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Narcotic prescribing

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https://www.readbyqxmd.com/read/29788455/a-10-yr-analysis-of-chronic-pelvic-pain-and-chronic-opioid-therapy-in-the-women-veteran-population
#1
Sara B Cichowski, Rebecca G Rogers, Yuko Komesu, Erin Murata, Clifford Qualls, Allison Murata, Glen Murata
Introduction: Chronic pelvic pain (CPP) affects an estimated 30% of women Veterans. Previous research shows high rates of narcotic abuse in the women Veteran population. Narcotics are not recommended for the treatment of CPP. Understanding how CPP impacts narcotic prescribing in the women Veteran population is critical to addressing the public health crisis of opioid abuse. Our objective was to compare chronic opioid therapy (COT) prescribed 5 yr prior to and following CPP diagnosis and to identify predictors of COT as well as adverse events associated with COT...
May 18, 2018: Military Medicine
https://www.readbyqxmd.com/read/29757882/american-association-of-nurse-practitioners-national-nurse-practitioner-sample-survey-update-on-acute-care-nurse-practitioner-practice
#2
Ruth Kleinpell, Michelle L Cook, Diane L Padden
BACKGROUND AND PURPOSE: Data from national surveys on the practice of nurse practitioners (NPs) provides valuable information on aspects of practice, demographic characteristics of providers and patients, plans for continued employment, and role satisfaction. The American Association of Nurse Practitioners (AANP) has been conducting the AANP Sample Survey since 1988. METHODS: The most recent AANP Sample Survey was conducted in 2016 with a random stratified survey of 40,000 NPs...
March 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29750761/toradol-following-breast-surgery-is-there-an-increased-risk-of-hematoma
#3
Brittany N Nguyen, Ruth J Barta, Christine E Stewart, Cherrie A Heinrich
BACKGROUND: Ketorolac tromethamine (Toradol), a nonsteroidal antiinflammatory drug, is used with increased frequency given its success in postoperative pain control and the subsequent decreased need for narcotics. Its use has been limited in plastic surgery for fear of postoperative bleeding and hematoma formation. In this study of breast surgery patients, the authors investigated whether ketorolac increased the risk of postoperative hematoma formation. METHODS: After obtaining institutional review board approval, the authors retrospectively reviewed the records of patients undergoing breast surgery from January of 2012 through December of 2014...
June 2018: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/29746919/opioid-medication-use-in-the-surgical-patient-an-assessment-of-prescribing-patterns-and-utilization
#4
Wen Hui Tan, Jennifer Yu, Sara Feaman, Jared M McAllister, Lindsey G Kahan, Mary A Quasebarth, Jeffrey A Blatnik, J Christopher Eagon, Michael M Awad, L Michael Brunt
BACKGROUND: With the epidemic of prescription opioid abuse in the United States, rates of opioid-related unintentional deaths have risen dramatically. However, little data exists comparing postoperative opioid prescriptions with patient use. We sought to better elucidate this relationship in surgical patients. STUDY DESIGN: A prospective cohort study was conducted of narcotic-naïve patients undergoing open and laparoscopic abdominal procedures on a minimally invasive surgery service...
May 7, 2018: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29704954/a-systematic-review-of-opioid-use-after-extremity-trauma-in-orthopedic-surgery
#5
REVIEW
Rikki M Koehler, Ugochi C Okoroafor, Lisa K Cannada
BACKGROUND: The United States is in a prescription opioid crisis. Orthopedic surgeons prescribe more opioid narcotics than any other surgical specialty. The purpose of this study was to evaluate the state of opioid use after extremity trauma in orthopedic surgery. METHODS: A computerized literature search of PubMed/MEDLINE was conducted to evaluate the status of opioids after extremity fractures. Six articles were identified and included in the review. RESULTS: Patients who consume more opioids communicate greater pain intensity and less satisfaction with pain control...
April 12, 2018: Injury
https://www.readbyqxmd.com/read/29700845/re-racialization-of-addiction-and-the-redistribution-of-blame-in-the-white-opioid-epidemic
#6
Sonia Mendoza, Allyssa Stephanie Rivera, Helena Bjerring Hansen
New York City has the largest number of opioid dependent people of U.S. cities, and within New York, Whites have the highest rate of prescription opioid and heroin overdose deaths. The rise of opioid abuse among Whites has resulted in popular narratives of victimization by prescribers, framing of addiction as a biological disease, and the promise of pharmaceutical treatments that differ from the criminalizing narratives that have historically described urban Latino and black narcotic use. Through an analysis of popular media press and interviews with opioid prescribers and community pharmacists in Staten Island-the epicenter of opioid overdose in New York City and the most suburban and white of its boroughs-we found that narratives of white opioid users disrupted notions of the addict as "other," producing alternative logics of blame that focus on prescribers and the encroachment of dealers from outside of white neighborhoods...
