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https://www.readbyqxmd.com/read/28636707/incidence-and-predictors-of-opioid-prescription-at-discharge-after-traumatic-injury
#1
Muhammad Ali Chaudhary, Andrew J Schoenfeld, Alyssa F Harlow, Anju Ranjit, Rebecca Scully, Ritam Chowdhury, Meesha Sharma, Stephanie Nitzschke, Tracey Koehlmoos, Adil H Haider
Importance: In the current health care environment with increased scrutiny and growing concern regarding opioid use and abuse, there has been a push toward greater regulation over prescriptions of opioids. Trauma patients represent a population that may be affected by this regulation, as the incidence of pain at hospital discharge is greater than 95%, and opioids are considered the first line of treatment for pain management. However, the use of opioid prescriptions in trauma patients at hospital discharge has not been explored...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28571723/opioid-consumption-after-rotator-cuff-repair
#2
Robert W Westermann, Chris A Anthony, Nic Bedard, Natalie Glass, Matt Bollier, Carolyn M Hettrich, Brian R Wolf
PURPOSE: Rising perioperative opioid use in the United States is of increasing concern. The purposes of this study were (1) to define opioid consumption after rotator cuff repair (RCR) in the United States and (2) to evaluate patient factors that may be associated with prolonged opioid use after arthroscopic RCR. METHODS: All arthroscopic RCRs performed between 2007 and 2014 were identified by use of Current Procedural Terminology code (29,827). Patients who filled opioid prescriptions preoperatively were divided into those who filled prescriptions at 1 to 3 months preceding RCR and those who filled opioid prescriptions only in the 1 month preceding RCR...
May 29, 2017: Arthroscopy: the Journal of Arthroscopic & related Surgery
https://www.readbyqxmd.com/read/28554207/provider-type-and-management-of-common-visits-in-primary-care
#3
Douglas W Roblin, Hangsheng Liu, Lee F Cromwell, Michael Robbins, Brandi E Robinson, David Auerbach, Ateev Mehrotra
OBJECTIVES: Debate continues on whether nurse practitioners (NPs) and physician assistants (PAs) are more likely to order ancillary services, or order more costly services among alternatives, than primary care physicians (PCPs). We compared prescription medication and diagnostic service orders associated with NP/PA versus PCP visits for management of neck or back (N/B) pain or acute respiratory infection (ARI). STUDY DESIGN: Retrospective, observational study of visits from January 2006 through March 2008 in the adult primary care practice of Kaiser Permanente in Atlanta, Georgia...
April 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28543422/defending-opioid-treatment-agreements-disclosure-not-promises
#4
Joshua B Rager, Peter H Schwartz
In order to receive controlled pain medications for chronic non-oncologic pain, patients often must sign a "narcotic contract" or "opioid treatment agreement" in which they promise not to give pills to others, use illegal drugs, or seek controlled medications from health care providers. In addition, they must agree to use the medication as prescribed and to come to the clinic for drug testing and pill counts. Patients acknowledge that if they violate the opioid treatment agreement (OTA), they may no longer receive controlled medications...
May 2017: Hastings Center Report
https://www.readbyqxmd.com/read/28538459/patient-comprehension-and-compliance-survey-to-assess-postoperative-pain-regimens-in-the-orthopaedic-trauma-population
#5
Anup K Gangavalli, Ajith Malige, Saqib Rehman, Chinenye O Nwachuku
OBJECTIVE: This study aims to determine the groups of patients who are at risk for noncompliance and misunderstanding of their pain regimen. DESIGN: Survey-based cohort study. SETTING: Suburban Level-I trauma center. PATIENTS/PARTICIPANTS: A total of 171 patients between the ages of 18-89 years who underwent surgical fixation of fractures involving the pelvis, long bones, or periarticular regions of the knee, ankle, elbow, and wrist...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28533997/metoclopramide-for-acute-migraine-treatment-in-the-emergency-department-an-effective-alternative-to-opioids
#6
REVIEW
Mejdi Najjar, Tyler Hall, Blanca Estupinan
In light of recent warnings by the United States (US) Surgeon General and Centers for Disease Control (CDC) guidelines for recommending more prudent use of opioid narcotics, the search for a non-opioid alternative for aborting acute migraines is particularly relevant. The CDC also estimates the prevalence of opioid dependence may be as high as 26% among patients prescribed opioids for chronic pain, not due to cancer, in the primary care setting. Given such staggering data, it is imperative that we, as caretakers, not foster opioid dependence but rather continue to investigate non-opioid therapies for the management of acute migraines in the emergent care settings...
April 20, 2017: Curēus
https://www.readbyqxmd.com/read/28474487/medication-safety-and-the-usability-of-electronic-prescribing-as-perceived-by-physicians-a-semistructured-interview-among-primary-health-care-physicians-in-finland
#7
Hanna Kauppinen, Riitta Ahonen, Pekka Mäntyselkä, Johanna Timonen
RATIONALE, AIMS AND OBJECTIVES: In Finland, a fully operational and nationwide electronic prescription (ePrescription) system was implemented by law in 2012 to 2015. From 2017, all prescriptions have to be electronic. ePrescriptions are intended to facilitate prescribing and to improve medication safety in Finnish health care. In this study, the aim was to explore physicians' experiences with the impacts of ePrescriptions on prescribing and medication safety in Finland. METHOD: Data were collected by conducting 42 interviews among primary health care physicians in spring 2015...
