August 2018 Briefing - Pain Management

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Here are what the editors at HealthDay consider to be the most important developments in Pain Management for August 2018. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Medical Bills in Collections Decrease With Patient Age

FRIDAY, Aug. 31, 2018 (HealthDay News) -- Medical collections decrease substantially with age, possibly because of increased health insurance coverage and incomes, according to a study published in the August issue of Health Affairs.

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14.6 Percent of U.S. Adults Used Marijuana in Past Year

FRIDAY, Aug. 31, 2018 (HealthDay News) -- Overall, 14.6 percent of U.S. adults report marijuana use in the past year, according to a research letter published online Aug. 28 in the Annals of Internal Medicine.

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Preemptive Analgesia May Cut Post-Op Pain in Anorectal Surgery

FRIDAY, Aug. 31, 2018 (HealthDay News) -- Preemptive pain medication is safe and reduces pain in the early postoperative period for patients undergoing anorectal surgery, according to a study published in the July issue of Diseases of the Colon & Rectum.

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No Meaningful Increase in Physician Compensation Last Year

THURSDAY, Aug. 30, 2018 (HealthDay News) -- There was no meaningful increase in physician compensation in 2017, and a decline in productivity was noted, according to the results of a survey conducted by AMGA Consulting.

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U.S. Opioid Use Not Declining, Despite Focus on Abuse

WEDNESDAY, Aug. 29, 2018 (HealthDay News) -- Rates of opioid use in the United States do not appear to be declining, according to a study published online Aug. 1 in The BMJ.

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Marketplace Premiums Increase More With Monopolist Insurers

WEDNESDAY, Aug. 29, 2018 (HealthDay News) -- Affordable Care Act Marketplace premiums increase more in areas with monopolist insurers, according to a study published in the August issue of Health Affairs.

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PT Better After Hip Surgery Than Opioids in Younger Adults

WEDNESDAY, Aug. 29, 2018 (HealthDay News) -- Physical therapy management is associated with better outcomes for young patients undergoing arthroscopic hip surgery, compared to primary or exclusive opioid treatment, according to a study recently published in Physical Therapy.

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FDA Warning Letters Target Illegal Online Sales of Opioids

TUESDAY, Aug. 28, 2018 (HealthDay News) -- Four more online networks that operate 21 websites illegally selling potentially dangerous, unapproved, and misbranded versions of opioid pain medications have been told to immediately stop their sales, the U.S. Food and Drug Administration says. The order was made in warning letters sent to the networks.

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Medical Practices Should Address Negative Online Reviews

TUESDAY, Aug. 28, 2018 (HealthDay News) -- Medical practice staff can effectively handle negative online reviews by staying calm and positive, looking for solutions, apologizing, and thanking the reviewers, according to an article published in Physicians Practice.

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Buprenorphine/Naloxone Rx Fills Up With Medicaid Expansion

TUESDAY, Aug. 28, 2018 (HealthDay News) -- There was an increase in buprenorphine with naloxone fills in expansion versus nonexpansion counties after Medicaid expansion, according to a study published online Aug. 17 in JAMA Network Open.

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Artificial Intelligence Holds Promise in Medicine

TUESDAY, Aug. 28, 2018 (HealthDay News) -- Artificial intelligence (AI) in health care offers opportunities for early detection and triage, diagnostics and personalized medicine, and medical decision-making, according to an article published in Managed Healthcare Executive.

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Alcohol Is Leading Risk Factor for Global Disease Burden

TUESDAY, Aug. 28, 2018 (HealthDay News) -- Globally, alcohol use is a leading risk factor for disease burden, according to research published online Aug. 23 in The Lancet.

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Experts Address Loss of the National Guideline Clearinghouse

TUESDAY, Aug. 28, 2018 (HealthDay News) -- The demise of the National Guideline Clearinghouse (NGC) in July 2018 is likely to impact evidence-based health care around the world, according to an Ideas and Opinions piece published online Aug. 28 in the Annals of Internal Medicine.

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Bigger Drop in Opioid Prescribing After CDC Guideline Release

MONDAY, Aug. 27, 2018 (HealthDay News) -- Release of the U.S. Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain in March 2016 corresponded to greater increases in several opioid prescribing patterns, according to a study published online Aug. 28 in the Annals of Internal Medicine.

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Most Research Participants Not Concerned About Data Sharing

MONDAY, Aug. 27, 2018 (HealthDay News) -- Few participants in clinical trials have strong concerns about the risks of data sharing, according to a special article recently published in the New England Journal of Medicine.

