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Opioids prescription guidelines

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https://www.readbyqxmd.com/read/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#1
Nicholas Cox, Casey R Tak, Susan E Cochella, Eric Leishman, Karen Gunning
INTRODUCTION: Primary care providers (PCPs) account for half of opioid prescriptions, often feel chronic pain patients are challenging to manage, and there is wide variability in practice patterns. The purpose of this pilot study was to evaluate the impact of a previsit pharmacist review of high-risk patients treated with opioids for chronic pain on compliance to guideline recommendations at a family medicine residency clinic. METHODS: All adult patients with an appointment for chronic pain who were prescribed >50 morphine milligram equivalents (MMEs)/day had charts reviewed by a pharmacist before each appointment; recommendations were sent electronically to the provider before the appointment...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29319627/opioid-prescription-morbidity-and-mortality-in-us-transplant-recipients
#2
Kevin C Abbott, Chyng-Wen Fwu, Paul W Eggers, Anne W Eggers, Prudence P Kline, Paul L Kimmel
BACKGROUND: CDC guidelines recommend caution in prescribing opioids for chronic pain. The characteristics of opioid prescription (OpRx) among kidney transplant (KTx) recipients has not been described in a national population. METHODS: We assessed OpRx prevalence among prevalent KTx recipients, and associated duration (chronic, defined as ≥90 days in a year) and dosing (in morphine milligram equivalents per day, MME, of <50, 50-89, and ≥90) with outcomes, death and graft loss, among incident KTx recipients using 2006-2010 US Renal Data System files, including Medicare Part D for medication ascertainment...
January 10, 2018: Transplantation
https://www.readbyqxmd.com/read/29282114/risk-factors-for-addiction-among-patients-receiving-prescribed-opioids-a-systematic-review-protocol
#3
Amber Cragg, Jeffrey P Hau, Stephanie A Woo, Christine Liu, Mary M Doyle-Waters, Corinne M Hohl
BACKGROUND: Opioid addiction prevention has become an urgent public health priority, with several countries declaring a state of emergency due to rising death tolls from opioid abuse. Reducing the risk of developing addiction among opioid-naïve patients exposed to prescribed opioids during the process of medical care may be an important primary prevention strategy. Our objective is to synthesize the available evidence about factors associated with the development of addiction among patients first exposed to prescribed opioids, with a focus on opioid-naïve patients...
December 28, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29280484/intranasal-tissue-necrosis-associated-with-opioid-abuse-case-report-and-systematic-review
#4
REVIEW
Danielle A Morrison, Sarah K Wise, John M DelGaudio, Naweed I Chowdhury, Joshua M Levy
OBJECTIVE: Opioid abuse is a common disorder affecting over 2 million Americans. Intranasal tissue necrosis is a previously described sequela of nasal opioid inhalation, with a similar presentation to invasive fungal rhinosinusitis (IFRS). The goal of this case report and systematic review is to evaluate the evidence supporting this uncommon disease, with qualitative analysis of the presentation, management and treatment outcomes. DATA SOURCES: MEDLINE, EMBASE, Google Scholar, Scopus, and Web of Science...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29275945/the-supply-of-prescription-opioids-contributions-of-episodic-care-prescribers-and-high-quantity%C3%A2-prescribers
#5
Todd Schneberk, Brian Raffetto, David Kim, David L Schriger
STUDY OBJECTIVE: We determine episodic and high-quantity prescribers' contribution to opioid prescriptions and total morphine milligram equivalents in California, especially among individuals prescribed large amounts of opioids. METHODS: This was a cross-sectional descriptive analysis of opioid prescribing patterns during an 8-year period using the de-identified Controlled Substance Utilization Review and Evaluation System (CURES) database, the California subsection of the prescription drug monitoring program...
December 21, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29240853/the-evaluation-of-medical-inpatients-who-are-admitted-on-long-term-opioid-therapy-for-chronic-pain
#6
Hilary Mosher, Shoshana J Herzig, Itai Danovitch, Christina Boutsicaris, Sameer Hassamal, Karl Wittnebel, Azadeh Dashti, Teryl Nuckols
Individuals who are on long-term opioid therapy (LTOT) for chronic noncancer pain are frequently admitted to the hospital with acute pain, exacerbations of chronic pain, or comorbidities. Consequently, hospitalists find themselves faced with complex treatment decisions in the context of uncertainty about the effectiveness of LTOT as well as concerns about risks of overdose, opioid use disorders, and adverse events. Our multidisciplinary team sought to synthesize guideline recommendations and primary literature relevant to assessing medical inpatients on LTOT, with the objective of assisting practitioners in balancing effective pain treatment and opioid risk reduction...
