Journal of general internal medicine
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Observational Study
Association Between Pain, Blood Pressure, and Medication Intensification in Primary Care: an Observational Study.
Treating hypertension is important but physicians often do not intensify blood pressure (BP) treatment in the setting of pain. ⋯ When patients reported pain, physicians were less likely to intensify antihypertensive treatment; nevertheless, patients reporting pain were not more likely to have elevated BP at the subsequent visit.
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Editorial
Promoting Patient-Centeredness in Opioid Deprescribing: a Blueprint for De-implementation Science.
A downward trend in opioid prescribing between 2011 and 2018 has brought per-capita opioid prescriptions below the levels of 2006, the earliest year for which the Centers for Disease Control and Prevention has published data. That trend has affected roughly ten million patients who previously received long-term opioid therapy. Any effort to reduce or replace a prior health practice is termed de-implementation. ⋯ It can deepen our understanding of how policies are chosen, communicated, and carried out. Policymakers and researchers who embrace this framework will need a better approach to measuring success and failure in health care where both pain and opioids are concerned. This would involve shifting from a reductive focus on opioid prescription counts toward measures that are more effective, holistic, and patient-centered.