North Carolina medical journal
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Management of chronic pain is often difficult. Interventional approaches, such as joint injections and nerve blocks, can reduce dependence on opioid therapy, polypharmacy, and long-term costs; they can also dramatically improve pain control and function. However, interventional techniques must be used ethically and judiciously as part of a comprehensive approach to patient-centered care.
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This issue of the NCMJ addresses the problem of chronic pain in North Carolina; its diagnosis and management in primary and specialty care; and the need to balance efficacy and safety when prescribing opioid medications, as these drugs are associated with significant potential for misuse and abuse. The commentaries in this issue not only address the use of opioids for the management of chronic pain but also explore various alternatives, including medical marijuana, epidural and other injections, surgery, acupuncture, and other integrative therapies. Articles in this issue also describe the management of chronic pain in palliative care, the ways in which mental health affects pain, and the unintended consequences of chronic pain management. Finally, this issue describes several initiatives across the state that are addressing the epidemic of prescription drug abuse; these initiatives are effecting systematic changes in clinical practice to more effectively manage chronic pain, protect patients, and minimize the negative impact of prescription drug abuse on communities.
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The North Carolina Immunization Registry (NCIR) has been available since 2004. We sought to measure its utilization among practices that provide primary care for children who are enrolled in a prospective influenza surveillance study. ⋯ More than 95% of children younger than 6 years of age had 2 or more immunizations documented in the NCIR; thus, the Centers for Disease Control and Prevention 2010 goal for immunization information systems was met in this population. We found substantial agreement between practice records and the NCIR for influenza and pneumococcal immunizations in children.