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Chronic noncancer pain

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https://www.readbyqxmd.com/read/27898458/smoking-status-and-opioid-related-problems-and-concerns-among-men-and-women-on-chronic-opioid-therapy
#1
Kelly C Young-Wolff, Daniella Klebaner, Constance Weisner, Michael Von Korff, Cynthia I Campbell
OBJECTIVES: Smokers on chronic opioid therapy for non-cancer pain use prescription opioids at higher dosages and are at increased risk for opioid misuse and dependence relative to non-smokers. The current study aims to assess whether smoking is associated with problems and concerns with chronic opioid therapy from the perspective of the patient. METHODS: In a large sample (N=972) of adult patients prescribed opioids for chronic noncancer pain, we examined sex-specific associations between smoking status and patient perceptions of problems and concerns with chronic opioid therapy using regression analyses, adjusting for covariates...
November 28, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27873754/addressing-the-limitations-of-the-cdc-guideline-for-prescribing-opioids-for-chronic-noncancer-pain
#2
Jason W Busse, David Juurlink, Gordon H Guyatt
No abstract text is available yet for this article.
November 21, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27860208/randomized-double-blind-trial-of-oral-methylnaltrexone-for-the-treatment-of-opioid-induced-constipation-in-patients-with-chronic-noncancer-pain
#3
Richard Rauck, Neal E Slatkin, Nancy Stambler, Joseph R Harper, Robert J Israel
BACKGROUND: Subcutaneous methylnaltrexone, a peripherally acting μ-opioid receptor antagonist, improves opioid-induced constipation (OIC) in patients with chronic noncancer pain. An oral methylnaltrexone formulation has been developed. METHODS: In this phase 3, double-blind trial, adults with chronic noncancer pain receiving opioid doses of ≥50 mg/d oral morphine equivalents with OIC were randomly assigned to oral methylnaltrexone (150 mg, 300 mg, or 450 mg) or placebo once daily (QD) for 4 weeks followed by as-needed dosing for 8 weeks...
November 17, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27844473/adherence-to-chronic-opioid-therapy-prescribing-guidelines-in-a-primary-care-clinic
#4
Cynthia Kay, Erica Wozniak, Sarah Koller, Audrey Ye, Joanne Bernstein
OBJECTIVE: Characterize primary care patients prescribed opioids for chronic noncancer pain (CNCP), explore guideline-recommended opioid-monitoring practices, and investigate predictors of pain agreements. DESIGN: Retrospective chart review. SETTING: Primary care clinic at a tertiary academic medical center. PATIENTS: Adults prescribed chronic opioids (three or more monthly prescriptions within a year) for CNCP between April 1, 2014 and April 1, 2015...
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27844472/patient-relevant-outcomes-and-health-related-quality-of-life-in-patients-with-chronic-severe-noncancer-pain-treated-with-tapentadol-prolonged-release-using-criteria-of-health-technology-assessment
#5
Johannes Fx Hofmann, Arun Lal, Maike Steffens, Robert Boettger
OBJECTIVE: To perform a systematic comparison of tapentadol prolonged release (PR) and oxycodone controlled release (CR) using patient-relevant endpoints of efficacy, safety, and health-related quality of life (HRQoL) according to criteria used in health technology assessment. To derive a minimal important difference (MID) for the EQ-5D from three pivotal trials to measure patient-relevant changes in HRQoL. DESIGN: Randomized, double-blind, placebo and active controlled...
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27782366/chronic-pain-features-relate-to-quality-of-life-more-than-physiopathology-a-cross-sectional-evaluation-in-pain-clinics
#6
Concepción Pérez, César Margarit, Sánchez-Magro Isabel, Ana de Antonio, Villoria Jesús
OBJECTIVE: To compare the impact of chronic pain physiopathology on health-related quality of life (HR-QoL), considering the influence of pain features and psychosocial adjustment (intensity, interference, psychological comorbidities, and sleep quality). DESIGN: A cross-sectional study involving 1,025 noncancer patients with predominantly neuropathic, nociceptive, or mixed chronic pain conditions was conducted in 88 pain clinics within Spain. The EuroQol 5-Dimensions instrument (EQ-5D) was used to measure HR-QoL...
