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Journal of Opioid Management

Srinivas Nalamachu, Jeffrey Gudin, Catherine Datto, Karin Coyne, Jiat-Ling Poon, Yiqun Hu
OBJECTIVE: Efficacy and safety of naloxegol, a peripherally acting µ-opioid receptor antagonist that significantly reduces opioid-induced constipation (OIC), were assessed for patient subgroups defined post hoc by baseline maintenance opioid characteristics. DESIGN: Post hoc, pooled analysis of data from two 12-week, randomized, double-blind, placebo-controlled, phase 3 studies. SETTING: Two hundred fifty-seven outpatient centers in the United States and Europe...
May 2018: Journal of Opioid Management
Douglas R Oyler, Kristy S Deep, Phillip K Chang
OBJECTIVE: To examine attitudes, beliefs, and influencing factors of inpatient healthcare providers regarding prescription of opioid analgesics. DESIGN: Electronic cross-sectional survey. SETTING: Academic medical center. PARTICIPANTS: Physicians, advanced practice providers, and pharmacists from a single academic medical center in the southeast United States. MAIN OUTCOME MEASURES: Respondents completed survey items addressing: (1) their practice demographics, (2) their opinions regarding overall use, safety, and efficacy of opioids compared to other analgesics, (3) specific clinical scenarios, (4) main pressures to prescribe opioids, and (5) confidence/comfort prescribing opioids or nonopioids in select situations...
May 2018: Journal of Opioid Management
Jane M Liebschutz, Allison V Lange, Orlaith D Heymann, Karen E Lasser, Pamela Corey, Christopher W Shanahan, Hannah S Kopinski, Jawad M Husain, Phoebe A Cushman, Victoria A Parker
OBJECTIVE: One approach to potential misuse of prescription opioids by patients with chronic pain is team-based collaborative primary care, with primary care visits complemented by frequent visits with nurse care managers (NCMs) specializing in addiction care. However, little is known about the communication strategies NCMs employ in these visits. This study aimed to describe strategies NCMs used with patients when discussing aberrancies encountered during opioid monitoring. DESIGN: Observational study of NCM-patient interactions...
May 2018: Journal of Opioid Management
David H Smith, Jennifer Kuntz, Lynn DeBar, Jill Mesa, Xiuhai Yang, David Boardman, Jennifer Schneider
OBJECTIVE: The authors undertook a qualitative study with open-ended, structured interviews to understand patient)s educational needs for patients undergoing total hip and total knee arthroplasty (THA/TKA). DESIGN: Provider interviews explored their approach with THA/TKA patients on: pain management; barriers to opioid tapering; and recommendations/changes on educational materials to support pain management and opioid reduction. Patient interviews explored their experience, understanding, beliefs surrounding opioids, and recommendations on important content...
May 2018: Journal of Opioid Management
Theddeus Iheanacho, Elina Stefanovics, Robert Rosenheck
OBJECTIVE: The aim of this study is to estimate the prevalence and sociodemographic and clinical correlates of opioid use disorder (OUD), a major cause of morbidity and mortality in the United States, among homeless veterans nationally in the Veterans Health Administration (VHA). DESIGN: Administrative data on 256,404 veterans who were homeless and/or had OUD in fiscal year 2012 were analyzed to evaluate OUD as a risk factor for homelessness along with associated characteristics, comorbidities, and patterns of service use...
May 2018: Journal of Opioid Management
Christina Mueller, Larry F Chu, Joanne C Lin, Fernando Ovalle, Jarred W Younger
No abstract text is available yet for this article.
May 2018: Journal of Opioid Management
Jordan C Smith, Christopher R Nicholas, Scott J Hetzel, Bri M Deyo, Randall T Brown
OBJECTIVE: To examine associations between Pain Catastrophizing Scale (PCS) scores and daily opioid dosage in traumatic injury patients. DESIGN: This was a prospective cohort study with patient assessments at baseline and 1-month following discharge. SETTING: Study visits were conducted at a Regional Level I Trauma Center and by phone at follow-up. PATIENTS: Forty-nine injured inpatients completed baseline PCS. A subsample of 23 patients continued to take prescribed opioid medication at 1-month postdischarge and were included in the current analyses...
May 2018: Journal of Opioid Management
Mellar P Davis, Carlos Fernandez, Sally Regel, Mary Lynn McPherson
Nalbuphine has been commercially available for 40 years for the treatment of acute pain; few studies have centered on management of chronic pain. Nalbuphine unique pharmacology is an advantage in pain management. It is µ antagonist, partial κ agonist for G-proteins and beta-arrestin-2. Benefits are related to G-protein interactions resulting in less nausea, pruritus, and respiratory depression than morphine. At low doses, nalbuphine reduces side effects particularly respiratory depression without loss of analgesia when combined with potent opioids...
March 2018: Journal of Opioid Management
Anna D Coutinho, Kavita Gandhi, Rupali M Fuldeore, Pamela B Landsman-Blumberg, Sanjay Gandhi
OBJECTIVE: Identify opioid abuse risk factors among chronic noncancer pain (CNCP) patients receiving long-term opioid therapy and assess healthcare resource use (HRU) among patients at elevated abuse risk. DESIGN: Data were obtained from an integrated administrative claims database. Classification and Regression Tree (CART) analysis identified risk factors potentially predictive of opioid abuse, which were used to classify the overall population into cohorts defined by levels of abuse risk...
