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Chronic noncancer pain

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https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#1
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29240019/integrating-patient-controlled-analgesia-using-implanted-intrathecal-pumps-for-postoperative-pain-management-a-case-report
#2
Alec Peniche, Lawrence Poree, Mark Schumacher, Xiaobing Yu
Intrathecal patient-controlled analgesia (IT-PCA) through implanted intrathecal infusion pumps has been increasingly utilized for severe cancer and chronic noncancer pain management. However, its application for acute postoperative pain management has not been reported to date. We present a case of a patient with an implanted intrathecal pump for chronic nonmalignant back pain who underwent an extensive spinal fusion surgery. The IT-PCA functionality of her intrathecal pump was successfully integrated into her postoperative multimodal pain regimen...
December 11, 2017: A & A Case Reports
https://www.readbyqxmd.com/read/29237039/development-of-a-brief-version-of-the-current-opioid-misuse-measure-comm-the-comm-9
#3
Stacey A McCaffrey, Ryan A Black, Albert J Villapiano, Robert N Jamison, Stephen F Butler
Objective: The Current Opioid Misuse Measure (COMM) is a commonly used self-report instrument to identify and monitor aberrant opioid-related behavior in chronic pain patients on opioid therapy. However, the length of the COMM may limit its clinical utility. Additionally, this paper-and-pencil screener requires hand scoring, which increases paperwork and staff burden. Therefore, the current study presents development of the "COMM-9," a brief electronically administered form of the COMM...
December 11, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29220525/impact-of-opioid-dose-reduction-and-risk-mitigation-initiatives-on-chronic-opioid-therapy-patients-at-higher-risk-for-opioid-related-adverse-outcomes
#4
Manu Thakral, Rod L Walker, Kathleen Saunders, Susan M Shortreed, Sascha Dublin, Michael Parchman, Ryan N Hansen, Evette Ludman, Karen J Sherman, Michael Von Korff
Objective: We aimed to determine if opioid risk reduction initiatives including dose reduction and risk mitigation strategies for chronic noncancer pain patients receiving chronic opioid therapy (COT) had a differential impact on average daily opioid doses of COT patients at higher risk for opioid-related adverse outcomes compared with lower-risk patients. Design: Interrupted time series. Setting: Group Health Cooperative (GH), a health care delivery system and insurance within Washington State, between 2006 and 2014...
December 6, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29207909/the-evolving-role-of-long-term-pharmacotherapy-for-opioid-induced-constipation-in-patients-being-treated-for-noncancer-pain
#5
Brandi L Bowers, Andrew J Crannage
Nationally, the prescription of opioids for acute and chronic pain is increasing. As opioid use continues to expand and become of increased concern for health-care practitioners, so do the adverse effects and long-term management of those effects. Opioid-induced constipation (OIC) presents a unique challenge because tolerance does not develop to this particular adverse effect, making chronic pain management a delicate balance between relieving pain and preventing long-term adverse effects such as constipation and dependence...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/29189365/using-integrative-medicine-in-pain-management-an-evaluation-of-current-evidence
#6
REVIEW
Yuan-Chi Lin, Limeng Wan, Robert N Jamison
Complementary medicine therapies are frequently used to treat pain conditions such as headaches and neck, back, and joint pain. Chronic pain, described as pain lasting longer than 3-6 months, can be a debilitating condition that has a significant socioeconomic impact. Pharmacologic approaches are often used for alleviating chronic pain, but recently there has been a reluctance to prescribe opioids for chronic noncancer pain because of concerns about tolerance, dependence, and addiction. As a result, there has been increased interest in integrative medicine strategies to help manage pain and to reduce reliance on prescription opioids to manage pain...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29179577/service-use-preceding-opioid-related-fatality
#7
Mark Olfson, Melanie Wall, Shuai Wang, Stephen Crystal, Carlos Blanco
OBJECTIVE: This study analyzed health service patterns before opioid-related death among nonelderly individuals in the Medicaid program, focusing on decedents with and without past-year diagnoses of noncancer chronic pain. METHODS: The authors identified opioid-related decedents, age ≤64 years, in the Medicaid program and characterized their clinical diagnoses, filled medication prescriptions, and nonfatal poisoning events during the 30 days and 12 months before death...
