ABSTRACT
Pain is a common but often ignored symptom in COVID-19 patients. Early and adequate treatment with detailed pain assessment in these patients may reduce the risk of pain chronicization, and mood dysregulation. To provide analgesia, paracetamol can be listed as the first option in these patients, and then NSAIDs can also be reliably used for pain management in patients with COVID-19 if there are no absolute contraindications such as kidney failure or gastric bleeding. Codeine is also a good alternative for patients with anxiety who do not respond to simple pain-relievers.
Subject(s)
Analgesics, Non-Narcotic/therapeutic use , COVID-19/complications , Pain/etiology , SARS-CoV-2 , Acetaminophen/administration & dosage , Acetaminophen/therapeutic use , Administration, Oral , Analgesics, Non-Narcotic/administration & dosage , Analgesics, Opioid/adverse effects , Analgesics, Opioid/therapeutic use , Humans , Pain/drug therapyABSTRACT
BACKGROUND: Anticipatory prescribing (AP) of injectable medications in advance of clinical need is established practice in community end-of-life care. Changes to prescribing guidelines and practice have been reported during the COVID-19 pandemic. AIMS AND OBJECTIVES: To investigate UK and Ireland clinicians' experiences concerning changes in AP during the COVID-19 pandemic and their recommendations for change. METHODS: Online survey of participants at previous AP national workshops, members of the Association for Palliative Medicine of Great Britain and Ireland and other professional organisations, with snowball sampling. RESULTS: Two hundred and sixty-one replies were received between 9 and 19 April 2020 from clinicians in community, hospice and hospital settings across all areas of the UK and Ireland. Changes to AP local guidance and practice were reported: route of administration (47%), drugs prescribed (38%), total quantities prescribed (35%), doses and ranges (29%). Concerns over shortages of nurses and doctors to administer subcutaneous injections led 37% to consider drug administration by family or social caregivers, often by buccal, sublingual and transdermal routes. Clinical contact and patient assessment were more often remote via telephone or video (63%). Recommendations for regulatory changes to permit drug repurposing and easier community access were made. CONCLUSIONS: The challenges of the COVID-19 pandemic for UK community palliative care has stimulated rapid innovation in AP. The extent to which these are implemented and their clinical efficacy need further examination.