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Chronic noncancer pain

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https://www.readbyqxmd.com/read/28898536/treatment-with-naloxegol-versus-placebo-pain-assessment-in-patients-with-noncancer-pain-and-opioid-induced-constipation
#1
Lynn Webster, Ulysses Diva, Raj Tummala, Mark Sostek
OBJECTIVE: To summarize results from pain and opioid use assessments with naloxegol in adults with opioid-induced constipation (OIC) and chronic noncancer pain. METHODS: Two phase 3 randomized, double-blind, 12-week studies evaluated the efficacy and safety of oral naloxegol (12.5 or 25 mg daily) in adults (18-<85 years) with confirmed OIC and chronic noncancer pain: KODIAC-04 (NCT01309841) and KODIAC-05 (NCT01323790). Pain level was assessed daily (11-point Numeric Rating Scale [NRS]; 0=no pain, 10=worst imaginable pain)...
September 12, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28858018/naloxegol-for-managing-opioid-induced-constipation
#2
Krystal N Shelton, Jennifer N Clements
Naloxegol is a peripherally acting mu-opioid receptor antagonist for opioid-induced constipation in adults with chronic noncancer pain. This drug's once-daily oral formulation can be used as monotherapy and helps to decrease the constipating effects of opioid therapy; however, it has been associated with abdominal pain.
September 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28831278/opioid-prescribing-practices-and-training-needs-of-qu%C3%A3-bec-family-physicians-for-chronic-noncancer-pain
#3
Élise Roy, Richard J Côté, Denis Hamel, Pierre-André Dubé, Éric Langlois, Maud Emmanuelle Labesse, Christiane Thibault, Aline Boulanger
AIM: To examine medical practices and training needs of Québec family physicians with respect to pain management and opioid prescription for chronic noncancer pain (CNCP). METHODOLOGY: An online survey was carried out in 2016. RESULTS: Of 636 respondents (43.0% men; 54.3% ≥ 50 years old), 15.2% and 70.9% felt very or somewhat confident that they could properly prescribe opioids for CNCP. Concerns related to abuse (72.5% strongly/somewhat agree), dependence (73...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28829519/looking-both-ways-before-crossing-the-street-assessing-the-benefits-and-risk-of-opioids-in-treating-patients-at-risk-of-sleep-disordered-breathing-for-pain-and-dyspnea
#4
Mellar P Davis, Bertrand Behm, Diwakar Balachandran
Opioids adversely influence respiration in five distinct ways. Opioids reduce the respiratory rate, tidal volume, amplitude, reflex responses to hypercapnia and hypoxia, and arousability related necessary for respiratory adaptive responses. Opioids cause impairment of upper pharyngeal dilator muscles leading to obstructive apnea. Opioids cause complex sleep disordered breathing (SDB) consisting of central sleep apnea and obstructive sleep apnea. Clinically opioids worsen pre-existing SDB. Recent studies have shown increased morbidity and mortality in patients receiving opioids for chronic noncancer pain and chronic obstructive pulmonary disease, which appear to be related to cardiovascular events, not overdose...
May 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28810695/long-term-safety-and-efficacy-of-subcutaneous-methylnaltrexone-in-patients-with-opioid-induced-constipation-and-chronic-noncancer-pain-a-phase-3-open-label-trial
#5
Lynn R Webster, Edward Michna, Arif Khan, Robert J Israel, Joseph R Harper
Objective: Methylnaltrexone, a peripherally acting µ-opioid receptor antagonist, alleviates opioid-induced constipation. Understanding its long-term safety and efficacy profile in patients with chronic noncancer pain is warranted given the persistence of opioid-induced constipation. Methods. : In this phase 3, multicenter, open-label trial, adults with chronic noncancer pain (N = 1034) received subcutaneous methylnaltrexone 12 mg once daily for 48 weeks...
August 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28810129/opioid-prescribing-for-chronic-pain-in-a-community-based-healthcare-system
#6
Robert J Romanelli, Laurence I Ikeda, Braden Lynch, Terri Craig, Joseph C Cappelleri, Trevor Jukes, Denis Y Ishisaka
OBJECTIVES: We sought to evaluate opioid prescribing in an ambulatory setting among patients with noncancer chronic pain (CP). STUDY DESIGN: Cross-sectional analysis. METHODS: We identified patients with at least 2 CP encounters at least 30 days apart in 2012 in the electronic health records of a community-based healthcare delivery system in northern California. We used logistic regression models to assess associations of receiving an opioid prescription with respect to number and type of CP conditions and patient demographics and characteristics...