December 6, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29228098/association-of-household-opioid-availability-and-prescription-opioid-initiation-among-household-members
#7
Marissa J Seamans, Timothy S Carey, Daniel J Westreich, Stephen R Cole, Stephanie B Wheeler, G Caleb Alexander, Virginia Pate, M Alan Brookhart
Importance: Increases in prescription opioid use in the United States have been attributed to changing prescribing guidelines and attitudes toward pain relief; however, the spread of opioid use within households through drug diversion may also be a contributing factor. Objective: To investigate whether individuals living in a household with a prescription opioid user are more likely to initiate prescription opioids themselves, compared with individuals in households with a prescription nonsteroidal anti-inflammatory drug (NSAID) user...
December 11, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29215370/opioid-use-after-discharge-in-postoperative-patients-a-systematic-review
#8
Adina E Feinberg, Tyler R Chesney, Sanjho Srikandarajah, Sergio A Acuna, Robin S McLeod
BACKGROUND: Over the past 2 decades, there has been an increase in opioid use and subsequently, opioid deaths. The amount of opioid prescribed to surgical patients has also increased. The aim of this systematic review was to determine postdischarge opioid consumption in surgical patients compared with the amount of opioid prescribed. Secondary outcomes included adequacy of pain control and disposal methods for unused opioids. OBJECTIVE: The objective of this study is to characterize postdischarge opioid consumption and prescription patterns in surgical patients...
December 5, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/29206984/rational-urine-drug-monitoring-in-patients-receiving-opioids-for-chronic-pain-consensus-recommendations
#9
Charles E Argoff, Daniel P Alford, Jeffrey Fudin, Jeremy A Adler, Matthew J Bair, Richard C Dart, Roy Gandolfi, Bill H McCarberg, Steven P Stanos, Jeffrey A Gudin, Rosemary C Polomano, Lynn R Webster
Objective: To develop consensus recommendations on urine drug monitoring (UDM) in patients with chronic pain who are prescribed opioids. Methods: An interdisciplinary group of clinicians with expertise in pain, substance use disorders, and primary care conducted virtual meetings to review relevant literature and existing guidelines and share their clinical experience in UDM before reaching consensus recommendations. Results: Definitive (e...
December 1, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29205415/systematic-review-human-gut-dysbiosis-induced-by-non-antibiotic-prescription-medications
#10
REVIEW
Q Le Bastard, G A Al-Ghalith, M Grégoire, G Chapelet, F Javaudin, E Dailly, E Batard, D Knights, E Montassier
BACKGROUND: Global prescription drug use has been increasing continuously for decades. The gut microbiome, a key contributor to health status, can be altered by prescription drug use, as antibiotics have been repeatedly described to have both short-term and long-standing effects on the intestinal microbiome. AIM: To summarise current findings on non-antibiotic prescription-induced gut microbiome changes, focusing on the most frequently prescribed therapeutic drug categories...
December 5, 2017: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29198638/guideline-for-discharge-opioid-prescriptions-after-inpatient-general-surgical-procedures
#11
Maureen V Hill, Ryland S Stucke, Sarah E Billmeier, Julia L Kelly, Richard J Barth
BACKGROUND: There is a paucity of data to inform appropriate opioid prescribing for patients who are discharged after a hospital admission for a surgical procedure. STUDY DESIGN: We studied 333 inpatients discharged to home after bariatric, benign foregut, liver, pancreas, ventral hernia, and colon surgery. Chronic opioid users or patients who had complications were excluded. Home opioid usage was quantified in 90% of the remaining patients by questionnaires and phone surveys...
November 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29189368/opioid-prescribing-for-the-treatment-of-acute-pain-in-children-on-hospital-discharge
#12
Constance L Monitto, Aaron Hsu, Shuna Gao, Paul T Vozzo, Paul S Park, Deborah Roter, Gayane Yenokyan, Elizabeth D White, Deepa Kattail, Amy E Edgeworth, Kelly J Vasquenza, Sara E Atwater, Joanne E Shay, Jessica A George, Barbara A Vickers, Sabine Kost-Byerly, Benjamin H Lee, Myron Yaster
BACKGROUND: The epidemic of nonmedical use of prescription opioids has been fueled by the availability of legitimately prescribed unconsumed opioids. The aim of this study was to better understand the contribution of prescriptions written for pediatric patients to this problem by quantifying how much opioid is dispensed and consumed to manage pain after hospital discharge, and whether leftover opioid is appropriately disposed of. Our secondary aim was to explore the association of patient factors with opioid dispensing, consumption, and medication remaining on completion of therapy...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29180552/neighborhood-socioeconomic-status-and-receipt-of-opioid-medication-for-new-back-pain-diagnosis
#13
Sarah Gebauer, Joanne Salas, Jeffrey F Scherrer
BACKGROUND: Although treatment for new back pain is heavily guideline driven, deviations occur frequently. Neighborhood socioeconomic status (nSES) may contribute to these deviations. OBJECTIVE: Determine whether nSES is associated with type of treatment provided for patients seeking treatment for new back pain in primary care clinics. METHODS: This retrospective cohort was conducted in academic internal and family medicine practices. Data were examined from the Primary Care Patient Data Registry...
