{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T08:20:26Z","timestamp":1777882826982,"version":"3.51.4"},"reference-count":17,"publisher":"SAGE Publications","issue":"1","license":[{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,6,1]],"date-time":"2025-06-01T00:00:00Z","timestamp":1748736000000},"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":["Palliative Medicine Reports"],"published-print":{"date-parts":[[2025,6,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background:<\/jats:title>\n                    <jats:p>Terminally ill cancer patients often experience pain and delirium. However, opioids administered for pain management may exacerbate patients\u2019 delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>To explore the real-world symptom trajectory associated with pharmacological interventions, including opioids and antipsychotics, in patients with cancer pain and terminal delirium.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design:<\/jats:title>\n                    <jats:p>A secondary analysis of a multicenter prospective observational study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting\/Subjects:<\/jats:title>\n                    <jats:p>Adult patients admitted to inpatient hospice or palliative care units in Japan. Participants were eligible if they had cancer pain (Integrated Palliative care Outcome Scale: IPOS \u22652) and delirium at the time that their Palliative Performance Scale had declined to \u226420 (day 1, immediately before death).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measurements:<\/jats:title>\n                    <jats:p>Pharmacological strategies, pain levels (using the IPOS), and delirium symptoms (using the Memorial Delirium Assessment Scale, item-9).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Among a total of 1896 patients, 1396 were assessed for eligibility on day 1, and 137 met the inclusion criteria for analysis. A total of 86 (63%) patients had agitated delirium (hyperactive or mixed) with a median survival time of three days. Regarding pharmacological strategies, 32 (23%) received opioid initiation\/dose escalation and 94 (69%) received regular administration of antipsychotics. These figures also included 25 (18%) patients who received both opioid initiation\/dose escalation and antipsychotics. Approximately 55% of all patients had persistent cancer pain (IPOS for pain \u22652) on day 2. Among those with agitated delirium, 79% continued to exhibit agitation symptoms on day 2.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Despite specialized palliative care, the combined distress of cancer pain and delirium in the last days of life remains complex and refractory.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/26892820251390525","type":"journal-article","created":{"date-parts":[[2025,10,24]],"date-time":"2025-10-24T15:04:54Z","timestamp":1761318294000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Pharmacological Strategies for Pain Relief in Patients with Terminal Delirium: A Secondary Data Analysis"],"prefix":"10.1177","volume":"6","author":[{"given":"Takaaki","family":"Hasegawa","sequence":"first","affiliation":[{"name":"Center for Psycho-oncology and Palliative Care, Nagoya City University Hospital, Nagoya, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masanori","family":"Mori","sequence":"additional","affiliation":[{"name":"Palliative and Supportive Care Division, Seirei Mikatahara General Hospital, Hamamatsu, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Takashi","family":"Yamaguchi","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Konan Medical Center, Kobe, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kengo","family":"Imai","sequence":"additional","affiliation":[{"name":"Seirei Hospice, Seirei Mikatahara General Hospital, Hamamatsu, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yoshinobu","family":"Matsuda","sequence":"additional","affiliation":[{"name":"Department of Psychosomatic Internal Medicine, NHO Kinki Chuo Chest Medical Center, Sakai, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isseki","family":"Maeda","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Senri-Chuo Hospital, Toyonaka, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yutaka","family":"Hatano","sequence":"additional","affiliation":[{"name":"Department of Palliative Care, Daini Kyoritsu Hospital, Kawanishi, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroto","family":"Ishiki","sequence":"additional","affiliation":[{"name":"Department of Palliative Medicine, National Cancer Center Hospital, Tokyo, Japan."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroyuki","family":"Otani","sequence":"additional","affiliation":[{"name":"Department of Palliative Care Team, Palliative and Supportive Care, National Hospital Organization Kyushu Cancer Center, Fukuoka, Japan."},{"name":"Department of Palliative Care Team, Palliative and Supportive 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