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Prescription monitoring program

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https://www.readbyqxmd.com/read/29165853/past-year-prescription-drug-monitoring-program-opioid-prescriptions-and-self-reported-opioid-use-in-an-emergency-department-population-with-opioid-use-disorder
#1
Kathryn Hawk, Gail D'Onofrio, David A Fiellin, Marek C Chawarski, Patrick G O'Connor, Patricia H Owens, Michael V Pantalon, Steven L Bernstein
BACKGROUND: Despite increasing reliance on Prescription Drug Monitoring Programs (PDMPs) as a response to the opioid epidemic, the relationship between aberrant drug-related behaviors captured by the PDMP and opioid use disorder is incompletely understood. How PDMP data should guide Emergency Department (ED) assessment has not been studied. STUDY OBJECTIVE: To evaluate a relationship between PDMP opioid prescription records and self-reported non-medical opioid use of prescription opioids in a cohort of opioid dependent ED patients enrolled in a treatment trial...
November 22, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29155988/opioid-prescribing-patterns-and-patient-outcomes-by-prescriber-type-in-the-oregon-prescription-drug-monitoring-program
#2
Patrick B Fink, Richard A Deyo, Sara E Hallvik, Christi Hildebran
Objective: Prescription drug monitoring programs (PDMPs) were created to facilitate responsible use of controlled substances. In Oregon, physicians, physician's assistants (MDs/DOs/PAs), dentists, nurse practitioners (NPs), and naturopathic physicians (NDs) may prescribe opioids, but differences in prescribing practices, patient mix, and patient outcomes among prescriber types have not been characterized. Methods: De-identified Oregon PDMP data from October 2011 through October 2014 were linked with vital records and a statewide hospital discharge registry...
November 16, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29150151/evaluating-short-and-long-term-impacts-of-a-medicaid-lock-in-program-on-opioid-and-benzodiazepine-prescriptions-dispensed-to-beneficiaries
#3
Rebecca B Naumann, Stephen W Marshall, Jennifer L Lund, Nisha C Gottfredson, Christopher L Ringwalt, Asheley C Skinner
BACKGROUND: Insurance-based "lock-in" programs (LIPs) have become a popular strategy to address controlled substance (CS) (e.g., opioid) misuse. However, little is known about their impacts. We examined changes in CS dispensing to beneficiaries in the 12-month North Carolina Medicaid LIP. METHODS: We analyzed Medicaid claims linked to Prescription Drug Monitoring Program (PDMP) records for beneficiaries enrolled in the LIP between October 2010 and September 2012 (n=2702)...
November 6, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29149155/lower-cutoffs-for-lc-ms-ms-urine-drug-testing-indicates-better-patient-compliance
#4
Kevin Krock, Amadeo Pesce, Dennis Ritz, Richard Thomas, Agnes Cua, Ryan Rogers, Phil Lipnick, Kristen Kilbourn
BACKGROUND: Urine drug testing is used by health care providers to determine a patient's compliance to their prescribed regimen and to detect non-prescribed medications and illicit drugs. However, the cutoff levels used by clinical labs are often arbitrarily set and may not reflect the urine drug concentrations of compliant patients. OBJECTIVES: Our aim was to test the hypothesis that commonly used cutoffs for many prescribed and illicit drugs were set too high, and methods using these cutoffs may yield a considerable number of false-negative results...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148570/robust-optimization-in-impt-using-quadratic-objective-functions-to-account-for-the-minimum-mu-constraint
#5
Jie Shan, Yu An, Martin Bues, Steven E Schild, Wei Liu
PURPOSE: Currently, in clinical practice of intensity-modulated proton therapy (IMPT), the influence of the minimum monitor unit (MU) constraint is taken into account through post-processing after the optimization is completed. This may degrade the plan quality and plan robustness. This study aims to mitigate the impact of the minimum MU constraint directly during the plan robust optimization. METHODS AND MATERIALS: Cao et al. have demonstrated a two-stage method to account for the minimum MU constraint using linear programming without the impact of uncertainties considered...
November 17, 2017: Medical Physics
https://www.readbyqxmd.com/read/29145417/associations-between-medical-cannabis-and-prescription-opioid-use-in-chronic-pain-patients-a-preliminary-cohort-study
#6
Jacob M Vigil, Sarah S Stith, Ian M Adams, Anthony P Reeve
BACKGROUND: Current levels and dangers of opioid use in the U.S. warrant the investigation of harm-reducing treatment alternatives. PURPOSE: A preliminary, historical, cohort study was used to examine the association between enrollment in the New Mexico Medical Cannabis Program (MCP) and opioid prescription use. METHODS: Thirty-seven habitual opioid using, chronic pain patients (mean age = 54 years; 54% male; 86% chronic back pain) enrolled in the MCP between 4/1/2010 and 10/3/2015 were compared to 29 non-enrolled patients (mean age = 60 years; 69% male; 100% chronic back pain)...
