{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T18:10:03Z","timestamp":1777918203980,"version":"3.51.4"},"reference-count":19,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,4,10]],"date-time":"2022-04-10T00:00:00Z","timestamp":1649548800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Palliat Med"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Real-world effectiveness of interventions in palliative care need to be systematically quantified to inform patient\/clinical decisions. Neuropathic pain is prevalent and difficult to palliate. Tricyclic antidepressants have an established role for some neuropathic pain aetiologies, but this is less clear in palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim:<\/jats:title>\n                    <jats:p>To describe the real-world use and outcomes from amitriptyline or nortriptyline for neuropathic pain in palliative care.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>An international, prospective, consecutive cohort post-marketing\/phase IV\/pharmacovigilance\/quality improvement study of palliative care patients with neuropathic pain where the treating clinician had already made the decision to use a tricyclic antidepressant. Data were entered at set times: baseline, and days 7 and 14. Likert scales graded benefits and harms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/participants:<\/jats:title>\n                    <jats:p>Twenty-one sites (inpatient, outpatient, community) participated in six countries between June 2016 and March 2019. Patients had clinician-diagnosed neuropathic pain.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>One hundred and fifty patients were prescribed amitriptyline (110) or nortriptyline (40) of whom: 85% had cancer; mean age 73.2\u2009years (SD 12.3); mean 0\u20134 scores for neuropathic pain at baseline were 1.8 (SD 1.0). By day 14, doses of amitriptyline were 57\u2009mg (SD 21) and nortriptyline (48\u2009mg (SD 21). Fifty-two (34.7%) patients had pain improvement by day 14 (amitriptyline (45\/110 (43.3%); nortriptyline (7\/40 (18.9%)). Thirty-nine (27.7%) had new harms; (amitriptyline 29\/104 (27.9%); nortriptyline 10\/37 (27.0%); dizziness ( n\u2009=\u200923), dry mouth ( n\u2009=\u200920), constipation ( n\u2009=\u200914), urinary retention ( n\u2009=\u200910)). Benefits without harms occurred (amitriptyline (26\/104 (25.0%); nortriptyline (4\/37 (10.8%)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>Benefits favoured amitriptyline while harms were similar for both medications.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/02692163221085855","type":"journal-article","created":{"date-parts":[[2022,4,11]],"date-time":"2022-04-11T01:09:10Z","timestamp":1649639350000},"page":"938-944","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":7,"title":["Pharmacovigilance in hospice\/palliative care: Net effect of amitriptyline or nortriptyline on neuropathic pain: UTS\/IMPACCT Rapid programme international consecutive cohort"],"prefix":"10.1177","volume":"36","author":[{"given":"Akram","family":"Hussein","sequence":"first","affiliation":[{"name":"Hunter New England Health, Newcastle, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madeline","family":"Digges","sequence":"additional","affiliation":[{"name":"Royal Melbourne Hospital, Parkville, VIC, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sungwon","family":"Chang","sequence":"additional","affiliation":[{"name":"IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jane","family":"Hunt","sequence":"additional","affiliation":[{"name":"IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matt","family":"Doogue","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Otago, Christchurch, New Zealand"},{"name":"Department of Clinical Pharmacology, Canterbury District Health Board, Christchurch, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Debra","family":"Rowett","sequence":"additional","affiliation":[{"name":"Clinical & Health Sciences, University of South Australia, Adelaide, South Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6756-6119","authenticated-orcid":false,"given":"Meera","family":"Agar","sequence":"additional","affiliation":[{"name":"IMPACCT, Faculty of Health, University of Technology Sydney, Ultimo, NSW, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7967-159X","authenticated-orcid":false,"given":"Aynharan","family":"Sinnarajah","sequence":"additional","affiliation":[{"name":"Family Medicine and Community Health Sciences, University of Calgary, Calgary, AB, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Danielle","family":"Kain","sequence":"additional","affiliation":[{"name":"Department of Medicine, Queen\u2019s University, Kingston, ON, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simon","family":"Allan","sequence":"additional","affiliation":[{"name":"Arohanui Hospice, Palmerston North, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5272-3057","authenticated-orcid":false,"given":"Jason W","family":"Boland","sequence":"additional","affiliation":[{"name":"Hull York Medical School, University of Hull, Hull, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1988-1250","authenticated-orcid":false,"given":"David C","family":"Currow","sequence":"additional","affiliation":[{"name":"Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, NSW, 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