November 2014 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 November 2014. 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.

Health Care Organizations See Value of Telemedicine

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- Health care organizations are developing and implementing telemedicine programs, although many have yet to receive reimbursement, according to a report published by Foley & Lardner.

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FDA Advisory Panel Votes on Epidural Steroid Shots for Pain

WEDNESDAY, Nov. 26, 2014 (HealthDay News) -- An expert advisory panel to the U.S. Food and Drug Administration decided on Tuesday not to recommend the agency issue a strong warning against the general use of steroid injections for neck or back pain; however, there is concern regarding transforaminal cervical injections with particulate steroids.

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Newly Insured Under ACA May Have Trouble Finding Doctors

MONDAY, Nov. 24, 2014 (HealthDay News) -- Millions of Americans bought health insurance coverage through the Affordable Care Act in the past year and physicians may be reluctant to accept these patients.

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AMA: Gender Inequality Still Exists in Medicine

FRIDAY, Nov. 21, 2014 (HealthDay News) -- Gender inequality still exists in medicine, according to an article published by the American Medical Association (AMA).

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Effect of Interventions to Improve Meds Adherence Vary

FRIDAY, Nov. 21, 2014 (HealthDay News) -- The effects of trials to improve medication adherence are inconsistent, with few studies of the highest quality demonstrating improvement in both adherence and clinical outcome, according to a review published online Nov. 20 in The Cochrane Library.

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FDA Approves Abuse-Resistant Extended-Release Hydrocodone

THURSDAY, Nov. 20, 2014 (HealthDay News) -- The U.S. Food and Drug Administration has approved Hysingla ER (hydrocodone bitartrate), an abuse-resistant, extended-release form of hydrocodone.

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Transcutaneous Electrical Nerve Stimulation Eases Vestibulodynia

THURSDAY, Nov. 20, 2014 (HealthDay News) -- Transcutaneous electrical nerve stimulation (TENS) may be useful as an additional treatment in the management of therapy-resistant provoked vestibulodynia (PVD), according to research published online Nov. 12 in the Journal of Sexual Medicine.

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Mortality Up for Long-Term Opioid Users With Chronic Pain

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- For adults with chronic noncancer pain, mortality is increased for long-term opioid users, with a smaller increase seen for short-term opioid users and for nonusers versus those without chronic pain, according to a study published in the November issue of PAIN.

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Patient-Doc Relationship Affects Alternative Med Use Disclosure

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- Patient-centered communication with a physician can improve the likelihood of cancer patients disclosing the use of complementary health approaches (CHAs), according to a study published online Nov. 11 in Cancer.

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Number of Pregnant Women on Opioids Doubles

WEDNESDAY, Nov. 19, 2014 (HealthDay News) -- The proportion of women dependent on drugs such as narcotic painkillers or heroin during pregnancy has more than doubled in the past decade and a half, though it still remains below a half-percent of all pregnancies, according to a study published in the December issue of Anesthesiology.

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NSAIDs Tied to Bleeding, Clotting in A-Fib Patients

TUESDAY, Nov. 18, 2014 (HealthDay News) -- Patients with atrial fibrillation who take common analgesics can significantly increase their risk for bleeding and thromboembolism, with risk higher among those on anticoagulation who also take a nonsteroidal anti-inflammatory drug (NSAID), according to a new study published in the Nov. 18 issue of the Annals of Internal Medicine.

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Triple Aim Should Be Expanded to Address Physician Burnout

FRIDAY, Nov. 14, 2014 (HealthDay News) -- Expanding the Triple Aim approach -- which includes enhancing patient experience, improving population health, and reducing costs -- to the Quadruple Aim by adding the goal of improving health care provider work life is recommended, according to the authors of an article published in the November/December issue of the Annals of Family Medicine.

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Peripheral Nerve Blocks OK for Migraines in Pregnancy

FRIDAY, Nov. 14, 2014 (HealthDay News) -- For migraines that do not respond to medications, peripheral nerve blocks may be a treatment option in pregnant women, according to research published online Nov. 5 in Obstetrics & Gynecology.

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Catastrophizing Linked to Pain, Disability in Low Back Pain

THURSDAY, Nov. 13, 2014 (HealthDay News) -- For patients with low back pain, catastrophizing may be associated with pain and disability, and fear-avoidance beliefs (FABs) correlate with poor treatment outcomes, according to two reviews published in the Nov. 1 issue of The Spine Journal.