October 26, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27754719/provider-experiences-with-the-identification-management-and-treatment-of-co-occurring-chronic-noncancer-pain-and-substance-use-in-the-safety-net
#7
Jamie Suki Chang, Margot Kushel, Christine Miaskowski, Rachel Ceasar, Kara Zamora, Emily Hurstak, Kelly R Knight
BACKGROUND: In the United States and internationally, providers have adopted guidelines on the management of prescription opioids for chronic noncancer pain (CNCP). For "high-risk" patients with co-occurring CNCP and a history of substance use, guidelines advise that providers monitor patients using urine toxicology screening tests, develop opioid management plans, and refer patients to substance use treatment. OBJECTIVE: We report primary care provider experiences in the safety net interpreting and implementing prescription opioid guideline recommendations for patients with CNCP and substance use...
October 18, 2016: Substance Use & Misuse
https://www.readbyqxmd.com/read/27741966/the-role-of-opioid-analgesics-in-geriatric-pain-management
#8
Jennifer Greene Naples, Walid F Gellad, Joseph T Hanlon
When possible, chronic noncancer pain (CNCP) in older adults should be managed by nonpharmacologic modalities in conjunction with nonopioid analgesics. If moderate-to-severe pain persists despite these approaches, however, nonparenteral opioids may be considered as adjunctive therapy. This article reviews the epidemiology of opioid use and their effectiveness for CNCP in older adults and summarizes important age-related changes in opioid pharmacokinetics and pharmacodynamics that increase the risks of adverse effects in the elderly...
November 2016: Clinics in Geriatric Medicine
https://www.readbyqxmd.com/read/27703395/using-social-media-to-challenge-unwarranted-clinical-variation-in-the-treatment-of-chronic-noncancer-pain-the-brainman-story
#9
Ruth White, Chris Hayes, Scott White, Fiona J Hodson
There is a substantial clinical variation in the contemporary treatment of chronic noncancer pain reflecting different explanatory models and treatment emphasis. Hunter Integrated Pain Service and collaborators developed three key messaging videos outlining the foundations of chronic pain treatment, thus challenging unwarranted clinical variation and calling for greater therapeutic consistency. The videos were released on YouTube as a low-cost public health intervention. Each video used an evidenced informed script appropriate for low literacy and a cartoonist to provide matching images...
2016: Journal of Pain Research
https://www.readbyqxmd.com/read/27676695/dose-and-duration-of-opioid-use-in-patients-with-cancer-and-noncancer-pain-at-an-outpatient-hospital-setting-in-malaysia
#10
Che S Zin, Norny A Rahman, Che R Ismail, Leong W Choy
BACKGROUND: There are currently limited data available on the patterns of opioid prescribing in Malaysia. This study investigated the patterns of opioid prescribing and characterized the dosing and duration of opioid use in patients with noncancer and cancer pain. METHODS: This retrospective, cross-sectional study was conducted at an outpatient hospital setting in Malaysia. All prescriptions for opioids (dihydrocodeine, fentanyl, morphine, and oxycodone) issued between January 2013 and December 2014 were examined...
September 27, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27651513/comparison-of-the-effects-of-intermittent-boluses-to-simple-continuous-infusion-on-patients-global-perceived-effect-in-intrathecal-therapy-for-pain-a-randomized-double-blind-crossover-study
#11
Sam Eldabe, Rui V Duarte, Grace Madzinga, Alan M Batterham, Morag E Brookes, Ashish P Gulve, Christophe Perruchoud, Jon H Raphael, David Lorenzana, Eric Buchser
OBJECTIVE:  Intrathecal drug delivery (ITDD) is commonly used for intractable pain management. A paucity of good-quality studies in chronic noncancer patients and concerns over increased dosages have focused interest on different modes of administration. The aim of this international multicenter randomized double-blind crossover trial was to compare the efficacy of the same daily dose of drugs administered by intermittent boluses vs simple continuous infusion. METHODS:  Eligible patients implanted with a programmable ITDD device were randomized to receive two weeks of either intermittent boluses or a simple continuous flow in period 1, followed by a crossover to the alternative mode of administration...
