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Prescribing Guidelines "AND"Controlled Substances

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https://www.readbyqxmd.com/read/29275945/the-supply-of-prescription-opioids-contributions-of-episodic-care-prescribers-and-high-quantity%C3%A2-prescribers
#1
Todd Schneberk, Brian Raffetto, David Kim, David L Schriger
STUDY OBJECTIVE: We determine episodic and high-quantity prescribers' contribution to opioid prescriptions and total morphine milligram equivalents in California, especially among individuals prescribed large amounts of opioids. METHODS: This was a cross-sectional descriptive analysis of opioid prescribing patterns during an 8-year period using the de-identified Controlled Substance Utilization Review and Evaluation System (CURES) database, the California subsection of the prescription drug monitoring program...
December 21, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29222285/five-lessons-learned-about-long-term-pain-management-in-adults-with-sickle-cell-disease
#2
REVIEW
Joshua J Field
Chronic pain affects one-half of adults with sickle cell disease (SCD). Despite the prevalence of chronic pain, few studies have been performed to determine the best practices for this patient population. Although the pathophysiology of chronic pain in SCD may be different from other chronic pain syndromes, many of the guidelines outlined in the pain literature and elsewhere are applicable; some were consensus-adopted in the 2014 National Heart, Lung, and Blood Institute SCD Guidelines. Recommended practices, such as controlled substance agreements and monitoring of urine, may seem unnecessary or counterproductive to hematologists...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29099982/sources-of-distress-in-primary-care-opioid-management-and-the-role-of-a-controlled-substance-review-group-a-qualitative-study
#3
Elizabeth Hulen, Somnath Saha, Benjamin J Morasco, Claire Zeigler, Katherine Mackey, Samuel T Edwards
Objective: The objective of the study was to explore provider perspectives surrounding opioid prescribing in the context of the early implementation of a multidisciplinary group, called the Controlled Substance Review Group, that provided structured opioid case discussion and consultation to primary care providers. Setting: A Veterans Health Administration primary care clinic in Portland, Oregon. Participants: 12 members of primary care clinic staff representing multiple disciplines with recent participation in the Controlled Substance Review Group...
November 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29049115/an-evidence-based-approach-to-the-prescription-opioid-epidemic-in-orthopedic-surgery
#4
REVIEW
Ellen M Soffin, Seth A Waldman, Roberta J Stack, Gregory A Liguori
Orthopedic surgery is associated with significant perioperative pain. Providing adequate analgesia is a critical component of patient care and opioids play a vital role in the acute postoperative setting. However, opioid prescribing for patients undergoing orthopedic procedures has recently been identified as a major contributor to the current opioid epidemic. As opioid usage and related morbidity and mortality continue to rise nationwide, opioid-prescribing practices are under increased scrutiny. Here, we update the evidence base and recommendations behind a set of interventions developed at the Hospital for Special Surgery to address the national epidemic at the local level...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#5
REVIEW
Cobin D Soelberg, Raeford E Brown, Derick Du Vivier, John E Meyer, Banu K Ramachandran
The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29049111/risk-management-for-opioid-prescribing-in-the-treatment-of-patients-with-pain-from-cancer-or-terminal-illness-inadvertent-oversight-or-taboo
#6
David J Copenhaver, Nicolas B Karvelas, Scott M Fishman
As the United States experiences an epidemic of prescription drug abuse, and guidelines on safe practices in prescribing opioids in chronic pain have subsequently emerged from professional organizations and governmental agencies, limited guidance exists for prescribers of opioids to treat pain in patients with cancer or terminal illness. Patients with active cancer or terminal illness often have pain and are frequently prescribed opioids and other controlled substances. Current studies suggest that patients with cancer have similar rates of risk for misuse, abuse, and addiction as the general public...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29026749/implementation-of-a-schedule-ii-patient-agreement-for-opioids-and-stimulants-in-an-adult-primary-care-practice
#7
Erin Downey, Wei Pan, Jan Harrison, Esther Poza-Juncal, Paula Tanabe
BACKGROUND: The consumption of controlled substances in North Carolina and the nation has created a health crisis with epidemic levels of medication diversion, abuse, overdose and death. Primary care providers are the principal prescribers of controlled substances and at greatest risk of encountering patients that abuse medications. Guidelines recommend patient agreements with monitoring requirements when prescribing opioids and stimulants. Studies have focused on opioids and excluded stimulants...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28935267/methylphenidate-doses-in-attention-deficit-hyperactivity-disorder-and-comorbid-substance-use-disorders
#8
Charlotte Skoglund, Lena Brandt, Brian D'Onofrio, Henrik Larsson, Johan Franck
Patients with Attention Deficit/Hyperactivity Disorder (ADHD) and comorbid Substance Use Disorders (SUD) are increasingly being treated with central stimulant medication despite limited evidence for its effectiveness. Lack of longitudinal follow-up studies of dosing and adverse effects has resulted in conflicting treatment guidelines. This study aims to explore whether individuals with ADHD and comorbid SUD are treated with higher stimulant doses than individuals with ADHD only, and whether doses increase over time as a sign of tolerance, a core symptom of addiction...
