ArticleBMC palliative care2020
"No thanks, I don't want to see snakes again": a qualitative study of pain management versus preservation of cognition in palliative care patients.
Article in BMC palliative care, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
7 citing papers in PubMed.
- The role of qualification and quality management in the prescription of antipsychotics and potentially inappropriate medication (PIM) in nursing home residents in Germany: results of the HIOPP-3-iTBX study.Aging clinical and experimental research · 2023Trial
- A Qualitative Study of the Effects of Opioids on Chronic Pain, Function, and Cognition in Community-Dwelling Older Adults.Journal of applied gerontology : the official journal of the Southern Gerontological Society · 2025Article
- Cannabis Perceptions and Patterns of Use Among Older Adult Cancer Survivors.Journal of aging and health · 2025Article
- Cancer stage and consideration of cannabis use among adult cancer survivors in Southern California.Journal of the National Cancer Institute. Monographs · 2024Article
- Cannabis use prevalence, patterns, and reasons for use among patients with cancer and survivors in a state without legal cannabis access.Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer · 2023Article
- Palliative Care and End-of-Life Issues in Patients with Brain Cancer Admitted to ICU.Medicina (Kaunas, Lithuania) · 2023Review
- "That Little Bit of Time": Transition-to-Hospice Perspectives From Hospice Staff and Bereaved Family.Innovation in aging · 2022Article
Corrections and comments
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundTowards the end of life, use of opioid analgesics becomes more common in patients to control pain and improve quality of life. While pain medication may help manage pain, unwanted cognitive side effects are frequently noted. This balancing act presents a trade-off for patients between pain relief and adverse effects, where the desire to relieve pain must be evaluated against the desire to maintain cognitive clarity and may represent a difficult decision for patients receiving palliative care. Our goal was to understand how patients' decision making about pain medications balances the pain relief from those medications against the cognitive decline often associated with them.
methodsWe conducted qualitative semi-structured interviews with patients receiving home-based palliative care from a program in Toronto, Canada. Interview recordings were transcribed and analyzed using thematic analysis.
resultsThirty-one interviews were conducted. Some patients preferred cognitive preservation over pain management because of a sense that cognition is central to their identity, the desire to maintain lucidity, a desire to continue participating in work or hobbies, and fear of addiction. Conversely, some patients preferred pain management over cognitive preservation because of a desire to avoid suffering, an inability to sleep without medications, or an acceptance of some cognitive compromise. A few patients attempted to find balance through tapering drugs, limiting their use of breakthrough analgesic doses, or using alternative strategies.
conclusionsDecision making around pain and pain management is a highly preference-sensitive process-with no clear right or wrong decisions, only the preferences of each patient. The findings from this study may influence the design of future patient-facing decision aids around pain management. Future studies should pilot interventions to better assist patients with this decision.
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