May 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28769587/health-care-resource-use-and-cost-differences-by-opioid-therapy-type-among-chronic-noncancer-pain-patients
#7
Pamela B Landsman-Blumberg, Nathaniel Katz, Kavita Gajria, Anna O D'Souza, Sham L Chaudhari, Paul P Yeung, Richard White
The study assessed 12-month chronic pain (CP)-related health care utilization and costs among chronic noncancer pain (CNCP) patients who initiated various long-term opioid treatments. Treatments included monotherapy with long-acting opioids (mono-LAOs), mono-therapy with short-acting opioids (mono-SAOs), both LAOs and SAOs (combination), and opioid therapy initiated with SAO or LAO and switched to the other class (switch). Using MarketScan(®) claims databases (2006-2012), we identified CNCP patients with ≥90 days opioid supply after pain diagnosis and continuous enrollment 12 months before pain diagnosis (baseline period) and 12 months after opioid start (post-index period)...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28747087/safety-and-effectiveness-of-once-daily-hysingla-extended-release-tablets-in-patients-with-baseline-depression-or-anxiety
#8
Louise Taber, Ellie He, Steven R Ripa
AIM: Long-term safety and effectiveness of a once daily, single-entity, extended-release formulation of hydrocodone bitartrate (HYD) for the treatment of moderate to severe noncancer and nonneuropathic pain among patients with and without concurrent depression/anxiety at baseline. MATERIALS & METHODS: Post hoc analysis. RESULTS: HYD demonstrated a safety profile consistent with μ-opioid agonists: Serious adverse events in 12% patients with depression/anxiety including four deaths; 6% without depression/anxiety including one death...
July 27, 2017: Pain Management
https://www.readbyqxmd.com/read/28715354/validation-of-eq-5d-and-15d-in-the-assessment-of-health-related-quality-of-life-in-chronic-pain
#9
Pekka Vartiainen, Pekka Mäntyselkä, Tarja Heiskanen, Nora Hagelberg, Seppo Mustola, Heli Forssell, Hannu Kautiainen, Eija Kalso
Chronic pain has a significant impact on quality of life. Measurement of health-related quality of life (HRQoL) is essential in the assessment of pain management outcomes, but different instruments have produced varying results. We assessed the validity of 2 HRQoL instruments, EuroQol 5 dimensions questionnaire (EQ-5D) and 15-dimensional health-related quality of life measure (15D), in patients with challenging chronic pain. Three hundred ninety-one chronic noncancer pain patients referred to tertiary pain clinics completed EQ-5D, 15D, and a broad set of questionnaires mapping socioeconomic factors, self-rated health, pain intensity and interference, depression, pain acceptance, pain-related anxiety, and sleep...
August 2017: Pain
https://www.readbyqxmd.com/read/28699416/interview-with-david-tauben-university-of-washington-chief-of-the-division-of-pain-medicine
#10
David Tauben
Dr Tauben is Clinical Professor jointly appointed in the Departments of Medicine and Anesthesia & Pain Medicine, and is the Hughes M & Katherine G Blake Endowed Professor, board certified in both Internal Medicine and Pain Medicine. He is also University of Washington (UW) Director of Medical Student and Resident Education in Pain Medicine, and Medical Director of UW TelePain, a tele-video-conferencing program intended to provide innovative pain education and consultative support to a five-state northwest regional primary care providers...
July 12, 2017: Pain Management
https://www.readbyqxmd.com/read/28650247/burden-of-alcohol-abuse-or-dependence-among-long-term-opioid-users-with-chronic-noncancer-pain
#11
Pamela B Landsman-Blumberg, Nathaniel Katz, Kavita Gajria, Anna D Coutinho, Paul P Yeung, Richard White
BACKGROUND: Substance abuse disorders among chronic noncancer pain (CNCP) patients add to the clinical challenges and economic burden of caring for such patients. Despite potential risks, some CNCP patients with a history of alcohol abuse or dependence (AAD) and pain that is refractory to nonopioid treatment options may still need opioids for pain management. However, there is a lack of data on adverse outcomes in long-term opioid users with CNCP and a history of substance abuse or AAD disorders...
July 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28626504/comparing-healthcare-utilization-and-costs-among-medicaid-insured-patients-with-chronic-noncancer-pain-with-and-without-opioid-induced-constipation-a-retrospective-analysis
#12
Tope Olufade, Amanda M Kong, Nicole Princic, Paul Juneau, Rucha Kulkarni, Kui Zhang, Catherine Datto
BACKGROUND: Constipation is a common adverse effect of opioid use and has been associated with increased healthcare utilization and costs among patients receiving opioids for pain management. OBJECTIVE: To compare the healthcare utilization and costs of Medicaid patients with chronic noncancer pain with and without constipation who were receiving opioids. METHODS: This retrospective, claims-based study was conducted using data from the Truven Health MarketScan Medicaid Multi-State database...
April 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28625114/the-role-of-testosterone-supplemental-therapy-in-opioid-induced-hypogonadism-a-retrospective-pilot-analysis
#13
Omer A Raheem, Sunil H Patel, David Sisul, Tim J Furnish, Tung-Chin Hsieh
Chronic opioid therapy for pain management is known to induce several endocrine changes. The authors examined the effect of testosterone supplemental therapy (TST) in patients with chronic, noncancer pain undergoing opioid therapy. It was hypothesized that treatment of opioid-induced hypogonadism (OIH) can reduce opioid requirements in patients suffering from chronic pain and approve their quality of life. Over 18 months period, patients with OIH were identified in a tertiary referral pain center, Numerical Rating Scale (NRS) pain scores and daily morphine equivalent dose (MED) were the primary outcomes measured...
