Journal of pain & palliative care pharmacotherapy
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J Pain Palliat Care Pharmacother · Jan 2005
Answering questions on a hospice foundation web site: the first five years.
The "ask a question" feature of the web site maintained by the Hospice Foundation of America is described. Sample questions are presented. The initial and current perspective son this feature are provided by the hospice medical consultant who replies to questions sent to the web site.
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The use of steroids administered into the epidural space to manage low back pain is described in a manner that a clinician might use to explain this intervention to a patient or care-giver.
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J Pain Palliat Care Pharmacother · Jan 2005
Non-medical use of OxyContin Tablets in the United States.
The non-medical use of OxyContin (controlled release oxycodone HCl) Tablets has been widely cited in media reports often leaving the impression that OxyContin was a source of primary or new onset drug abuse. However, no published research to date has examined the drug use history of those reporting non-medical use of OxyContin. This study examined rates of non-medical OxyContin use in the United States and the demographic and drug use profiles of those reporting such use, based on data from the 1999, 2000, and 2001 Substance Abuse and Mental Health Services Administration National Household Survey on Drug Abuse. ⋯ Compared to those reporting non-medical use of prescription analgesics other than OxyContin, non-medical OxyContin users were more likely to show a pattern of more serious drug abuse: they used multiple drugs, used needles for drug injection, and had higher rates of abuse and dependence. Approximately 83% of non-medical OxyContin users reported having used illicit drugs or other prescription medications non-medically prior to their first non-medical use of prescription analgesics. Even compared to those who reported non-medical use of other prescription analgesics, non-medical OxyContin users already had a more significant pattern of drug abuse before they began using prescription analgesics for non-medical purposes, suggesting that non-medical use of OxyContin is rarely the initiating factor leading to the abuse of other drugs.
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J Pain Palliat Care Pharmacother · Jan 2005
Assessing the value of hospice care: is documentation of cost savings necessary.
Hospice care is one end-of-life option that since its inception has been the subject of numerous cost comparisons. Early hospice care emerged as a social movement in the United Kingdom. This movement began outside the medical services establishment and sought to improve care for the terminally ill through palliative and supportive services, provided in the patient's own home (1). ⋯ The results of the National Hospice study, which documented medical cost savings during the last six months of life for hospice patients as compared to conventional care patients, was seen as the impetus for Medicare reimbursement for hospice services (2,3). Against this backdrop, the Medicare Hospice Benefit was enacted in 1982 with the goal of providing humane, compassionate and cost-effective care for Medicare beneficiaries with incurable advanced disease. Ever increasing concerns about rising health care costs and the economics of dying have fueled numerous studies trying to quantify the cost savings at the end of life that may result from hospice versus conventional care.
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J Pain Palliat Care Pharmacother · Jan 2005
Physician perspectives on a pilot prescription monitoring program.
In 2003, during implementation of a pilot electronic prescription monitoring program in southwest Virginia, a survey was mailed to 672 physicians to learn about their knowledge of and attitudes toward the program and its impact on their opioid prescribing behaviors. A total of 275 surveys were returned yielding a response rate of 41%. ⋯ Sixty-eight percent reported that the prescription monitoring program was useful for monitoring patients' prescription histories and decreasing doctor shopping; however, only 11% had requested information from the prescription monitoring program database, primarily due to access barriers. Recommendations include education to increase physician awareness of and utilization of the program and to address their concerns about scrutiny of practice and collection of relevant data that examines the impact of the program on diversion, abuse, and quality of patient care for persons in pain.