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Prescription Drug Monitoring Program May Not Cut Opioid Use

MONDAY, Aug. 27, 2018 (HealthDay News) -- Implementation of a mandatory prescription drug monitoring program (PDMP) does not necessarily reduce the overall rate of opioid prescribing or the mean number of pills prescribed for patients undergoing general surgical procedures, according to a study published online Aug. 22 in JAMA Surgery.

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AMA Adopts Policy Promoting Health Equity As a Goal

FRIDAY, Aug. 24, 2018 (HealthDay News) -- The American Medical Association (AMA) House of Delegates has adopted a policy that sets health equity as a goal for the U.S. health care system, according to a report published in the organization's AMA Wire.

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Hydrocodone Schedule Change Affected Post-Op Opioid Rx

FRIDAY, Aug. 24, 2018 (HealthDay News) -- Hydrocodone's change from schedule III to schedule II in 2014 was associated with an increase in the amount of opioids filled in the initial prescription after surgery, according to a study published online Aug. 22 in JAMA Surgery.

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Small Practices Also at Risk for Data Breaches

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- Data breaches can happen to small medical practices, but staff can take steps to prevent them, according to an article published in Medical Economics.

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Strategy Outlined for Shooter Incident in Health Care Facility

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- Adhering to a "secure, preserve, fight" strategy is recommended for health care professionals working with a vulnerable patient population, according to a Medicine and Society piece published in the Aug. 9 issue of the New England Journal of Medicine.

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National Provider Identifiers Are Vulnerable to Theft

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- National Provider Identifiers (NPIs) are vulnerable to identity theft, according to an article published in Physicians Practice.

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Advantages for HDHP Enrollees in Large Versus Small Firms

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- Workers in small firms are more likely to have higher deductible levels and lack employer contributions to help pay for out-of-pocket expenses compared to workers in larger firms, according to a study published in the August issue of Health Affairs.

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Spinal Manipulation Plus Exercise Effective for Teen Low Back Pain

WEDNESDAY, Aug. 22, 2018 (HealthDay News) -- Twelve weeks of spinal manipulative therapy (SMT) combined with exercise therapy (ET) is more effective than ET alone over a one-year period for adolescents with chronic low back pain (LBP), according to a study published in the July issue of PAIN.

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Doctors Often Not Discussing Risk Factors With Patients

TUESDAY, Aug. 21, 2018 (HealthDay News) -- Patients report that doctors are routinely not discussing known risk factors for common causes of death, according to a survey conducted by ImagineMD.

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Patient Education Urged to Prevent Opioid OD After Sobriety

TUESDAY, Aug. 21, 2018 (HealthDay News) -- The American Medical Association (AMA) encourages patient education to raise awareness of the risks associated with opioid use after a prolonged period of sobriety, according to a report in the organization's AMA Wire.

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Hypnosis Doesn't Cut Post-Op Pain in Breast Cancer Surgery

TUESDAY, Aug. 21, 2018 (HealthDay News) -- Hypnosis before general anesthesia does not reduce postoperative breast pain among patients undergoing minor breast cancer surgery, according to a study published online Aug. 17 in JAMA Network Open.

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Pennsylvania Case Could Affect Evidence for Malpractice Defense

TUESDAY, Aug. 21, 2018 (HealthDay News) -- The Pennsylvania Supreme Court has agreed to hear a case that could affect what evidence physicians may present in defense during medical malpractice suits, according to an article published in the American Medical Association's AMA Wire.

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Odds of Death Up With Exposure to Pregabalin, Opioids

MONDAY, Aug. 20, 2018 (HealthDay News) -- Concomitant exposure to pregabalin and opioids is associated with increased odds of opioid-related death, according to a research letter published online Aug. 21 in the Annals of Internal Medicine.

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NYU Becomes First Medical School to Cover All Tuition

MONDAY, Aug. 20, 2018 (HealthDay News) -- The NYU School of Medicine has announced that it is offering full-tuition scholarships to all current and future students in its M.D. degree program, regardless of need or merit.

Press Release

Experts Offer Tips for Provider Appeal of Denied Medical Claims

MONDAY, Aug.20, 2018 (HealthDay News) -- Knowing payer policies and regulatory requirements is critical to appealing denials, according to an article published in Medical Economics.

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Declines in Life Expectancy in Many High-Income Countries

MONDAY, Aug. 20, 2018 (HealthDay News) -- Life expectancy has declined in recent years in some high-income countries, and in the United States, midlife mortality has increased due to several causes, according to two studies published online Aug. 15 in The BMJ.