September 19, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27606040/increased-burden-of-healthcare-utilization-and-cost-associated-with-opioid-related-constipation-among-patients-with-noncancer-pain
#12
Ancilla W Fernandes, David M Kern, Catherine Datto, Yen-Wen Chen, Charles McLeskey, Ozgur Tunceli
BACKGROUND: Opioids are widely accepted as treatment for moderate to severe pain, and opioid-induced constipation is one of the most common side effects of opioids. This side effect negatively affects pain management and patients' quality of life, which could result in increased healthcare utilization and costs. OBJECTIVE: To assess healthcare utilization and costs (all-cause, constipation-related, and pain-related) for individuals with and without opioid-induced constipation during the 12 months after initiation of opioid therapy for noncancer pain...
May 2016: American Health & Drug Benefits
https://www.readbyqxmd.com/read/27605589/development-of-short-form-versions-of-the-screener-and-opioid-assessment-for-patients-with-pain-revised-soapp-r-a-proof-of-principle-study
#13
Matthew D Finkelman, Niels Smits, Ronald J Kulich, Kevin L Zacharoff, Britta E Magnuson, Hong Chang, Jinghui Dong, Stephen F Butler
BACKGROUND: The Screener and Opioid Assessment for Patients with Pain-Revised (SOAPP-R) is a 24-item questionnaire designed to assess risk of aberrant medication-related behaviors in chronic pain patients. The introduction of short forms of the SOAPP-R may save time and increase utilization by practitioners. OBJECTIVE: To develop and evaluate candidate SOAPP-R short forms. DESIGN: Retrospective study. SETTING: Pain centers...
September 7, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27589376/dialyzability-of-oxycodone-and-its-metabolites-in-chronic-noncancer-pain-patients-with-end-stage-renal-disease
#14
Boaz Gedaliahu Samolsky Dekel, Gabriele Donati, Alessio Vasarri, Anna Laura Croci Chiocchini, Alberto Gori, Giuseppe Cavallari, Gianfranco Di Nino, Laura Mercolini, Michele Protti, Roberto Mandrioli, Rita Maria Melotti, Gaetano La Manna
OBJECTIVES: Opioids are the preferred analgesic drugs to treat severe chronic pain conditions among dialysis patients; however, knowledge about their dialyzability features is limited. Oxycodone is increasingly used for the treatment of chronic pain conditions as oral controlled release (CR) tablets; however, evidence about this drug and its metabolites' dialyzability is lacking. METHODS: We assessed, during 4-hour dialysis sessions, the effect of standard hemodialysis (HD) and online hemodiafiltration (HDF) methods on the plasma concentration of oxycodone and its metabolites in n = 20 chronic pain patients with end-stage renal disease who were stably treated with oral CR oxycodone...
September 2, 2016: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/27583928/effect-of-opioid-prescribing-guidelines-in-primary-care
#15
Jonathan H Chen, Jason Hom, Ilana Richman, Steven M Asch, Tanya Podchiyska, Nawal Atwan Johansen
Long-term opioid use for noncancer pain is increasingly prevalent yet controversial given the risks of addiction, diversion, and overdose. Prior literature has identified the problem and proposed management guidelines, but limited evidence exists on the actual effectiveness of implementing such guidelines in a primary care setting.A multidisciplinary working group of institutional experts assembled comprehensive guidelines for chronic opioid prescribing, including monitoring and referral recommendations. The guidelines were disseminated in September 2013 to our medical center's primary care clinics via in person and electronic education...
