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Opioid prescribing

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https://www.readbyqxmd.com/read/28109052/the-use-of-methadone-to-facilitate-opioid-weaning-in-pediatric-critical-care-patients-a-systematic-review-of-the-literature-and-meta-analysis
#1
REVIEW
Leslie A Dervan, Beryl Yaghmai, Robert Scott Watson, Fredric M Wolf
BACKGROUND: Continuous opioid infusion therapy is commonly utilized in the pediatric intensive care setting to treat pain and facilitate tolerance of invasive therapies. Transitioning to methadone is one common strategy for weaning from continuous opioid infusions, but in practice this transition can be challenging, and many children still experience iatrogenic withdrawal. AIM: We reviewed the literature to evaluate the best available evidence to guide methadone therapy in this setting, and to summarize associated adverse events...
January 20, 2017: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/28108642/the-potential-role-for-smartphones-among-older-adults-with-chronic-noncancer-pain-a-qualitative-study
#2
Joshua E Richardson, Jennifer I Lee, Anita Nirenberg, M Carrington Reid
: OBJECTIVE : To determine the role that smartphones may play in supporting older adults with chronic noncancer pain (CNCP) in order to improve pain management in this expanding population. DESIGN:  Qualitative study. SETTING:  One academically affiliated primary care practice serving older adults with CNCP in New York City. SUBJECTS : Thirteen older adults (age 65-85 years) with CNCP on chronic opioid therapy, that is, continuous use of opioids for at least six months...
January 20, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28107478/correction-high-dose-opioid-prescribing-and-opioid-related-hospitalization-a-population-based-study
#3
(no author information available yet)
[This corrects the article DOI: 10.1371/journal.pone.0167479.].
2017: PloS One
https://www.readbyqxmd.com/read/28101968/defined-daily-doses-ddd-do-not-accurately-reflect-opioid-doses-used-in-contemporary-chronic-pain-treatment
#4
Suzanne Nielsen, Natasa Gisev, Raimondo Bruno, Wayne Hall, Milton Cohen, Briony Larance, Gabrielle Campbell, Marian Shanahan, Fiona Blyth, Nicholas Lintzeris, Sallie Pearson, Richard Mattick, Louisa Degenhardt
OBJECTIVE: To assess how well the defined daily dose (DDD) metric reflects opioid utilisation among chronic non-cancer pain patients. DESIGN: Descriptive, cross-sectional study, utilising a 7-day medication diary. SETTING: Community-based treatment settings, Australia. SUBJECTS: A sample of 1101 people prescribed opioids for chronic non-cancer pain. METHODS: Opioid dose data was collected via a self-completed 7-day medication diary capturing names, strengths and doses of each medication taken in the past week...
January 19, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28101955/prescription-drug-monitoring-programs-produce-a-limited-impact-on-painkiller-prescribing-in-medicare-part-d
#5
Courtney R Yarbrough
OBJECTIVE: To measure the impact of prescription drug monitoring programs (PDMPs) on prescribing of opioid and nonopioid painkillers. DATA SOURCE: 2010-2013 physician-level Medicare Part D prescribing data released by the Centers for Medicare and Medicaid Services and Propublica. STUDY DESIGN: Using difference-in-differences models with physician-level fixed effects, the study compares prescribing in states with and without PDMPs for opioid and nonopioid analgesics, oxycodone, hydrocodone, and opioids by controlled substances Schedules II-IV...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28099791/mitigating-the-prescription-drug-abuse-epidemic
#6
Mike Midgley
Focused attention on the prescription drug abuse epidemic needs to include evidence-based training for clinicians who manage patients with pain to facilitate accurate screening with consideration of comorbid conditions, diagnosis, selection of the appropriate treatment regimen, and focused monitoring of adherence to the established course of therapy. DEA licensure requirements need to be amended to mandate targeted training focused on pain medication upon initial application and renewal of license. A nationwide mandated real-time dispenser database that requires verification every time a clinician prescribes opioids and other key controlled substances should be a top priority...