November 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28832425/transitioning-florida-nps-to-opioid-prescribing
#9
Alicia Craig-Rodriguez, Glenna Gordon, Louise Kaplan, Laurie Grubbs
Prior to statutory changes in prescriptive authority for controlled substances, this study examined the knowledge gaps and prescribing limitations of Florida advanced registered nurse practitioners regarding opioids. Study results revealed statistically significant knowledge gaps in the areas of federal and state guidelines; opioid classes and proper doses; risk assessment skills; monitoring of treatment; and confidence in dealing with challenges of opioid prescribing.
September 21, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28715535/improving-adherence-to-long-term-opioid-therapy-guidelines-to-reduce-opioid-misuse-in-primary-care-a-cluster-randomized-clinical-trial
#10
RANDOMIZED CONTROLLED TRIAL
Jane M Liebschutz, Ziming Xuan, Christopher W Shanahan, Marc LaRochelle, Julia Keosaian, Donna Beers, George Guara, Kristen O'Connor, Daniel P Alford, Victoria Parker, Roger D Weiss, Jeffrey H Samet, Julie Crosson, Phoebe A Cushman, Karen E Lasser
Importance: Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. Objective: To determine whether a multicomponent intervention, Transforming Opioid Prescribing in Primary Care (TOPCARE; http://mytopcare.org/), improves guideline adherence while decreasing opioid misuse risk. Design, Setting, and Participants: Cluster-randomized clinical trial among 53 primary care clinicians (PCCs) and their 985 patients receiving long-term opioid therapy for pain...
September 1, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28666143/prevalence-of-prescription-opioid-use-disorder-among-chronic-opioid-therapy-patients-after-health-plan-opioid-dose-and-risk-reduction-initiatives
#11
Michael Von Korff, Rod L Walker, Kathleen Saunders, Susan M Shortreed, Manu Thakral, Michael Parchman, Ryan N Hansen, Evette Ludman, Karen J Sherman, Sascha Dublin
BACKGROUND: No studies have assessed the comparative effectiveness of guideline-recommended interventions to reduce risk of prescription opioid use disorder among chronic opioid therapy (COT) patients. We compared the prevalence of prescription opioid use disorder among COT patients from intervention clinics that had implemented opioid dose and risk reduction initiatives for more than 4 years relative to control clinics that had not. METHODS: After a healthcare system in Washington State implemented interventions to reduce opioid dose and risks, we surveyed 1588 adult primary care COT patients to compare the prevalence of prescription opioid use disorder among COT patients from the intervention and control clinics...
June 27, 2017: International Journal on Drug Policy
https://www.readbyqxmd.com/read/28600754/substance-use-disorder-treatment-following-clinician-initiated-discontinuation-of-long-term-opioid-therapy-resulting-from-an-aberrant-urine-drug-test
#12
Shannon M Nugent, Steven K Dobscha, Benjamin J Morasco, Michael I Demidenko, Thomas H A Meath, Joseph W Frank, Travis I Lovejoy
BACKGROUND: It is unclear whether substance use disorder (SUD) treatment is offered to, or utilized by, patients who are discontinued from long-term opioid therapy (LTOT) following aberrant urine drug tests (UDTs). OBJECTIVE: To describe the proportion of patients who were referred to, and engaged in, SUD treatment following LTOT discontinuation and to examine differences in SUD treatment referral and engagement based on the substances that led to discontinuation...
June 9, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28411574/risperidone-versus-olanzapine-in-the-acute-treatment-of-persistent-delusional-disorder-a-retrospective-analysis
#13
Karishma Kulkarni, Rashmi Arasappa, Krishna Prasad M, Amit Zutshi, Prabhat K Chand, Pratima Murthy, Mariamma Philip, Kesavan Muralidharan
There is a dearth of prospective trials studying treatment response in Persistent Delusional Disorder (PDD) to guide clinical practice. Available retrospective data indicate good response to second-generation antipsychotics (SGAs). We selected the data of patients prescribed either olanzapine or risperidone from a retrospective chart review of PDD (n=455) at our centre. We compared the two groups olanzapine (n =86) versus risperidone (n =280) on dose, drug adherence, response and adverse effects. The two groups were comparable on socio-demographic and clinical characteristics of PDD...
