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Opioid dosing guidelines

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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
#1
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/27994790/a-nationwide-retrospective-study-of-opioid-management-patterns-in-2-468-patients-with-spinal-pain-in-korea
#2
Sung-Soo Chung, Chun-Kun Park, Kyu-Jung Cho, Kyoung Hyo Choi, Jin-Hyok Kim, Sung-Bum Kim, Sung-Uk Kuh, Jae Chul Lee, Jae Hyup Lee, Kyu-Yeol Lee, Sun-Ho Lee, Seong-Hwan Moon, Si-Young Park, Jae Hang Shim, Byung-Chul Son, Myung Ha Yoon, Hye-Jeong Park
STUDY DESIGN: Retrospective patient data collection and investigator survey. PURPOSE: To investigate patterns of opioid treatment for pain caused by spinal disorders in Korea. OVERVIEW OF LITERATURE: Opioid analgesic prescription and adequacy of consumption measures in Korea have markedly increased in the past decade, suggesting changing patterns in pain management practice; however, there is lack of integrated data specific to Korean population...
December 2016: Asian Spine Journal
https://www.readbyqxmd.com/read/27984229/sedation-after-cardiac-surgery-is-one-drug-better-than-another
#3
Hong Liu, Fuhai Ji, Ke Peng, Richard L Applegate, Neal Fleming
The classic high-dose narcotic-based cardiac anesthetic has been modified to facilitate a fast-track, rapid recovery in the intensive care unit (ICU). Postoperative sedation is consequently now an essential component in recovery of the patient undergoing cardiac surgery. It must facilitate the patient's unawareness of the environment as well as reduce the discomfort and anxiety caused by surgery, intubation, mechanical ventilation, suction, and physiotherapy. Benzodiazepines seem well suited for this role, but propofol, opioids, and dexmedetomidine are among other agents commonly used for sedation in the ICU...
December 15, 2016: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/27973601/high-dose-opioid-prescribing-and-opioid-related-hospitalization-a-population-based-study
#4
Kimberly Fernandes, Diana Martins, David Juurlink, Muhammad Mamdani, J Michael Paterson, Luke Spooner, Samantha Singh, Tara Gomes
AIMS: To examine the impact of national clinical practice guidelines and provincial drug policy interventions on prevalence of high-dose opioid prescribing and rates of hospitalization for opioid toxicity. DESIGN: Interventional time-series analysis. SETTING: Ontario, Canada, from 2003 to 2014. PARTICIPANTS: Ontario Drug Benefit (ODB) beneficiaries aged 15 to 64 years from 2003 to 2014. INTERVENTIONS: Publication of Canadian clinical practice guidelines for use of opioids in chronic non-cancer pain (May 2010) and implementation of Ontario's Narcotics Safety and Awareness Act (NSAA; November 2011)...
2016: PloS One
https://www.readbyqxmd.com/read/27890625/pharmacological-treatment-optimization-for-stable-chronic-obstructive-pulmonary-disease-proposals-from-the-soci%C3%A3-t%C3%A3-de-pneumologie-de-langue-fran%C3%A3-aise
#5
M Zysman, F Chabot, P Devillier, B Housset, C Morelot-Panzini, N Roche
The Société de Pneumologie de Langue Française proposes a decision algorithm on long-term pharmacological COPD treatment. A working group reviewed the literature published between January 2009 and May 2016. This document lays out proposals and not guidelines. It only focuses on pharmacological treatments except vaccinations, smoking cessation treatments and oxygen therapy. Any COPD diagnosis, based on pulmonary function tests, should lead to recommend smoking cessation, vaccinations, physical activity, pulmonary rehabilitation in case of activity limitation, and short-acting bronchodilators...
December 2016: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/27862243/antidepressant-adherence-patterns-in-older-patients-use-of-a-clustering-method-on-a-prescription-database
#6
David Braunstein, Amélie Hardy, Quentin Boucherie, Elisabeth Frauger, Olivier Blin, Gaétan Gentile, Joëlle Micallef
According to the World Health Organization, depression will become the second most important cause of disability worldwide by 2020. Our objective was to identify patterns of adherence to antidepressant treatments in older patients using several indicators of adherence and to characterize these patterns in term of medication exposure. We conducted a retrospective cohort study using the French National Health Insurance reimbursement database. Incident antidepressant users aged more than 65 were included from July 1, 2010 to June 30, 2011 and followed-up for 18 months...
