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Li L, Fu L, Li H, Liu T, Sun J. Emerging trends and patterns in healthcare-seeking behavior: A systematic review. Medicine (Baltimore) 2024; 103:e37272. [PMID: 38394511 PMCID: PMC11309724 DOI: 10.1097/md.0000000000037272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/25/2024] [Indexed: 02/25/2024] Open
Abstract
OBJECTIVES The study of healthcare-seeking behavior is essential for optimizing resource allocation and improving healthcare services. Its complexity and diversity have made it a prominent research area. Understanding factors influencing healthcare-seeking decisions allows targeted interventions and policy development to address barriers and ensure equitable access to quality healthcare for diverse populations. Such research plays a vital role in enhancing healthcare outcomes and overall population health. METHODS The study utilized a systematic quantitative literature review approach, employing the Web of Science (WOS) Core Collection and PubMed databases as data sources. Additionally, bibliometric tools such as CiteSpace and VOSviewer were employed for analysis and visualization of the literature. RESULTS A comprehensive statistical analysis and visualization were performed on the annual publication volume, publication countries, journals, keywords, and keyword co-occurrence patterns up until 2023. Through this analysis, a framework was established, identifying the determinants and fundamental elements of healthcare-seeking behavior. These findings contribute to the advancement of research in this field and inform future studies and interventions aimed at improving healthcare-seeking behavior. CONCLUSIONS Based on the aforementioned literature review and framework, several conclusions were drawn. The determinants that facilitate healthcare-seeking behavior include improving health education awareness, enhancing healthcare resources, reducing costs, and ensuring system soundness. Additionally, providing social environment support was found to be crucial. Furthermore, the fundamental elements of healthcare-seeking behavior were identified as healthcare demand, healthcare choices, and the process of diagnosis and treatment. These findings provide valuable insights for developing interventions and policies to promote optimal healthcare-seeking behavior.
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Affiliation(s)
- Limin Li
- School of Health Care Management, Anhui Medical University, Hefei, China
| | - Li Fu
- School of Health Care Management, Anhui Medical University, Hefei, China
| | - Hui Li
- School of Health Care Management, Anhui Medical University, Hefei, China
| | - Tong Liu
- School of Health Care Management, Anhui Medical University, Hefei, China
| | - Jiangjie Sun
- School of Health Care Management, Anhui Medical University, Hefei, China
- School of Management, Hefei University of Technology, Hefei, China
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Cuomo A. Fentanyl in cancer pain management: avoiding hasty judgments and discerning its potential benefits. Drugs Context 2023; 12:2023-10-2. [PMID: 38148830 PMCID: PMC10751104 DOI: 10.7573/dic.2023-10-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Accepted: 11/14/2023] [Indexed: 12/28/2023] Open
Abstract
Cancer pain is an important challenge in treatment and requires a rapid onset of action for its control. In particular, breakthrough cancer pain (BTcP) should be adequately controlled with a stable dose of a short-acting oral opioid. Fentanyl is a synthetic, highly selective opioid with many advantageous chemical properties, including high lipophilicity and distinct pharmacokinetic properties. It is recommended for pain management in a variety of settings, including acute pain, chronic pain and BTcP. To date, its variously designed formulations allow non-invasive administration; amongst others, sublingual fentanyl has proven useful in the management of BTcP and in improving the quality of life of patients with cancer. This review provides an update on the management of BTcP with fentanyl, with consideration of safety, as it remains an important tool in the treatment of cancer pain.
