vilnius University, Faculty of Medicine, Institute of Biomedical Sciences, Pharmacy and Pharmacology center, Vilnius 2023. Title of the thesis: Pain Management in Terminal Conditions. Aim of the study: Evaluate and analyse pain management strategies, trends and challenges in terminal conditions. Tasks of research: - Based on the experience of experts, to find out the peculiarities of prescribing analgesics belonging to the N02 pharmacotherapeutic group registered in Lithuania. - To analyse the first-line analgesics prescribed for patients with terminal conditions and the problems caused by their use. - To obtain expert opinion on the characteristics of the pain management process in terminal patients and the most common difficulties encountered. Methods: A review of scientific literature, publications, aimed at comparing pain management strategies, exploring the variety of analgesics of primary choice and comparing their efficacy. A qualitative study will be used to administer a semi-structured questionnaire to oncologists to assess the frequency of prescribing of N02 pharmacotherapeutic agents and groups of N02 pharmacotherapeutic agents, the specifics of the pain management process in terminal patients, the most frequent difficulties encountered, and the solutions. Study participants: Oncologists who consult patients in various cities across Lithuania. Results: Main challenges of pain management in terminal conditions were identified, principles of analgesic prescribing were highlighted. First-line analgesics and expert recommendations were added. Conclusions: Basic principles of prescribing N02 analgesics are based on the following basic strategies - starting with "weak" narcotic analgesics. Adjuvants, NSAIDs, adjustments to pharmaceutical forms, and non-pharmacological approaches to pain management are added, depending on the side-effects experienced, the patient's condition, life prognosis, comorbidities, and tolerance to the medication. According to experts, the main challenges in the management of pain in terminal conditions are medication side effects, lack of individualised treatment strategies, gaps in the legal framework, poor pain communication, incomplete pain management, arbitrary dose adjustments by patients, lack of control during outpatient treatment, deep fear and stigma of opioids. . |