November 28, 2017: American Journal of Psychiatry
https://www.readbyqxmd.com/read/29177439/attitudes-beliefs-practices-and-concerns-among-clinicians-prescribing-opioids-in-a-large-academic-institution
#8
Jon O Ebbert, Lindsey M Philpot, Casey M Clements, Jenna K Lovely, Wayne T Nicholson, Sarah M Jenkins, Tim J Lamer, Halena M Gazelka
Objectives: Opioid treatment of chronic noncancer pain (CNCP) adds complexity and uncertainty to patient interactions. We sought to assess clinician attitudes, beliefs, practice styles, and concerns around opioid prescribing following the release of the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids for chronic pain. Methods: E-mailed electronic survey to clinicians at a large academic medical institution. Results: A total of 961 clinicians responded to the survey (response rate = 40%), 720 of whom prescribed opioids and were not in training...
June 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29139482/opioid-misuse-in-gastroenterology-and-non-opioid-management-of-abdominal-pain
#9
REVIEW
Eva Szigethy, Mitchell Knisely, Douglas Drossman
Opioids were one of the earliest classes of medications used for pain across a variety of conditions, but morbidity and mortality have been increasingly associated with their chronic use. Despite these negative consequences, chronic opioid use is increasing worldwide, with the USA and Canada having the highest rates. Chronic opioid use for noncancer pain can have particularly negative effects in the gastrointestinal and central nervous systems, including opioid-induced constipation, narcotic bowel syndrome, worsening psychopathology and addiction...
November 15, 2017: Nature Reviews. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29121327/short-acting-opioids-are-associated-with-comparable-analgesia-to-long-acting-opioids-in-patients-with-chronic-osteoarthritis-with-a-reduced-opioid-equivalence-dosing
#10
Ameer Ghodke, Stephanie Barquero, Paul R Chelminski, Timothy J Ives
Setting: There are no studies that exist within the primary care setting that address optimal opioid therapy in osteoarthritis patients. In light of the recently released US Centers for Disease Control and Prevention guidelines on opioid use in chronic noncancer pain, there is a pressing need to better characterize the effectiveness of long- and short-acting opioids. Objective: To examine the effectiveness of short-acting opioids (SAO) vs long-acting opioids (LAO) and combination therapies (SAO and LAO) for treating chronic osteoarthritis pain in a retrospective trial...
November 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29108612/sleep-disordered-breathing-caused-by-chronic-opioid-use-diverse-manifestations-and-their-management
#11
REVIEW
Susmita Chowdhuri, Shahrokh Javaheri
Opioid-induced sleep disordered breathing presents a therapeutic predicament with the increasing incidence of prescription opioid use for noncancer chronic pain in the United States. Central sleep apnea with a Biot or cluster breathing pattern is characteristic of polysomnography studies; however, long-term clinical outcomes and the impact of therapy remain unknown. Novel ampakine-based therapies are being investigated. Randomized controlled trials with therapies that target the underlying pathophysiologic mechanisms of opioid-induced sleep disordered breathing are required...
December 2017: Sleep Medicine Clinics
https://www.readbyqxmd.com/read/29092627/evidence-based-review-of-pharmacotherapy-for-opioid-induced-constipation-in-noncancer-pain
#12
Julie A Murphy, Erica A Sheridan
OBJECTIVE: To summarize and evaluate the existing literature regarding medications to treat opioid-induced constipation (OIC) in patients with chronic noncancer pain (CNCP). DATA SOURCES: PubMed, EMBASE, and Web of Science were searched using the following terms: constipation, opioid, chronic, pain, noncancer, nonmalignant, methylnaltrexone, alvimopan, lubiprostone, naloxegol, and naldemedine. STUDY SELECTION AND DATA EXTRACTION: The search was limited to randomized controlled trials reporting human outcomes...
October 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29091230/2017-hiv-medicine-association-of-infectious-diseases-society-of-america-clinical-practice-guideline-for-the-management-of-chronic-pain-in-patients-living-with-human-immunodeficiency-virus
#13
R Douglas Bruce, Jessica Merlin, Paula J Lum, Ebtesam Ahmed, Carla Alexander, Amanda H Corbett, Kathleen Foley, Kate Leonard, Glenn Jordan Treisman, Peter Selwyn
Pain has always been an important part of human immunodeficiency virus (HIV) disease and its experience for patients. In this guideline, we review the types of chronic pain commonly seen among persons living with HIV (PLWH) and review the limited evidence base for treatment of chronic noncancer pain in this population. We also review the management of chronic pain in special populations of PLWH, including persons with substance use and mental health disorders. Finally, a general review of possible pharmacokinetic interactions is included to assist the HIV clinician in the treatment of chronic pain in this population...
