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https://www.readbyqxmd.com/read/27908840/prescription-opioid-taper-support-for-outpatients-with-chronic-pain-a-randomized-controlled-trial
#1
Mark D Sullivan, Judith A Turner, Cory DiLodovico, Angela D'Appolonio, Kari Stephens, Ya-Fen Chan
Patients receiving long-term opioid therapy for chronic pain and interested in tapering their opioid dose were randomly assigned to a 22-week taper support intervention (psychiatric consultation, opioid dose tapering, and 18 weekly meetings with a physician assistant to explore motivation for tapering and learn pain self-management skills) or usual care (N=35). Assessments were conducted at baseline and 22 and 34 weeks after randomization. Using an intention-to-treat approach, we constructed linear regression models to compare groups at each follow-up...
November 28, 2016: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/27905916/study-protocol-a-dose-escalating-phase-2-study-of-oral-lisdexamfetamine-in-adults-with-methamphetamine-dependence
#2
Nadine Ezard, Adrian Dunlop, Brendan Clifford, Raimondo Bruno, Andrew Carr, Alexandra Bissaker, Nicholas Lintzeris
BACKGROUND: The treatment of methamphetamine dependence is a continuing global health problem. Agonist type pharmacotherapies have been used successfully to treat opioid and nicotine dependence and are being studied for the treatment of methamphetamine dependence. One potential candidate is lisdexamfetamine, a pro-drug for dexamphetamine, which has a longer lasting therapeutic action with a lowered abuse potential. The purpose of this study is to determine the safety of lisdexamfetamine in this population at doses higher than those currently approved for attention deficit hyperactivity disorder or binge eating disorder...
December 1, 2016: BMC Psychiatry
https://www.readbyqxmd.com/read/27903034/prescription-drug-abuse-a-timely-update
#3
Benny Monheit, Danusia Pietrzak, Sandra Hocking
BACKGROUND: Prescription drug abuse is a rising problem in Australia and pharmaceutical drugs have been the most frequent contributors to overdose deaths in Victoria in recent years. OBJECTIVE: The objectives of this article are to examine the main prescription drugs contributing to overdose deaths and to consider how doctors may help in reducing this problem. DISCUSSION: Data from the Coroners Court of Victoria list the main drugs that contributed to drug-related deaths in 2009-15...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27901359/buprenorphine-transdermal-system-utilization
#4
Laura Wallace, Aditi Kadakia
OBJECTIVES: To evaluate utilization patterns in patients initiating buprenorphine transdermal system (BTDS), CIII, and estimate the proportion decreasing their total opioid dose over time. METHODS: This retrospective cohort study used data from the Truven Health Analytics MarketScan® Commercial Claims and Encounters Database from January 1, 2011 through December 31, 2015. Eligible individuals were adults aged 18-64 years newly dispensed BTDS (index prescription) who had at least six months of insurance coverage prior to (baseline period) and following (study period) the index prescription...
November 30, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27898458/smoking-status-and-opioid-related-problems-and-concerns-among-men-and-women-on-chronic-opioid-therapy
#5
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/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#6
Yu-Ping Chang, Peggy Compton
The United States is amid an epidemic of prescription opioid drug abuse, bringing with it not only high rates of overdose, but growing rates of heroin abuse and addiction. Liberal opioid drug prescribing on the part of well-meaning clinicians has in part fueled this epidemic, being correlated to opioid death and addiction treatment admission rates. Misuse and abuse of prescription opioid drugs is greatest among young adults (ages 18 to 25); however, the fastest growing age group for opioid drug misuse/abuse is older (ages 50 to 64)...
December 1, 2016: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/27897471/use-of-risk-mitigation-practices-by-family-nurse-practitioners-prescribing-opioids-for-the-management-of-chronic-non-malignant-pain
#7
Sahil Chaudhary, Peggy Compton
BACKGROUND: Ongoing opioid analgesic use in patients suffering from chronic non-malignant pain (CNMP) has been associated with the development of opioid misuse, abuse, addiction, and overdose. To prevent these adverse outcomes, it is important that family nurse practitioners (FNPs) implement recommended risk mitigation practices (RMPs) when treating CNMP patients with opioids. METHODS: A national sample of 856 FNPs was invited to answer an online survey about their utilization of opioids and RMPs in treating CNMP...
November 29, 2016: Substance Abuse
https://www.readbyqxmd.com/read/27895505/evaluating-increased-resource-use-in-fibromyalgia-using-electronic-health-records
#8
Jay M Margolis, Elizabeth T Masters, Joseph C Cappelleri, David M Smith, Steven Faulkner
OBJECTIVE: The management of fibromyalgia (FM), a chronic musculoskeletal disease, remains challenging, and patients with FM are often characterized by high health care resource utilization. This study sought to explore potential drivers of all-cause health care resource utilization and other factors associated with high resource use, using a large electronic health records (EHR) database to explore data from patients diagnosed with FM. METHODS: This was a retrospective analysis of de-identified EHR data from the Humedica database...