May 4, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28449307/the-efficacy-of-non-narcotic-analgesics-on-post-operative-endodontic-pain-a-systematic-review-and-meta-analysis-the-efficacy-of-non-steroidal-anti-inflammatory-drugs-and-or-paracetamol-on-post-operative-endodontic-pain
#8
REVIEW
A Shirvani, S Shamszadeh, M J Eghbal, S Asgary
The objective of this review was to evaluate the efficacy of non-narcotic analgesics including non-steroidal anti-inflammatory drugs (NSAIDs) and/or paracetamol in the treatment of post-operative endodontic pain. Additionally, we aimed to examine the possible association of study covariates on the pain scores using meta-regression analysis. An electronic search was performed in 2016. After data extraction and quality assessment of the included studies (n = 27, representing 2188 patients), meta-analysis was performed using a random-effect inverse variance method...
April 27, 2017: Journal of Oral Rehabilitation
https://www.readbyqxmd.com/read/28423940/preoperative-risk-factors-for-complications-in-elective-ankle-and-hindfoot-reconstruction
#9
Ryan P Mulligan, Kevin J McCarthy, Benjamin J Grear, David R Richardson, Susan N Ishikawa, G Andrew Murphy
BACKGROUND: The purpose of this study was to examine medical, social, and psychological factors associated with complications and reoperation after foot and ankle reconstruction. METHODS: A retrospective chart review was conducted of 132 patients (135 feet; 139 operative cases) who had elective foot and ankle reconstruction. Medical, social, and psychological variables were documented. Primary outcomes included complications and reoperations. RESULTS: The overall complication rate was 28% (39/139), and the reoperation rate was 17% (24/139)...
April 1, 2017: Foot & Ankle Specialist
https://www.readbyqxmd.com/read/28296623/medicalizing-the-opioid-epidemic-in-the-u-s-in-the-era-of-health-care-reform
#10
David E Smith
The medicalization of the current opioid epidemic in the era of health care reform and parity, and its possible dismantling, poses many challenges. Between 2002 and 2013, drug overdose rates quadrupled. Parallel to an increase in prescription opioid overdose, heroin overdose deaths are increasing as patients shift to cheaper and more accessible heroin from the prescription opioids which physicians are prescribing less often due to increasing regulatory restrictions, as well as enhanced education and awareness...
April 2017: Journal of Psychoactive Drugs
https://www.readbyqxmd.com/read/28292504/pharmacists-perceptions-regarding-the-impact-of-hydrocodone-rescheduling-on-prescription-volume-workflow-management-and-patient-outcomes
#11
Tyler J Varisco, Motolani E Ogunsanya, Jamie C Barner, Marc L Fleming
OBJECTIVES: To determine (1) pharmacists' perceptions of how rescheduling of hydrocodone combination products (HCPs) from Drug Enforcement Agency (DEA) Schedule III to DEA Schedule II has influenced prescription volume and revenue, pharmacy workflow management, and patient outcomes; and (2) whether perceptions differed between pharmacists who support versus those who oppose HCP rescheduling. DESIGN: A cross-sectional mail survey. SETTING: Texas community pharmacies from October to December 2015...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28240756/assessment-and-therapeutic-choice-in-septic-arthritis-of-the-hip-in-an-intravenous-drug-abuser-case-report-at-14-years-follow-up-and-review-of-literature
#12
REVIEW
P Persiani, F M Ranaldi, O Mazza, A Calistri, M Bove, M Crostelli, C Villani
INTRODUCTION: Osteoarticular infections are found frequently in drug addicted individuals, representing one of the main reasons for their hospitalization. Through inoculation, the pathogenic agents can enter the individual's system directly through the skin or parenterally, transmitted, that is, through syringes and other objects used during such practice. In these particular conditions, or when the medical history is vague, a warranted suspicion and the execution of targeted research can help in the diagnosis of high-risk patients such as addicts...
January 2017: La Clinica Terapeutica
https://www.readbyqxmd.com/read/28211545/the-effect-of-gut-microbiome-on-tolerance-to-morphine-mediated-antinociception-in-mice
#13
Minho Kang, Ryan A Mischel, Sukhada Bhave, Essie Komla, Alvin Cho, Charity Huang, William L Dewey, Hamid I Akbarali
There is growing appreciation for the importance of gastrointestinal microbiota in many physiological and pathophysiological processes. While morphine and other narcotics are the most widely prescribed therapy for moderate to severe pain clinically, they have been noted to alter microbial composition and promote bacterial translocation to other tissues. Here we examined the pharmacodynamic properties of chronic morphine in mice following bacterial depletion with oral gavage of an antibiotic cocktail (ABX). ABX significantly reduced gut bacteria and prevented chronic morphine induced increases in gut permeability, colonic mucosal destruction, and colonic IL-1β expression...