2017: PloS One
https://www.readbyqxmd.com/read/29143401/assessment-of-risk-behaviors-in-patients-with-opioid-prescriptions-a-study-of-indiana-s-inspect-data
#7
Marion S Greene, Robert Andrew Chambers, Constantin T Yiannoutsos, Eric R Wright, Gregory K Steele, Terrell W Zollinger
BACKGROUND AND OBJECTIVES: Prescription Drug Monitoring Programs (PDMPs) can serve as screening tools and support the clinical decision-making process in patients receiving opioids. The objective of the study was to utilize 2014 INSPECT (Indiana's PDMP) data to identify factors that increase patients' likelihood to engage in opioid-related risk behaviors. METHODS: Based on a literature review, four risk behaviors were identified: Receiving >90 morphine milligram equivalents (MME), having >4 opioid prescribers, obtaining opioids from >4 pharmacies, and concurrent use of opioids and benzodiazepines...
November 16, 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/29124117/proton-pump-inhibitors-and-the-risk-of-severe-cognitive-impairment-the%C3%A2-role-of-posttraumatic-stress-disorder
#8
Sean A P Clouston, Oren Shapira, Roman Kotov, Lan Lei, Monika Waszczuk, Evelyn J Bromet, Benjamin J Luft
Introduction: Proton pump inhibitors (PPIs), a common treatment for gastroesophageal reflux disease (GERD), were recently associated with increased risk of dementia. However, severe or chronic stress including, for example, posttraumatic stress disorder (PTSD) was not accounted for. This study examined whether PPI use was associated with severe cognitive impairment (SCI) and whether PTSD explained this association in a cohort of World Trade Center (WTC) responders. Method: A prospective cohort study of 3779 WTC responders attending a university-based monitoring and treatment program...
November 2017: Alzheimer's & Dementia: Translational Research & Clinical Interventions
https://www.readbyqxmd.com/read/29122454/ayurveda-formulations-a-roadmap-to-address-the-safety-concerns
#9
Kishor Patwardhan, Jigyasa Pathak, Rabinarayan Acharya
It is a matter of serious concern that the number of case reports pointing at a possible association between the clinical toxicity and the use of Ayurveda formulations is increasing significantly over the years in scientific medical literature. Though most of these cases are connected with the presence of heavy metals such as lead, mercury and arsenic in these formulations, there are also reports suggesting toxicity due to the presence of toxic chemicals of herbal origin. In the year 2008, the Government of India took an initiative of establishing the National Pharmacovigilance Programme for Ayurveda, Siddha and Unani drugs in a structured way...
November 6, 2017: Journal of Ayurveda and Integrative Medicine
https://www.readbyqxmd.com/read/29096292/prescribing-patterns-of-buprenorphine-waivered-physicians
#10
Cindy Parks Thomas, Erin Doyle, Peter W Kreiner, Christopher M Jones, Joel Dubenitz, Alexis Horan, Bradley D Stein
BACKGROUND: DATA 2000 enabled physicians with approved training to be waivered to prescribe buprenorphine for the treatment of opioid use disorders (OUD) for a limited number of patients. A rule change in 2016 increased the patient limit for certain buprenorphine waivered physicians from 100 to 275. This study examines the prescribing patterns of buprenorphine prescribers by waiver limit status (30- or 100-patient limit). METHODS: Prescription Monitoring Program (PMP) data from Ohio, California, and Maine were used to identify prescriptions for buprenorphine for OUD from January 2010 to April 2015...
October 18, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29080523/fatal-poisonings-involving-propoxyphene-before-and-after-voluntary-withdrawal-from-the-united-states-market-an-analysis-from-the-state-of-florida
#11
Chris Delcher, Guanming Chen, Yanning Wang, Svetla Slavova, Bruce A Goldberger
The synthetic opioid propoxyphene was a schedule IV controlled substance with multiple reported health risks before the US Food and Drug Administration issued a request for voluntary market withdrawal in November 2010. The purpose of this study is to investigate the characteristics and occurrences of propoxyphene-related deaths in Florida before and after voluntary market removal. Decedent-level toxicology data from Florida's Medical Examiners Commission was used to compare the temporal, polysubstance use, sociodemographic, and geographic profiles associated with propoxyphene-involved deaths for a pre-withdrawal (November 2008-November 2010) and post-withdrawal (December 2010-December 2012) period...
October 14, 2017: Forensic Science International
https://www.readbyqxmd.com/read/29070156/born-into-addiction-neonatal-abstinence-syndrome-and-pediatric-dentistry
#12
Jennifer L Cully
Drug overdose and opioid-involved deaths continue to increase across the United States. An end-condition related to opioid abuse is neonatal abstinence syndrome (NAS). The implications for pregnant or post-partum women using an opioid, whether prescribed or illicit, can have significant effects on their infant. First described in the 1970s, NAS is defined as a postnatal drug withdrawal syndrome that primarily occurs in opioid-exposed infants. There are no nationally accepted, evidence-based treatment protocols for these infants...