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Affiliation(s)
- Arturo Cuomo
- Istituto Nazionale dei Tumori, IRCCS Fondazione G. Pascale, Naples,
Italy
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Lin R, Zhu J, Luo Y, Lv X, Lu M, Chen H, Zou H, Zhang Z, Lin S, Wu M, Li X, Zhou M, Zhao S, Su L, Liu J, Huang C. Intravenous Patient-Controlled Analgesia Versus Oral Opioid to Maintain Analgesia for Severe Cancer Pain: A Randomized Phase II Trial. J Natl Compr Canc Netw 2022; 20:1013-1021.e3. [PMID: 36075387 DOI: 10.6004/jnccn.2022.7034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2022] [Accepted: 05/16/2022] [Indexed: 11/17/2022]
Abstract
BACKGROUND Optimal analgesic maintenance for severe cancer pain is unknown. This study evaluated the efficacy and safety of intravenous patient-controlled analgesia (IPCA) with continuous infusion plus rescue dose or bolus-only dose versus conventional oral extended-release morphine as a background dose with normal-release morphine as a rescue dose to maintain analgesia in patients with severe cancer pain after successful opioid titration. METHODS Patients with persistent severe cancer pain (≥7 at rest on the 11-point numeric rating scale [NRS]) were randomly assigned to 1 of 3 treatment arms: (A1) IPCA hydromorphone with bolus-only dose where dosage was 10% to 20% of the total equianalgesic over the previous 24 hours (TEOP24H) administered as needed, (A2) IPCA hydromorphone with continuous infusion where dose per hour was the TEOP24H divided by 24 and bolus dosage for breakthrough pain was 10% to 20% of the TEOP24H, and (B) oral extended-release morphine based on TEOP24H/2 × 75% (because of incomplete cross-tolerance) every 12 hours plus normal-release morphine based on TEOP24H × 10% to 20% for breakthrough pain. After randomization, patients underwent IPCA hydromorphone titration for 24 hours to achieve pain control before beginning their assigned treatment. The primary endpoint was NRS over days 1 to 3. RESULTS A total of 95 patients from 9 oncology study sites underwent randomization: 30 into arm A1, 32 into arm A2, and 33 into arm B. Arm B produced a significantly higher NRS over days 1 to 3 compared with arm A1 or A2 (P<.001). Daily NRS from day 1 to day 6 and patient satisfaction scores on day 3 and day 6 were worse in arm B. Median equivalent-morphine consumption increase was significantly lower in A1 (P=.024) among the 3 arms. No severe adverse event occurred in any arm. CONCLUSIONS Compared with oral morphine maintenance, IPCA hydromorphone for analgesia maintenance improves control of severe cancer pain after successful titration. Furthermore, IPCA hydromorphone without continuous infusion may consume less opioid.
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Affiliation(s)
- Rongbo Lin
- Gastrointestinal Medical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou.,College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou.,Fujian Key Laboratory of Translational Cancer Medicine, Fuzhou.,Fujian Key Laboratory of Advanced Technology for Cancer Screening and Early Diagnosis, Fuzhou
| | - Jinfeng Zhu
- Medical Oncology, Quanzhou First Hospital, Quanzhou
| | - Yushuang Luo
- Medical Oncology, Qinghai University Affiliated Hospital, Xining
| | - Xia Lv
- Medical Oncology, Xiamen Humanity Hospital & Fujian Medical University Xiamen Humanity Hospital, Xiamen
| | - Mingqian Lu
- Medical Oncology, Yichang Central People's Hospital, Yichang
| | - Haihui Chen
- Medical Oncology, Liuzhou Workers' Hospital, Liuzhou
| | - Huichao Zou
- Pain Medicine, Cancer Hospital Affiliated with Harbin Medical University, Harbin
| | | | - Shaowei Lin
- School of Public Health, Fujian Medical University, Fuzhou
| | - Milu Wu
- Medical Oncology, Qinghai University Affiliated Hospital, Xining
| | - Xiaofeng Li
- Medical Oncology, Quanzhou First Hospital, Quanzhou
| | - Min Zhou
- Gastrointestinal Medical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou
| | - Shen Zhao
- Gastrointestinal Medical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou.,College of Clinical Medicine for Oncology, Fujian Medical University, Fuzhou
| | - Liyu Su
- Gastrointestinal Medical Oncology, Fujian Cancer Hospital & Fujian Medical University Cancer Hospital, Fuzhou
| | - Jiang Liu
- Medical Oncology, People's Hospital of Xinjiang Uygur Autonomous Region, Urumqi; and
| | - Cheng Huang
- Medical Oncology, Xiamen Humanity Hospital & Fujian Medical University Xiamen Humanity Hospital, Xiamen.,Thoracic Oncology, Fujian Cancer Hospital, Fuzhou, China
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