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Opioid prescribing

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https://www.readbyqxmd.com/read/28423917/management-of-opioid-induced-constipation-in-hospice-patients
#1
Leah Sera, Mary Lynn McPherson
BACKGROUND: Constipation is a common symptom in patients with advanced disease taking opioids. Opioid-induced constipation (OIC) is commonly treated with laxatives and stool softeners. Recently, newer agents have come to market which broaden options for patients in whom first-line therapies are not effective. OBJECTIVE: To determine what pharmacologic regimens are currently used in hospice programs to prevent and treat OIC, whether those regimens have changed with the introduction of newer agents and evidence discouraging the use of docusate, and whether hospice programs are standardizing the management of OIC...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/28421563/the-current-utilization-and-perceptions-of-prescription-drug-monitoring-programs-among-emergency-medicine-providers-in-florida
#2
Henry W Young, Joseph A Tyndall, Linda B Cottler
BACKGROUND: Pain is among the most commonly treated symptoms in the emergency department, and opioids are commonly prescribed from the emergency department to treat moderate to severe pain. Prescription drug monitoring programs (PDMP) can be used to assist physicians identify individuals at increased risk to misuse or abuse opioids. While the use of the PDMP has been shown useful among clinicians, in the past, utilization of the PDMP has been less than optimal. The objective of this study was to assess the current utilization and perceptions of the prescription drug monitoring program among emergency medicine providers in Florida...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28419384/risk-factors-for-serious-prescription-opioid-induced-respiratory-depression-or-overdose-comparison-of-commercially-insured-and-veterans-health-affairs-populations
#3
Pramit A Nadpara, Andrew R Joyce, E Lenn Murrelle, Nathan W Carroll, Norman V Carroll, Marie Barnard, Barbara K Zedler
Objective. : To characterize the risk factors associated with overdose or serious opioid-induced respiratory depression (OIRD) among medical users of prescription opioids in a commercially insured population (CIP) and to compare risk factor profiles between the CIP and Veterans Health Administration (VHA) population. Subjects and Methods. : Analysis of data from 18,365,497 patients in the IMS PharMetrics Plus health plan claims database (CIP) who were dispensed a prescription opioid in 2009 to 2013...
April 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28418816/safe-and-competent-opioid-prescribing-education-increasing-dissemination-with-a-train-the-trainers-program
#4
Lara Zisblatt, Sean M Hayes, Patrice Lazure, Ilana Hardesty, Julie L White, Daniel P Alford
BACKGROUND: Due to the high prevalence of prescription opioid misuse, the US Food and Drug Administration (FDA) mandated a Risk Evaluation and Mitigation Strategy (REMS) requiring manufacturers of extended-release/long-acting (ER/LA) opioids to fund continuing education based on an FDA curricular Blueprint. This paper describes the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) Train-the-Trainers program and its impact on 1) disseminating the SCOPE of Pain curriculum and 2) knowledge, confidence, attitudes, and performance of the participants of trainer-led compared to expert-led meetings...
April 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28418777/er-la-opioid-rems-and-accredited-education-survey-results-provide-insight-into-clinical-roles-educational-needs-and-learner-preferences
#5
Cynthia Kear, Tom McKeithen, Sheila Robertson
BACKGROUND: The Collaborative for REMS Education (CO*RE) includes 13 organizations who provide REMS Program Companies (RPC) grant-supported accredited education on extended-release and long-acting (ER/LA) opioid therapy. This report summarizes results of a survey designed to investigate the impact of participant criteria and to better understand the roles and preferences of CME/CE participants. METHODS: In April 2015, we made an online survey available to an estimated 10,000 clinicians who had completed a CO*RE CME/CE activity since 2013...
April 18, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28410339/patterns-of-buprenorphine-naloxone-treatment-for-opioid-use-disorder-in-a-multistate-population
#6
Brendan Saloner, Matthew Daubresse, G Caleb Alexander
BACKGROUND: Buprenorphine-naloxone treatment for opioid use disorder has rapidly expanded, yet little is known about treatment outcomes among patients in the general population. OBJECTIVE: To examine predictors of treatment duration, dosage, and continuity in a diverse community setting. RESEARCH DESIGN: We examined QuintilesIMS Real World Data, an all-payer, pharmacy claims database, to conduct an analysis of individuals age 18 years and above initiating buprenorphine-naloxone treatment between January 2010 and July 2012 in 11 states...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28410338/multiple-sources-of-prescription-payment-and-risky-opioid-therapy-among-veterans
#7
William C Becker, Brenda T Fenton, Cynthia A Brandt, Erin L Doyle, Joseph Francis, Joseph L Goulet, Brent A Moore, Virginia Torrise, Robert D Kerns, Peter W Kreiner
BACKGROUND: Opioid overdose and other related harms are a major source of morbidity and mortality among US Veterans, in part due to high-risk opioid prescribing. OBJECTIVES: We sought to determine whether having multiple sources of payment for opioids-as a marker for out-of-system access-is associated with risky opioid therapy among veterans. RESEARCH DESIGN: Cross-sectional study examining the association between multiple sources of payment and risky opioid therapy among all individuals with Veterans Health Administration (VHA) payment for opioid analgesic prescriptions in Kentucky during fiscal year 2014-2015...