August 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27575828/novel-peer-review-method-for-improving-controlled-substance-prescribing-in-primary-care
#16
Brian Penti, Jane M Liebschutz, Brian Kopcza, Ziming Xuan, Christine Odell, Robert Saper
OBJECTIVE: Determine if peer feedback through a chart review tool (CRT) can impact opioid prescribing for patients with chronic noncancer pain in an outpatient family medicine clinic at an urban, safety-net teaching hospital and to assess providing practices. DESIGN: A quality improvement (QI) project, comparing preopioid and postopioid prescribing practices. SETTING: Outpatient family medicine clinic at urban, safety-net teaching hospital...
July 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27550948/knowledge-attitude-and-practice-survey-of-prescribing-opioids-for-chronic-noncancer-pain-in-taiwan-comparison-of-pain-and-non-pain-physicians
#17
Tso-Chou Lin, Luo-Ping Ger, Joseph V Pergolizzi, Robert B Raffa, Ju-O Wang, Shung-Tai Ho
BACKGROUND: Prescribing opioids for chronic noncancer pain (CNCP) has been strictly regulated in Taiwan. This study was undertaken to survey pain and non-pain related physicians' knowledge, attitudes, and practices regarding prescribing opioids for CNCP. METHODS: A questionnaire survey was conducted in this comparison study. All 66 physicians who were treating officially registered CNCP outpatients were visited and completed anonymous questionnaires. The other physicians (anesthesiologists, oncologists, and non-pain physicians) were surveyed by a mailed questionnaire...
August 22, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27476539/laxative-utilization-over-time-in-chronic-pain-patients-with-opioid-induced-constipation
#18
Catherine J Datto, Robert J LoCasale, Mary Kay Margolis, Christine L Thompson, Karin S Coyne
AIM: To determine laxative utilization over time among chronic noncancer pain patients with opioid-induced constipation (OIC). SETTING: A prospective longitudinal study conducted in the USA, Canada, Germany and UK. METHODS: Patients on daily opioid therapy for treatment of chronic noncancer pain with OIC were recruited from clinics to complete a survey at Baseline and weeks 2, 4, 6, 8, 12, 16, 20 and 24. RESULTS: 489 patients completed baseline with 452 completing one or more follow-up visits...
November 2016: Pain Management
https://www.readbyqxmd.com/read/27473188/efficacy-of-ultra-micronized-palmitoylethanolamide-um-pea-in-geriatric-patients-with-chronic-pain-study-protocol-for-a-series-of-n-of-1-randomized-trials
#19
Maura Marcucci, Federico Germini, Anna Coerezza, Luca Andreinetti, Lorenzo Bellintani, Alessandro Nobili, Paolo Dionigi Rossi, Daniela Mari
BACKGROUND: Chronic pain in older people is highly prevalent, often underestimated, and associated with adverse outcomes. Most available analgesic drugs are often either ineffective or not tolerated, with many side effects. Palmitoylethanolamide (PEA) is an endogenous widely distributed N-acylethanolamina involved in neuroinflammation and pain-generating processes. Formulations containing ultra-micronized palmitoylethanolamide (um-PEA) are available but their effectiveness on chronic pain in highly heterogeneous geriatric patients is not clear and probably not generalizable...
2016: Trials
https://www.readbyqxmd.com/read/27445632/finding-ways-to-lift-barriers-to-care-for-chronic-pain-patients-outcomes-of-using-internet-based-self-management-activities-to-reduce-pain-and-improve-quality-of-life
#20
Kevin Rod
Background. Chronic pain is prevalent, disabling, costly, and undertreated. There is clearly a need to improve patient understanding of ways to manage their pain. Internet-based programs are continually being developed to facilitate mental health improvement, providing tailored content for patients to manage their pain, anxiety, and depression. Objective. To evaluate the impact of Internet-based patient self-management education and activities on patients' pain, anxiety, and quality of life in patients who could not access multidisciplinary pain management...
2016: Pain Research & Management: the Journal of the Canadian Pain Society
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