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Journal of Opioid Management

David M Erekson, Liliana Bautista, Dallin Albright
OBJECTIVE: Opioid misuse risk assessment has been highlighted as an important part of clinical practice, but there is a paucity of research identifying an effective approach to assessment. Currently, practitioners use patient history, interviews, and formal questionnaires, and these data are weighed clinically to assign risk. The authors propose the use of an actuarial method-the Bayesian nomogram-as a simple, standard, evidence-based approach to opioid misuse risk assessment. INTERVENTIONS: The Bayesian nomogram relies solely on empirically established relationships between risk factors and risk and has been found in other fields to be both more efficient and more consistent than clinical judgment...
September 2018: Journal of Opioid Management
Jennifer G Erensen, J David Haddox, Maigh S Attre, Luis N Bauza
OBJECTIVE: To characterize pharmacy-related theft data reported to the Rx Pattern Analysis Tracking Robberies and Other Losses (RxPATROL®) database during the time periods before (2007-2010) and after (2011-2016) the August 2010 switch to reformulated OxyContin® (oxycodone hydrochloride) extended-release tablets (Purdue Pharma L.P.). METHODS: The RxPATROL® database was queried to identify characteristics associated with theft of drug products. Variables analyzed included incident counts, drugs involved (OxyContin or other oxycodone products), pharmacy-security features, and other incident-related information...
September 2018: Journal of Opioid Management
Diana Meske, Ernest A Kopecky, Steven Passik, Megan J Shram
OBJECTIVE: To further characterize the human abuse potential and pharmacokinetics (PK) of Oxycodone DETERx (Xtampza® ER) after intact and chewed oral administration. DESIGN: Randomized, double-blind, triple-dummy, active- and placebo-controlled, single-dose, six-period, crossover comparison study. SETTING: Clinical research unit. SUBJECTS: Adult, nondependent recreational opioid users who liked the effects of crushed immediate-release (IR) oxycodone in solution and were able to differentiate the effects from placebo solution...
September 2018: Journal of Opioid Management
Valerie Hruschak, Gerald Cochran, Ajay D Wasan
OBJECTIVE: Opioid misuse in the context of chronic noncancer pain (CNCP) is a multifaceted and complex issue. As opioid misuse and corresponding rates of addiction and overdose deaths exceed epidemic proportions, there is an urgent need for research in this area. The objective of this review is to evaluate the literature addressing psychosocial interventions targeting CNCP and prescription opioid misuse. DESIGN: A systematic search of PubMed, MEDLINE, PsychINFO, ClinicalTrials...
September 2018: Journal of Opioid Management
Guillermo Alberto Keller, Cecilia Villa Etchegoyen, Nicolás Fernandez, Nancy Mónica Olivera, Patricia Noemí Quiroga, Roberto Alejandro Diez, Guillermo Di Girolamo
OBJECTIVE: To evaluate frequency and risk factors for dextropropoxypheneinduced QT-interval prolongation in the clinical setting. DESIGN: Prospective, noninterventional, observational, longitudinal cohort approach. Electrocardiograms were blindly evaluated by independent professionals. SETTING: General ward of a public hospital of metropolitan Buenos Aires. PATIENTS, PARTICIPANTS: Ninety-two patients with indication of receiving dextropropoxyphene for analgesic purposes were included consecutively...
September 2018: Journal of Opioid Management
Elias Youssef, Han Tony Gao, Conor Russell, Shorok Hassan, Brahim Ardolic, Barry Hahn
OBJECTIVES: In this study, we aim to identify and discuss the clinical and demographic characteristics of previous emergency department (ED) patient visits, at one of the only two medical centers in Staten Island, the epicenter of the opioid epidemic within Staten Island, who subsequently present to the ED with an opioid overdose. DESIGN: This was a retrospective, observational study of all patients presenting to the emergency ED between July 1, 2010 and December 31, 2015...
September 2018: Journal of Opioid Management
Julianna Fernandez, James Douglas Thornton, Sanika Rege, Benjamin Lewing, Shweta Bapat, Qingqing Xu, Marc L Fleming
OBJECTIVE: To qualitatively assess prescribers) perceptions regarding the consequences associated with hydrocodone rescheduling among geriatric patients being discharged from inpatient settings. DESIGN: This was a cross-sectional study. SETTING: Two focus groups were conducted by a trained facilitator in a metropolitan academic medical center in January 2016. PARTICIPANTS: Prescribers who manage noncancer pain for geriatric patients were recruited...
September 2018: Journal of Opioid Management
Jeannie S Huang, Cynthia L Kuelbs
OBJECTIVE: Little is known regarding clinician prescribing of opioid medications and of patient use of prescribed opioid medications in pediatrics. The authors sought to learn more about pediatric clinician opioid prescribing practices and patient utilization and disposal of prescribed opioids. DESIGN: Cross-sectional, observational study. SETTING: Tertiary care pediatric healthcare center. PARTICIPANTS: Pediatric clinicians who prescribe opioid medications and parents of children prescribed an opioid medication...
