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https://www.readbyqxmd.com/read/29026458/safe-opioid-prescription-a-smart-on-fhir-approach-to-clinical-decision-support
#1
Shyamashree Sinha, Mark Jensen, Sarah Mullin, Peter L Elkin
Background Prescription opioid pain medication overuse, misuse and abuse have been a significant contributing factor in the opioid epidemic. The rising death rates from opioid overdose have caused healthcare practitioners and researchers to work on optimizing pain therapy and limiting the prescriptions for pain medications. The state of New York has implemented a prescription drug monitoring program(PDMP), amended public health law to limit the prescription of opioids for acute pain and utilized the resources of the state and county health departments to help in curbing this epidemic...
2017: Online Journal of Public Health Informatics
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
#2
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/28985090/policies-to-mitigate-nonmedical-use-of-prescription-medications-how-should-emerging-evidence-of-gabapentin-misuse-be-addressed
#3
Alyssa M Peckham, Kathleen A Fairman, David A Sclar
Over the past decade, increased prescription supply has facilitated an epidemic of nonmedical use of controlled substances, including predominantly opioids, as well as benzodiazepines, z-hypnotics, and stimulants. Areas covered: More recently, misuse of noncontrolled prescriptions, such as gabapentin, has been detected. Gabapentin misuse has been associated with drug-related harm and increased healthcare service utilization in a few studies, including a recent large-sample analysis of commercially insured enrollees in the United States (U...
October 6, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28978492/prescription-drug-monitoring-program-design-and-function-a-qualitative-analysis
#4
Lainie Rutkow, Katherine C Smith, Alden Yuanhong Lai, Jon S Vernick, Corey S Davis, G Caleb Alexander
BACKGROUND: Opioid-related overdose deaths are a major public health challenge. Forty-nine states have implemented Prescription Drug Monitoring Programs (PDMPs) that collect information about individuals' prescription medications. Little is known about state governments' implementation of PDMPs. We conducted semi-structured interviews with PDMP staff, law enforcement officials, and administrative agency employees to learn about their attitudes and experiences with PDMPs. METHODS: From May 2015 to June 2016, we conducted 37 semi-structured interviews with state actors in four states...
September 28, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28976421/high-risk-prescribing-and-opioid-overdose-prospects-for-prescription-drug-monitoring-program-based-proactive-alerts
#5
Peter Geissert, Sara Hallvik, Joshua Van Otterloo, Nicole OʼKane, Lindsey Alley, Jody Carson, Gillian Leichtling, Christi Hildebran, Wayne Wakeland, Richard A Deyo
In order to develop a simple, valid model to identify patients at high risk for opioid overdose-related hospitalization and mortality Oregon PDMP, Vital Records, and Hospital Discharge data were linked to estimate two logistic models; A first model that included a broad range of risk factors from the literature and a second simplified model. ROC curves, sensitivity and specificity of the models were analyzed. Variables retained in the final model were age categories over 35, number of prescribers, number of pharmacies, and prescriptions for long acting opioids, benzodiazepines/sedatives, or carisoprodol...
September 30, 2017: Pain
https://www.readbyqxmd.com/read/28953315/implications-of-prescription-drug-monitoring-and-medical-cannabis-legislation-on-opioid-overdose-mortality
#6
Elyse Phillips, Julie Gazmararian
OBJECTIVES: To determine whether specific state legislation has an effect on opioid overdose mortality rates compared to states without those types of legislation. DESIGN: Ecological study estimating opioid-related mortality in states with and without a prescription drug monitoring program (PDMP) and/or medical cannabis legislation. SETTING AND PARTICIPANTS: Opioid-related mortality rates for 50 states and Washington DC from 2011 to 2014 were obtained from CDC WONDER...
July 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28952830/time-series-analysis-of-the-impact-of-prescription-drug-monitoring-programs-on-heroin-treatment-admissions
#7
Douglas Keith Branham
BACKGROUND: Prescription drug abuse has become a major issue in the United States in recent years. Prescription drug monitoring programs (PDMPs) are designed to help health care providers to prevent such abuses. There may be unintended effects of these programs. Specifically, PDMPs may move prescription opioid users to begin use of heroin. OBJECTIVES: This article aims to evaluate the impact of PDMPs on heroin abuse across several different states through use of treatment admissions records obtained from the Treatment Episode Data Set...
September 27, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28905438/research-to-support-optimization-of-prescription-drug-monitoring-programs
#8
Sheri Doyle, Gillian Leichtling, Christi Hildebran, Cynthia Reilly
PURPOSE: Research is needed to evaluate the impact of prescription drug monitoring programs (PDMPs). This paper describes research priorities for PDMPs that were initially discussed at a 2015 meeting of PDMP administrators, researchers, public health officials, and other stakeholders. METHODS: Meeting participants defined the current landscape of PDMP research and identified research gaps. Research priorities were grouped by theme. RESULTS: Prescription drug monitoring program research priorities were identified for 3 key areas: individual patient health outcomes, prescriber use and decision making, and population-level outcomes...