April 9, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28226334/prescription-opioid-abuse-in-chronic-pain-an-updated-review-of-opioid-abuse-predictors-and-strategies-to-curb-opioid-abuse-part-2
#14
Alan D Kaye, Mark R Jones, Adam M Kaye, Juan G Ripoll, Donald E Jones, Vincent Galan, Burton D Beakley, Frank Calixto, Jamie L Bolden, Richard D Urman, Laxmaiah Manchikanti
Chronic pain and prescription opioid abuse are extremely prevalent in the United States and worldwide. The consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. The risk for misuse of prescribed opioids is much higher in patients with chronic pain, especially those with concurrent substance use and /or mental health disorders. Several reasons can account for the occurrence of opioid abuse and misuse, including self-medication, use for reward, compulsive use related to addiction, and diversion for profit...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226333/prescription-opioid-abuse-in-chronic-pain-an-updated-review-of-opioid-abuse-predictors-and-strategies-to-curb-opioid-abuse-part-1
#15
REVIEW
Alan D Kaye, Mark R Jones, Adam M Kaye, Juan G Ripoll, Vincent Galan, Burton D Beakley, Frank Calixto, Jamie L Bolden, Richard D Urman, Laxmaiah Manchikanti
Chronic pain and prescription opioid abuse are extremely prevalent both in this country and worldwide. Consequences of opioid misuse can be life-threatening with significant morbidity and mortality, exacting a heavy toll on patients, physicians, and society. Individuals with chronic pain and co-occurring substance use disorders and/or mental health disorders, are at a higher risk for misuse of prescribed opioids. Opioid abuse and misuse occurs for a variety of reasons, including self-medication, use for reward, compulsive use because of addiction, and diversion for profit...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#16
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/27794549/clinicians-use-of-prescription-drug-monitoring-programs-in-clinical-practice-and-decision-making
#17
Gillian J Leichtling, Jessica M Irvine, Christi Hildebran, Deborah J Cohen, Sara E Hallvik, Richard A Deyo
Objectives.:  Little is known about clinicians' use of prescription drug monitoring program (PDMP) profiles in decision-making. The objective of this qualitative study was to understand how clinicians use, interpret, and integrate PDMP profiles with other information in making clinical decisions. Design.:  Qualitative interviews of clinician PDMP users. Setting.:  Oregon registrants in the state's PDMP. Subjects.:  Thirty-three clinicians practicing in primary care, emergency medicine, pain management, psychiatry, dentistry, and surgery...
June 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27530106/assessing-the-impact-of-prescribing-directives-on-opioid-prescribing-practices-among-veterans-health-administration-providers
#18
Catherine Barber, David Gagnon, Jennifer Fonda, Kelly Cho, John Hermos, Matthew Miller
PURPOSE: The study aimed to test whether directives on opioid prescribing released by the Veterans Health Administration (VHA) or the Food and Drug Administration (FDA) had an impact on prescribing among VHA providers. METHODS: We used the VHA's linked pharmacy and patient medical records database to identify new prescriptions written for propoxyphene, fentanyl, and controlled release (CR) oxycodone between 1/1/2000 and 12/31/2009. We plotted the monthly proportion of these prescriptions that complied with components of four specific safety alerts or directives for these substances issued by the VHA or FDA between 1/1/2001 and 12/31/2008...
January 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27135134/childhood-attention-deficit-hyperactivity-disorder-prescribing-by-prescriber-type-and-specialty-in-oregon-medicaid
#19
Tracy A Klein, Shannon Panther, Teri Woo, Tamara Odom-Maryon, Kenn Daratha
OBJECTIVE: This study compares nurse practitioner (NP) and physician (MD/DO) prescribing patterns for treatment of children with an attention-deficit/hyperactivity disorder (ADHD)-related diagnosis covered by Oregon Medicaid from 2012 to 2013. METHODS: This study is a limited data set review of Oregon pharmacy claims for youth aged 3-18 at time of prescription fill, who were continuously enrolled for at least 10 months of the index year. Claims with selected ICD-9 codes (n = 197,364) were further defined by 30-day prescriptions and prescription drug events (PDE) linked to each prescriber type of interest...
August 2016: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/26939351/as-opioid-overdose-deaths-reach-record-highs-call-for-systematic-changes-grows-louder
#20
(no author information available yet)
With deaths from opioid overdoses up sharply, a number of organizations are calling for systematic changes to curb the prescription of opioids while also making it easier for patients with addiction problems to access evidence- based treatment. New data from the National Center for Health Statistics un- derscore the scope of the problem: Deaths related to prescription overdoses reached an all-time high in 2014, nearing the 19,000 mark. Deaths linked to heroin reached 10,574, a three-fold increase from 2010...
February 2016: ED Management: the Monthly Update on Emergency Department Management
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