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Acupuncture, Exercise May Ease Pain for Breast Cancer Patients

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Breast cancer patients who experience pain and swelling related to their treatment may find relief in acupuncture and exercise, new research suggests. The two studies have been published in the November issue of the Journal of the National Cancer Institute Monographs.

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U.S. Prices Soaring for Some Generic Drugs

THURSDAY, Nov. 13, 2014 (HealthDay News) -- Market forces are dramatically driving up the cost of some generic drugs, prompting U.S. investigations into the pricing of what should be cheap alternatives to brand-name medications.

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Pain, Depression Tied to Delirium Risk Post-Surgery

WEDNESDAY, Nov. 12, 2014 (HealthDay News) -- Pain and depression before an operation may increase seniors' risk for delirium after surgery, according to a study published in the November issue of The Lancet Psychiatry.

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NSAID Use Linked to Increased Risk of Incident A-Fib

MONDAY, Nov. 10, 2014 (HealthDay News) -- Nonsteroidal anti-inflammatory drug (NSAID) use is associated with an increased risk of atrial fibrillation (AF) incidence, particularly among new users, according to a meta-analysis published in the Nov. 15 issue of The American Journal of Cardiology.

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Want to Be a Leader? Cultivate a Healthy Look

FRIDAY, Nov. 7, 2014 (HealthDay News) -- It's more important for potential business or political leaders to look healthy than intelligent, according to a study published online Nov. 5 in Frontiers in Human Neuroscience.

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Better Physician Communication at Shift Change Reduces Errors

FRIDAY, Nov. 7, 2014 (HealthDay News) -- Changing how doctors communicate during shift changes in hospitals reduces the risk of adverse events in patients by 30 percent, according to a study published in the Nov. 6 issue of the New England Journal of Medicine.

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Docs Spend ~16.6 Percent of Their Time on Administration

FRIDAY, Nov. 7, 2014 (HealthDay News) -- About 16.6 percent of doctors' working hours are spent on administrative work, according to a study published recently in the International Journal of Health Services.

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Predictors of Insomnia ID'd in Long-Term Care Facilities

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Predictors of insomnia in long-term care facilities in Europe and Israel include age, depression, hypnosedatives, and stressful life events, according to a study published online Oct. 30 in the Journal of the American Geriatrics Society.

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Lower Doses of Rheumatoid Arthritis Meds May Work for Some

THURSDAY, Nov. 6, 2014 (HealthDay News) -- Some patients in the early stages of rheumatoid arthritis may be able to have their medication doses safely lowered once their symptoms are well under control, according to a study published in the Nov. 6 issue of the New England Journal of Medicine.

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Urinary Retention Seen in ~5% of Posterior Lumbar Surgeries

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- The risk of developing postoperative urinary retention (POUR) after posterior lumbar spine surgery is approximately 5 percent, with certain patient factors associated with higher risk, according to a study published in the Oct. 15 issue of Spine.

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AMA: New Mapping Tool IDs Areas in Need of Physicians

WEDNESDAY, Nov. 5, 2014 (HealthDay News) -- A new interactive mapping tool can help physicians and their staff determine locations to establish or expand their practice, according to a report published by the American Medical Association (AMA).

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Many Americans May Get Hospice Care Too Late

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Of the more than 1.5 million patients who received hospice care in the United States in 2013, one-third died within one week, according to a new report from the National Hospice and Palliative Care Organization.

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Long-Term Shift Work May Drain the Brain

TUESDAY, Nov. 4, 2014 (HealthDay News) -- Working non-standard hours -- "shift work" -- for many years is not only hard on the body, but may also dull the mind, new research suggests. According to the study, published online Nov. 3 in Occupational & Environmental Medicine, those who do shift work for more than 10 years seem to have the equivalent of an extra 6.5 years of age-related decline in memory and thinking skills.

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End-of-Life Care Discussions May Miss Patient Priorities

MONDAY, Nov. 3, 2014 (HealthDay News) -- Important points are often missed when doctors have end-of-life discussions with patients and their families, according to a study published online Nov. 3 in CMAJ, the journal of the Canadian Medical Association.

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AMA: Absence of Health Insurer Competition in Many Areas

MONDAY, Nov. 3, 2014 (HealthDay News) -- In most metropolitan areas, there is a significant absence of health insurer competition, according to a report published by the American Medical Association (AMA).

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