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Opioid prescribing

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https://www.readbyqxmd.com/read/29150198/comparative-effectiveness-of-extended-release-naltrexone-versus-buprenorphine-naloxone-for-opioid-relapse-prevention-x-bot-a-multicentre-open-label-randomised-controlled-trial
#1
Joshua D Lee, Edward V Nunes, Patricia Novo, Ken Bachrach, Genie L Bailey, Snehal Bhatt, Sarah Farkas, Marc Fishman, Phoebe Gauthier, Candace C Hodgkins, Jacquie King, Robert Lindblad, David Liu, Abigail G Matthews, Jeanine May, K Michelle Peavy, Stephen Ross, Dagmar Salazar, Paul Schkolnik, Dikla Shmueli-Blumberg, Don Stablein, Geetha Subramaniam, John Rotrosen
BACKGROUND: Extended-release naltrexone (XR-NTX), an opioid antagonist, and sublingual buprenorphine-naloxone (BUP-NX), a partial opioid agonist, are pharmacologically and conceptually distinct interventions to prevent opioid relapse. We aimed to estimate the difference in opioid relapse-free survival between XR-NTX and BUP-NX. METHODS: We initiated this 24 week, open-label, randomised controlled, comparative effectiveness trial at eight US community-based inpatient services and followed up participants as outpatients...
November 14, 2017: Lancet
https://www.readbyqxmd.com/read/29149155/lower-cutoffs-for-lc-ms-ms-urine-drug-testing-indicates-better-patient-compliance
#2
Kevin Krock, Amadeo Pesce, Dennis Ritz, Richard Thomas, Agnes Cua, Ryan Rogers, Phil Lipnick, Kristen Kilbourn
BACKGROUND: Urine drug testing is used by health care providers to determine a patient's compliance to their prescribed regimen and to detect non-prescribed medications and illicit drugs. However, the cutoff levels used by clinical labs are often arbitrarily set and may not reflect the urine drug concentrations of compliant patients. OBJECTIVES: Our aim was to test the hypothesis that commonly used cutoffs for many prescribed and illicit drugs were set too high, and methods using these cutoffs may yield a considerable number of false-negative results...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149154/philosophical-issues-and-psychological-variables-that-influence-the-determination-of-opioid-effectiveness-a-narrative-review
#3
Daniel Michael Doleys
BACKGROUND: The prescribing of opioids in the chronic pain setting is often based on the pharmacodynamics, pharmacokinetics, and pharmacogenetics of the drug obtained during development and clinical trials. However, the effectiveness of opioids varies widely and often appears to bear no relationship to the aforementioned variables. The impact of philosophical issues and psychological factors on determining how clinically effective opioid therapy is has often been over looked. OBJECTIVES: This manuscript provides a selective review and narrative summary of the philosophical issues and psychological factors which can influence opioid effectiveness...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149119/pain-management-strategies-for-screening-and-monitoring-patients-receiving-chronic-opioid-therapy%C3%A2
#4
Karen Hande
The current state of pain management within the oncology setting, effectiveness of opioids for the relief of pain, and limited alternatives for chronic pain management have produced reliance on opioid medications with an inherent risk for aberrant behavior. Although standardization is lacking among prescribers who manage cancer-related pain, advanced practice RNs must act according to the available evidence that suggests assessing and monitoring for abuse and misuse. 
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December 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29148954/our-life-depends-on-this-drug-competence-inequity-and-voluntary-consent-in-clinical-trials-on-supervised-injectable-opioid-assisted-treatment
#5
Daniel Steel, Kirsten Marchand, Eugenia Oviedo-Joekes
Supervised injectable opioid assisted treament (siOAT) prescribes injectable opioids to individuals for whom other forms of addiction treatment have been ineffective. In this article, we examine arguments that opioid-dependent people should be assumed incompetent to voluntarily consent to clinical research on siOAT unless proven otherwise. We agree that concerns about competence and voluntary consent deserve careful attention in this context. But we oppose framing the issue solely as a matter of the competence of opioid-dependent people and emphasize that it should be considered in the context of inequities in access to siOAT as a medical treatment...
December 2017: American Journal of Bioethics: AJOB
https://www.readbyqxmd.com/read/29148351/opioid-prescribing-by-nurse-practitioners-in-medicare-part-d-impact-of-state-scope-of-practice-legislation
#6
Elissa Ladd, Casey Fryer Sweeney, Anthony Guarino, Alex Hoyt
Many state legislatures restrict nurse practitioner (NP) scope of practice as a way of addressing patient safety concerns. The purpose of this study was to investigate the influence of state NP scope of practice laws on the prescription of oxycodone and hydrocodone containing medications by NP and MD/DO/PA prescribers to Medicare Part D beneficiaries. Using the Medicare Part D public use file, we analyzed oxycodone and hydrocodone containing prescriptions per Medicare Part D beneficiary by prescriber type, NP state scope of practice, and geographic variables...