July 2017: American Journal of Men's Health
https://www.readbyqxmd.com/read/28483845/guideline-for-opioid-therapy-and-chronic-noncancer-pain
#14
Jason W Busse, Samantha Craigie, David N Juurlink, D Norman Buckley, Li Wang, Rachel J Couban, Thomas Agoritsas, Elie A Akl, Alonso Carrasco-Labra, Lynn Cooper, Chris Cull, Bruno R da Costa, Joseph W Frank, Gus Grant, Alfonso Iorio, Navindra Persaud, Sol Stern, Peter Tugwell, Per Olav Vandvik, Gordon H Guyatt
No abstract text is available yet for this article.
May 8, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/28394752/the-risks-of-opioid-treatment-perspectives-of-primary-care-practitioners-and-patients-from-safety-net-clinics
#15
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 2017: Substance Abuse
https://www.readbyqxmd.com/read/28379504/low-risk-of-producing-an-opioid-use-disorder-in-primary-care-by-prescribing-opioids-to-prescreened-patients-with-chronic-noncancer-pain
#16
Martin D Cheatle, Rollin M Gallagher, Charles P O'Brien
Objective. : To examine the risk of developing aberrant behaviors that might lead to a substance use disorder (addiction) when prescribing opioids for the relief of chronic noncancer pain in primary care settings. Design. : Longitudinal, prospective, descriptive design with repeated measures. Setting. : Private community-based internal medicine and family medicine clinics. Subjects. : Patients with chronic musculoskeletal pain...
March 31, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28371937/a-phase-2b-randomized-double-blind-placebo-controlled-study-to-evaluate-the-efficacy-and-safety-of-naldemedine-for-the-treatment-of-opioid-induced-constipation-in-patients-with-chronic-noncancer-pain
#17
Lynn R Webster, Tadaaki Yamada, Juan Camilo Arjona Ferreira
Objective. : This study evaluated the efficacy and safety of oral naldemedine 0.1 mg, 0.2 mg, or 0.4 mg once daily in patients who had opioid-induced constipation (OIC) and maintained a stable laxative regimen. Methods. : This four-week, phase 2b, randomized, double-blind placebo-controlled trial (clinicaltrials.gov identifier NCT01443403) enrolled patients on long-term opioid therapy for chronic noncancer pain with OIC. The primary efficacy end point was change in weekly spontaneous bowel movement (SBM) frequency from baseline to the last two weeks of treatment...
March 23, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28371881/from-opiophobia-to-overprescribing-a-critical-scoping-review-of-medical-education-training-for-chronic-pain
#18
Fiona Webster, Samantha Bremner, Eric Oosenbrug, Steve Durant, Colin J McCartney, Joel Katz
Background: Chronic pain is a significant health problem strongly associated with a wide range of physical and mental health problems, including addiction. The widespread prevalence of pain and the increasing rate of opioid prescriptions have led to a focus on how physicians are educated about chronic pain. This critical scoping review describes the current literature in this important area, identifying gaps and suggesting avenues for further research starting from patients' standpoint...
August 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28371835/effectiveness-and-safety-of-once-daily-extended-release-hydrocodone-in-individuals-previously-receiving-immediate-release-oxycodone-for-chronic-pain
#19
Joseph Pergolizzi, Maribeth Kowalski, Ellie He
Objectives. : This study evaluated the safety and effectiveness of a once-daily, single-entity, extended-release hydrocodone bitartrate (HYD) among patients with chronic noncancer and non-neuropathic pain who required opioid rotation from a previous analgesic regimen that primarily consisted of immediate-release (IR) oxycodone. Methods. : Post hoc analyses of a primary study that assessed HYD 20 to 120 mg over a 52-week period are presented. The primary study included a dose titration period (up to 45 days), a 52-week maintenance period, and an optional taper period (up to 14 days)...
March 28, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340185/knowledge-of-opioid-overdose-and-attitudes-to-supply-of-take-home-naloxone-among-people-with-chronic-noncancer-pain-prescribed-opioids
#20
Suzanne Nielsen, Amy Peacock, Nicholas Lintzeris, Raimondo Bruno, Briony Larance, Louisa Degenhardt
Objective.:  Take-home naloxone (THN) is recommended in response to pharmaceutical opioid-related mortality. Some health professionals are reluctant to discuss THN for fear of causing offense. The aims of this study were to assess knowledge of opioid overdose and attitudes toward THN for opioid overdose reversal in people with chronic noncancer pain (CNCP). Design.:  Prospective cohort study. Setting.:  Australia, September to October 2015...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
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