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https://www.readbyqxmd.com/read/28803076/palliative-care-in-vietnam-long-term-partnerships-yield-increasing-access
#1
Eric L Krakauer, Dang Huy Quoc Thinh, Quach Thanh Khanh, Hoang Thi Mong Huyen, Tran Diep Tuan, Than Ha Ngoc The, Do Duy Cuong, Tran Van Thuan, Nguyen Phi Yen, Pham Van Anh, Nguyen Thi Phuong Cham, Kathleen P Doyle, Nguyen Thi Hai Yen, Luong Ngoc Khue
Palliative care began in Vietnam in 2001, but steady growth in palliative care services and education commenced several years later when partnerships for ongoing training and technical assistance by committed experts were created with the Ministry of Health (MoH), major public hospitals, and medical universities. An empirical analysis of palliative care need by the MoH in 2006 was followed by national palliative care clinical guidelines, initiation of clinical training for physicians and nurses, and revision of opioid prescribing regulations...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28803074/hospice-palliative-care-development-in-hungary
#2
Agnes Csikos, Csilla Busa, Katalin Muszbek
During the past 25 years many developmental steps have occurred in Hungary in palliative care. Further education and service development is needed to provide a quality palliative care for all the Hungarian people. Hungary has a universal health care system with a developed infrastructure. The first Hungarian hospice team started in 1991. At that time the concept of hospice care was unknown. Symptom control and psychosocial support for the dying patient was inadequate. The regulatory framework was based on the 1997 Health Care Act which was followed by significant palliative care legislation including documents on the legal requirements for palliative care (2004)...
August 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28802595/variability-in-opioid-prescribing-for-children-undergoing-ambulatory-surgery-in-the-united-states
#3
William C Van Cleve, Eliot B Grigg
STUDY OBJECTIVE: We attempted to describe the opioid prescribing patterns for ambulatory pediatric surgery in the United States from 2007 to 2014. DESIGN: Retrospective database review. SETTING: Operating room ambulatory encounters as determined by the Truven Health Marketscan Commercial Claims and Encounters database. PATIENTS: A total of 929,874 ambulatory surgical encounters were identified in patients <18years of age and, of these, 439,286 encounters generated an analgesic prescription...
September 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28801005/pain-and-policy-studies-group-two-decades-of-working-to-address-regulatory-barriers-to-improve-opioid-availability-and-accessibility-around-the-world
#4
James F Cleary, Martha A Maurer
For two decades, the Pain & Policy Studies Group (PPSG), a global research program at the University of Wisconsin Carbone Cancer Center, has worked passionately to fulfil its mission of improving pain relief by achieving balanced access to opioids worldwide. PPSG's early work highlighted the conceptual framework of balance leading to the development of the seminal guidelines and criteria for evaluating opioid policy. It has collaborated at the global level with UN agencies to promote access to opioids and has developed a unique model of technical assistance to help national governments assess regulatory barriers to essential medicines for pain relief and amend existing or develop new legislation that facilitates appropriate and adequate opioid prescribing according to international standards...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28801000/palliative-care-development-in-ukraine
#5
Victoria Tymoshevska, Kseniya Shapoval-Deinega
There are approximately 1 million cancer patients in Ukraine and 90,000 cancer deaths a year, 35% of these are diagnosed in the late stage of disease. Ukraine has the most severe HIV epidemic in the region with more than 200,000 persons living with HIV/AIDS and 6000-10000 deaths annually. The morphine consumption rate is among the lowest in the. The first palliative care services were established in 1996 and the number has slowly increased with services provided in inpatient units, home and day care programs and by a range of health care providers...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28799863/interprofessional-prescription-opioid-abuse-communication-among-prescribers-and-pharmacists-a-qualitative-analysis
#6
Nicholas E Hagemeier, Fred Tudiver, Scott Brewster, Elizabeth J Hagy, Brittany Ratliff, Angela Hagaman, Robert P Pack
No abstract text is available yet for this article.
August 11, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28797851/palliative-care-development-in-georgia
#7
Nina Kiknadze, Pati Dzotsenidze
Georgia has established the foundational measures for a national palliative care program-policy, education, drug availability, and implementation. Amendments to legislation needed to develop palliative care have been approved. Palliative care has been recognized as a subspecialty in oncology, critical care, internal medicine and surgery. The National Plan for Palliative Care for 2011-2016 was approved. Opioids, especially oral morphine, are available on a limited basis for patients at home but oral morphine is not available for patients in the hospital...