February 17, 2017: Scientific Reports
https://www.readbyqxmd.com/read/27986184/the-canadian-gynaecologic-oncology-perioperative-management-survey-baseline-practice-prior-to-implementation-of-enhanced-recovery-after-surgery-eras-society-guidelines
#14
Alon D Altman, Gregg S Nelson
OBJECTIVE: To survey the current practice of Society of Gynecologic Oncology of Canada (GOC) members about preoperative, intraoperative, and postoperative phases of care. The survey was carried out prior to publication of the Enhanced Recovery After Surgery (ERAS) Society gynaecologic/oncology guidelines. METHODS: A survey was developed by the GOC and distributed to all surgical members between September and December 2015. RESULTS: The survey was completed by 77 of 92 practising gynaecologic oncologists (84%), representing 19 centres in 16 cities across Canada...
December 2016: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/27973601/high-dose-opioid-prescribing-and-opioid-related-hospitalization-a-population-based-study
#15
Kimberly Fernandes, Diana Martins, David Juurlink, Muhammad Mamdani, J Michael Paterson, Luke Spooner, Samantha Singh, Tara Gomes
AIMS: To examine the impact of national clinical practice guidelines and provincial drug policy interventions on prevalence of high-dose opioid prescribing and rates of hospitalization for opioid toxicity. DESIGN: Interventional time-series analysis. SETTING: Ontario, Canada, from 2003 to 2014. PARTICIPANTS: Ontario Drug Benefit (ODB) beneficiaries aged 15 to 64 years from 2003 to 2014. INTERVENTIONS: Publication of Canadian clinical practice guidelines for use of opioids in chronic non-cancer pain (May 2010) and implementation of Ontario's Narcotics Safety and Awareness Act (NSAA; November 2011)...
2016: PloS One
https://www.readbyqxmd.com/read/27936362/prevalence-of-self-reported-prescription-drug-use-in-a-national-sample-of-u-s-drivers
#16
Tara Kelley-Baker, Geetha Waehrer, Robin A Pollini
OBJECTIVE: Drug-involved driving has become an increasing concern. Although the focus has been on illegal drugs, there is evidence that prescribed medications can impair driving ability. The purpose of this study was to determine the self-reported prevalence of prescription drug use, including medical and nonmedical use, among a nationally representative sample of drivers and to report related driver characteristics. METHOD: As part of the 2013-2014 National Roadside Survey, drivers from 60 sites were randomly recruited and asked to complete a survey on prescription drug use...
January 2017: Journal of Studies on Alcohol and Drugs
https://www.readbyqxmd.com/read/27843963/comparative-evaluation-between-two-methods-of-induced-hypotension-with-infusion-of-remifentanil-and-labetalol-during-sinus-endoscopy
#17
Parvin Sajedi, Ali Rahimian, Gholamreza Khalili
OBJECTIVE: This study aimed to compare two methods of controlled hypotension using labetalol and remifentanil in terms of capability to create controlled hypotension and to investigate the obtained complications, and satisfaction rate of surgeon and patient during functional endoscopic sinus surgery. METHODS: In this prospective clinical trial, 62 patients underwent endoscopic sinus surgery in Al-Zahra and Ayatollah Kashani Hospitals of Isfahan were divided into two groups: in the first group, 20 mg bolus dose of labetalol and then infusion of it, at a rate of 0...
October 2016: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/27842790/otolaryngology-concerns-for-illicit-and-prescription-drug-use
#18
REVIEW
Nathan J Gonik, Martin H Bluth
Concern for illicit and restricted drug use in otolaryngology is similar to other surgical specialties with a few notable exceptions. Many illicit drugs are consumed transnasally. Repeated nasal exposure to stimulants or narcotics can cause local tissue destruction that can present as chronic rhinosinusitis or nasoseptal perforation. Further, the Food and Drug Administration has taken a stance against codeine for pediatric patients undergoing adenotonsillectomy. They have identified an increased risk of death postoperatively with these medications...
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27670911/erratum-to-prescription-reporting-with-immediate-medication-utilization-mapping-primum-development-of-an-alert-to-improve-narcotic-prescribing
#19
Rachel B Seymour, Daniel Leas, Meghan K Wally, Joseph R Hsu
No abstract text is available yet for this article.
2016: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/27600629/primary-caregiver-perception-of-pain-control-following-pediatric-adenotonsillectomy-a-cross-sectional-survey
#20
Justin C Sowder, Craig M Gale, Jacob L Henrichsen, Kristy Veale, Katie B Liljestrand, Barbara C Ostlund, Aaron Sherwood, Austin Smith, Griffin H Olsen, Mark Ott, Jeremy D Meier
OBJECTIVES: To (1) review pain medications prescribed following pediatric adenotonsillectomy (T&A), (2) identify pain medications reported to be helpful, and (3) compare parent-reported outcomes among various combinations of pain medications. STUDY DESIGN: Case series with planned data collection. SETTING: Multihospital network. SUBJECTS AND METHODS: The primary caregivers of children aged 1 to 18 years who underwent isolated T&A from June to December 2014 were contacted 14 to 21 days after surgery...
November 2016: Otolaryngology—Head and Neck Surgery
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