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Opioids prescription guidelines

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https://www.readbyqxmd.com/read/28538457/patterns-of-opioid-prescribing-for-an-orthopaedic-trauma-population
#1
John Ruder, Meghan K Wally, McKell Oliverio, Rachel B Seymour, Joseph R Hsu
OBJECTIVES: To determine opioid-prescribing practices to the orthopaedic trauma (OT) population at one Level I trauma center. DESIGN: A retrospective study of discharge prescriptions for adult patients with OT. Prescription details, injury burden, and patient demographics were abstracted for patients from initial injury through a 2-month follow-up. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: Adult patients with OT admitted over a 30-day period (n = 110)...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28504992/trends-in-perioperative-practice-and-resource-utilization-in-patients-with-obstructive-sleep-apnea-undergoing-joint-arthroplasty
#2
Crispiana Cozowicz, Jashvant Poeran, Ashley Olson, Madhu Mazumdar, Eva E Mörwald, Stavros G Memtsoudis
BACKGROUND: Emerging evidence associating obstructive sleep apnea (OSA) with adverse perioperative outcomes has recently heightened the level of awareness among perioperative physicians. In particular, estimates projecting the high prevalence of this condition in the surgical population highlight the necessity of the development and adherence to "best clinical practices." In this context, a number of expert panels have generated recommendations in an effort to provide guidance for perioperative decision-making...
May 11, 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28488993/physician-guide-to-appropriate-opioid-prescribing-for-noncancer-pain
#3
Timothy Munzing
Prescription opioid use for relief of noncancer pain has risen dramatically in the last 15 years, contributing to a quadrupling of opioid overdoses and prescription opioid-related deaths. This crisis is resulting in heightened attention by health care professionals and organizations, law enforcement, and the government. In this article, I highlight key topics in the management of patients using opioids (or potentially needing opioids) in outpatient clinical practice; federal and state law enforcement actions regarding physicians' illegal prescribing of opioids; multimodal approaches to pain control; nonmedication management of pain; response strategies when suspecting a patient of diverting or misusing opioids; and warning signs for abuse or diversion...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28476268/past-year-prevalence-of-prescription-opioid-misuse-among-those-11-to-30years-of-age-in-the-united-states-a-systematic-review-and-meta-analysis
#4
Ashly E Jordan, Natalie A Blackburn, Don C Des Jarlais, Holly Hagan
BACKGROUND: There are high levels of prescription and consumption of prescription opioids in the US. Misuse of prescription opioids has been shown to be highly correlated with prescription opioid-related morbidity and mortality including fatal and non-fatal overdose. We characterized the past-year prevalence of prescription opioid misuse among those 11-30years of age in the US. METHODS: A systematic review and meta-analysis were carried out following a published protocol and PRISMA guidelines...
June 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28446522/improving-opioid-safety-practices-in-primary-care-protocol-for-the-development-and-evaluation-of-a-multifaceted-theory-informed-pilot-intervention-for-healthcare-providers
#5
Pamela Leece, Daniel Z Buchman, Michael Hamilton, Caitlyn Timmings, Yalnee Shantharam, Julia Moore, Andrea D Furlan
INTRODUCTION: In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. METHODS AND ANALYSIS: Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28441685/stagnant-physical-therapy-referral-rates-alongside-rising-opioid-prescription-rates-in-patients-with-low-back-pain-in-the-united-states-1997-2010
#6
Patricia Zheng, Ming-Chih Kao, Nicholas V Karayannis, Matthew Smuck
STUDY DESIGN: A cross-sectional observational study utilizing the National Ambulatory and National Hospital Ambulatory Medical Care Surveys between 1997 and 2010. OBJECTIVE: The aim of this study was to characterize national physical therapy (PT) referral trends during primary care provider (PCP) visits in the United States. SUMMARY OF BACKGROUND DATA: Despite guidelines recommending PT for the initial management of low back pain (LBP), national PT referral rates remain low...
May 1, 2017: Spine
https://www.readbyqxmd.com/read/28435482/state-emergency-department-opioid-guidelines-current-status
#7
Robert I Broida, Tanner Gronowski, Andrew F Kalnow, Andrew G Little, Christopher M Lloyd
INTRODUCTION: The purpose of this study was to evaluate and categorize current state-sponsored opioid guidelines for the practice of emergency medicine (EM). METHODS: We conducted a comprehensive search of EM-specific opioid prescribing guidelines and/or policies in each state to determine current state involvement in EM opioid prescribing, as well as to evaluate some of the specifics of each guideline or policy. The search was conducted using an online query and a follow-up email request to each state chapter of ACEP...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28431089/the-impact-of-prescription-drug-monitoring-programs-and-prescribing-guidelines-on-opioid-prescribing-behaviors-a-time-for-institutional-and-regulatory-changes
#8
Martin D Cheatle
No abstract text is available yet for this article.
