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https://www.readbyqxmd.com/read/28057027/clinical-practice-guidelines-for-the-management-of-chronic-musculoskeletal-pain-in-primary-healthcare-a-systematic-review
#1
REVIEW
Dawn V Ernstzen, Quinette A Louw, Susan L Hillier
BACKGROUND: Up-to-date, high quality, evidence-based clinical practice guidelines (CPGs) that are applicable for primary healthcare are vital to optimize services for the population with chronic musculoskeletal pain (CMSP). The study aimed to systematically identify and appraise the available evidence-based CPGs for the management of CMSP in adults presenting in primary healthcare settings. METHODS: A systematic review was conducted. Twelve guideline clearinghouses and six electronic databases were searched for eligible CPGs published between the years 2000 and May 2015...
January 5, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28034982/enhancing-risk-assessment-in-patients-receiving-chronic-opioid-analgesic-therapy-using-natural-language-processing
#2
Irina V Haller, Colleen M Renier, Mitch Juusola, Paul Hitz, William Steffen, Michael J Asmus, Terri Craig, Jack Mardekian, Elizabeth T Masters, Thomas E Elliott
OBJECTIVES:  Clinical guidelines for the use of opioids in chronic noncancer pain recommend assessing risk for aberrant drug-related behaviors prior to initiating opioid therapy. Despite recent dramatic increases in prescription opioid misuse and abuse, use of screening tools by clinicians continues to be underutilized. This research evaluated natural language processing (NLP) together with other data extraction techniques for risk assessment of patients considered for opioid therapy as a means of predicting opioid abuse...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28034973/opioid-induced-constipation-and-bowel-dysfunction-a-clinical-guideline
#3
Stefan Müller-Lissner, Gabrio Bassotti, Benoit Coffin, Asbjørn Mohr Drewes, Harald Breivik, Elon Eisenberg, Anton Emmanuel, Françoise Laroche, Winfried Meissner, Bart Morlion
OBJECTIVE:  To formulate timely evidence-based guidelines for the management of opioid-induced bowel dysfunction. SETTING:  Constipation is a major untoward effect of opioids. Increasing prescription of opioids has correlated to increased incidence of opioid-induced constipation. However, the inhibitory effects of opioids are not confined to the colon, but also affect higher segments of the gastrointestinal tract, leading to the coining of the term "opioid-induced bowel dysfunction...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28033313/increases-in-drug-and-opioid-involved-overdose-deaths-united-states-2010-2015
#4
Rose A Rudd, Puja Seth, Felicita David, Lawrence Scholl
The U.S. opioid epidemic is continuing, and drug overdose deaths nearly tripled during 1999-2014. Among 47,055 drug overdose deaths that occurred in 2014 in the United States, 28,647 (60.9%) involved an opioid (1). Illicit opioids are contributing to the increase in opioid overdose deaths (2,3). In an effort to target prevention strategies to address the rapidly changing epidemic, CDC examined overall drug overdose death rates during 2010-2015 and opioid overdose death rates during 2014-2015 by subcategories (natural/semisynthetic opioids, methadone, heroin, and synthetic opioids other than methadone)...
December 30, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27994790/a-nationwide-retrospective-study-of-opioid-management-patterns-in-2-468-patients-with-spinal-pain-in-korea
#5
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/27973601/high-dose-opioid-prescribing-and-opioid-related-hospitalization-a-population-based-study
#6
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/27903034/prescription-drug-abuse-a-timely-update
#7
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/27898133/opioid-misuse-abuse-and-quality-persistent-pain-management-in-older-adults
#8
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/27869630/a-prospective-evaluation-of-opioid-utilization-after-upper-extremity-surgical-procedures-identifying-consumption-patterns-and-determining-prescribing-guidelines
#9
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/27862243/antidepressant-adherence-patterns-in-older-patients-use-of-a-clustering-method-on-a-prescription-database
#10
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/27857265/interdisciplinary-pain-education-moving-from-discipline-specific-to-collaborative-practice
#11
Bansari Patel, Eileen Hacker, Catherine M Murks, Catherine J Ryan
BACKGROUND: Pain is a common symptom reported by hospitalized patients with cancer. Cancer pain management requires an interdisciplinary approach for quality patient care. Although the literature suggests that most cancer pain can be managed with available treatments, many patients continue to experience pain even with opioid prescriptions. Implementation of evidence-based guidelines, such as the National Comprehensive Cancer Network's guidelines for adult cancer pain, promotes collaboration across disciplines and enhances patient care...
December 1, 2016: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/27844473/adherence-to-chronic-opioid-therapy-prescribing-guidelines-in-a-primary-care-clinic
#12
Cynthia Kay, Erica Wozniak, Sarah Koller, Audrey Ye, Joanne Bernstein
OBJECTIVE: Characterize primary care patients prescribed opioids for chronic noncancer pain (CNCP), explore guideline-recommended opioid-monitoring practices, and investigate predictors of pain agreements. DESIGN: Retrospective chart review. SETTING: Primary care clinic at a tertiary academic medical center. PATIENTS: Adults prescribed chronic opioids (three or more monthly prescriptions within a year) for CNCP between April 1, 2014 and April 1, 2015...