November 14, 2016: Fundamental & Clinical Pharmacology
https://www.readbyqxmd.com/read/27843413/effectiveness-of-radiotherapy-for-metastatic-spinal-cord-compression-in-patients-with-short-life-expectancy
#7
Alexandra Giraldo, Sergi Benavente, Mónica Ramos, Ramona Vergés, Odimar Coronil, Lina Arbeláez, Xavier Maldonado, Manuel Altabas, Meritxell Mollà, Victoria Reyes, Begoña Navalpotro, Jordi Giralt
AIM: To analyze the effect of radiotherapy (RT) in patients with metastatic spinal cord compression (MSCC) and poor prognosis in our center. BACKGROUND: RT is an effective treatment for MSCC. MATERIALS AND METHODS: Prospective evaluation on patients with MSCC and limited survival (according to Rades' scale), and treated with single-dose 8 Gy RT (February 2013-August 2014). Pain, ambulatory status and sphincter control were recorded. Pain relief was evaluated following the International Bone Metastases Consensus Working Party Guidelines...
January 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/27768177/addressing-practice-gaps-in-cutaneous-surgery-advances-in-diagnosis-and-treatment
#8
Kathryn L Kreicher, Jeremy S Bordeaux
Importance: Cutaneous surgery is performed by otolaryngologists, plastic surgeons, oculoplastic surgeons, dermatologic surgeons, and some primary care physicians. Practice gaps exist among cutaneous surgeons, as do differences in how different physicians approach preoperative, intraoperative, and postoperative decision-making. Objective: To present the newest and best evidence to close common practice gaps in cutaneous surgery. Evidence Review: We performed a detailed search of peer-reviewed publications that were identified through a search of PubMed/MEDLINE (January 1, 2000, through June 30, 2016) using the literature search terms "cutaneous surgery," "Mohs micrographic surgery," "plastic surgery," in combination with "safety," "cost," "anesthesia," "anti-coagulation," "bleeding," "pain," "analgesia," "anxiety," or "infection," among others...
October 20, 2016: JAMA Facial Plastic Surgery
https://www.readbyqxmd.com/read/27738299/opioid-therapy-for-chronic-non-cancer-pain-guidelines-for-hong-kong
#9
C W Cheung, T Cw Chan, P P Chen, M C Chu, W Cm Chui, P T Ho, F Lam, S W Law, J Ly Lee, S Hs Wong, V Kc Wong
Opioids are increasingly used to control chronic non-cancer pain globally. International opioid guidelines have been issued in many different countries but a similar document is not generally available in Hong Kong. Chronic opioid therapy has a role in multidisciplinary management of chronic non-cancer pain despite insufficient evidence for its effectiveness and safety for long-term use. This document reviews the current literature to inform Hong Kong practitioners about the rational use of chronic opioid therapy in chronic non-cancer pain...
October 2016: Hong Kong Medical Journal, Xianggang Yi Xue za Zhi
https://www.readbyqxmd.com/read/27717535/trends-in-major-opioid-analgesic-consumption-in-taiwan-2002-2014
#10
Kai-Hsiang Kang, Li-Fen Kuo, I-Chen Cheng, Chih-Shiuh Chang, Wen-Ing Tsay
BACKGROUND/PURPOSE: According to WHO guideline, the consumption of opioids is an important sign of national progress in cancer pain relief. However, precise data on the consumption of opioid analgesics consumption in Taiwan has not been published. We investigate opioid analgesic consumption in Taiwan between 2002 and 2014 compare the results with those in other countries to see what we could learn about other methods of pain management. To find out the different patterns between Taiwan and other country, improves the quality of pain management...