September 14, 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28898808/associations-between-statewide-prescription-drug-monitoring-program-pdmp-requirement-and-physician-patterns-of-prescribing-opioid-analgesics-for-patients-with-non-cancer-chronic-pain
#9
Hsien-Chang Lin, Zhi Wang, Carol Boyd, Linda Simoni-Wastila, Anne Buu
OBJECTIVE: State-level prescription drug monitoring programs (PDMPs) have been implemented in most states. PDMPs enable registered prescribers to obtain real-time information on patients' prescription history to reduce non-medical use of controlled drugs. This study examined whether PDMP implementation and different levels of PDMP requirements were associated with physicians' patterns of prescribing opioid analgesics for patients with non-cancer chronic pain. METHODS: This is a secondary analysis study using cross-sectional national data...
January 2018: Addictive Behaviors
https://www.readbyqxmd.com/read/28874942/effect-of-a-no-superuser-opioid-prescription-policy-on-ed-visits-and-statewide-opioid-prescription
#10
Zachary P Kahler, Paul I Musey, Jason T Schaffer, Annelyssa N Johnson, Christian C Strachan, Charles M Shufflebarger
INTRODUCTION: The U.S. opioid epidemic has highlighted the need to identify patients at risk of opioid abuse and overdose. We initiated a novel emergency department- (ED) based interventional protocol to transition our superuser patients from the ED to an outpatient chronic pain program. The objective was to evaluate the protocol's effect on superusers' annual ED visits. Secondary outcomes included a quantitative evaluation of statewide opioid prescriptions for these patients, unique prescribers of controlled substances, and ancillary testing...
August 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28865800/the-role-of-continuing-medical-education-in-increasing-enrollment-in-prescription-drug-monitoring-programs
#11
John T Finnell, Robert K Twillman, Stephanie A Breslan, Jan Schultz, Lyerka Miller
PURPOSE: Opioid diversion, misuse, and abuse are rapidly growing problems in the United States; >60% of all drug overdose deaths involve an opioid. At least 49 states now have fully operational prescription drug monitoring programs (PDMPs) to support legitimate medical use of controlled substances; however, there is considerable underutilization of such programs. METHODS: To increase awareness of PDMPs and their use, a continuing medical education program including 2 webcasts and a series of newsletters was offered to health care providers...
August 30, 2017: Clinical Therapeutics
https://www.readbyqxmd.com/read/28863055/the-last-state-to-grant-nurse-practitioners-dea-licensure-an-education-improvement-initiative-on-the-florida-prescription-drug-monitoring-program
#12
Joni R Kellams, John P Maye
Nurse practitioners (NPs) now have prescriptive authority for controlled substances in all 50 states in the United States. Florida, the last state to grant NPs DEA licensure, has been wrought with prescription diversion practices for a number of years as pill mills, doctor shopping, and overprescribing proliferated. Prescription Drug Monitoring Programs (PDMPs) help curb drug diversion activity and play a key role in reducing the abuse of controlled substances. The primary objective of this education improvement initiative was to increase knowledge of actively licensed NPs in the state of Florida regarding the state's PDMP...
July 2017: Journal of Addictions Nursing
https://www.readbyqxmd.com/read/28844949/role-of-membrane-gm1-on-early-neuronal-membrane-actions-of-a%C3%AE-during-onset-of-alzheimer-s-disease
#13
E J Fernández-Pérez, F J Sepúlveda, R Peoples, Luis G Aguayo
The ability of beta-amyloid peptide (Aβ) to disrupt the plasma membrane through formation of pores and membrane breakage has been previously described. However, the molecular determinants for these effects are largely unknown. In this study, we examined if the association and subsequent membrane perforation induced by Aβ was dependent on GM1 levels. Pretreatment of hippocampal neurons with D-PDMP decreased GM1 and Aβ clustering at the membrane (Aβ fluorescent-punctas/20μm, control=16.2±1.1 vs. D-PDMP =6...
August 24, 2017: Biochimica et Biophysica Acta
https://www.readbyqxmd.com/read/28814907/new-prognostic-biomarkers-and-therapeutic-effect-of-bevacizumab-for-patients-with-non-small-cell-lung-cancer
#14
Maiko Niki, Takashi Yokoi, Takayasu Kurata, Shosaku Nomura
BACKGROUND: Several biomarkers have emerged as potential prognostic and predictive markers for non-small-cell lung cancer (NSCLC). Successful inhibition of angiogenesis with the antivascular endothelial growth factor antibody, bevacizumab, has improved the efficacy seen with standard cytotoxic therapy of NSCLC. However, despite such enhanced treatment strategies, the prognosis for patients with advanced NSCLC remains poor. PATIENTS AND METHODS: We assessed potential biomarkers in 161 NSCLC patients and 42 control patients...
