Journal of opioid management
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Nurses should be educated in pain management because they are more likely than other healthcare professionals to educate patients about their pain. The authors sought to identify the knowledge gaps in postoperative pain management among postsurgical nursing staff and the existence of institutional policies and educational programs to support them in delivering optimal pain management services. ⋯ The survey results demonstrate general gaps in pain management knowledge among nurses, particularly in recognizing signs and symptoms of pain. This work may guide the development of programs that improve postoperative pain management by increasing the frequency of nurses' pain education and improving the availability of pain-related policies and protocols.
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Randomized Controlled Trial Multicenter Study
Hydromorphone extended release for neuropathic and non-neuropathic/nociceptive chronic low back pain: a post hoc analysis of data from a randomized, multicenter, double-blind, placebo-controlled clinical trial.
The aim of this study was to determine the efficacy and tolerability of hydromorphone extended release (ER) in patients with chronic low back pain (LBP) with or without a neuropathic component. ⋯ The results of this study indicate that hydromorphone ER is efficacious and generally well tolerated in the management of patients with non-neuropathic and neuropathic chronic LBP.
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Randomized Controlled Trial
Pharmacological and toxicological profile of opioid-treated, chronic low back pain patients entering a mindfulness intervention randomized controlled trial.
Refractory chronic low back pain (CLBP) often leads to treatment with long-term opioids. Our goal was to describe the pharmaco-toxicological profile of opioid-treated CLBP patients and identify potential areas for care optimization. ⋯ Study findings corroborate existing evidence for high medication burden and high likelihood of substance misuse among opioid-treated CLBP patients. Further research is needed to help understand causality and ways to optimize care and clinical outcomes.
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To determine whether an educational intervention combined with a voluntary decision support system improves inpatient pain control. ⋯ A combination of a resident educational intervention, CDSS, and pocket cards did not improve MPSs over time for patients on an internal medicine teaching service.
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Opioids remain a common method of treating chronic pain conditions despite some controversy. In an effort to address some of the risks of opioid medications, opioid risk assessment has become a standard of care when opioids are used to treat a chronic pain condition. Research to date has found that clinical interviews may be superior to currently available patient-completed written questionnaires in identifying patients likely to engage in medication aberrant behavior. ⋯ Follow-up data found that the BRI was a good predictor of medication aberrant behavior and offered better sensitivity and better overall predictive accuracy than the ORT or the SOAPP-R. Overall, it appears that the BRI is a valid risk assessment tool that, after a brief training session, can be used effectively by pain clinicians. Further study is needed in other practice settings and with larger sample sizes.