Phys Clinical Cases · oncological
Pain Management IN Cancer AND Chronic Disease — DCE Clinical Case
DCE long-case and short-case station for Pain Management IN Cancer AND Chronic Disease.
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Pain Management IN Cancer AND Chronic Disease — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Pain Management IN Cancer AND Chronic Disease. [1]
Presenting complaint: Subacute or acute symptoms referable to Pain Management IN Cancer AND Chronic Disease, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
References3ShowHide
- [1]Wiffen PJ, McQuay HJ Oral morphine for cancer pain Cochrane Database Syst Rev, 2007.PMID 17943804
- [2]Wiffen PJ, Wee B, Derry S, et al. Opioids for cancer pain - an overview of Cochrane reviews Cochrane Database Syst Rev, 2017.PMID 28683172
- [3]Coluzzi PH, Schwartzberg L, Conroy JD, et al. Breakthrough cancer pain: a randomized trial comparing oral transmucosal fentanyl citrate (OTFC) and morphine sulfate immediate release (MSIR) Pain, 2001.PMID 11240084