Articles: opioid.
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The study objective was to describe trends in the medical management of migraine in the emergency department (ED) using the 2010-2017 National Hospital Ambulatory Medical Care Survey (NHAMCS) datasets. ⋯ Opioid administration for migraine in EDs across the US declined 10% annually between 2010 and 2017, demonstrating improved adherence to migraine guidelines recommending against opioids. We identified several factors associated with opioid administration for migraine, identifying groups at higher risk for unnecessary opioids in the ED setting.
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J Pain Palliat Care Pharmacother · Mar 2021
Defining an Opioid Sparing Treatment Pathway for Chronic Abdominal Pain of Somatic and Visceral Origin: A Case Series.
Chronic non-malignant abdominal pain presents a treatment challenge for pain physicians. Treatment algorithms are often defined by single specialty and are unimodal with a dependence on opioids. We present a treatment algorithm for chronic abdominal pain using a combination of interventional therapy using transversus abdominis plane (TAP) blocks along with post injection medical management for treatment of somatic and visceral pain. ⋯ Patients receiving TAP blocks along with post injection medical management saw their VAS scores decrease by 68.5%. Their total daily milligram morphine equivalents (MME) consumption decreased by a mean of 68.9%. There were no readmissions for abdominal pain within the 1 year follow up period.
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A perioperative surgical home, the Anesthesia Perioperative Care Service (APCS), was created to execute enhanced recovery after surgery pathways for total knee and total hip arthroplasty patients at the Tennessee Valley Health System Nashville VA Medical Center. We hypothesized that the APCS would be associated with reduced length of stay, in-hospital and post-discharge opioid exposure, costs, and hospital readmissions. ⋯ This cohort study showed significant improvements in important post-surgical outcomes after total knee and hip arthroplasty that were associated with the implementation of an APCS.
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Pharmacoepidemiol Drug Saf · Mar 2021
Identifying opioid dose reductions and discontinuation among patients with chronic opioid therapy.
To identify and systematically categorize opioid dose reductions and discontinuations in large administrative datasets. ⋯ Dose reductions and discontinuations after a COT episode can be identified in large administrative datasets. Those with a discontinuation were more likely to have riskier prescription profiles during their COT episode.