September 2016: Journal of Opioid Management
https://www.readbyqxmd.com/read/27842785/toxicology-in-pain-management
#13
REVIEW
Daniel A Schwarz, M P George, Martin H Bluth
Toxicology testing in pain management has become the standard of care. The Center for Disease Control and Prevention published guidelines including urine drug testing prior to initiating opioid therapy and for monitoring prescription and illicit drugs. Physicians must know indications for toxicology testing, and the frequency based upon risk stratification. This includes personal and family history of alcohol or substance related disorders, mental illness and smoking. Knowledge of opioid metabolism and various matrices to test are described...
December 2016: Clinics in Laboratory Medicine
https://www.readbyqxmd.com/read/27823911/-trend-in-buprenorphine-and-methadone-shopping-behavior-in-france-from-2004%C3%A2-to-2014
#14
Mélanie Kernisant, Jessica Delorme, Jean-Luc Kabore, Georges Brousse, Catherine Laporte, Marie Zenut, Chouki Chenaf, Nicolas Authier
INTRODUCTION: The opioid maintenance treatments (OMT) are widely misused and diverted in many countries. Doctor shopping represented the main way to obtain high quantities of opioids in abuse/diversion. The aim of this study was to assess the trends in the prevalence of doctor shopping for high dosage buprenorphine (HDB) and methadone (MTD) from 2004 to 2014 by using the French Health Insurance claims. METHODS: This was a cross-sectional study of patients treated by OMT (High Dosage Buprenorphine or Methadone) between 2004 and 2014 from a representative sample of the French Health Insurance claims...
December 2016: La Presse Médicale
https://www.readbyqxmd.com/read/27794549/clinicians-use-of-prescription-drug-monitoring-programs-in-clinical-practice-and-decision-making
#15
Gillian J Leichtling, Jessica M Irvine, Christi Hildebran, Deborah J Cohen, Sara E Hallvik, Richard A Deyo
OBJECTIVES:  Little is known about clinicians' use of prescription drug monitoring program (PDMP) profiles in decision-making. The objective of this qualitative study was to understand how clinicians use, interpret, and integrate PDMP profiles with other information in making clinical decisions. DESIGN : Qualitative interviews of clinician PDMP users. SETTING:  Oregon registrants in the state's PDMP. SUBJECTS:  Thirty-three clinicians practicing in primary care, emergency medicine, pain management, psychiatry, dentistry, and surgery...
October 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/27776797/-patterns-of-prescription-of-opioid-analgesics-in-h%C3%A3-tel-dieu-de-france-of-beyrouth
#16
P Noufi, E Khoury, E Ayoub, N Naccache, S Richa
OBJECTIVES: Use of chronic opioid therapy has increased substantially over the past few years, even though opioid therapy is associated with potentially serious harms, including opioid-related adverse effects and outcomes. Prescription of opioids for chronic pain, particularly nonmalignant chronic pain, remains controversial. In the midst of this controversy, patterns of actual prescription and influences on these patterns are not well understood. This study aims to describe the frequency of prescription of opioid analgesics in a university hospital, the attitudes of doctors towards this category of drugs, and the follow-up modalities of patients taking these drugs...
December 2016: L'Encéphale
https://www.readbyqxmd.com/read/27771783/accessibility-of-opioid-analgesics-and-barriers-to-optimal-chronic-pain-treatment-in-poland-in-2000-2015
#17
Tomasz Dzierżanowski, Aleksandra Ciałkowska-Rysz
PURPOSE: Based on the international reports, consumption of opioid analgesics in Poland is relatively low. There is limited information on possible impediments to optimal opioid use. This study was aimed to identify possible barriers to access to opioid analgesics and causes of failure to comply with current clinical guidelines. METHODS: Consumption data per capita in 2000-2015 were analyzed in terms of oral morphine equivalents in total, per prescription type, per reimbursement status, to identify the impact of regulations specific for Poland...
October 22, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27764082/declines-in-opioid-prescribing-after-a-private-insurer-policy-change-massachusetts-2011-2015
#18
Macarena C García, Anton B Dodek, Tom Kowalski, John Fallon, Scott H Lee, Michael F Iademarco, John Auerbach, Michele K Bohm
Overdose deaths involving opioid pain medications are epidemic in the United States, in part because of high opioid prescribing rates and associated abuse of these drugs (1). In 2014, nearly 2 million U.S. residents either abused or were dependent on prescription opioids (2). In Massachusetts, unintentional opioid-related overdose deaths, including deaths involving heroin, increased 45% from 2012 to 2013.* In 2014, the rate of these deaths reached 20.0 per 100,000, nearly 2.5 times higher than the U.S. rate overall (3,4)...
October 21, 2016: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/27754719/provider-experiences-with-the-identification-management-and-treatment-of-co-occurring-chronic-noncancer-pain-and-substance-use-in-the-safety-net
#19
Jamie Suki Chang, Margot Kushel, Christine Miaskowski, Rachel Ceasar, Kara Zamora, Emily Hurstak, Kelly R Knight
BACKGROUND: In the United States and internationally, providers have adopted guidelines on the management of prescription opioids for chronic noncancer pain (CNCP). For "high-risk" patients with co-occurring CNCP and a history of substance use, guidelines advise that providers monitor patients using urine toxicology screening tests, develop opioid management plans, and refer patients to substance use treatment. OBJECTIVE: We report primary care provider experiences in the safety net interpreting and implementing prescription opioid guideline recommendations for patients with CNCP and substance use...
January 28, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/27738299/opioid-therapy-for-chronic-non-cancer-pain-guidelines-for-hong-kong
#20
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
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