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ABSTRACT: Management of neuropathic pain is challenging. Medications that interfere with sodium channel transport, such as lidocaine, mexilitene and flecainide, are promising as analgesics.
In a general population of patients with a working diagnosis of neuropathic pain, whether if flecainide produces enough of an improvement in pain to warrant further clinical study is determined.
Phase I/II prospective exploratory clinical trial. Eligible patients were observed for week 1, then 50 mg flecainide was administered twice daily for week 2 and then administered 100 mg twice daily for week 3. SETTING/ SUBJECTS: Multi-institutional members of the Eastern Co-operative Oncology Group. Patients had neuropathic pain diagnosed by their oncologists as defined by the International Association for the Study of Pain and a diagnosis of cancer or AIDS.
The Wisconsin Brief Pain Inventory was used. The primary endpoint was a decrease of 3 points (0-10 numerical scale) or a decrease of 50% in the worst pain rating at either day 15 or day 22 relative to the average of days 1 and 8 ratings.
Nineteen patients were registered for the study. Four patients were ineligible. Of the remaining 15, one was unevaluable due to incomplete pain rating. Four out of 14 patients had an average drop of 5 points or 53% in their worst pain ratings on a 0-10 numerical scale of pain. No patients withdrew from study because of toxicity. There were no life-threatening or lethal toxicities. All patients were alive at the time of the analysis.
Flecainide produced a 30% response rate. Response in this study was defined to be highly relevant and clinically significant reduction in pain. The drug merits study in a randomized placebo-controlled trial.
Palliative Medicine 01/2008; 21(8):667-72. · 2.38 Impact Factor
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Elizabeth A Hahn,
David Cella,
Deborah Dobrez,
Gail Shiomoto,
Elizabeth Marcus, Samuel G Taylor,
Mala Vohra,
Chih-Hung Chang,
Benjamin D Wright,
John M Linacre,
Barry D Weiss,
Veronica Valenzuela,
Hsaio-Lin Chiang,
Kimberly Webster
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ABSTRACT: Cancer patients who are deficient in literacy skills are particularly vulnerable to experiencing different outcomes due to disparities in care or barriers to care. Outcomes measurement in low literacy patients may provide new insight into problems previously undetected due to the challenges of completing paper-and-pencil forms.
A multimedia program was developed to provide a quality of life assessment platform that would be acceptable to patients with varying literacy skills and computer experience. One item at a time is presented on the computer touchscreen, accompanied by a recorded reading of the question. Various colors, fonts and graphic images are used to enhance visibility, and a small picture icon appears near each text element allowing patients to replay the sound as many times as they wish. Evaluation questions are presented to assess patient burden and preferences.
An ethnically diverse group of 126 cancer patients with a range of literacy skills and computer experience reported that the 'talking touchscreen' (TT) was easy to use, and commented on the usefulness of the multimedia approach.
The TT is a practical, user-friendly data acquisition method that provides greater opportunities to measure self-reported outcomes in patients with a range of literacy skills.
Psycho-Oncology 03/2004; 13(2):86-95. · 3.34 Impact Factor
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ABSTRACT: Fortunately for the physician, the majority of human ills for which he is consulted are self-limited or are only matters of temporary discomfort that can be remedied with relative ease. Nevertheless, every human being must have one fatal disease or accident. From the philosophical standpoint it could be argued that life itself is the only inevitably fatal condition, yet it is obvious that there are many pathological states that result in inexorable death. These fatal diseases have been progressively eliminated by advances in medical science until there are only three main categories of causes of fatality, namely, cardiac failure and the degenerative diseases in the broad sense, accidents and war, and malignant neoplastic diseases.Of death due to these three problems, death due to cancer is the most preventable from the standpoint of the individual physician. Therein lies the tragic irony of this disease. Death from cancer should be unnecessary,
Journal of the American Medical Association 12/1952; 150(10):1012-1015.
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Elizabeth A Hahn,
David Cellal,
Deborah G Dobrez,
Gail Shiomoto, Samuel G Taylor,
Angel G Galvez,
Patricia Diaz,
Veronica Valenzuela,
Hsaio-Lin Chiang,
Shaheen Khan,
Stacie A Hudgens,
Hongyan Du
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ABSTRACT: Cancer patients who have limited literacy skills or English language proficiency are particularly vulnerable to receiving sub-optimal care. Outcome measurement in these patients may provide new insight into previously undetected problems. This report describes the development and testing of a Spanish language, multimedia program for quality of life (QOL) assessment. Pilot testing was conducted with 30 Latino cancer patients with a range of education levels and computer experience. Patients found the program easy to use and understand. The "Talking Touchscreen" is a practical, user-friendly method that provides greater opportunities to assess QOL in Spanish-speaking patients with a range of literacy skills.
The Journal of oncology management: the official journal of the American College of Oncology Administrators 12(5):9-12.