August 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29146621/effect-of-fda-investigation-on-opioid-prescribing-to-children-after-tonsillectomy-adenoidectomy
#7
Kao-Ping Chua, Mark G Shrime, Rena M Conti
BACKGROUND: In August 2012, the Food and Drug Administration investigated the safety of codeine use by children after tonsillectomy and/or adenoidectomy, culminating in a black box warning in February 2013. The objective of this study was to evaluate the association between the investigation and opioid prescribing to children undergoing these surgeries. METHODS: We identified 362 992 privately insured children in the 2010-2015 Truven MarketScan Commercial Claims and Encounters database who underwent tonsillectomy and/or adenoidectomy...
November 16, 2017: Pediatrics
https://www.readbyqxmd.com/read/29145698/illicit-drug-use-illicit-drug-use-disorders-and-drug-overdose-deaths-in-metropolitan-and-nonmetropolitan-areas-united-states
#8
EDITORIAL
Karin A Mack, Christopher M Jones, Michael F Ballesteros
PROBLEM/CONDITION: Drug overdoses are a leading cause of injury death in the United States, resulting in approximately 52,000 deaths in 2015. Understanding differences in illicit drug use, illicit drug use disorders, and overall drug overdose deaths in metropolitan and nonmetropolitan areas is important for informing public health programs, interventions, and policies. REPORTING PERIOD: Illicit drug use and drug use disorders during 2003-2014, and drug overdose deaths during 1999-2015...
December 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/29143483/the-impact-of-mental-health-comorbidities-on-adherence-to-buprenorphine-a-claims-based-analysis
#9
Megan Litz, Douglas Leslie
BACKGROUND AND OBJECTIVES: Previous research has been inconclusive about whether opioid-dependent patients with psychiatric comorbidities have shorter treatment retention and higher relapse rates. This study aims to evaluate the impact of mental health comorbidities on adherence to buprenorphine using a large, national health insurance claims data base. METHODS: We used MarketScan® data from 2012 to 2014 to perform this analysis. Inclusion criteria included all patients with an opioid use disorder-related ICD-9 code who had been prescribed buprenorphine (n = 2947)...
November 16, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29143401/assessment-of-risk-behaviors-in-patients-with-opioid-prescriptions-a-study-of-indiana-s-inspect-data
#10
Marion S Greene, Robert Andrew Chambers, Constantin T Yiannoutsos, Eric R Wright, Gregory K Steele, Terrell W Zollinger
BACKGROUND AND OBJECTIVES: Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision-making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients' likelihood to engage in opioid-related risk behaviors. METHODS: Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines...
November 16, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29141653/test-of-a-workforce-development-intervention-to-expand-opioid-use-disorder-treatment-pharmacotherapy-prescribers-protocol-for-a-cluster-randomized-trial
#11
Todd Molfenter, Hannah K Knudsen, Randy Brown, Nora Jacobson, Julie Horst, Mark Van Etten, Jee-Seon Kim, Eric Haram, Elizabeth Collier, Sanford Starr, Alexander Toy, Lynn Madden
BACKGROUND: Overdoses due to non-medical use of prescription opioids and other opiates have become the leading cause of accidental deaths in the USA. Buprenorphine and extended-release naltrexone are key evidence-based pharmacotherapies available to addiction treatment providers to address opioid use disorder (OUD) and prevent overdose deaths. Treatment organizations' efforts to provide these pharmacotherapies have, however, been stymied by limited success in recruiting providers (physicians, nurse practitioners, and physician assistants) to prescribe these medications...
November 15, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29137580/prevalence-and-predictors-of-persistent-post-surgical-opioid-use-a-prospective-observational-cohort-study
#12
N Stark, S Kerr, J Stevens
Post-surgical opioid prescribing intended for the short-term management of acute pain may lead to long-term opioid use. This study was undertaken to determine the prevalence of persistent post-surgical opioid use and patient-related factors associated with post-surgical opioid use. One thousand and thirteen opioid-naïve patients awaiting elective surgery in a tertiary private hospital in Sydney were enrolled. Preoperatively, patients completed a questionnaire comprising potential predictors of persistent post-surgical opioid use...
November 2017: Anaesthesia and Intensive Care
https://www.readbyqxmd.com/read/29136228/opioid-prescription-use-in-nursing-home-residents-with-advanced-dementia
#13
Charlotte Griffioen, Bettina S Husebo, Elisabeth Flo, Monique A A Caljouw, Wilco P Achterberg
Background: Although proper pain treatment may require opioids, discussion continues about possible undertreatment or overtreatment in persons with advanced dementia. Objective: To investigate the prevalence of pain, frequency of opioid prescription use, and factors associated with strong opioid prescription use in nursing homes. Design: Cross-sectional study. Setting and Subjects: Eighteen Norwegian nursing homes; 327 persons with advanced dementia and behavioral disturbances participated...
