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https://www.readbyqxmd.com/read/29050932/characteristics-of-patients-using-specialty-medications
#1
Taehwan Park, Scott K Griggs, Paul D Chung
BACKGROUND: Specialty medications include innovative drugs and biologic agents requiring special handling and close monitoring. Although specialty medications have been widely used for various chronic conditions, increased use of these medications has contributed a growing share of total health care expenditures. OBJECTIVE: The aim of this study was to examine patient characteristics related to specialty medication use. METHODS: Using Medical Expenditure Panel Survey (MEPS) data from 2000 through 2013, this study identified U...
October 14, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#2
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/29045316/understanding-the-relationship-between-coach-and-athlete-perceptions-of-training-intensity-in-youth-sport
#3
Sean Scantlebury, Kevin Till, Tom Sawczuk, Jonathon Weakley, Ben Jones
To alleviate issues arising from the over/under prescription of training load, coaches must ensure that desired athlete responses to training are being achieved. The present study aimed to assess the level of agreement between the coach intended (pre-session) and observed (post-session) rating of perceived exertion (RPE), with athlete RPE during different training intensities (easy, moderate, hard). Coach intended RPE was taken prior to all field based training sessions over an 8 week in-season period. Following training, all coaches and athletes, whom were participants in hockey, netball, rugby and soccer were asked to provide an RPE measure for the completed session...
October 16, 2017: Journal of Strength and Conditioning Research
https://www.readbyqxmd.com/read/29036295/psychotropic-medications-prescribing-trends-in-adolescents-a-nationwide-population-based-study-in-taiwan
#4
Chin-Yen Tsai, Hsuan-Chia Yang, Mohaimenul Islam, Wan-Shan Hsieh, Shing-Hwa Juan, Jiang-Chen Chen, Hafsah Arshed Ali Khan, Wen-Shan Jian
Objective: To describe psychotropic medications prescription patterns among adolescents in Taiwan; focusing on age, gender, duration of treatments and various classes of psychotropic medications. Design: A retrospective description analysis. Setting: Taiwan National Health Insurance Database. Participants: Twelve to seventeen years' patients treated with psychotropic medications. Intervention: None...
September 20, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29032024/characteristics-of-self-inflicted-drug-overdose-deaths-in-north-carolina
#5
Anna E Austin, Scott K Proescholdbell, Kathleen E Creppage, Alex Asbun
BACKGROUND: Drug overdose mortality is a major public health concern in the United States, with prescription opioids contributing substantially to recent increases in drug overdose deaths. Compared to unintentional drug overdose deaths, relatively little data describes intentional self-inflicted drug overdose deaths (i.e., suicide by drug overdose). The aim of this study was to examine the characteristics of self-inflicted drug overdose deaths, overall and in comparison to unintentional drug overdose deaths...
October 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29030323/gender-and-the-association-between-long-term-prescription-opioid-use-and-new-onset-depression
#6
Joanne Salas, Jeffrey F Scherrer, Brian K Ahmedani, Laurel A Copeland, Kathleen K Bucholz, Mark D Sullivan, Thomas Burroughs, F David Schneider, Patrick J Lustman
Women have a higher prevalence of chronic non-cancer pain conditions and report more severe pain, yet, it is not known if the association between long term opioid analgesic use (OAU) and risk of a new depression episode (NDE) differs by gender. We analyzed patient data from the Veterans Health Administration (VHA; 2000 to 2012; n=70,997) and a large private-sector health care organization (2003 to 2012; n=22,981) to determine whether long-term OAU and risk of NDE differed by gender. Patients were free of depression and OAU for two years prior to baseline...
October 10, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29030133/use-of-a-national-database-as-a-tool-to-identify-primary-medication-non-adherence-the-estonian-eprescription-system
#7
Ott Laius, Heti Pisarev, Daisy Volmer, Sulev Kõks, Aare Märtson, Katre Maasalu
BACKGROUND: Medication adherence can be divided into primary and secondary adherence. Primary medication non-adherence (PMN) occurs when a patient does not obtain medicine with their initial prescription. Secondary non-adherence measures prescription refills among patients who previously filled their first prescription. While secondary non-adherence has been studied thoroughly, PMN has been assessed less extensively, due to lack of available data. Estonian ePrescription system might prove a valuable tool for this...
October 5, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29029272/bsr-and-bhpr-guideline-for-the-prescription-and-monitoring-of-non-biologic-disease-modifying-anti-rheumatic-drugs
#8
Jo Ledingham, Nicola Gullick, Katherine Irving, Rachel Gorodkin, Melissa Aris, Jean Burke, Patrick Gordon, Dimitrios Christidis, Sarah Galloway, Eranga Hayes, Andrew Jeffries, Scott Mercer, Janice Mooney, Sander van Leuven, James Galloway
No abstract text is available yet for this article.
