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Chronic noncancer pain

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https://www.readbyqxmd.com/read/28092648/does-brief-chronic-pain-management-education-change-opioid-prescribing-rates-a-pragmatic-trial-in-australian-early-career-general-practitioners
#1
Simon Mark Holliday, Chris Hayes, Adrian J Dunlop, Simon Morgan, Amanda Tapley, Kim M Henderson, Mieke L van Driel, Elizabeth G Holliday, Jean I Ball, Andrew Davey, Neil Allan Spike, Lawrence Andrew McArthur, Parker John Magin
We aimed to evaluate the effect of pain education on opioid prescribing by early-career general practitioners. A brief training workshop was delivered to general practice registrars of a single regional training provider. The workshop significantly reduced "hypothetical" opioid prescribing (in response to paper-based vignettes) in an earlier evaluation. The effect of the training on "actual" prescribing was evaluated using a nonequivalent control group design nested within the Registrar Clinical Encounters in Training (ReCEnT) cohort study: 4 other regional training providers were controls...
February 2017: Pain
https://www.readbyqxmd.com/read/28059430/attitudes-toward-the-canadian-guideline-for-safe-and-effective-use-of-opioids-for-chronic-non-cancer-pain-a-qualitative-study
#2
Yaping Chang, Kan Lun Zhu, Ivan D Florez, Sung Min Cho, Nasim Zamir, Augustin Toma, Reza Donald Mirza, Gordon H Guyatt, Norman Buckley, Jason W Busse
BACKGROUND: Chronic noncancer pain (CNCP) refers to all pain disorders, not due to cancer, that persist for ≥3 months. The point prevalence of CNCP in the general population of Western countries is between 19 and 33 percent. Opioids are commonly prescribed for CNCP and are associated with both benefits and harms. The Canadian Guideline for Safe and Effective Use of Opioids for CNCP was published in 2010 to provide guidance for optimal opioid prescribing in patients with CNCP. OBJECTIVES: To investigate the attitudes toward, and use of, the Canadian Opioids Guideline among pain physicians...
November 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/28042914/the-polyanalgesic-consensus-conference-pacc-recommendations-for-intrathecal-drug-delivery-guidance-for-improving-safety-and-mitigating-risks
#3
REVIEW
Timothy R Deer, Jason E Pope, Salim Hayek, Tim J Lamer, Iler Elias Veizi, Michael Erdek, Mark S Wallace, Jay S Grider, Robert M Levy, Joshua Prager, Steven M Rosen, Michael Saulino, Tony L Yaksh, Jose A De Andrés, David Abejon Gonzalez, Jan Vesper, Stefan Schu, Brian Simpson, Nagy Mekhail
INTRODUCTION: Intrathecal therapy is an important part of the pain treatment algorithm for chronic disease states. The use of this option is a viable treatment strategy, but it is inherent for pain physicians to understand risk assessment and mitigation. In this manuscript, we explore evidence and mitigating strategies to improve safety with intrathecal therapy. METHODS: A robust literature search was performed covering January 2011 to October 9, 2016, in PubMed, Embase, MEDLINE, Biomed Central, Google Scholar, Current Contents Connect, and International Pharmaceutical Abstracts...
January 2, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/28034982/enhancing-risk-assessment-in-patients-receiving-chronic-opioid-analgesic-therapy-using-natural-language-processing
#4
Irina V Haller, Colleen M Renier, Mitch Juusola, Paul Hitz, William Steffen, Michael J Asmus, Terri Craig, Jack Mardekian, Elizabeth T Masters, Thomas E Elliott
OBJECTIVES:  Clinical guidelines for the use of opioids in chronic noncancer pain recommend assessing risk for aberrant drug-related behaviors prior to initiating opioid therapy. Despite recent dramatic increases in prescription opioid misuse and abuse, use of screening tools by clinicians continues to be underutilized. This research evaluated natural language processing (NLP) together with other data extraction techniques for risk assessment of patients considered for opioid therapy as a means of predicting opioid abuse...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28024664/long-term-use-of-opioids-in-210-officially-registered-patients-with-chronic-noncancer-pain-in-taiwan-a-cross-sectional-study
#5
Tso-Chou Lin, Luo-Ping Ger, Joseph V Pergolizzi, Robert B Raffa, Ju-O Wang, Shung-Tai Ho
BACKGROUND/PURPOSE: Prescribing opioids for chronic noncancer pain has been strictly regulated for two decades in Taiwan. The aim of this study was to survey the patients' perspectives and potential drawbacks following long-term use of opioids. METHODS: An observational cross-sectional survey using the Taiwanese version of Brief Pain Inventory was conducted among outpatients with chronic noncancer pain registered by the Taiwan Food and Drug Administration. Patients were also asked about their sexual behavior, depression, opioid misuse behaviors, and use of complementary and alternative medicine...
December 23, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27982672/the-effect-of-ehr-integrated-patient-reported-outcomes-on-satisfaction-with-chronic-pain-care
#6
Christopher A Harle, Nicole M Marlow, Siegfried O F Schmidt, Jonathan J Shuster, Alyson Listhaus, Roger B Fillingim, Robert W Hurley
OBJECTIVES: Given its complexity, chronic noncancer pain presents an opportunity to use health information technology (IT) to improve care experiences. The objective of this study was to assess whether integrating patient-reported outcomes (PROs) data in an electronic health record (EHR) affects provider and patient satisfaction with chronic noncancer pain care. STUDY DESIGN: We conducted a pragmatic cluster randomized trial involving 4 family medicine clinics. METHODS: We enrolled primary care providers (PCPs) and their patients with chronic noncancer pain...
December 1, 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27938897/translating-clinical-findings-into-the-patient-s-perspective-post-hoc-pooled-analysis-of-bowel-movement-changes-as-a-predictor-of-improvement-in-patients-opioid-induced-constipation-symptoms-and-outcomes
#7
Karin S Coyne, Jiat-Ling Poon, Christine Thompson, Yiqun Hu, Catherine J Datto, Mark Sostek
PURPOSE: Opioid-induced constipation (OIC) is a bothersome side effect of opioid use for the management of noncancer pain, affecting patients' health-related quality of life and chronic-pain management. The objective of this study was to examine the relationship between changes in the frequency of spontaneous bowel movements (SBMs) and changes in patient-reported outcomes (PROs) among patients with OIC treated with naloxegol. METHODS: Post hoc analyses were conducted using pooled data from two Phase III 12-week, placebo-controlled trials of naloxegol for the treatment of OIC (NCT01309841 and NCT01323790)...
December 6, 2016: Clinical Therapeutics
https://www.readbyqxmd.com/read/27898458/smoking-status-and-opioid-related-problems-and-concerns-among-men-and-women-on-chronic-opioid-therapy
#8
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
#9
Jason W Busse, David Juurlink, Gordon H Guyatt
No abstract text is available yet for this article.
December 6, 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
#10
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
#11
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
#12
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
#13
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
#14
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...
January 28, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/27741966/the-role-of-opioid-analgesics-in-geriatric-pain-management
#15
REVIEW
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
#16
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
#17
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
#18
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
#19
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
#20
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
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