April 27, 2018: Medical Anthropology Quarterly
https://www.readbyqxmd.com/read/29681163/patterns-of-narcotic-prescribing-by-orthopedic-surgeons-for-medicare-patients
#7
Matthew R Boylan, Kelly I Suchman, James D Slover, Joseph A Bosco
In recent years, narcotics have been subject to increased regulation and monitoring because of their side effects and potential for misuse. Currently, variation in prescribing patterns of narcotics among orthopedic surgeons is unknown. The Medicare Part D claims database was used to identify orthopedic surgeons who prescribed at least one schedule II or III narcotic during 2014. The median duration of a narcotic prescription was 8.2 days. The median prescription duration was shortest for hand surgeons (5.6 days) and longest for spine surgeons (12...
April 1, 2018: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29605354/trends-in-the-management-of-secondary-post-tonsillectomy-hemorrhage-in-children
#8
Christine M Clark, Jane R Schubart, Michele M Carr
OBJECTIVE: To define current practices in management of secondary post-tonsillectomy hemorrhage (PTH) in children by pediatric and general otolaryngologists. INTRODUCTION: Bleeding after tonsillectomy is common. Our goal was to describe management methods across the U.S. METHODS: Questions regarding perioperative management and treatment in response to three hypothetical cases featuring secondary post-tonsillectomy bleeding were posed via REDCap survey...
May 2018: International Journal of Pediatric Otorhinolaryngology
https://www.readbyqxmd.com/read/29605272/impact-of-ambiguous-and-restrictive-regulations-on-opioid-prescribing-practice-in-georgia
#9
Pati Dzotsenidze, Tamar Lekashvili, Nino Chikhladze, Maka Jorbenadze, Ioseb Abesadze, Dimitri Kordzaia
CONTEXT: Chronic pain management with opioids in incurable patients remains a challenge of modern medicine regardless of the evidence-based effectiveness of opioids and recommendations of authorities such as the World Health Organization and International Narcotics Control Board. Many countries, including Georgia, maintain overly restrictive regulations that contribute to inadequate pain management. OBJECTIVE: To identify barriers to pain management in Georgia caused by legislation, administrative issues, and physicians' lack of knowledge and understanding of legislative aspects governing opioid use, and their impact on opioid-prescribing practice...
March 29, 2018: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29594968/profiles-of-patients-who-use-marijuana-for-inflammatory-bowel-disease
#10
Ann Marie Kerlin, Millie Long, Michael Kappelman, Christopher Martin, Robert S Sandler
BACKGROUND: Marijuana is legal in a number of states for indications that include inflammatory bowel diseases (IBD), and patients are interested in its potential benefits. AIMS: We aimed to describe the legal use of marijuana in individuals with IBD in the USA who participate within the CCFA Partners internet-based cohort. METHODS: A total of 2357 participants who lived in states where prescription or recreational marijuana was legal, were offered the opportunity to complete a survey on marijuana use and IBD symptoms including perceived benefits of therapy...
March 29, 2018: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29584496/evaluating-drugged-driving-effects-of-exemplar-pain-and-anxiety-medications
#11
Timothy L Brown, Gary Milavetz, Gary Gaffney, Andrew Spurgin
OBJECTIVE: Distracted and drug-influenced driving presents a major risk for traffic safety morbidity and mortality. As part of an ongoing research program, we examined the effects of a commonly prescribed combination of medications for pain relief: alprazolam, a benzodiazepine, and a hydrocodone preparation, a combination opiate and acetaminophen, on a simulated driving protocol. METHODS: Utilizing a within-subjects design, we recruited 8 healthy experienced drivers without major physical and psychological histories...
February 28, 2018: Traffic Injury Prevention
https://www.readbyqxmd.com/read/29582450/tamper-resistant-prescription-forms-for-narcotics-in-france-should-we-generalise-them
#12
Amélie Daveluy, Lucie Sauvaget, Angela Bastien, Maryse Lapeyre-Mestre, Cédric Collin, Nathalie Richard, Françoise Haramburu
In France, prescription of narcotics must be written on a tamper-resistant prescription form with specific technical particularities. Dosage and daily dose of medicines shall be written out entirely in letters. These prescription forms are also mandatory for buprenorphine, clorazepate, clonazepam, tianeptine, buccal midazolam and zolpidem owing to traffic, abuse or diversion. In 2012, to assess the use of standard and tamper-resistant prescription forms and the acceptability of the generalization of the latter to all medicines, a national opinion survey was performed, with a postal questionnaire, within 3 randomized samples of 1,500 prescribers (physicians, dentists and midwives)...
March 27, 2018: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/29567001/battling-the-opioid-epidemic-with-prospective-pain-threshold-measurement
#13
Brian T Nickel, Mitchell R Klement, William A Byrd, David E Attarian, Thorsten M Seyler, Samuel S Wellman
BACKGROUND: Responsible analgesic prescribing is paramount in the opioid epidemic era, yet no standardized protocol exists. We aim to (1) quantify and correlate outpatient opioid need after total knee and hip arthroplasties (TKA and THA) with preoperative objective pain pressure thresholds (PPTs) and subjective pain measures and (2) report incidence of nonsurgical opioid prescriptions 6 weeks postoperatively. METHODS: Prospectively, PPTs were measured using an algometer with a maximum force of 20 pounds in 160 consecutive patients (90 TKA and 70 THA)...