September 28, 2017: Rheumatology
https://www.readbyqxmd.com/read/29026749/implementation-of-a-schedule-ii-patient-agreement-for-opioids-and-stimulants-in-an-adult-primary-care-practice
#9
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/29026592/yield-of-prolonged-wireless-ph-monitoring-in-achalasia-patients-successfully-treated-with-pneumatic-dilation
#10
Aurelio Mauro, Marianna Franchina, Alessandra Elvevi, Delia Pugliese, Andrea Tenca, Dario Conte, Roberto Penagini
BACKGROUND: Gastro-oesophageal reflux disease (GORD) is a long-term complication of achalasia treatments. The aim of our study was to evaluate the yield of prolonged wireless pH monitoring in patients with successfully treated achalasia and its influence on proton pump inhibitor (PPI) use. METHODS: Twenty-five patients with achalasia who underwent prolonged wireless pH monitoring after a successful treatment with pneumatic dilation were enrolled. pH variables were analysed in the first 24 hours of monitoring to determine if tracings were indicative of GORD; the same variables were analysed in the following 24-hour period in order to obtain a worst-day diagnosis of GORD...
October 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/29026458/safe-opioid-prescription-a-smart-on-fhir-approach-to-clinical-decision-support
#11
Shyamashree Sinha, Mark Jensen, Sarah Mullin, Peter L Elkin
Background Prescription opioid pain medication overuse, misuse and abuse have been a significant contributing factor in the opioid epidemic. The rising death rates from opioid overdose have caused healthcare practitioners and researchers to work on optimizing pain therapy and limiting the prescriptions for pain medications. The state of New York has implemented a prescription drug monitoring program(PDMP), amended public health law to limit the prescription of opioids for acute pain and utilized the resources of the state and county health departments to help in curbing this epidemic...
2017: Online Journal of Public Health Informatics
https://www.readbyqxmd.com/read/29025024/implementing-prescription-drug-monitoring-and-other-clinical-decision-support-for-opioid-risk-mitigation-in-a-military-health-care-setting-a-qualitative-feasibility-study
#12
Erin P Finley, Suyen Schneegans, Claudina Tami, Mary Jo Pugh, Don McGeary, Lauren Penney, Jennifer Sharpe Potter
Objective: Chronic noncancer pain is a highly prevalent condition among service members returning from deployment overseas. The US Army has a higher rate of opioid misuse than the civilian population. Although most states and many health care systems have implemented prescription drug monitoring programs (PDMPs) or other clinician decision support (CDS) to aid providers in delivering guideline-recommended opioid therapy, similar tools are lacking in military health settings. Materials and Methods: We conducted a pre-implementation feasibility and needs assessment guided by the Promoting Action Research in Health Services framework...
August 21, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29024333/united-we-stand-divided-we-conquer-pilot-study-of-multidisciplinary-general-medicine-heart-failure-care-program
#13
Omar Wahbi Izzettin, Ingrid Hopper, Edward Ritchie, Vathy Nagalingam, Ar Kar Aung
BACKGROUND: Heart failure care and education require a multifaceted approach to ensure appropriate transition from inpatient to outpatient care. AIMS: To explore the feasibility of a multidisciplinary heart failure care model, General Medicine Heart Failure Care Program (GM-HFCP) within a General Medical Unit (GMU). METHODS: Prospective non-randomised before-and-after observational quality improvement intervention over a 6-month period. All consecutive patients admitted to GMU at Alfred Hospital with diagnosis of acute decompensated heart failure were included...
October 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29024092/pharmaceutical-opioid-use-and-harm-in-australia-the-need-for-proactive-and-preventative-responses
#14
Briony Larance, Louisa Degenhardt, Amy Peacock, Natasa Gisev, Richard Mattick, Samantha Colledge, Gabrielle Campbell
There are parallels between the North American experience of escalating pharmaceutical opioid utilisation and harm and the trends being observed in Australia. In Australia, opioid utilisation has increased dramatically over the past two decades. There have been significant shifts away from the predominant prescribing of 'weak' and short-acting opioids, to 'strong' and long-acting opioids, for an increasing range of chronic pain indications. In concordance with escalating use, Australia is experiencing increases in opioid-related hospital admissions and overdose, as well as opioid dependence and treatment seeking...