January 2017: Journal of Healthcare Risk Management: the Journal of the American Society for Healthcare Risk Management
https://www.readbyqxmd.com/read/28097532/medication-overuse-in-chronic-pain
#7
REVIEW
Eric S Hsu
PURPOSE OF REVIEW: Chronic pain is usually managed by various pharmacotherapies after exhausting the conservative modalities such as over-the-counter choices. The goal of this review is to investigate current state of opioids and non-opioid medication overuse that includes NSAIDs, skeletal muscle relaxants, antidepressants, membrane stabilization agents, and benzodiazepine. How to minimize medication overuse and achieve better outcome in chronic pain management? RECENT FINDINGS: Although antidepressants and membrane stabilization agents contribute to the crucial components for neuromodulation, opioids were frequently designated as a rescue remedy in chronic pain since adjunct analgesics usually do not provide instantaneous relief...
January 2017: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/28092648/does-brief-chronic-pain-management-education-change-opioid-prescribing-rates-a-pragmatic-trial-in-australian-early-career-general-practitioners
#8
Simon Mark Holliday, Chris Hayes, Adrian J Dunlop, Simon Morgan, Amanda Tapley, Kim M Henderson, Mieke L van Driel, Elizabeth G Holliday, Jean I Ball, Andrew Davey, Neil Allan Spike, Lawrence Andrew McArthur, Parker John Magin
We aimed to evaluate the effect of pain education on opioid prescribing by early-career general practitioners. A brief training workshop was delivered to general practice registrars of a single regional training provider. The workshop significantly reduced "hypothetical" opioid prescribing (in response to paper-based vignettes) in an earlier evaluation. The effect of the training on "actual" prescribing was evaluated using a nonequivalent control group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study: 4 other regional training providers were controls...
February 2017: Pain
https://www.readbyqxmd.com/read/28092325/persistent-pain-after-motor-vehicle-collision-comparative-effectiveness-of-opioids-vs-nonsteroidal-antiinflammatory-drugs-prescribed-from-the-emergency-department-a-propensity-matched-analysis
#9
Francesca L Beaudoin, Roee Gutman, Roland C Merchant, Melissa A Clark, Robert A Swor, Jeffrey S Jones, David C Lee, David A Peak, Robert M Domeier, Niels K Rathlev, Samuel A McLean
Each year millions of Americans present to the emergency department (ED) for care after a motor vehicle collision (MVC); the majority (>90%) are discharged to home after evaluation. Acute musculoskeletal pain is the norm in this population, and such patients are typically discharged to home with prescriptions for oral opioid analgesics or nonsteroidal antiinflammatory drugs (NSAIDs). The influence of acute pain management on subsequent pain outcomes in this common ED population is unknown. We evaluated the effect of opioid analgesics vs NSAIDs initiated from the ED on the presence of moderate to severe musculoskeletal pain and ongoing opioid use at 6 weeks in a large cohort of adult ED patients presenting to the ED after MVC (n = 948)...
February 2017: Pain
https://www.readbyqxmd.com/read/28089521/trends-in-naloxone-prescriptions-prescribed-after-implementation-of-a-national-academic-detailing-service-in-the-veterans-health-administration-a-preliminary-analysis
#10
Mark Bounthavong, Michael A Harvey, Daina L Wells, Sarah J Popish, Julianne Himstreet, Elizabeth M Oliva, Chad L Kay, Marcos K Lau, Priyanka P Randeria-Noor, Andrea G Phillips, Melissa L D Christopher
OBJECTIVES: To evaluate the effects of the U.S. Veterans Health Administration (VA) National Academic Detailing Service alongside the Opioid Overdose Education and Naloxone Distribution (OEND) program on naloxone prescriptions prescribed from October 2014 to September 2016. METHODS: A retrospective, repeated measures cohort study was conducted to evaluate the effectiveness of a real-world application of academic detailing (AD) alongside OEND on providers' outpatient naloxone prescribing from October 2014 to September 2016...