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Comments Open on End of NIH Review for Gene Therapy Studies

FRIDAY, Aug. 17, 2018 (HealthDay News) -- A U.S. National Institutes of Health oversight panel will no longer review all applications for gene therapy experiments. Instead, the panel will assume an advisory role, while the U.S. Food and Drug Administration will assess gene therapy experiments and products as it does with other treatments and drugs. The proposed change will take effect after a public comment period which runs through Oct. 16.

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Comment on Regulations

Psych Screening Beneficial in Pediatric Abdominal Pain

FRIDAY, Aug. 17, 2018 (HealthDay News) -- Systematic screening for anxiety, disability, and pain can increase psychological referral rates among pediatric patients with abdominal pain, according to a study published in the August issue of Pediatrics.

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Residents' Sleep Deteriorates During Training

FRIDAY, Aug. 17, 2018 (HealthDay News) -- First-year residents experience worsening sleep duration and quality as well as daytime sleepiness, according to a study published in the June issue of the Journal of General Internal Medicine.

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Practice Names, Logos Should Be Carefully Designed

THURSDAY, Aug. 16, 2018 (HealthDay News) -- Practice names and logos should be carefully designed to emphasize what is unique about a practice, according to a blog post published in Physicians Practice.

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NIH Panel Will No Longer Review Gene Therapy Experiments

THURSDAY, Aug. 16, 2018 (HealthDay News) -- A U.S. National Institutes of Health oversight panel will no longer review all applications for gene therapy experiments, according to a perspective piece published online Aug. 15 in the New England Journal of Medicine.

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Steps Provided for Discharging Patient From Practice

THURSDAY, Aug. 16, 2018 (HealthDay News) -- Certain steps should be taken when discharging a patient for failure or inability to meet financial obligations, according to an article published in Physicians Practice.

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Patient Portals Don't Appear to Have Much Traction

THURSDAY, Aug. 16, 2018 (HealthDay News) -- Patient portals have not taken off as expected, according to an article published in Medical Economics.

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Liposomal Bupivacaine Block No Aid for Cesarean Pain

THURSDAY, Aug. 16, 2018 (HealthDay News) -- A liposomal bupivacaine incisional block at the time of cesarean delivery does not improve pain scores in the first 48 hours postoperatively, according to a study published in the July issue of Obstetrics & Gynecology.

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Opioid Dependence More Common Before Spine Surgery

THURSDAY, Aug. 16, 2018 (HealthDay News) -- Opioid dependence is more likely to occur in patients with degenerative spondylolisthesis (DS) before surgery than afterward, according to a study recently published in the Journal of Neurosurgery: Spine.

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ACA Coverage Gains Include Workers Without Insurance

THURSDAY, Aug. 16, 2018 (HealthDay News) -- After the expanded coverage provisions of the Affordable Care Act (ACA) were implemented in 2014, self-employed individuals and wage earners without employer-sponsored health coverage offers had coverage gains equal to or greater than those of people not employed, according to a report published in the August issue of Health Affairs.

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Health Professionals Have Role in Warning About Impaired Driving

WEDNESDAY, Aug. 15, 2018 (HealthDay News) -- Physicians, pharmacists, and public health officials play an important role in educating individuals about the risks of impaired driving caused by marijuana or opioids, according to a report from the Governors Highway Safety Association (GHSA) funded by the Foundation for Advancing Alcohol Responsibility.

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Integration of Opioid, Infectious Disease Treatment Needed

WEDNESDAY, Aug. 15, 2018 (HealthDay News) -- Steps should be taken to integrate treatment at the intersection of opioid use disorder (OUD) and related HIV and hepatitis C virus (HCV) infectious disease epidemics, according to an Ideas and Opinion piece published online July 13 in the Annals of Internal Medicine. The article was published to coincide with the National Academies of Sciences, Engineering, and Medicine (NASEM) expert panel's recommendations for treating opioid abuse and its related infectious epidemics.

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Marijuana May Improve Quality of Life in Head and Neck Cancer

WEDNESDAY, Aug. 15, 2018 (HealthDay News) -- For patients with newly diagnosed head and neck cancer (HNC), quality of life may improve with marijuana use, according to a study published online Aug. 2 in JAMA Otolaryngology-Head & Neck Surgery.

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6 Factors Related to Inclusion in Health Care Workplace ID'd

TUESDAY, Aug. 14, 2018 (HealthDay News) -- There are six broad factors that can affect inclusion within health care organizations, according to a study published online Aug. 3 in JAMA Network Open.