August 7, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28796696/opioid-prescription-and-usage-in-adolescents-undergoing-orthopaedic-surgery-in-the-united-states-a-systematic-review
#8
Erin A Dautremont, Edward Ebramzadeh, Jennifer J Beck, Richard E Bowen, Sophia N Sangiorgio
BACKGROUND: The proper use of opioid analgesia for postoperative pain management is controversial. While opioids are considered the standard of care for multimodal postoperative pain modulation in the United States, there is a lack of established protocols for prescribing opioids in adolescents undergoing outpatient orthopaedic surgery. The objective of this review was to identify and report on current literature on opioid prescription for pain management in adolescents undergoing all procedures, as well as in adults undergoing outpatient orthopaedic surgery...
August 8, 2017: JBJS Reviews
https://www.readbyqxmd.com/read/28794653/real-world-utilization-of-once-daily-extended-release-abuse-deterrent-formulation-of-hydrocodone-a-comparison-with-the-pre-approval-randomized-clinical-trials
#9
Louise Taber, T Christopher Bond, Xuezhe Wang, Aditi Kadakia, Tracy J Mayne
BACKGROUND AND OBJECTIVE: Hydrocodone bitartrate extended release (Hysingla(®) ER, HYD) was previously studied in a 12-week randomized, double-blind, placebo-controlled trial and a 52-week open-label safety study. Both of these preapproval studies allowed dose titration to efficacy. The purpose of the present analysis was to compare dosing and utilization patterns in these previous clinical trials with real-world data (RWD) usage in a retrospective claim analysis performed 12-14 months post approval in the US...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28792290/pearls-and-pitfalls-for-prescribing-opioids-in-a-climate-of-increased-provider-scrutiny
#10
Joanna Gedzior, Arlen Kwong
In August 2016, U.S. Surgeon General Vivek Murthy, MD, MBA, issued a letter to healthcare providers requesting aid in addressing "an urgent health crisis facing America: the opioid epidemic." In this article, we address some of the more poignant challenges that surface in treating patients with opiate addiction. We provide an outline of recommendations from the leading medical organizations to educate primary care providers on how to navigate patients to decreased or discontinued medication loads.
March 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28791786/emergency-department-provider-perspectives-on-benzodiazepine-opioid-co-prescribing-a-qualitative-study
#11
Howard S Kim, Danielle M McCarthy, Jason A Hoppe, D Mark Courtney, Bruce L Lambert
OBJECTIVE: Benzodiazepines and opioids are prescribed simultaneously (i.e. "co-prescribed") in many clinical settings, despite guidelines advising against this practice and mounting evidence that concomitant use of both medications increases overdose risk. This study sought to characterize the contexts in which benzodiazepine-opioid co-prescribing occurs and providers' reasons for co-prescribing. METHODS: We conducted focus groups with ED providers (resident and attending physicians, advanced practice providers, and pharmacists) from three hospitals using semi-structured interviews to elicit perspectives on benzodiazepine-opioid co-prescribing...
August 9, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28790075/implementation-of-a-pharmacist-managed-clinic-for-patients-with-chronic-nonmalignant-pain
#12
Jessica L Norman, Miranda E Kroehl, Huong Mindy Lam, Carmen L Lewis, Chelsea N Mitchell, Cindy L O'Bryant, Katy E Trinkley
PURPOSE: A pharmacist-managed chronic pain clinic (PMCPC) in a primary care setting is described. SUMMARY: As primary care providers (PCPs) may be unprepared or lack time to manage high-risk patients receiving opioids for chronic nonmalignant pain, alternative models of care are needed. The University of Colorado PMCPC is integrated into an internal medicine outpatient clinic. The PMCPC is staffed by 1 clinical pharmacist, with pharmacy students and residents also performing clinic duties...
August 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28782703/the-contribution-of-the-international-pain-policy-fellowship-in-improving-opioid-availability-in-georgia
#13
Pati Dzotsenidze, Martha A Maurer, Dimitri Kordzaia, Ioseb Abesadze, Mary M Skemp Brown, Aaron M Gilson, James F Cleary
In the Republic of Georgia, the incidence and prevalence of cancer is increasing, signifying a growing need for palliative care and pain relief, including with controlled opioid medicines. As a signatory to the Single Convention, the Georgian government has a responsibility to ensure the adequate availability of controlled medicines for medical purposes, however the consumption of morphine is very low, suggesting a high occurrence of unrelieved pain. In Georgia, palliative care development began in the 2000s including the adoption of a policy document in 2005, the creation of the National Palliative Care Coordinator in 2006 and important changes in Georgian legislation in 2007 and 2008, which served to lay a foundation for improving opioid availability...
August 3, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28782114/cancer-survivorship-and-opioid-prescribing-rates-a-population-based-matched-cohort-study-among-individuals-with-and-without-a-history-of-cancer
#14
Rinku Sutradhar, Armend Lokku, Lisa Barbera
BACKGROUND: Little is known about opioid prescribing among individuals who have survived cancer. Our aim is to examine a predominantly socio-economically disadvantaged population for differences in opioid prescribing rates among cancer survivors compared with matched controls without a prior diagnosis of cancer. METHODS: This was a retrospective population-wide matched cohort study. Starting in 2010, individuals residing in Ontario, Canada, who were 18 to 64 years of age and at least 5 years past their cancer diagnosis were matched to controls without a prior cancer diagnosis based on sex and calendar year of birth...
