Articles: opioid.
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J Pain Palliat Care Pharmacother · Dec 2020
Acetaminophen in Patients Receiving Strong Opioids for Cancer Pain.
The mainstay of treatment in advanced cancer pain is opioids; however, non-opioid medications such as acetaminophen continue to be included in guidelines despite a lack of clear, convincing evidence for their use. The aim of our study was to determine if acetaminophen improves pain control or reduces opioid utilization in hospitalized patients receiving strong opioids for cancer pain managed by the palliative care consult service (PCCS). We carried out at single-center retrospective cohort study of 194 adult cancer patients seen by the PCCS and who received strong opioids. ⋯ There was no difference between groups in achieving a 30% reduction in pain (35.8% vs. 35.4%, adjusted odds ratio 0.87, 95% confidence interval [CI] 0.46 to 1.63). Acetaminophen was associated with a longer LOS (8 days vs. 6 days, adjusted relative risk 1.67, 95% CI 1.30 to 2.15). In this study of cancer patients receiving strong opioids, acetaminophen use was not associated with improved pain control or reduced opioid utilization, but was associated with a greater LOS.
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To test the association between self-reported opioid disposal education and self-reported disposal of leftover opioids among older adults. ⋯ In this nationally representative survey, 49% had leftover opioids, yet only 20% of older adults reported disposal of leftover opioids. Opioid disposal education was variable in delivery, but was associated with disposal behaviors among certain populations. Strategies to promote disposal should integrate patient education on the risks of leftover opioid medications and explore additional barriers to accessing opioid disposal methods.
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Res Social Adm Pharm · Dec 2020
Routine opioid outcome monitoring in community pharmacy: Outcomes from an open-label single-arm implementation-effectiveness pilot study.
In response to rising harms with prescription opioids, recent attention has focused on how to better utilise community pharmacists to monitor outcomes with opioid medicines. ⋯ Pharmacists' confidence in identifying and responding to opioid-related problems significantly increased from baseline to follow up across several domains, however scores indicated that there is still significant scope to further increase confidence in responding to opioid-related problems. ROOM is feasible and acceptable, though more extensive pharmacist training with opportunity to practice skills may assist in developing confidence and skills in this challenging clinical area.
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Postoperative opioid use can lead to dependence, contributing to the opioid epidemic in the United States. New persistent opioid use after minor surgeries occurs in 5.9% of patients. With increased documentation of persistent opioid use postoperatively, surgeons must pursue interventions to reduce opioid use perioperatively. ⋯ Clear and standardized education regarding postoperative pain management is feasible and associated with high patient satisfaction. Initiation of such education may support efforts to minimize unnecessary opioid prescriptions in the population undergoing endocrine surgery.