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Four Pros to Integrating EHR, Practice Management Software

MONDAY, Aug. 13, 2018 (HealthDay News) -- Consolidating electronic health records and practice management software allows practices to save time and money, make fewer mistakes, and reduce the risk of privacy breaches, according to an article published in Physicians Practice.

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CDC: EMS Administration of Naloxone Up From 2012 to 2016

MONDAY, Aug. 13, 2018 (HealthDay News) -- The rate of naloxone administrations by emergency medical services (EMS) providers increased 75 percent from 2012 to 2016, according to research published in the Aug. 10 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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CDC: Rates of Opioid Use Disorder Seen at Time of Delivery Up

FRIDAY, Aug. 10, 2018 (HealthDay News) -- Opioid use disorder rates at delivery more than quadrupled nationally from 1999 to 2014, according to research published in the Aug. 10 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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AMA Adopts Policy on Augmented Intelligence

FRIDAY, Aug. 10, 2018 (HealthDay News) -- The American Medical Association (AMA) House of Delegates has adopted a policy on augmented intelligence, according to a report published in the association's AMA Wire.

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AMA Adopts Policy to Advance Gender Equity in Medicine

THURSDAY, Aug. 9, 2018 (HealthDay News) -- The American Medical Association (AMA) House of Delegates has adopted a new policy to study, act for, and advocate to advance gender equity in medicine, according to a report published in the association's AMA Wire.

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Cyber Insurance Recommended for All Physician Practices

WEDNESDAY, Aug. 8, 2018 (HealthDay News) -- The growing threat of hacking is increasing the number of physicians buying cyber insurance, according to an article published in Medical Economics.

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Steps Taken to Increase Use of Electronic Tools in Medicine

WEDNESDAY, Aug. 8, 2018 (HealthDay News) -- Additional codes have been approved by the Current Procedural Terminology (CPT) Editorial Panel for chronic care remote physiologic monitoring and internet consultations, according to a report published by the American Medical Association (AMA).

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AMA Proposes Policy Opposing Medicaid 'Lockout' Provisions

TUESDAY, Aug. 7, 2018 (HealthDay News) -- A new policy opposing lockout provisions that block Medicaid patients from the program for lengthy periods and instead supporting allowing patients to reapply immediately for redetermination was adopted by the American Medical Association (AMA) House of Delegates during the AMA's annual meeting in Chicago, according to an article published in the association's AMA Wire.

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Variation in Specialty Drug Coverage Across Health Plans

FRIDAY, Aug. 3, 2018 (HealthDay News) -- There is considerable variation in specialty drug coverage across commercial health plans, according to a study published in the July issue of Health Affairs.

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Some Bacteria Now More Tolerant of Alcohol-Based Sanitizers

FRIDAY, Aug. 3, 2018 (HealthDay News) -- Some types of bacteria are developing tolerance of alcohol-based hand sanitizers used in hospitals, according to a study published in the Aug. 1 issue of Science Translational Medicine.

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Groups Urge CMS to Reconsider Suspending Risk Adjustment

FRIDAY, Aug. 3, 2018 (HealthDay News) -- In a letter sent to Administrator Seema Verma of the Centers for Medicare & Medicaid Services (CMS), medical organizations are urging reconsideration of the decision to suspend payments to insurers as required under the Affordable Care Act's risk-adjustment program.

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Health Affairs Announces Launch of New Three-Year Initiative

THURSDAY, Aug. 2, 2018 (HealthDay News) -- A council on health care spending and value has been established by the journal Health Affairs.

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Three Financial Metrics Can Improve Practice Performance

THURSDAY, Aug. 2, 2018 (HealthDay News) -- By understanding three indices and metrics, physicians can change the financial outcome of their medical practice, according to a report published in Medical Economics.

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New Short-Term Health Plans Have Large Coverage Gaps

THURSDAY, Aug. 2, 2018 (HealthDay News) -- There are large coverage gaps in short-term health plans that were approved Wednesday by the Trump administration, and are described by critics as "junk insurance."

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National Guideline Clearinghouse Offline Due to Funding Cuts

WEDNESDAY, Aug. 1, 2018 (HealthDay News) -- The National Guideline Clearinghouse (NGC) and National Quality Measures Clearinghouse (NQMC) websites were taken down on July 16 when funding for these federal databases ended, according to an announcement by the Agency for Healthcare Research and Quality (AHRQ).

Announcement
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Steps Can Be Taken by Doctors to Minimize Risk of Lawsuits

WEDNESDAY, Aug. 1, 2018 (HealthDay News) -- Targeted steps can be taken to minimize future risks of lawsuits, according to an article published in Physicians Practice.

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