2016: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/27895142/curb-prescriptions-to-combat-opioid-crisis
#9
Lauren Vogel, Barbara Sibbald
No abstract text is available yet for this article.
November 28, 2016: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/27894311/access-to-substance-use-treatment-among-young-adults-who-use-prescription-opioids-non-medically
#10
Elliott J Liebling, Jesse L Yedinak, Traci C Green, Scott E Hadland, Melissa A Clark, Brandon D L Marshall
BACKGROUND: Non-medical prescription opioid (NMPO) use is a substantial public health problem in the United States, with 1.5 million new initiates annually. Only 746,000 people received treatment for NMPO use in 2013, demonstrating substantial disparities in access to treatment. This study aimed to assess correlates of accessing substance use treatment among young adult NMPO users in Rhode Island, a state heavily impacted by NMPO use and opioid overdose. METHODS: This analysis uses data from a study of 200 Rhode Island residents aged 18 to 29 who reported NMPO use in the past 30 days...
November 29, 2016: Substance Abuse Treatment, Prevention, and Policy
https://www.readbyqxmd.com/read/27882841/association-of-a-controlled-substance-scoring-algorithm-with-health-care-costs-and-hospitalizations-a-cohort-study
#11
Catherine I Starner, Yang Qiu, Pinar Karaca-Mandic, Patrick P Gleason
BACKGROUND: Patients often misuse a combination of prescription drugs including opioids; however, the relationship between a controlled substance (CS) score and health outcomes is unknown. OBJECTIVE: To examine the association between a CS scoring algorithm and health care use, specifically total cost of care, hospitalizations, and emergency room (ER) visits. METHODS: This analysis was a retrospective cohort study using administrative claims data from a large U...
December 2016: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/27880633/diversion-alert-1-year-evaluation-across-northern-new-england-2013-2014
#12
Sarah Levin Martin, Clare Desrosiers
This report describes Diversion Alert, a unique online tool aimed at reducing misuse and diversion of prescription drugs, and reports the results of a 1-year evaluation of Diversion Alert's impact in Maine. We used a quasi-experimental research design to compare survey data in Maine with those of neighboring states (New Hampshire and Vermont, 2013 and 2014). Compared with their counterparts in New Hampshire and Vermont who did not use Diversion Alert, prescribers and pharmacists in Maine who used Diversion Alert increased their communication with patients and other providers involved in their patients' care, became aware of patients arrested for prescription drugs possession or diversion, used best practices associated with prevention or detection of addiction and diversion more frequently, and attributed positive changes in their prescribing practices to Diversion Alert...
November 23, 2016: Preventing Chronic Disease
https://www.readbyqxmd.com/read/27875056/opioid-nsaid-and-otc-analgesic-medications-for-dental-procedures-pearl-network-findings
#13
Ying Jo Wong, James Keenan, Keith Hudson, Henry Bryan, Frederick Naftolin, Van P Thompson, Ronald G Craig, Don Vena, Damon Collie, Hongyu Wu, Abigail G Matthews, Ashley C Grill, Frederick A Curro
OBJECTIVE: Dental treatment is often categorized as a moderately or severely painful experience; however, no clinical data reported by the patient and dentist currently exists to support this degree of pain. This has contributed possibly to the overprescribing of analgesics, in particular the opioid class of medications. The primary objective of the study was to document the dentists' postprocedural prescriptions and recommendations for analgesic medications and their effectiveness for a 5-day period...
November 2016: Compendium of Continuing Education in Dentistry
https://www.readbyqxmd.com/read/27871180/prescription-opioid-prescribing-use-misuse-harms-and-treatment-among-aboriginal-people-in-canada-a-narrative-review-of-available-data-and-indicators
#14
Cayley Russell, Michelle Firestone, Len Kelly, Christopher Mushquash, Benedikt Fischer
INTRODUCTION: Prescription opioid (PO) misuse and related harms are high in Canada, and a major public health challenge. In Canada, 1.4 million individuals (4.3% of the total population) self-identify as Aboriginal, among whom substance use and related harms are elevated. While there are reports of PO use and associated problems among Aboriginal groups, no comprehensive data review currently exists. METHODS: A review of available data sources (ie journal publications, public reports and 'grey' literature) was conducted following principles of a scoping review...