October 4, 2016: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/27696218/analgesic-drug-prescription-patterns-on-five-international-paediatric-wards
#11
MULTICENTER STUDY
Sebastian Botzenhardt, Asia N Rashed, Ian C K Wong, Stephen Tomlin, Antje Neubert
AIM: Analgesic and anti-inflammatory drugs are frequently prescribed in paediatrics. Prescribing and dosing patterns in hospitalised children are not well known. This study explores analgesic drug utilisation on five paediatric wards and discusses its findings in comparison with World Health Organization (WHO) guidelines. METHOD: A sub-analysis of a prospective, multicentre, observational cohort study was undertaken. Prescription data of children aged up to ≤18 years were collected between October 2008 and December 2009 on paediatric general medical wards in five hospitals in Australia, Germany, the United Kingdom (UK), Hong Kong (HK) and Malaysia...
December 2016: Paediatric Drugs
https://www.readbyqxmd.com/read/27685513/the-inherited-patient-on-opioids-a-challenge-for-primary-care-clinicians
#12
Christopher L Owston
Chronic pain is a common problem, affecting more than 100 million people in the United States, and primary care providers are highly likely to encounter patients on chronic opioid therapy. Initial encounters with a new patient already on high-dose opioids can be difficult and lead to apprehension for both patient and provider. This article describes how to use current opioid prescribing guidelines, conduct a comprehensive pain assessment, and implement risk mitigation strategies to improve patient safety and effectively manage this patient population...
October 2016: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/27605322/collaborative-practice-model-for-management-of-pain-in-patients-with-cancer
#13
Kathryn J Hammer, Eve M Segal, Laura Alwan, Shan Li, Amila M Patel, Melinda Tran, Helen M Marshall
PURPOSE: The use of a collaborative drug therapy agreement (CDTA) by oncology pharmacists in a comprehensive pain clinic is described. SUMMARY: Recognizing the complex clinical services required by patients with cancer, the Seattle Cancer Care Alliance began offering cancer pain management through a specialized pain service. Initially, the clinic was staffed by one attending physician; however, as the volume of patient referrals increased, the clinic expanded into an interprofessional team that includes physicians, advanced practice providers, nurses, and pharmacists...
September 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27540189/an-audit-of-the-management-of-acute-pain-in-children
#14
Junndeep Sidhu, Neil Tickner
AIM: To evaluate clinical management of acute pain with respect to pain assessment, scoring and timing of analgesia and whether appropriate supportive medicines were prescribed alongside strong opiates. A previous pain audit found dosing of analgesia was appropriate but did not assess clinical management against pain scores. Our paediatric guideline does not currently stipulate guidance on appropriate time frames to administer analgesia and re-assess pain. Standards were developed with a multidisciplinary team to audit against...
September 2016: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/27499655/use-of-microdoses-for-induction-of-buprenorphine-treatment-with-overlapping-full-opioid-agonist-use-the-bernese-method
#15
Robert Hämmig, Antje Kemter, Johannes Strasser, Ulrich von Bardeleben, Barbara Gugger, Marc Walter, Kenneth M Dürsteler, Marc Vogel
BACKGROUND: Buprenorphine is a partial µ-opioid receptor agonist used for maintenance treatment of opioid dependence. Because of the partial agonism and high receptor affinity, it may precipitate withdrawal symptoms during induction in persons on full µ-opioid receptor agonists. Therefore, current guidelines and drug labels recommend leaving a sufficient time period since the last full agonist use, waiting for clear and objective withdrawal symptoms, and reducing pre-existing full agonist therapies before administering buprenorphine...
2016: Substance Abuse and Rehabilitation
https://www.readbyqxmd.com/read/27477581/factors-associated-with-opioid-dose-increases-a-chart-review-of-patients-first-year-on-long-term-opioids
#16
Christopher A Bautista, Ana-Maria Iosif, Barth L Wilsey, Joy A Melnikow, Althea Crichlow, Stephen G Henry
OBJECTIVE:  To examine encounter-level factors associated with opioid dose increases during patients' first year on opioid therapy for chronic pain. DESIGN:  Case-control study analyzing all opioid prescriptions for patients with chronic pain during their first year after opioid initiation. Cases were patients who experienced an overall dose escalation of ≥ 30 mg morphine equivalents over the 1-year period; controls did not experience overall dose escalation...