March 2018: Journal of Opioid Management
Stefan Wirz, Richard K Ellerkmann, Martin Soehle, Christian-Dieter Wirtz
PURPOSE: In clinical practice, using different opioid analgesics is common during the induction and maintenance of general anesthesia and for postoperative analgesia. However, if the opioid analgesic could be limited to a single drug, we hypothesized that the risk of adverse drug interactions could be reduced, with fewer adverse effects. We examined the use of oxycodone as a single opioid in a well-defined cohort of orthopedic patients undergoing general anesthesia. METHODS: In this retrolective, monocentric investigation, we reviewed data from 83 patients who underwent general anesthesia and received intravenous oxycodone as the sole analgesic (0...
March 2018: Journal of Opioid Management
Charles P Opperman, Melissa M Butler, Andrew K Stroud, Michael R Sun
A retrospective, cross-sectional study was completed on 220 patients to determine the effects of implementation of an aggressive policy to curb opioid misuse/abuse in an internal medicine residency clinic. Our findings suggest that the development of a clear and consistent protocol for approaching patients on chronic controlled substances, as well as the initiation of regular didactic sessions addressing chronic pain and pain management, led to a dramatic reduction in the number or opioid prescriptions written by our resident providers without much reduction in patient volume...
March 2018: Journal of Opioid Management
Jean C McCalmont, Kim D Jones, Robert M Bennett, Ronald Friend
OBJECTIVES: (1) To assess providers' experience and knowledge of chronic noncancer pain (CNCP) management. (2) To assess providers' utilization of the Centers for Disease Control and Prevention (CDC) 2016 Guideline for Prescribing Opioids for Chronic Pain. (3) To assess the influence of the 2016 CDC guideline on provider confidence in managing CNCP and adherence to the CDC recommendations. METHODS: A cross-sectional, web-based survey conducted with 417 Oregon prescribing providers, divided into three continuing medical education (CME) groups composed of minimal (0-3), moderate (4-10), and high (≥11) hours of training...
March 2018: Journal of Opioid Management
Lauren Hundley, Shelley Spradley, Scott Donelenko
OBJECTIVE: To assess the impact of tapering of chronic high dose opioid therapy in veterans prompted by the implementation of the Opioid Safety Initiative in 2013. DESIGN: IRB and VA Office of Research and Development-approved retrospective, observational chart review. SETTING: North Florida/South Georgia Veterans Health System Patients: Veterans on high dose opioid therapy (≥300 mg of morphine equivalents per day) for chronic non-cancer pain as of 1/1/2012 with an opioid agreement discontinuation note documented in the medical record were included...
March 2018: Journal of Opioid Management
Lauren K Dunn, Sandeep Yerra, Shenghao Fang, Mark F Hanak, Maren K Leibowitz, Salome B Alpert, Siny Tsang, Marcel E Durieux, Edward C Nemergut, Bhiken I Naik
OBJECTIVE: To investigate the incidence of perioperative adverse events in patients receiving intravenous methadone for major spine surgery. DESIGN: Retrospective review of perioperative records from March 2011 and February 2016. SETTING: University of Virginia Healthsystem. PATIENTS: Adult patients undergoing elective spinal fusion of two or more levels. MAIN OUTCOME MEASURES: Incidence of respiratory depression, time to extubation, hypotension, hypoxemia, reintubation, cardiac complications, and death...
March 2018: Journal of Opioid Management
Hanna Hollingsworth, Chris Herndon
No abstract text is available yet for this article.
March 2018: Journal of Opioid Management
Cayley Russell, Benedikt Fischer, Thiago M Fidalgo
No abstract text is available yet for this article.
March 2018: Journal of Opioid Management
Maryann Mazer-Amirshahi, Sergey Motov, Lewis S Nelson
Hydromorphone (HM) is a potent opioid analgesic that is commonly administered in the emergency department (ED) and other acute care settings, such as medical surgical wards. In recent years, there has been a significant increase in the ED administration of HM relative to other opioids. Although HM is an effective analgesic, its use has been commonly implicated in adverse drug events and medication errors. In addition, intravenous HM has potent euphoric effects that may contribute to its abuse liability. There are limited data regarding how acute parenteral administration of opioid analgesics in the setting of high rates of preexisting chronic opioid use (medical or nonmedical) may contribute to or reinforce addictive behavior, making the potential contribution of rising HM administration to subsequent prescription opioid abuse and overdose uncertain...
January 2018: Journal of Opioid Management
Ioannis D Gkegkes, Evelyn Eleni Minis, Christos Iavazzo
BACKGROUND: The role of analgesia is crucial in the management of postoperative pain. Different combinations of oral analgesics have been proposed in the past. The oxycodone/naloxone (OXN) combination is a recent addition and is being used by different surgical specialties. The aim of our study was to clarify the possible role, advantages, and disadvantages of OXN in the pain management of surgical patients. METHOD: The authors retrieved the included studies after performing a systematic search in PubMed and Scopus...
January 2018: Journal of Opioid Management
Robinder Bahniwal, Jarrett Sell, Abdul Waheed
OBJECTIVE: Determine patient recall, attitudes, and perceptions of their pain contract in a family medicine resident out-patient clinic. DESIGN: A cross-sectional study design using a telephone survey to all eligible subjects who signed a hardcopy pain contract from August 29, 2014 to May 19, 2016 at a resident outpatient clinic. SETTING: Penn State Hershey Family and Community Medicine Residency clinic. PARTICIPANTS: All patients who signed a hardcopy pain contract at the practice site who met specific inclusion criteria...
January 2018: Journal of Opioid Management
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