2017: Lung Cancer: Targets and Therapy
https://www.readbyqxmd.com/read/28797171/novel-composite-drug-delivery-system-as-a-novel-radio-sensitizer-for-the-local-treatment-of-cervical-carcinoma
#15
Shan Xu, Yu Ying Tang, Yan Xin Yu, Qin Yun, Jing Pin Yang, Heng Zhang, Qiuxia Peng, Xiaoyang Sun, Ling Lin Yang, ShaoZhi Fu, Jing Bo Wu
In this study, we investigated in vivo radiosensitizing effects of a gel-based dual drug delivery system (DDS) (PECE/DDP + mPEG-PCL/PTX, or PDMP) in a cervical cancer model, and determined its possible mechanisms of action. A xenograft cervical cancer model was used to investigate the radio sensitization effect of PDMP. Mice underwent paclitaxel (PTX) + cisplatin (DDP), PECE, or PDMP treatment followed by single radiation doses ranging from 0 Gy to 20 Gy. Radio sensitization was analyzed by tumor regrowth delay (TGD)...
November 2017: Drug Delivery
https://www.readbyqxmd.com/read/28775166/aneuploid-cell-survival-relies-upon-sphingolipid-homeostasis
#16
Yun-Chi Tang, Hui Yuwen, Kaiying Wang, Peter M Bruno, Kevin Bullock, Amy Deik, Stefano Santaguida, Marianna Trakala, Sarah J Pfau, Na Zhong, Tao Huang, Lan Wang, Clary B Clish, Michael T Hemann, Angelika Amon
Aneuploidy, a hallmark of cancer cells, poses an appealing opportunity for cancer treatment and prevention strategies. Using a cell-based screen to identify small molecules that could selectively kill aneuploid cells, we identified the compound N-[2-hydroxy-1-(4-morpholinylmethyl)-2-phenylethyl]-decanamide monohydrochloride (DL-PDMP), an antagonist of UDP-glucose ceramide glucosyltransferase. DL-PDMP selectively inhibited proliferation of aneuploid primary mouse embryonic fibroblasts and aneuploid colorectal cancer cells...
August 3, 2017: Cancer Research
https://www.readbyqxmd.com/read/28759893/kilmartin-s-castigation-of-physicians-medical-society-regarding-warrantless-searches-into-pdmp-demeans-ag-s-office
#17
Michael E Migliori
No abstract text is available yet for this article.
August 1, 2017: Rhode Island Medical Journal
https://www.readbyqxmd.com/read/28738683/state-prescription-drug-monitoring-programs-and-fatal-drug-overdoses
#18
Young Hee Nam, Dennis G Shea, Yunfeng Shi, John R Moran
OBJECTIVES: To examine the impact of prescription drug monitoring programs (PDMPs) on drug overdose deaths. STUDY DESIGN: We used variation in the timing of state PDMP legislation and implementation to estimate the impact of these programs on drug overdose mortality rates across all drug categories from 1999 to 2014 and separately for each category from 1999 to 2010. Data used include US all-jurisdiction mortality data, estimated population data, and sociodemographic data from the CDC and the US Census Bureau...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28722211/using-prescription-monitoring-program-data-to-characterize-out-of-pocket-payments-for-opioid-prescriptions-in-a-state-medicaid-program
#19
Daniel M Hartung, Sharia M Ahmed, Luke Middleton, Joshua Van Otterloo, Kun Zhang, Shellie Keast, Hyunjee Kim, Kirbee Johnston, Richard A Deyo
BACKGROUND: Out-of-pocket payment for prescription opioids is believed to be an indicator of abuse or diversion, but few studies describe its epidemiology. Prescription drug monitoring programs (PDMPs) collect controlled substance prescription fill data regardless of payment source and thus can be used to study this phenomenon. OBJECTIVE: To estimate the frequency and characteristics of prescription fills for opioids that are likely paid out-of-pocket by individuals in the Oregon Medicaid program...
September 2017: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/28692945/impact-of-new-york-prescription-drug-monitoring-program-i-stop-on-statewide-overdose-morbidity
#20
Richard Brown, Moira R Riley, Lydia Ulrich, Ellen Percy Kraly, Paul Jenkins, Nicole L Krupa, Anne Gadomski
BACKGROUND: Prescription Drug Monitoring programs (PDMPs) are intended to reduce opioid prescribing and aberrant drug-related behavior thereby reducing morbidity and mortality due to prescription opioid overdose. Expansion of the New York (NY) State's PDMP in 2013 included the institution of the I-STOP law that mandated clinicians to consult the statewide PDMP database to review the patient's prescription history prior to prescribing opioids. METHODS: Trends in prescription opioid distribution, prescribing, and prescription opioid and heroin overdose morbidity in NY were analyzed using time series...
June 23, 2017: Drug and Alcohol Dependence
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