November 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29178843/a-qualitative-evidence-synthesis-to-explore-healthcare-professionals-experience-of-prescribing-opioids-to-adults-with-chronic-non-malignant-pain
#14
Fran Toye, Kate Seers, Stephanie Tierney, Karen Louise Barker
BACKGROUND: Despite recent guidelines suggesting that patients with chronic non-malignant pain might not benefit, there has been a significant rise in opioid prescription for chronic non-malignant pain. This topic is important because an increasing number of HCPs are prescribing opioids despite very limited evidence for long-term opioid therapy for chronic non-malignant pain outside of end-of-life care. To better understand the challenges of providing effective treatment, we conducted the first qualitative evidence synthesis to explore healthcare professionals' experience of treating people with chronic non-malignant pain...
November 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/29177439/attitudes-beliefs-practices-and-concerns-among-clinicians-prescribing-opioids-in-a-large-academic-institution
#15
Jon O Ebbert, Lindsey M Philpot, Casey M Clements, Jenna K Lovely, Wayne T Nicholson, Sarah M Jenkins, Tim J Lamer, Halena M Gazelka
Objectives: Opioid treatment of chronic noncancer pain (CNCP) adds complexity and uncertainty to patient interactions. We sought to assess clinician attitudes, beliefs, practice styles, and concerns around opioid prescribing following the release of the US Centers for Disease Control and Prevention (CDC) guideline for prescribing opioids for chronic pain. Methods: E-mailed electronic survey to clinicians at a large academic medical institution. Results: A total of 961 clinicians responded to the survey (response rate = 40%), 720 of whom prescribed opioids and were not in training...
June 15, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29170340/43%C3%A2-management-of-acute-low-back-pain-in-the-ed-a-systematic-review
#16
Jane Ashbrook, Nikos Rodgdakis, Peter Goodwin, Gill Yeowell, Michael Callaghan
STUDY OBJECTIVE: There is no consensus on the management of low back pain in the ED and evidence suggests that these patients are likely to receive unwarranted imaging and inappropriate opioid prescription.The purpose of this study is to review the available literature pertaining to the clinical management of acute low back pain in the ED. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Realist And Meta-narrative Evidence Syntheses: Evolving Standards (RAMESES) guidelines were observed during this review...
December 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29149155/lower-cutoffs-for-lc-ms-ms-urine-drug-testing-indicates-better-patient-compliance
#17
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/29126848/evaluation-of-external-vibratory-stimulation-as-a-treatment-for-chronic-scrotal-pain-in-adult-men-a-single-center-open-label-pilot-study
#18
Yash S Khandwala, Fernando Serrano, Michael L Eisenberg
BACKGROUND AND AIMS: Chronic scrotal pain is a common yet poorly understood urologic disease. Current treatment paradigms are sub-optimal and include anti-inflammatory drugs and opioids as well as invasive surgical management such as microdenervation of the spermatic cord. In this study, the efficacy of external vibratory stimulation (EVS) was evaluated as an alternative treatment option for idiopathic scrotal pain. MATERIALS AND METHODS: Ten consecutive patients presenting to an academic urology clinic between December 2016 and April 2017 with scrotal pain were prospectively enrolled...
November 7, 2017: Scandinavian Journal of Pain
https://www.readbyqxmd.com/read/29100223/using-pill-identification-calls-to-poison-centers-as-a-marker-of-drug-abuse-at-three-texas-military-bases
#19
Patrick C Ng, Joseph K Maddry, Daniel Sessions, Douglas J Borys, Vikhyat S Bebarta
OBJECTIVES: Opioid abuse is a growing problem in civilian communities, and it has developed in the military as well. Telephone calls to poison centers requesting pill identification (ID) is a marker of drug abuse. This study identifies the number of pill ID calls made to the poison centers from areas containing and surrounding three Texas military bases during an 8-year period. METHODS: We performed a retrospective observational study identifying calls to certified poison centers in Texas from 2002 to 2009 that identified hydrocodone tablets and other pain medications...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29078056/pain-management-after-outpatient-foot-and-ankle-surgery
#20
Akash Gupta, Kanupriya Kumar, Matthew M Roberts, Austin E Sanders, Mackenzie T Jones, David S Levine, Martin J O'Malley, Mark C Drakos, Andrew J Elliott, Jonathan T Deland, Scott J Ellis
BACKGROUND: The number of opioids prescribed and used has increased precipitously over the past 2 decades for a number of reasons and has led to increases in long-term dependency, opioid-related deaths, and diversion. Most studies examining the role of prescribing habits have investigated nonoperative providers, although there is some literature describing perioperative opioid prescription and use. There are no studies looking at the number of pills consumed after outpatient foot and ankle surgeries, nor are there guidelines for how many pills providers should prescribe...
October 1, 2017: Foot & Ankle International
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