Articles: opioid-analgesics.
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The opioid epidemic continues to worsen with a concomitant increase in opioid-related mortality. In response, the Department of Defense and Veterans Health Agency recommended against the use of long-acting opioids (LAOs) and concurrent use of opioids with benzodiazepines. Subsequently, we eliminated benzodiazepines and LAOs from our postoperative pain control regimen. ⋯ Replacement of benzodiazepines and LAOs in the pain control regimen for single-level TLIFs did not affect pain scores and was associated with decreased opioid use, a reduction in trigger medications, and shorter hospitalizations.
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Preventive medicine · May 2020
Association of prescription opioids and incident cardiovascular risk factors among post-9/11 Veterans.
Reports indicate that long-term opioid therapy is associated with cardiovascular disease (CVD). Using VA electronic health record data, we measured the impact of opioid use on the incidence of modifiable CVD risk factors. We included Veterans whose encounter was between October 2001 to November 2014. ⋯ Those with long-term exposure were at higher risk of having hypertension (adjusted average hazards ratio [HR] 1.45, 99% confidence interval [CI] 1.33-1.59), dyslipidemia (HR 1.45, 99% CI 1.35-156), diabetes (HR 1.30, 99% CI 1.07-1.57), current smoking status (HR 1.34, 99% CI 1.24-1.46), and obesity (HR 1.22, 99% CI 1.12-1.32). Compared to short-term exposure, long-term had higher risk of current smoking status (HR 1.12, 99% CI 1.01-1.24). These findings suggest potential benefit to screening and surveillance of CVD risk factors for patients prescribed opioids, especially long-term opioid therapy.
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IEEE J Biomed Health Inform · May 2020
Network Analysis and Visualisation of Opioid Prescribing Data.
In many countries around the world (including Australia), the prescribing of opioid analgesic drugs is an increasing trend associated with significant increases in drug-related patient harm such as abuse, overdose, and death. In Australia, the Medicines Regulation and Quality Unit within Queensland Health maintains a database recording opioid analgesic drug prescriptions dispensed across the State (population 4.703 million). In this work, we propose the use of network visualisation and analysis as a tool for improved understanding of these data. ⋯ Local analysis is also carried out to demonstrate the clinical utility of the technique, including the dynamics of the graph structure over time. A variety of network statistics that measure network structural and dynamic properties are presented to reveal the characteristics and trends of drug seeking and prescribing behaviours. This approach has been recognised by healthcare professionals at Queensland Health as leading to new and useful insights on the relationship between patients and prescribers and supporting their advisory role to reduce patient harm from inappropriate use of prescription drugs.
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To study how an educational intervention given to surgical residents affected postoperative opioid prescribing. To determine whether decreased opioid prescription amounts increased patients' rate of refills, emergency department visits, or readmissions. ⋯ After a single education intervention given to surgical residents, MME prescribed after common general surgeries can be decreased significantly without increasing rates of refills or utilization of care.