Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2009
Impact of constipation on opioid use patterns, health care resource utilization, and costs in cancer patients on opioid therapy.
Patterns of opioid use, resource utilization, and costs in cancer patients with and without constipation were compared using retrospective insurance claims data. Inclusion criteria were > =30 days of opioid use and continuous plan coverage for > or =6 months before and > or =12 months following first opioid claim (index date). Constipation was defined as > or =1 ICD-9-CM diagnosis codes in the range of 564.0x during the 12 months postindex date. ⋯ Compared with controls, patients with constipation had substantially higher total costs (P < .0001). This study suggests that in opioid-treated cancer patients, constipation significantly impacts opioid-use patterns, resource utilization, and costs. Alleviation of constipation may optimize opioid therapy and reduce costs.
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J Pain Palliat Care Pharmacother · Jan 2009
Do international model drug control laws provide for drug availability?
A preliminary review of the United Nations Office on Drugs and Crime (UNODC) model drug control laws was conducted by the Pain & Policy Studies Group (PPSG) to determine whether the models provided governments with language they can use to carry out the obligation to ensure adequate availability of opioid analgesics for the relief of pain and suffering, specified in the Single Convention on Narcotic Drugs, 1961 as amended, and as recommended by the International Narcotics Control Board in 1995. The results showed that current model laws lack the drug availability provisions. Based on initial positive feedback from the International Narcotics Control Board, the UNODC, and the World Health Organization, the PPSG developed preliminary recommendations based on existing provisions in the Single Convention. ⋯ If these models convey the dual obligations of governments, the models would be considered "balanced," and national governments would have model policy language not only for control of licit drugs, but also for their availability. Most governments have already adopted laws to implement the Single Convention; however, it is not known if they followed the Single Convention itself or model laws. The PPSG conducted this preliminary assessment of whether the models published by the United Nations Office on Drugs and Crime are balanced, using as a guide the 1995 recommendations of the International Narcotics Control Board (www.incb.org/pdf/e/ar/1995/suppl1en.pdf) and the 2000 WHO publication Achieving Balance in National Opioids Control Policies: Guidelines for Assessment (www.painpolicy.wisc.edu/publicat/00whoabi/00whoabi.htm).
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J Pain Palliat Care Pharmacother · Jan 2009
Analysis of controlled substance agreements from private practice physicians.
Controlled substance management agreements (contracts) are widely used by pain specialists in the United States, but what do they contain? This survey analysis answers that question by taking a thorough look at 41 controlled substance medication management agreements from physicians in private practice.
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The various institutes and offices of the National Institutes of Health (NIH) publish a range of public information articles on pain and its management. The National Institute of Neurological Disorders and Stroke (NINDS) updated its public information on chronic pain last august. That information is available to the public and clinicians will find it useful to learn what the information to which their patients have ready access via the World Wide Web. The most recent NINDS description of chronic pain is presented.