January 11, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28087986/barriers-to-access-to-opioid-medicines-for-patients-with-opioid-dependence-a-review-of-legislation-and-regulations-in-eleven-central-and-eastern-european-countries
#11
Marjolein J M Vranken, Aukje K Mantel-Teeuwisse, Saskia Jünger, Lukas Radbruch, Willem Scholten, John A Lisman, Marija Subataite, Marie-Hélène D B Schutjens
BACKGROUND AND AIMS: Barriers linked to drug control systems are considered to contribute to inequitable access to controlled medicines, leaving millions of people in pain and suffering. Most studies focus on access to opioids for the treatment of severe (cancer) pain. This study aims to identify specific access barriers for patients with opioid dependence in legislation and regulations of 11 Central and Eastern European countries. METHODS: This study builds on a previous analysis of legislation and regulations as part of the EU 7th Framework Access To Opioid Medication in Europe (ATOME) project...
January 14, 2017: Addiction
https://www.readbyqxmd.com/read/28087496/digital-pills-to-measure-opioid-ingestion-patterns-in-emergency-department-patients-with-acute-fracture-pain-a-pilot-study
#12
Peter R Chai, Stephanie Carreiro, Brendan J Innes, Rochelle K Rosen, Conall O'Cleirigh, Kenneth H Mayer, Edward W Boyer
BACKGROUND: Nonadherence to prescribed regimens for opioid analgesic agents contributes to increasing opioid abuse and overdose death. Opioids are frequently prescribed on an as-needed basis, placing the responsibility to determine opioid dose and frequency with the patient. There is wide variability in physician prescribing patterns because of the lack of data describing how patients actually use as-needed opioid analgesics. Digital pill systems have a radiofrequency emitter that directly measures medication ingestion events, and they provide an opportunity to discover the dose, timing, and duration of opioid therapy...
January 13, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28086944/prenatal-treatment-for-opioid-dependency-observations-from-a-large-inner-city-clinic
#13
Kelley Saia, Sarah M Bagley, Elisha M Wachman, Payal P Patel, Marisa D Nadas, Susan B Brogly
BACKGROUND: The objective of this study was to review changes in the prevalence of opioid use disorder in pregnancy, and to describe the prenatal care and neonatal outcomes following the implementation of buprenorphine treatment at a large US obstetrical clinic during the on-going opioid epidemic. METHODS: We conducted a retrospective cohort study of 310 women (332 pregnancies) with opioid use disorders and their neonates delivered between June 2006 and December 2010 at an obstetrical clinic in the US...
January 13, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28076255/problem-drug-related-behavior-and-discontinuation-of-opioids-following-the-introduction-of-an-opioid-management-program
#14
Lucinda A Grande, Ellen Campbell Thompson, Margaret A Au, Devin Sawyer, Laura-Mae Baldwin, Roger Rosenblatt
PURPOSE: Problem drug-related behavior (PDB) among patients on chronic opioid therapy may reflect an opioid use disorder. This study assessed PDB prevalence and the relationship between PDB and ongoing prescription of opioids at a primary care clinic that implemented a multifaceted opioid management program. METHODS: A chart review of patients in a chronic opioid registry assessed prevalence of different types of PDB over 2 years, and whether opioids were prescribed during the last 3 months of the 2-year study period among patients with different levels of PDB...
November 2016: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28074831/rgs9-2-modulates-responses-to-oxycodone-in-pain-free-and-chronic-pain-states
#15
Sevasti Gaspari, Valeria Cogliani, Lefteris Manouras, Ethan M Anderson, Vasiliki Mitsi, Kleopatra Avrampou, Fiona B Carr, Venetia Zachariou
Regulator of G protein signalling 9-2 (RGS9-2) is a striatal enriched signal transduction modulator, known to play a critical role in the development of addiction-related behaviours following exposure to psychostimulants or opioids. RGS9-2 controls the function of several GPCRs, including dopamine and mu opioid (MOR) receptors. We previously showed that RGS9-2 complexes negatively control morphine analgesia, and promote the development of morphine tolerance. In contrast, RGS9-2 positively modulates the actions of other opioid analgesics, such as fentanyl and methadone...