April 13, 2017: Medical Care
https://www.readbyqxmd.com/read/28409480/genetic-testing-for-opioid-pain-management-a-primer
#8
Deepti Agarwal, Mercy A Udoji, Andrea Trescot
Patients see their primary care physicians (PCPs) for a variety of medical conditions, chronic pain being one of the most common. An increased use of prescription medications (especially opioids) has led to an increase in adverse drug reactions and has heightened our awareness of the variability in response to medications. Opioids and other pain adjuvants are widely used, and drug-drug interactions involving these analgesics can be problematic and potentially lethal. Pharmacogenetics has improved our understanding of drug efficacy and response, opened doors to individual tailoring of medical management, and created a series of ethical and economic considerations...
April 13, 2017: Pain and Therapy
https://www.readbyqxmd.com/read/28408172/opioid-dispensing-and-overlap-in-veterans-with-non-cancer-pain-eligible-for-medicare-part-d
#9
Katie J Suda, Bridget M Smith, Lauren Bailey, Walid F Gellad, Zhiping Huo, Muriel Burk, Francesca Cunningham, Kevin T Stroupe
OBJECTIVES: Pain is the most prevalent problem among veterans, who receive pain diagnoses 5 times more frequently than the general population. Opioids are commonly prescribed for pain, but they have potential for misuse and serious adverse events. The study objective was to evaluate opioid dispensing patterns and predictors for overlap in veterans who are eligible for Medicare Part D benefits. METHODS: A sample of male and all female veterans aged 66 years and older without cancer in 2005-2009 was included...
April 10, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28403427/new-persistent-opioid-use-after-minor-and-major-surgical-procedures-in-us-adults
#10
Chad M Brummett, Jennifer F Waljee, Jenna Goesling, Stephanie Moser, Paul Lin, Michael J Englesbe, Amy S B Bohnert, Sachin Kheterpal, Brahmajee K Nallamothu
Importance: Despite increased focus on reducing opioid prescribing for long-term pain, little is known regarding the incidence and risk factors for persistent opioid use after surgery. Objective: To determine the incidence of new persistent opioid use after minor and major surgical procedures. Design, Setting, and Participants: Using a nationwide insurance claims data set from 2013 to 2014, we identified US adults aged 18 to 64 years without opioid use in the year prior to surgery (ie, no opioid prescription fulfillments from 12 months to 1 month prior to the procedure)...
April 12, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28402570/prescription-opioid-access-patterns-and-factors-associated-with-increasing-number-of-prescribers-pharmacies-and-dispensings-an-observational-study-using-pharmaceutical-claims
#11
Bianca Blanch, Louisa Degenhardt, Nicholas A Buckley, Natasa Gisev, Timothy Dobbins, Emily A Karanges, Briony Larance, Sarah Larney, Sallie-Anne Pearson
Objective. : To examine associations between patient factors and increasing opioid access measured by three metrics: number of unique prescribers, pharmacies, and dispensings in 12 months. Methods. : We used pharmaceutical claims for a random 10% sample of Australians age 18 years or older initiating or reinitiating strong opioid treatment (≥90 days of no strong opioid dispensing) between July 2010 and December 2012. We report the distribution of opioid access by metric...
April 10, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28402482/opioid-analgesic-prescribing-facts-vs-assumptions
#12
Mark Edmund Rose
No abstract text is available yet for this article.
April 11, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28401133/fatal-overdoses-involving-hydromorphone-and-morphine-among-inpatients-a-case-series
#13
Amanda Lowe, Michael Hamilton, Julie Greenall BScPhm MHSc, Jessica Ma, Irfan Dhalla, Nav Persaud
BACKGROUND: Opioids have narrow therapeutic windows, and errors in ordering or administration can be fatal. The purpose of this study was to describe deaths involving hydromorphone and morphine, which have similar-sounding names, but different potencies. METHODS: In this case series, we describe deaths of patients admitted to hospital or residents of long-term care facilities that involved hydromorphone and morphine. We searched for deaths referred to the Patient Safety Review Committee of the Office of the Chief Coroner for Ontario between 2007 and 2012, and subsequently reviewed by 2014...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28394752/the-risks-of-opioid-treatment-perspectives-of-primary-care-practitioners-and-patients-from-safety-net-clinics
#14
Emily E Hurstak, Margot Kushel, Jamie Chang, Rachel Ceasar, Kara Zamora, Christine Miaskowski, Kelly Knight
BACKGROUND: Patients with a history of substance use are more likely than those without substance use to experience chronic noncancer pain (CNCP), to be prescribed opioids, and to experience opioid misuse or overdose. Primary care practitioners (PCPs) in safety-net settings care for low-income patients with CNCP and substance use, usually without specialist consultation. To inform communication related to opioid risk, we explored PCPs' and patients' perceptions of the risks of chronic opioid therapy...