October 30, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29088916/managing-pain-in-patients-with-chronic-medical-illnesses-and-serious-mental-illnesses
#14
Sean O'Mahony, Steven Bines, James Gerhart, Erin Bagwell, McHugh Marlene, Ariel Card
OBJECTIVES: This study investigated the use of opioid treatment plans that included the implementation of opioid dependence risk with a validated screening tool and opioid dependence risk tool (UDT) in a noncancer palliative pain clinic. METHODS: We retrospectively reviewed the medical records for diagnostic information, information on analgesic medications, daily morphine equivalent dose, presence of pain management agreements and opioid dependence risk tools (ORT), and UDT...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29049114/alternatives-to-opioids-in-the-pharmacologic-management-of-chronic-pain-syndromes-a-narrative-review-of-randomized-controlled-and-blinded-clinical-trials
#15
REVIEW
Andrea L Nicol, Robert W Hurley, Honorio T Benzon
Chronic pain exerts a tremendous burden on individuals and societies. If one views chronic pain as a single disease entity, then it is the most common and costly medical condition. At present, medical professionals who treat patients in chronic pain are recommended to provide comprehensive and multidisciplinary treatments, which may include pharmacotherapy. Many providers use nonopioid medications to treat chronic pain; however, for some patients, opioid analgesics are the exclusive treatment of chronic pain...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29048571/pain-in-survivors-of-pediatric-cancer-applying-a-prevention-framework
#16
Amanda L Stone, Cynthia W Karlson, Lauren C Heathcote, Abby R Rosenberg, Tonya M Palermo
To apply a biopsychosocial framework to understand factors influencing pain in survivors of pediatric cancer to inform pain prevention efforts and highlight the need for interdisciplinary care. This topical review draws from both pediatric cancer survivorship research and chronic noncancer pain research to illustrate how components of a preventative model can be applied to pain in survivorship. Pain is a common experience among long-term survivors of pediatric cancer. The pain experience in survivorship can be conceptualized in terms of biological disease and treatment factors, cognitive and affective factors, and social and contextual factors...
August 31, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/29029586/use-and-misuse-of-opioids-in-chronic-pain
#17
Nora Volkow, Helene Benveniste, A Thomas McLellan
The prescribing of opioid analgesics for pain management-particularly for management of chronic noncancer pain (CNCP)-has increased more than fourfold in the United States since the mid-1990s. Yet there is mounting evidence that opioids have only limited effectiveness in the management of CNCP, and the increased availability of prescribed opioids has contributed to upsurges in opioid-related addiction cases and overdose deaths. These concerns have led to critical revisiting and modification of prior pain management practices (e...
October 13, 2017: Annual Review of Medicine
https://www.readbyqxmd.com/read/29028748/problematic-use-of-prescribed-opioids-for-chronic-noncancer-pain-no-scarcity-of-data-outside-the-united-states
#18
Winfried Häuser, Thomas Tölle
No abstract text is available yet for this article.
November 2017: Pain
https://www.readbyqxmd.com/read/29025024/implementing-prescription-drug-monitoring-and-other-clinical-decision-support-for-opioid-risk-mitigation-in-a-military-health-care-setting-a-qualitative-feasibility-study
#19
Erin P Finley, Suyen Schneegans, Claudina Tami, Mary Jo Pugh, Don McGeary, Lauren Penney, Jennifer Sharpe Potter
Objective: Chronic noncancer pain is a highly prevalent condition among service members returning from deployment overseas. The US Army has a higher rate of opioid misuse than the civilian population. Although most states and many health care systems have implemented prescription drug monitoring programs (PDMPs) or other clinician decision support (CDS) to aid providers in delivering guideline-recommended opioid therapy, similar tools are lacking in military health settings. Materials and Methods: We conducted a pre-implementation feasibility and needs assessment guided by the Promoting Action Research in Health Services framework...
August 21, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29020263/2017-hivma-of-idsa-clinical-practice-guideline-for-the-management-of-chronic-pain-in-patients-living-with-hiv
#20
R Douglas Bruce, Jessica Merlin, Paula J Lum, Ebtesam Ahmed, Carla Alexander, Amanda H Corbett, Kathleen Foley, Kate Leonard, Glenn Jordan Treisman, Peter Selwyn
Pain has always been an important part of human immunodeficiency virus (HIV) disease and its experience for patients. In this guideline, we review the types of chronic pain commonly seen among persons living with HIV (PLWH) and review the limited evidence base for treatment of chronic noncancer pain in this population. We also review the management of chronic pain in special populations of PLWH, including persons with substance use and mental health disorders. Finally, a general review of possible pharmacokinetic interactions is included to assist the HIV clinician in the treatment of chronic pain in this population...
September 14, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
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