Pain medicine : the official journal of the American Academy of Pain Medicine
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Observational Study
Changes in prevalence of prescription opioid abuse after introduction of an abuse-deterrent opioid formulation.
The reformulation of oxycodone hydrochloride controlled-release (CR) tablets in August 2010 created a natural experiment at a national scale, providing an opportunity to evaluate patterns of abuse of prescription opioids and other drugs before and after introduction of this abuse-deterrent formulation (ADF). ⋯ Replacement of a widely prescribed opioid formulation known for its abuse potential alone may have had little impact on overall rates of prescription opioids as a class. However, changes in abuse levels of certain opioids coinciding with ADF introduction suggest possible switching of abuse among this study sample to specific long-acting opioid analgesics. Additional follow-up studies will be important to monitor changing abuse patterns and their public health impact as new opioid formulations are developed and introduced to market.
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Observational Study
Tricyclic antidepressants: is your patient taking them? Observations on adherence and unreported use using prescriber-reported medication lists and urine drug testing.
Tricyclic antidepressants (TCAs) are first-line treatment for neuropathic pain. Despite widespread use, many health care providers do not know which patients are currently taking TCAs. The objective of this retrospective data analysis was to determine adherence rates to amitriptyline, nortriptyline, or imipramine. The rate at which patients used TCAs (confirmed by presence of TCA in the urine) but did not inform their health care provider is also reported (non-informed prescriber rate). Finally, the effects of age, sex, and number of prescriptions on adherence and non-informed prescriber rates were assessed. ⋯ This analysis reveals that many prescribers are not informed when patients start and stop using TCAs.
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The aim of this study is to evaluate prospectively the efficacy of caudal epidural steroid injection (CESI) and transforaminal epidural steroid injection (TFESI) in lumbar spinal stenosis patients with sciatic pain. ⋯ The effectiveness of transforaminal steroid injection for the stenosis patients with sciatica was superior to caudal at 6 months postinjection.
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Multicenter Study Observational Study
Sustained effectiveness of 10 kHz high-frequency spinal cord stimulation for patients with chronic, low back pain: 24-month results of a prospective multicenter study.
The aim of this study was to investigate the long-term efficacy and safety of paresthesia-free high-frequency spinal cord stimulation (HF10 SCS) for the treatment of chronic, intractable pain of the low back and legs. ⋯ In patients with chronic low back pain, HF10 SCS resulted in clinically significant and sustained back and leg pain relief, functional and sleep improvements, opioid use reduction, and high patient satisfaction. These results support the long-term safety and sustained efficacy of HF10 SCS.
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Observational Study
Overgeneral autobiographical memory in patients with chronic pain.
Overgenerality and delay of the retrieval of autobiographical memory (AM) are well documented in a range of clinical conditions, particularly in patients with emotional disorder. The present study extended the investigation to chronic pain, attempting to identify whether the retrieval of AM in patients with chronic pain tends to be overgeneral or delayed. ⋯ The retrieval of AM in patients with chronic pain tends to be overgeneral and delayed, and the retrieval style of AM may be contributed to negative emotions and chronic pain conditions.