January 11, 2017: Neuropsychopharmacology: Official Publication of the American College of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28073688/state-legal-innovations-to-encourage-naloxone-dispensing
#16
Corey Davis, Derek Carr
OBJECTIVES: The opioid overdose epidemic continues to claim the lives of tens of thousands of Americans every year. Increased access to the opioid antagonist naloxone can reduce opioid-related morbidity and mortality. In this commentary, we describe several recent legal innovations designed to encourage pharmacists to ensure that naloxone is available when and where it is needed, and dispel some common misconceptions regarding potential legal risks associated with pharmacy naloxone dispensing...
January 7, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28072812/is-kratom-the-new-legal-high-on-the-block-the-case-of-an-emerging-opioid-receptor-agonist-with-substance-abuse-potential
#17
George C Chang-Chien, Charles A Odonkor, Prin Amorapanth
Kratom is an unscheduled opioid receptor agonist that comes in the form of dietary supplements currently being abused by chronic pain patients on prescription opioids. Active alkaloids isolated from kratom such as mitragynine and 7-hydroxymitragynine are thought to act on mu- and delta-opioid receptors as well as alpha-2 adrenergic and 5-HT2A receptors. Animal studies suggest that kratom may be more potent than morphine. Consequently, kratom consumption produces analgesic and euphoric feelings among users. In particular, some chronic pain patients on opioids take kratom to counteract the effects of opioid withdrawal...
January 2017: Pain Physician
https://www.readbyqxmd.com/read/28068780/long-acting-injectable-naltrexone-induction-a-randomized-trial-of-outpatient-opioid-detoxification-with-naltrexone-versus-buprenorphine
#18
Maria Sullivan, Adam Bisaga, Martina Pavlicova, C Jean Choi, Kaitlyn Mishlen, Kenneth M Carpenter, Frances R Levin, Elias Dakwar, John J Mariani, Edward V Nunes
OBJECTIVE: At present there is no established optimal approach for transitioning opioid-dependent adults to extended-release injection naltrexone (XR-naltrexone) while preventing relapse. The authors conducted a trial examining the efficacy of two methods of outpatient opioid detoxification for induction to XR-naltrexone. METHOD: Participants were 150 opioid-dependent adults randomly assigned 2:1 to one of two outpatient detoxification regimens, naltrexone-assisted detoxification or buprenorphine-assisted detoxification, followed by an injection of XR-naltrexone...
January 10, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/28068268/what-every-dentist-should-know-about-opioids
#19
Lara M Seidman, Patricia A Tordik, Nasir Bashirelahi
Prescription drug abuse is on the rise, causing detrimental health consequences and taking lives. Since dentists comprise a large percentage of opioid prescribers, they should be well educated on the uses and effects of opioids. This article discusses the consequences of long-term opioid use, how to identify signs of dependence, and how to prevent future abuse.
January 2017: General Dentistry
https://www.readbyqxmd.com/read/28062816/primary-care-clinic-re-design-for-prescription-opioid-management
#20
Michael L Parchman, Michael Von Korff, Laura-Mae Baldwin, Mark Stephens, Brooke Ike, DeAnn Cromp, Clarissa Hsu, Ed H Wagner
BACKGROUND: The challenge of responding to prescription opioid overuse within the United States has fallen disproportionately on the primary care clinic setting. Here we describe a framework comprised of 6 Building Blocks to guide efforts within this setting to address the use of opioids for chronic pain. METHODS: Investigators conducted site visits to thirty primary care clinics across the United States selected for their use of team-based workforce innovations...
January 2017: Journal of the American Board of Family Medicine: JABFM
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