November 9, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29135839/patterns-of-opioid-prescribing-and-predictors-of-chronic-opioid-use-in-an-industrial-cohort-2003-to-2013
#14
Mellisa A Pensa, Deron H Galusha, Linda F Cantley
OBJECTIVE: To appreciate the impact of the opioid epidemic in workers, we described opioid prescription patterns in a US industrial cohort over a 10-year period and assessed predictors of chronic prescription. METHODS: A multiyear (2003 to 2013) cross-sectional analysis of employer-sponsored health care claims for enrolled workers (N: 21,357 to 44,769) was performed. RESULTS: The proportion of workers prescribed opioids nearly doubled in the 10-year period...
November 13, 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/29135698/associations-between-early-care-decisions-and-the-risk-for-long-term-opioid-use-for-patients-with-low-back-pain-with-a-new-physician-consultation-and-initiation-of-opioid-therapy
#15
Julie M Fritz, Jordan B King, Carrie McAdams-Marx
OBJECTIVE: Identify associations between early care decisions and long-term opioid use in opioid-naïve patients with a new physician consultation for low back pain at which an opioid was prescribed. METHODS: Retrospective study of claims data was used to identify opioid-naïve low back pain patients who were prescribed opioids at the index physician visit. Early care variables captured included additional non-opioid medications prescribed within 14 days, and provider visits or diagnostic imaging within 30 days of the index visit...
November 10, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29135696/effect-of-a-scenario-tailored-opioid-messaging-program-on-parents-risk-perceptions-and-opioid-decision-making
#16
Terri Voepel-Lewis, Brian J Zikmund-Fisher, Carol J Boyd, Philip T Veliz, Sean Esteban McCabe, Monica Weber, Alan R Tait
OBJECTIVES: Poor parental understanding of prescription opioid risks is associated with potentially dangerous decisions that can contribute to adverse drug events (ADE) in children and adolescents. This study examined whether an interactive Scenario-Tailored Opioid Messaging Program (STOMP™) would (1) enhance opioid risk perceptions and (2) improve the safety of parents' decision-making. METHODS: 546 parents were randomized to receive the STOMP™ versus Control information and 516 completed the program...
November 10, 2017: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29135671/support-for-safer-opioid-prescribing-practices-a-catalog-of-published-use-after-orthopaedic-surgery
#17
Francis Lovecchio, Peter Derman, Jeffrey Stepan, Sravisht Iyer, Alexander Christ, Peter Grimaldi, Kanupriya Kumar, Anil Ranawat, Samuel A Taylor
No abstract text is available yet for this article.
November 15, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/29133312/exploring-perceptions-and-experiences-of-patients-who-have-chronic-pain-as-state-prescription-opioid-policies-change-a-qualitative-study-in-indiana
#18
Morhaf Al Achkar, Debra Revere, Barbara Dennis, Palmer MacKie, Sumedha Gupta, Shaun Grannis
OBJECTIVES: The misuse and abuse of prescription opioids (POs) is an epidemic in the USA today. Many states have implemented legislation to curb the use of POs resulting from inappropriate prescribing. Indiana legislated opioid prescribing rules that went into effect in December 2013. The rules changed how chronic pain is managed by healthcare providers. This qualitative study aims to evaluate the impact of Indiana's opioid prescription legislation on the patient experiences around pain management...
November 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/29130474/interventions-for-the-reduction-of-prescribed-opioid-use-in-chronic-non-cancer-pain
#19
REVIEW
Christopher Eccleston, Emma Fisher, Kyla H Thomas, Leslie Hearn, Sheena Derry, Cathy Stannard, Roger Knaggs, R Andrew Moore
BACKGROUND: This is the first update of the original Cochrane Review published in 2013. The conclusions of this review have not changed from the 2013 publication. People with chronic non-cancer pain who are prescribed and are taking opioids can have a history of long-term, high-dose opioid use without effective pain relief. In those without good pain relief, reduction of prescribed opioid dose may be the desired and shared goal of both patient and clinician. Simple, unsupervised reduction of opioid use is clinically challenging, and very difficult to achieve and maintain...
November 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29130384/characterising-the-growth-in-palliative-care-prescribing-2011-2015-analysis-of-national-medical-and-non-medical-activity
#20
Lucy Ziegler, Michael I Bennett, Matt Mulvey, Tim Hamilton, Alison Blenkinsopp
BACKGROUND: The role of non-medical prescribers working in palliative care has been expanding in recent years and prescribers report improvements in patient care, patient safety, better use of health professionals' skills and more flexible team working. Despite this, there is a lack of empirical evidence to demonstrate its clinical and economic impact, limiting our understanding of the future role of non-medical prescribers within a healthcare system serving an increasing number of people with palliative care needs...
November 1, 2017: Palliative Medicine
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