September 15, 2017: Pediatric Dentistry
https://www.readbyqxmd.com/read/29054493/association-of-prescription-drug-monitoring-program-use-with-opioid-prescribing-and-health-outcomes-a-comparison-of-program-users-and-non-users
#13
Richard A Deyo, Sara E Hallvik, Christi Hildebran, Miguel Marino, Rachel Springer, Jessica M Irvine, Nicole O'Kane, Joshua Van Otterloo, Dagan A Wright, Gillian Leichtling, Lisa M Millet, Jody Carson, Wayne Wakeland, Dennis McCarty
Prescription drug monitoring programs (PDMPs) are a response to the prescription opioid epidemic, but their impacts on prescribing and health outcomes remain unclear, with conflicting reports. We sought to determine if prescriber use of Oregon's prescription drug monitoring program (PDMP) led to fewer high-risk opioid prescriptions or overdose events. We conducted a retrospective cohort study from October, 2011 through October, 2014, using statewide PDMP data, hospitalization registry, and vital records. Early PDMP registrants (n=927) were matched with clinicians who never registered during the study period, using baseline prescribing metrics in a propensity score...
October 17, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29049113/the-us-opioid-crisis-current-federal-and-state-legal-issues
#14
REVIEW
Cobin D Soelberg, Raeford E Brown, Derick Du Vivier, John E Meyer, Banu K Ramachandran
The United States is in the midst of a devastating opioid misuse epidemic leading to over 33,000 deaths per year from both prescription and illegal opioids. Roughly half of these deaths are attributable to prescription opioids. Federal and state governments have only recently begun to grasp the magnitude of this public health crisis. In 2016, the Centers for Disease Control and Prevention released their Guidelines for Prescribing Opioids for Chronic Pain. While not comprehensive in scope, these guidelines attempt to control and regulate opioid prescribing...
November 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29032024/characteristics-of-self-inflicted-drug-overdose-deaths-in-north-carolina
#15
Anna E Austin, Scott K Proescholdbell, Kathleen E Creppage, Alex Asbun
BACKGROUND: Drug overdose mortality is a major public health concern in the United States, with prescription opioids contributing substantially to recent increases in drug overdose deaths. Compared to unintentional drug overdose deaths, relatively little data describes intentional self-inflicted drug overdose deaths (i.e., suicide by drug overdose). The aim of this study was to examine the characteristics of self-inflicted drug overdose deaths, overall and in comparison to unintentional drug overdose deaths...
October 10, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/29026749/implementation-of-a-schedule-ii-patient-agreement-for-opioids-and-stimulants-in-an-adult-primary-care-practice
#16
Erin Downey, Wei Pan, Jan Harrison, Esther Poza-Juncal, Paula Tanabe
BACKGROUND: The consumption of controlled substances in North Carolina and the nation has created a health crisis with epidemic levels of medication diversion, abuse, overdose and death. Primary care providers are the principal prescribers of controlled substances and at greatest risk of encountering patients that abuse medications. Guidelines recommend patient agreements with monitoring requirements when prescribing opioids and stimulants. Studies have focused on opioids and excluded stimulants...
January 2017: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/29026458/safe-opioid-prescription-a-smart-on-fhir-approach-to-clinical-decision-support
#17
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
#18
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/29024333/united-we-stand-divided-we-conquer-pilot-study-of-multidisciplinary-general-medicine-heart-failure-care-program
#19
Omar Wahbi Izzettin, Ingrid Hopper, Edward Ritchie, Vathy Nagalingam, Ar Kar Aung
BACKGROUND: Heart failure care and education require a multifaceted approach to ensure appropriate transition from inpatient to outpatient care. AIMS: To explore the feasibility of a multidisciplinary heart failure care model, General Medicine Heart Failure Care Program (GM-HFCP) within a General Medical Unit (GMU). METHODS: Prospective non-randomised before-and-after observational quality improvement intervention over a 6-month period. All consecutive patients admitted to GMU at Alfred Hospital with diagnosis of acute decompensated heart failure were included...
October 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29021110/collaborative-care-from-the-emergency-department-for-injured-patients-with-prescription-drug-misuse-an-open-feasibility-study
#20
Lauren K Whiteside, Doyanne Darnell, Karlee Jackson, Jin Wang, Joan Russo, Dennis M Donovan, Douglas F Zatzick
Collaborative Care is a comprehensive longitudinal care management strategy. The purpose of this pilot effectiveness-implementation hybrid study was to determine the feasibility of a Collaborative Care intervention initiated from the Emergency Department and proceeding longitudinally for six months for injured patients with prescription drug misuse (PDM). Adult patients presenting to an urban ED with an injury were screened for eligibility from 2/2015-8/2015. Eligible participants with a positive screen for PDM were enrolled in the 'ED-LINC' intervention which included the following elements: 1) active care coordination and linkage, 2) medication safety and utilization of opioid guidelines 3) longitudinal care management and 4) utilization of Electronic Medical Record (EMR) innovations such as the statewide Emergency Department Information Exchange (EDIE) and statewide prescription monitoring program information for assessment and follow-up...
November 2017: Journal of Substance Abuse Treatment
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