April 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28394740/self-regulating-profession-administrative-discipline-of-pill-mill-physicians-in-florida
#15
Corey S Davis, Derek H Carr
BACKGROUND: A relatively large number of "pill mills," in which physicians prescribed and sometimes dispensed controlled substances without medical justification, operated in Florida beginning in the mid-2000's. Investigations into these operations have resulted in the arrest and conviction of dozens of physicians for activities related to illegal trafficking in controlled substances. METHODS: Using information from the federal Drug Enforcement Administration, the Florida Department of Health, and court records, we constructed a database of Florida-licensed medical doctors who had been indicted or convicted of crimes related to illegal prescribing of controlled substances in Florida during 2010-2015...
April 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28394736/what-do-providers-want-to-know-about-opioid-prescribing-a-qualitative-analysis-of-their-questions
#16
Phoebe A Cushman, Jane M Liebschutz, Joseph G Hodgkin, Christopher W Shanahan, Julie L White, Ilana Hardesty, Daniel P Alford
BACKGROUND: In 2012, the US Food and Drug Administration (FDA) responded to the opioid crisis with a Risk Evaluation and Mitigation Strategy, requiring manufacturers of extended-release/long-acting opioids to fund continuing medical education based on the "FDA Blueprint for Prescriber Education." Topics in the Blueprint are "Assessing Patients for Treatment," "Initiating Therapy, Modifying Dosing, and Discontinuing Use," "Managing Therapy," "Counseling Patients and Caregivers about Safe Use," "General Drug Information," and "Specific Drug Information...
April 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28394733/training-internal-medicine-residents-to-manage-chronic-pain-and-prescription-opioid-misuse
#17
Allison L Ruff, Daniel P Alford, Robert Butler, J Henry Isaacson
BACKGROUND: Residents feel unprepared to care for patients with chronic pain on long-term opioids who exhibit signs of prescription opioid misuse. OBJECTIVE: Describe an educational intervention for internal medicine residents to improve confidence, practices, attitudes, and self-reported knowledge of resources for chronic pain and opioid misuse. METHODS: The intervention included 2 sessions. Session 1 (3 hours): a lecture on chronic pain, prescription opioid misuse, and opioid use disorders and communication skills practice...
April 10, 2017: Substance Abuse
https://www.readbyqxmd.com/read/28394437/access-to-treatment-for-opioid-use-disorders-medical-student-preparation
#18
Elinore F McCance-Katz, Paul George, Nicole Alexander Scott, Richard Dollase, Allan R Tunkel, James McDonald
The current opioid epidemic requires new approaches to increasing access to treatment for patients with opioid use disorders and to improve availability of medication assisted treatment. We propose a model where medical students complete the necessary training to be eligible for the waiver to prescribe opioid medications to treat these disorders by the time of medical school graduation. This plan would increase the number of Drug Abuse Treatment Act of 2000 (DATA 2000) waivered physicians who could gain additional experience in treating substance use disorders during residency and provide the access to clinical care needed for individuals suffering with opioid use disorder...
April 10, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28392713/a-case-report-on-the-treatment-of-complex-chronic-pain-and-opioid-dependence-by-a-multidisciplinary-transitional-pain-service-using-the-act-matrix-and-buprenorphine-naloxone
#19
Aliza Z Weinrib, Lindsay C Burns, Alex Mu, Muhammad Abid Azam, Salima Sj Ladak, Karen McRae, Rita Katznelson, Saam Azargive, Cieran Tran, Joel Katz, Hance Clarke
In an era of growing concern about opioid prescribing, the postsurgical period remains a critical window with the risk of significant opioid dose escalation, particularly in patients with a history of chronic pain and presurgical opioid use. The purpose of this case report is to describe the multidisciplinary care of a complex, postsurgical pain patient by an innovative transitional pain service (TPS). A 59-year-old male with complex chronic pain, as well as escalating long-term opioid use, presented with a bleeding duodenal ulcer requiring emergency surgery...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28392133/patients-at-risk-large-opioid-prescriptions-after-total-knee-arthroplasty
#20
Nicholas M Hernandez, Joshua A Parry, Michael J Taunton
BACKGROUND: Opioids are an effective, and often necessary, treatment of postoperative pain after total knee arthroplasty (TKA). However, it is often difficult to know how much medication patients will need after discharge. The purpose of this study was to determine if patients discharged with greater quantities of opioids after TKA are more likely to request refills. METHODS: This is a retrospective review of 105 primary TKAs performed with at least 1 year of follow-up...
March 2, 2017: Journal of Arthroplasty
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