August 7, 2017: Cancer
https://www.readbyqxmd.com/read/28769582/cyp2d6-phenotypes-are-associated-with-adverse-outcomes-related-to-opioid-medications
#15
Jennifer L St Sauver, Janet E Olson, Veronique L Roger, Wayne T Nicholson, John L Black, Paul Y Takahashi, Pedro J Caraballo, Elizabeth J Bell, Debra J Jacobson, Nicholas B Larson, Suzette J Bielinski
BACKGROUND: Variation in the CYP2D6 gene may affect response to opioids in both poor and ultrarapid metabolizers, but data demonstrating such associations have been mixed, and the impact of variants on toxicity-related symptoms (e.g., nausea) is unclear. Therefore, we examined the association between CYP2D6 phenotype and poor pain control or other adverse symptoms related to the use of opioids in a sample of primary care patients. MATERIALS AND METHODS: We identified all patients in the Mayo Clinic RIGHT Protocol who were prescribed an opioid medication between July 01, 2013 and June 30, 2015, and categorized patients into three phenotypes: poor, intermediate to extensive, or ultrarapid CYP2D6 metabolizers...
2017: Pharmacogenomics and Personalized Medicine
https://www.readbyqxmd.com/read/28768631/us-doctor-is-shot-dead-after-refusing-to-prescribe-opioids
#16
Owen Dyer
No abstract text is available yet for this article.
August 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28768628/risk-of-neonatal-drug-withdrawal-after-intrauterine-co-exposure-to-opioids-and-psychotropic-medications-cohort-study
#17
Krista F Huybrechts, Brian T Bateman, Rishi J Desai, Sonia Hernandez-Diaz, Kathryn Rough, Helen Mogun, Leslie S Kerzner, Jonathan M Davis, Megan Stover, Devan Bartels, Jennifer Cottral, Elisabetta Patorno
Objectives To assess the impact of in utero co-exposure to psychotropic medications and opioids on the incidence and severity of neonatal drug withdrawal.Design Observational cohort study.Setting Nationwide sample of pregnancies in publicly insured women in the US, nested in the Medicaid Analytic eXtract (2000-10).Participants 201 275 pregnant women with public insurance who were exposed to opioids around the time of delivery and their liveborn infants.Interventions In utero exposure to psychotropic medications, in particular antidepressants, atypical antipsychotics, benzodiazepines, gabapentin, and non-benzodiazepine hypnotics (Z drugs), with prescriptions filled within the same time window as prescriptions for opioids...
August 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28768614/prescribing-opioids-and-psychotropic-drugs-in-pregnancy
#18
EDITORIAL
Stephen W Patrick, William O Cooper, Matthew M Davis
No abstract text is available yet for this article.
August 2, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28767538/two-fatal-intoxications-due-to-tramadol-alone-autopsy-case-reports-and-review-of-the-literature
#19
Sara Gioia, Massimo Lancia, Mauro Bacci, Fabio Suadoni
Since tramadol was marketed, it has been widely prescribed as a pain killer because of its relatively safe profile among opioids.Nevertheless, intoxication can occur: overdose can lead to fatal outcomes mostly in association with other drugs, via the potential interaction with serotonergic antidepressant medications, as well as the potential for increased central nervous system (CNS) depression.Fatal outcomes only attributable to tramadol are a rare entity. In this case report, 2 fatal cases are described due to tramadol stand-alone intoxication with peculiar characteristics...
August 1, 2017: American Journal of Forensic Medicine and Pathology
https://www.readbyqxmd.com/read/28766982/serum-met-5-enkephalin-levels-are-reduced-in-multiple-sclerosis-and-restored-by-low-dose-naltrexone
#20
Michael D Ludwig, Ian S Zagon, Patricia J McLaughlin
Low-dose naltrexone is a widely used off-label therapeutic prescribed for a variety of immune-related disorders. The mechanism underlying low-dose naltrexone's efficacy for fatigue, Crohn's disease, fibromyalgia, and multiple sclerosis is, in part, intermittent blockade of opioid receptors followed by upregulation of endogenous opioids. Short, intermittent blockade by naltrexone specifically blocks the opioid growth factor receptor resulting in biofeedback events that increase production of the endogenous opioid growth factor (OGF) (chemically termed [Met(5)]-enkephalin) facilitating interactions between opioid growth factor and opioid growth factor receptor that ultimately, result in inhibited cell proliferation...
January 1, 2017: Experimental Biology and Medicine
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