October 12, 2017: Drug and Alcohol Review
https://www.readbyqxmd.com/read/29021110/collaborative-care-from-the-emergency-department-for-injured-patients-with-prescription-drug-misuse-an-open-feasibility-study
#15
Lauren K Whiteside, Doyanne Darnell, Karlee Jackson, Jin Wang, Joan Russo, Dennis M Donovan, Douglas F Zatzick
Collaborative Care is a comprehensive longitudinal care management strategy. The purpose of this pilot effectiveness-implementation hybrid study was to determine the feasibility of a Collaborative Care intervention initiated from the Emergency Department and proceeding longitudinally for six months for injured patients with prescription drug misuse (PDM). Adult patients presenting to an urban ED with an injury were screened for eligibility from 2/2015-8/2015. Eligible participants with a positive screen for PDM were enrolled in the 'ED-LINC' intervention which included the following elements: 1) active care coordination and linkage, 2) medication safety and utilization of opioid guidelines 3) longitudinal care management and 4) utilization of Electronic Medical Record (EMR) innovations such as the statewide Emergency Department Information Exchange (EDIE) and statewide prescription monitoring program information for assessment and follow-up...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29018100/randomized-crossover-trial-of-blood-volume-monitoring-guided-ultrafiltration-biofeedback-to-reduce-intradialytic-hypotensive-episodes-with-hemodialysis
#16
Kelvin C W Leung, Robert R Quinn, Pietro Ravani, Henry Duff, Jennifer M MacRae
BACKGROUND AND OBJECTIVES: Intradialytic hypotension (IDH) is associated with morbidity. The effect of blood volume-guided ultrafiltration biofeedback, which automatically adjusts fluid removal rate on the basis of blood volume parameters, on the reduction of IDH was tested in a randomized crossover trial. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We performed a 22-week, single blind, randomized crossover trial in patients receiving maintenance hemodialysis who had >30% of sessions complicated by symptomatic IDH in five centers in Calgary, Alberta, Canada...
October 10, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29016883/pharmacists-role-in-opioid-safety-a-focus-group-investigation
#17
Daniel M Hartung, Jennifer Hall, Sarah N Haverly, David Cameron, Lindsey Alley, Christi Hildebran, Nicole O'Kane, Deborah Cohen
Objective: The pharmacist's role and responsibilities in addressing the opioid epidemic have yet to be clearly defined, particularly from the patient's point of view. This qualitative study explores the pharmacist's role in promoting opioid safety from the perspective of pharmacists and patients. Design: Focus groups. Setting: Patient groups were held in person, and pharmacist groups were held online. Subjects: Oregon pharmacists (N = 19, M age  = 39...
June 17, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28993507/dialysate-potassium-dialysate-magnesium-and-hemodialysis-risk
#18
Patrick H Pun, John P Middleton
One of the fundamental goals of the hemodialysis prescription is to maintain serum potassium levels within a narrow normal range during both the intradialytic and interdialytic intervals. Considering the extraordinarily high rate of cardiovascular mortality in the hemodialysis population, clinicians are obligated to explore whether factors related to dialytic potassium removal can be modified to improve clinical outcomes. Observational studies and circumstantial evidence suggest that extreme concentrations of serum and dialysate potassium can trigger cardiac arrest...
October 9, 2017: Journal of the American Society of Nephrology: JASN
https://www.readbyqxmd.com/read/28990160/monitoring-of-potentially-inappropriate-prescriptions-in-older-inpatients-a-french-multicenter-study
#19
Irène Pandraud-Riguet, Dominique Bonnet-Zamponi, Elsa Bourcier, Marion Buyse, Sandra Laribe-Caget, Patrick Frémont, Eric Pautas, Christiane Verny, Patrick Hindlet, Christine Fernandez
OBJECTIVES: To determine whether potentially inappropriate medications (PIMs) or potentially inappropriate associations (PIAs) prescribed knowingly are associated with patient monitoring. DESIGN: Prospective observational study. SETTING: Geriatric units (n = 56) in 28 hospitals. PARTICIPANTS: Inpatients aged 75 and older (N = 1,327). MEASUREMENTS: Potentially inappropriate prescriptions (PIP) were defined as a PIM or a PIA selected by an expert board from lists of explicit criteria (Beers, Priscus, Laroche, French Health Agency) using a Delphi process...
October 9, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28988943/how-addictive-are-gabapentin-and-pregabalin-a-systematic-review
#20
REVIEW
U Bonnet, N Scherbaum
In the last ten years, gabapentin and pregabalin have been becoming dispensed broadly and sold on black markets, thereby, exposing millions to potential side-effects. Meanwhile, several pharmacovigilance-databases have warned for potential abuse liabilities and overdose fatalities in association with both gabapentinoids. To evaluate their addiction risk in more detail, we conducted a systematic review on PubMed/Scopus and included 106 studies. We did not find convincing evidence of a vigorous addictive power of gabapentinoids which is primarily suggested from their limited rewarding properties, marginal notes on relapses, and the very few cases with gabapentinoid-related behavioral dependence symptoms (ICD-10) in patients without a prior abuse history (N=4)...
October 5, 2017: European Neuropsychopharmacology: the Journal of the European College of Neuropsychopharmacology
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