October 2016: Rural and Remote Health
https://www.readbyqxmd.com/read/27870657/health-care-utilization-and-cost-in-children-and-adolescents-with-chronic-pain-analysis-of-health-care-claims-data-one-year-before-and-after-intensive-interdisciplinary-pain-treatment
#15
Ann-Kristin Ruhe, Michael Frosch, Julia Wager, Roland Linder, Ingo Pfenning, Dirk Sauerland, Boris Zernikow
OBJECTIVES: The aim of this study was to analyze changes in health care utilization and cost among a sample of highly impaired children and adolescents who sought a three-week intensive interdisciplinary pain treatment (IIPT). MATERIALS AND METHODS: Claims data from seven statutory health insurance companies were analyzed for 65 children and adolescents who sought IIPT at the German Paediatric Pain Centre. The annual health care utilization and cost were determined for the following four areas: outpatient care, inpatient care, medications, and remedies and aids...
November 18, 2016: Clinical Journal of Pain
https://www.readbyqxmd.com/read/27869630/a-prospective-evaluation-of-opioid-utilization-after-upper-extremity-surgical-procedures-identifying-consumption-patterns-and-determining-prescribing-guidelines
#16
REVIEW
Nayoung Kim, Jonas L Matzon, Jack Abboudi, Christopher Jones, William Kirkpatrick, Charles F Leinberry, Frederic E Liss, Kevin F Lutsky, Mark L Wang, Mitchell Maltenfort, Asif M Ilyas
BACKGROUND: Although adequate management of postoperative pain with oral analgesics is an important aspect of surgical procedures, inadvertent overprescribing can lead to excess availability of opioids in the community for potential diversion. The purpose of our study was to prospectively evaluate opioid consumption following outpatient upper-extremity surgical procedures to determine opioid utilization patterns and to develop prescribing guidelines. METHODS: All patients undergoing outpatient upper-extremity surgical procedures over a consecutive 6-month period had the following prospective data collected: patient demographic characteristics, surgical details, anesthesia type, and opioid prescription and consumption patterns...
October 19, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27864296/a-mechanistic-investigation-of-thrombotic-microangiopathy-associated-with-intravenous-abuse-of-opana-er
#17
Ryan Hunt, Ayla Yalamanoglu, James Tumlin, Tal Schiller, Jin Hyen Baek, Andrew Wu, Agnes B Fogo, Haichun Yang, Edward Wong, Peter Miller, Paul W Buehler, Chava Kimchi-Sarfaty
Since 2012, a number of case reports have described the occurrence of thrombotic microangiopathy (TMA) following intravenous abuse of extended release oxymorphone hydrochloride (Opana ER), an oral opioid for long-term treatment of chronic pain. Here, we present unique clinical features of three patients and investigate intravenous exposure to the tablet's inert ingredients as a possible causal mechanism. Guinea pigs were used as an animal model to understand the hematopathologic and nephrotoxic potential of the inert ingredient mixture (termed here as PEO+) which primarily contains high molecular weight polyethylene oxide (HMW PEO)...
November 18, 2016: Blood
https://www.readbyqxmd.com/read/27862681/differences-in-analgesic-use-in-community-dwelling-persons-with-and-without-alzheimer-s-disease
#18
A Hamina, H Taipale, A Tanskanen, A-M Tolppanen, J Tiihonen, S Hartikainen
BACKGROUND: There are conflicting findings about analgesic use among persons with cognitive impairment compared to cognitively intact older persons. The objective of our study was to investigate the prevalence of analgesic use in community-dwelling persons with and without Alzheimer's disease (AD), within six months after AD diagnosis and to find out factors associated with the use of analgesics and specific analgesic groups. METHOD: We utilized data from register based MEDALZ (Medication use and Alzheimer's disease) cohort consisting of all community-dwelling persons diagnosed with AD during 2005-2011 in Finland and their matched comparison persons without AD...
November 14, 2016: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/27862597/impact-of-an-opioid-risk-reduction-initiative-on-motor-vehicle-crash-risk-among-chronic-opioid-therapy-patients
#19
Ryan N Hansen, Rod L Walker, Susan M Shortreed, Sascha Dublin, Kathleen Saunders, Evette J Ludman, Michael Von Korff
PURPOSE: Although prescription opioids have been associated with higher motor vehicle crash (MVC) risk, it is unknown whether health system initiatives to better manage chronic opioid therapy (COT) can reduce MVC risk at the population level. METHODS: We conducted an interrupted time series population-level cohort study at Group Health (GH), between January 2006 and September 2014, comparing MVC risk among COT patients who were GH members receiving care in either group practice or contracted care settings...
November 14, 2016: Pharmacoepidemiology and Drug Safety
https://www.readbyqxmd.com/read/27862243/antidepressant-adherence-patterns-in-older-patients-use-of-a-clustering-method-on-a-prescription-database
#20
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
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