May 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28418816/safe-and-competent-opioid-prescribing-education-increasing-dissemination-with-a-train-the-trainer-program
#9
Lara Zisblatt, Sean M Hayes, Patrice Lazure, Ilana Hardesty, Julie L White, Daniel P Alford
BACKGROUND: Due to the high prevalence of prescription opioid misuse, the US Food and Drug Administration (FDA) mandated a Risk Evaluation and Mitigation Strategy (REMS) requiring manufacturers of extended-release/long-acting (ER/LA) opioids to fund continuing education based on an FDA curricular Blueprint. This paper describes the Safe and Competent Opioid Prescribing Education (SCOPE of Pain) train-the-trainer program and its impact on (1) disseminating the SCOPE of Pain curriculum and (2) knowledge, confidence, attitudes, and performance of the participants of trainer-led compared with expert-led meetings...
April 2017: Substance Abuse
https://www.readbyqxmd.com/read/28384742/how-would-you-manage-opioid-use-in-these-three-patients-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#10
Daniel P Alford, Marc L Cohen, Eileen E Reynolds
The increase in overdose deaths from prescription opioids and heroin in the United States over the past 20 years is believed to have resulted from increases in prescription of opioids for management of acute and chronic pain. Managing chronic pain is challenging for primary care clinicians for many reasons, including the lack of evidence to guide practice. The Centers for Disease Control and Prevention published a comprehensive guideline in 2016 to help clinicians with opioid prescribing for chronic pain. In this Grand Rounds, the guideline is reviewed and an expert discusses its application to 3 patients prescribed opioids to treat chronic pain...
April 4, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28376444/discussing-opioid-risks-with-patients-to-reduce-misuse-and-abuse-evidence-from-2-surveys
#11
Joachim O Hero, Caitlin McMurtry, John Benson, Robert Blendon
We used 2 population-representative surveys to evaluate the recommendation from recent clinical guidelines for prescribing opioid analgesics that physicians discuss the risk of long-term use disorders with patients. In nationally representative data we observed a 60% lower rate, after adjustment for covariates, in a self-reported saving of pills among respondents who say they talked with their physicians about the risks of prescription painkiller addiction (67% lower rate without adjustment). These findings suggest patient education efforts, as currently practiced in the United States, may have positive behavioral consequences that could lower the risks of prescription painkiller abuse...
November 2016: Annals of Family Medicine
https://www.readbyqxmd.com/read/28363320/the-prescription-opioid-addiction-treatment-study-what-have-we-learned
#12
REVIEW
Roger D Weiss, Vinod Rao
BACKGROUND: The multi-site Prescription Opioid Addiction Treatment Study (POATS), conducted by the National Drug Abuse Treatment Clinical Trials Network, was the largest clinical trial yet conducted with patients dependent upon prescription opioids (N=653). In addition to main trial results, the study yielded numerous secondary analyses, and included a 3.5-year follow-up study, the first of its kind with this population. This paper reviews key findings from POATS and its follow-up study...
April 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28363316/targeting-practitioners-a-review-of-guidelines-training-and-policy-in-pain-management
#13
REVIEW
Kelly S Barth, Constance Guille, Jenna McCauley, Kathleen T Brady
This paper reviews the current literature on clinical guidelines, practitioner training, and government/payer policies that have come forth in response to the national rise in prescription opioid overdoses. A review of clinical opioid prescribing guidelines highlights the need for more research on safe and effective treatment options for chronic pain, improved guidance for the best management of post-operative pain, and evaluation of the implementation and impact of guideline recommendations on patient risk and outcomes...