February 21, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29559867/opiate-prescribing-practices-in-the-postpartum-unit
#14
Angela Nakahara, Nicole D Ulrich, Rajiv Gala
Background: Louisiana is significantly impacted by the opioid epidemic. In preparation for a quality improvement project aimed at decreasing postpartum narcotics prescriptions, we evaluated routine prescribing practices on a postpartum unit and the number of patient-initiated encounters for postpartum pain. Methods: We conducted a retrospective medical record review of all vaginal deliveries occurring at Ochsner Baptist Medical Center in New Orleans, LA in December 2016 and January 2017...
2018: Ochsner Journal
https://www.readbyqxmd.com/read/29559326/canadian-trends-in-carpal-tunnel-surgery
#15
Blair Peters, Jennifer L Giuffre
PURPOSE: Treatment patterns of carpal tunnel surgery by members of the American Society of Surgery of the Hand (ASSH) have recently been published. The majority of cases in this study were performed in the general operating room with intravenous (IV) sedation or a Bier block. Patients were most commonly prescribed hydrocodone for postoperative pain. The majority of carpal tunnel releases at our center are performed under local anesthesia alone, with plain acetaminophen (Tylenol) or codeine prescribed for postoperative pain...
March 17, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29557264/opioids-and-the-otolaryngologist-an-ambulatory-assessment
#16
Suresh Mohan, Neil Bhattacharyya
Objectives To recognize current opioid prescription patterns in otolaryngology and determine changes in rates of outpatient opioid prescribing over time. Study Design Cross-sectional analysis of national survey database. Setting Ambulatory care settings in the United States. Subjects and Methods The National Ambulatory Medical Care Survey from 2006 to 2013 was analyzed for outpatient otolaryngology visits. The rate of opioid medication prescribing was determined with patient and visit characteristics associated with an opioid prescription, including corresponding diagnoses...
March 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29528997/lack-of-consensus-in-physician-recommendations-regarding-return-to-driving-after-cervical-spine-surgery
#17
Michael J Moses, Jared C Tishelman, Saqib Hasan, Peter L Zhou, Ioanna Zevgaras, Justin S Smith, Aaron J Buckland, Yong Kim, Afshin Razi, Themistocles S Protopsaltis
STUDY DESIGN: Cross-Sectional Study. OBJECTIVE: The goal of this study is to investigate how surgeons differ in collar and narcotic use, as well as return to driving recommendations following cervical spine surgeries and the associated medico-legal ramifications of these conditions. SUMMARY OF BACKGROUND DATA: Restoration of quality of life is one of the main goals of cervical spine surgery. Patients frequently inquire when they may safely resume driving after cervical spine surgery...
March 9, 2018: Spine
https://www.readbyqxmd.com/read/29489736/current-state-of-the-opioid-epidemic-as-it-pertains-to-pediatric-orthopaedics-from-the-advocacy-committee-of-the-pediatric-orthopaedic-society-of-north-america
#18
Ellen M Raney, Harold J P van Bosse, Kevin G Shea, Joshua M Abzug, Richard M Schwend
INTRODUCTION: The opioid epidemic in the United States has reached crisis proportions. Urgent response is needed. Hydrocodone in combination with acetaminophen is the most prescribed drug in the United States. The most common source of opioids available for misuse is the unused portions of postoperative prescriptions. Among high school seniors, 80% of those who reported nonmedical use of prescription opioids previously had legitimate prescriptions but recreationally used leftover doses...
May 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29476355/pain-states-the-opioid-epidemic-and-the-role-of-radiologists
#19
REVIEW
Mark R Jones, Alan D Kaye, Laxmaiah Manchikanti, Joshua A Hirsch
PURPOSE OF REVIEW: The prevalence of chronic pain and prescription opioid abuse has resulted in epidemic problems for patients and clinicians. The consequences are taking a heavy toll on patients, physicians, and society. Specific to radiology, a significant need exists for best practice assessment and treatment approaches for pain management, as patients with chronic pain often undergo radiological tests of unclear clinical relevance. RECENT FINDINGS: The USA is amid an opioid-prescribing epidemic and resultant overdose public health emergency...
February 23, 2018: Current Pain and Headache Reports
https://www.readbyqxmd.com/read/29475404/dose-related-mucositis-with-hydroxyurea-for-cytoreduction-in-acute-myeloid-leukemia
#20
Morgan L Trepte, Jessica J Auten, Stephen M Clark, Hendrik W van Deventer
Hyperleukocytosis occurs in 15-20% of all newly diagnosed acute myeloid leukemia patients and requires emergent treatment with leukapheresis or hydroxyurea when accompanied by signs or symptoms of leukostasis. Currently, there is no standardized hydroxyurea dosing strategy, although usual dosing ranges from 50 to 150 mg/kg/day, and prescribing patterns vary significantly among oncologists and institutions. In addition to other hematologic and dermatologic toxicities, the use of hydroxyurea may be associated with significant mucositis and mucositis-related pain...
January 1, 2018: Journal of Oncology Pharmacy Practice
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