July 31, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27448465/guidelines-for-the-first-line-treatment-of-restless-legs-syndrome-willis-ekbom-disease-prevention-and-treatment-of-dopaminergic-augmentation-a-combined-task-force-of-the-irlssg-eurlssg-and-the-rls-foundation
#17
Diego Garcia-Borreguero, Michael H Silber, John W Winkelman, Birgit Högl, Jacquelyn Bainbridge, Mark Buchfuhrer, Georgios Hadjigeorgiou, Yuichi Inoue, Mauro Manconi, Wolfgang Oertel, William Ondo, Juliane Winkelmann, Richard P Allen
A Task Force was established by the International Restless Legs Syndrome Study Group (IRLSSG) in conjunction with the European Restless Legs Syndrome Study Group (EURLSSG) and the RLS Foundation (RLS-F) to develop evidence-based and consensus-based recommendations for the prevention and treatment of long-term pharmacologic treatment of dopaminergic-induced augmentation in restless legs syndrome/Willis-Ekbom disease (RLS/WED). The Task Force made the following prevention and treatment recommendations: As a means to prevent augmentation, medications such as α2δ ligands may be considered for initial RLS/WED treatment; these drugs are effective and have little risk of augmentation...
May 2016: Sleep Medicine
https://www.readbyqxmd.com/read/27435604/metamizole-dipyrone-for-the-relief-of-cancer-pain-a-systematic-review-and-evidence-based-recommendations-for-clinical-practice
#18
Jan Gaertner, Ulrike M Stamer, Constanze Remi, Raymond Voltz, Claudia Bausewein, Rainer Sabatowski, Stefan Wirz, Gabriele Müller-Mundt, Steffen T Simon, Anne Pralong, Friedemann Nauck, Markus Follmann, Lukas Radbruch, Winfried Meißner
BACKGROUND: Dipyrone (metamizole) is one of the most widely used non-opioid analgesics for the treatment of cancer pain. AIM: Because evidence-based recommendations are not yet available, a systematic review was conducted for the German Guideline Program in Oncology to provide recommendations for the use of dipyrone in cancer pain. DESIGN: First, a systematic review for clinical trials assessing dipyrone in adult patients with cancer pain was conducted...
January 2017: Palliative Medicine
https://www.readbyqxmd.com/read/27411064/multicenter-evaluation-of-prehospital-opioid-pain-management-in-injured-children
#19
Lorin R Browne, Manish I Shah, Jonathan R Studnek, Daniel G Ostermayer, Stacy Reynolds, Clare E Guse, David C Brousseau, E Brooke Lerner
BACKGROUND: The National Association of Emergency Medical Services Physicians' (NAEMSP) Position Statement on Prehospital Pain Management and the joint National Highway Traffic Safety Administration (NHTSA) and Emergency Medical Services for Children (EMSC) Evidence-based Guideline for Prehospital Analgesia in Trauma aim to improve the recognition, assessment, and treatment of prehospital pain. The impact of implementation of these guidelines on pain management in children by emergency medical services (EMS) agencies has not been assessed...
November 2016: Prehospital Emergency Care
https://www.readbyqxmd.com/read/27405370/prescription-opioids-v-metabolism-and-excretion-of-oxymorphone-in-urine-following-controlled-single-dose-administration
#20
Anne Z DePriest, Rebecca Heltsley, David L Black, John M Mitchell, Charles LoDico, Ronald Flegel, Edward J Cone
Oxymorphone (OM), a prescription opioid and metabolite of oxycodone, was included in the recently published proposed revisions to the Mandatory Guidelines for Federal Workplace Drug Testing Programs. To facilitate toxicological interpretation, this study characterized the time course of OM and its metabolite, noroxymorphone (NOM), in hydrolyzed and non-hydrolyzed urine specimens. Twelve healthy subjects were administered a single 10 mg controlled-release OM dose, followed by a periodic collection of pooled urine specimens for 54 h following administration...
October 2016: Journal of Analytical Toxicology
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