April 1, 2017: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/28345746/an-analysis-of-errors-discrepancies-and-variation-in-opioid-prescriptions-for-adult-outpatients-at-a-teaching-hospital
#14
Mark C Bicket, Deepa Kattail, Myron Yaster, Christopher L Wu, Peter Pronovost
OBJECTIVE: To determine opioid-prescribing patterns and rate of three types of errors, discrepancies, and variation from ideal practice. DESIGN: Retrospective review of opioid prescriptions processed at an outpatient pharmacy. SETTING: Tertiary institutional medical center. PATIENTS: We examined 510 consecutive opioid medication prescriptions for adult patients processed at an institutional outpatient pharmacy in June 2016 for patient, provider, and prescription characteristics...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28345742/a-qualitative-exploration-of-chronic-pain-and-opioid-treatment-among-hiv-patients-with-drug-use-disorders
#15
Sarina R Isenberg, Allysha C Maragh-Bass, Kathleen Ridgeway, Mary C Beach, Amy R Knowlton
OBJECTIVE: The study explored high-risk participants' experiences with pain management regarding clinical access to and use of prescription opioids. DESIGN: Qualitative semistructured interviews and focus groups. SETTING: Data were collected August 2014 to May 2015 at an urban community-based research facility in Baltimore City, MD. PARTICIPANTS: HIV participants with chronic pain and a history of illicit drug use. METHODS: Qualitative coding and analysis used an iterative, inductive, and thematic approach and coders achieved inter-coder consistency...
January 2017: Journal of Opioid Management
https://www.readbyqxmd.com/read/28301454/characteristics-of-initial-prescription-episodes-and-likelihood-of-long-term-opioid-use-united-states-2006-2015
#16
Anuj Shah, Corey J Hayes, Bradley C Martin
Because long-term opioid use often begins with treatment of acute pain (1), in March 2016, the CDC Guideline for Prescribing Opioids for Chronic Pain included recommendations for the duration of opioid therapy for acute pain and the type of opioid to select when therapy is initiated (2). However, data quantifying the transition from acute to chronic opioid use are lacking. Patient records from the IMS Lifelink+ database were analyzed to characterize the first episode of opioid use among commercially insured, opioid-naïve, cancer-free adults and quantify the increase in probability of long-term use of opioids with each additional day supplied, day of therapy, or incremental increase in cumulative dose...
March 17, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28267689/an-educational-intervention-decreases-opioid-prescribing-after-general-surgical-operations
#17
Maureen V Hill, Ryland S Stucke, Michelle L McMahon, Julia L Beeman, Richard J Barth
OBJECTIVE: The aim of this study was to determine whether an educational intervention was sufficient to decrease opioid prescribing after general surgical operations. SUMMARY OF BACKGROUND DATA: We recently analyzed opioid prescription and use for 5 common outpatient operations at our institution: partial mastectomy (PM), PM with sentinel lymph node biopsy (PM SLNB), laparoscopic cholecystectomy (LC), laparoscopic inguinal hernia repair (LIH), and open inguinal hernia repair (IH)...
March 6, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28261561/interventional-analgesic-management-of-lung-cancer-pain
#18
REVIEW
Uri Hochberg, Maria Francisca Elgueta, Jordi Perez
Lung cancer is one of the four most prevalent cancers worldwide. Comprehensive patient care includes not only adherence to clinical guidelines to control and when possible cure the disease but also appropriate symptom control. Pain is one of the most prevalent symptoms in patients diagnosed with lung cancer; it can arise from local invasion of chest structures or metastatic disease invading bones, nerves, or other anatomical structures potentially painful. Pain can also be a consequence of therapeutic approaches like surgery, chemotherapy, or radiotherapy...
2017: Frontiers in Oncology
https://www.readbyqxmd.com/read/28245872/public-sector-low-threshold-office-based-buprenorphine-treatment-outcomes-at-year-7
#19
Elenore Patterson Bhatraju, Ellie Grossman, Babak Tofighi, Jennifer McNeely, Danae DiRocco, Mara Flannery, Ann Garment, Keith Goldfeld, Marc N Gourevitch, Joshua D Lee
BACKGROUND: Buprenorphine maintenance for opioid dependence remains of limited availability among underserved populations, despite increases in US opioid misuse and overdose deaths. Low threshold primary care treatment models including the use of unobserved, "home," buprenorphine induction may simplify initiation of care and improve access. Unobserved induction and long-term treatment outcomes have not been reported recently among large, naturalistic cohorts treated in low threshold safety net primary care settings...
February 28, 2017: Addiction Science & Clinical Practice
https://www.readbyqxmd.com/read/28239510/lidocaine-infusion-a-promising-therapeutic-approach-for-chronic-pain
#20
Enas Kandil, Emily Melikman, Bryon Adinoff
Opioid abuse is a national epidemic in the United States, where it is estimated that a prescription drug overdose death occurs every 19 minutes. While opioids are highly effective in acute and subacute pain control, their use for treatment of chronic pain is controversial. Chronic opioids use is associated with tolerance, dependency, hyperalgesia. Although there are new strategies and practice guidelines to reduce opioid dependence and opioid prescription drug overdose, there has been little focus on development of opioid-sparing therapeutic approaches...
January 2017: Journal of Anesthesia & Clinical Research
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