September 2018: Journal of Opioid Management
Jessica J Wyse, Benjamin J Morasco, Steven K Dobscha, Michael I Demidenko, Thomas H A Meath, Travis I Lovejoy
OBJECTIVE: Urine drug testing (UDT) is increasingly performed as a means of identifying aberrant behavior that may be grounds for discontinuation of long-term opioid therapy (LTOT). Little is known, however, about the ways in which positive UDT results may differentially inform decisions to discontinue LTOT based on the type of substance for which the UDT screened positive. The aim of this study was to examine the likelihood of clinician-initiated discontinuation of LTOT attributed to positive UDT results across three discrete categories of substances: (1) cannabis, (2) alcohol or illicit substances (excluding cannabis), and (3) controlled prescription medications that were not prescribed...
July 2018: Journal of Opioid Management
Amitabh Dutta, Nitin Sethi, Prabhat Choudhary, Jayashree Sood, Bhuwan Chand Panday, Parul Takkar Chugh
OBJECTIVE: Postoperative nausea and vomiting (PONV) is commonly attributed to opioid analgesics; consequently, perioperative opioid dosage reduction is a common practice. However, inadequate fentanyl analgesia may have adverse implications (sympathetic activation, pain). We conducted this randomized clinical study to analyze whether preinduction fentanyl 3 µg kg-1 administered by different techniques increases incidence of PONV. DESIGN: Randomized-control, prospective, investigator and observer blinded, two-arm, single-center comparison...
July 2018: Journal of Opioid Management
Ulrike Ott, Matthew S Thiese, Brenden B Ronna, Kristine Hegmann, Kurt T Hegmann
OBJECTIVES: Working-age adults are disproportionately impacted by opioid misuse. Factors associated with opioid misuse in people with workers compensation (WC) claims are not well studied. WC in some states is a "captured" market making it a more efficient site for researching the opioids epidemic. A pilot study was conducted to identify factors associated with opioid use using a large WC insurer's claims in Utah. METHODS: This was a case-control study using a large WC insurer's database...
July 2018: Journal of Opioid Management
Maryann Mazer-Amirshahi, Diana Ladkany, Peter M Mullins, Sergey Motov, Jeanmarie Perrone, Lewis S Nelson, Jesse M Pines
OBJECTIVE: To examine recent trends in and predictors of hydromorphone administration in US emergency departments (EDs) compared with other opioids. DESIGN: Retrospective review of data from the National Hospital Ambulatory Medical Care Survey from 2007 to 2014. PARTICIPANTS: All adult ED visits where an opioid analgesic was administered were included. MAIN OUTCOME MEASURES: Trends in and predictors of hydromorphone administration were assessed using survey-weighted logistic regression, comparing hydromorphone visits with ED visits where other opioids were administered...
July 2018: Journal of Opioid Management
John W Shumway, Renzhong Ran, Jeff McClusky, Zubaid Rafique, Cedric Dark, W Frank Peacock, Alexie Cintron, Michelle Ludwig
OBJECTIVE: The objective of this study was to examine the rescheduling of hydrocodone-combination products (HCPs) and associated changes in prescriber patterns in an urban county healthcare system in Texas. METHODS: Pharmacy data were obtained electronically for tramadol, hydrocodone-acetaminophen, and acetaminophen-codeine from 180 days before and after the schedule change on October 6, 2014. x 2 and t tests were used to calculate the significance of changes between the medications over the studied time...
July 2018: Journal of Opioid Management
Asmaa Janah, Anne-Déborah Bouhnik, Sébastien Cortaredona, Julien Mancini, Philippe Jean Bousquet, Patrick Peretti-Watel, Marc-Karim Bendiane
INTRODUCTION AND OBJECTIVES: According to World Health Organization recommendations, opioids prescription is a key aspect of improvement in cancer pain relief. However, studies on opioids prescription in France are scarce. This study aimed principally to investigate the impact of cancer on opioids prescription and then to identify factors associated with this prescription, focusing on patients& characteristics impact. METHODS: We matched the following two cohorts: cancer survivors (N = 6,760) and individuals without cancer (N = 6,760)...
July 2018: Journal of Opioid Management
Chris Gillette, Mark A Bush, Kate M L Rogers, Geoffrey Mospan, Kimberly Nealy, Michelle DeGeeter, April M Robinson
OBJECTIVE: To examine if North Carolina (NC) opioid prescribing guidelines were associated with changes in opioid prescribing. METHOD: Retrospective secondary analysis of the Medicare Provider Utilization and Payment Data: Part D Prescriber datasets from 2013 to 2015. PARTICIPANTS: Providers who prescribed at least one opioid from 2013 to 2015 and paid by Medicare Part D. MAIN OUTCOME MEASURE: Per-prescriber Medicare-population adjusted number of analgesic opioid claims and per-prescriber average day supply...
July 2018: Journal of Opioid Management
Maurizio Coppola, Raffaella Mondola
No abstract text is available yet for this article.
July 2018: 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
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