September 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 September 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.

Physicians Often Don't Address Their Burnout

FRIDAY, Sept. 28, 2018 (HealthDay News) -- More than half of physicians experience burnout, and many do not seek treatment for burnout, according to a report published in the American Medical Association's AMA Wire.

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Business Degree Increasingly Useful for Doctors

THURSDAY, Sept. 27, 2018 (HealthDay News) -- Having a Master of Business Administration degree (M.B.A.) can help doctors with important, practice-related decisions, according to a report published recently in Physician Practice.

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Opioid Bill Gets Bipartisan Support

THURSDAY, Sept. 27, 2018 (HealthDay News) -- In a rare bipartisan move, both the House and Senate have reached a compromise on legislation to address the opioid epidemic.

The New York Times Article

Practices Should Set Rules for Staff Social Media Use

THURSDAY, Sept. 27, 2018 (HealthDay News) -- Medical practices can take steps to avoid problems related to use of social media by staff members, according to an article published in Medical Economics.

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Burnout, Career Choice Regret Prevalent in U.S. Residents

WEDNESDAY, Sept. 26, 2018 (HealthDay News) -- Symptoms of burnout and career choice regret are prevalent among U.S. resident physicians, according to a study published in the Sept. 18 issue of the Journal of the American Medical Association.

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Editorial (subscription or payment may be required)

Persistent Post-Op Opioid Use in Young Cancer Patients Explored

WEDNESDAY, Sept. 26, 2018 (HealthDay News) -- Higher inpatient pain scores and postoperative opioid consumption are associated with persistent opioid use of up to six months among children and adolescents who have undergone cytoreductive surgery with hyperthermic intraperitoneal chemotherapy, according to a study published in a recent issue of Pediatric Anesthesia.

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Combo Therapy Not Needed If Low RA Disease Activity Achieved

WEDNESDAY, Sept. 26, 2018 (HealthDay News) -- Once low rheumatoid arthritis (RA) disease activity is achieved with tocilizumab (TCZ) plus methotrexate (MTX), patients can discontinue MTX without significant disease worsening, according to a study published in the August issue of Arthritis & Rheumatology.

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Inflammatory Back Pain Resolves in Many Patients

TUESDAY, Sept. 25, 2018 (HealthDay News) -- Inflammatory back pain (IBP) often resolves, while in 30 percent of patients it progresses to spondyloarthritis (SpA) within 10 years, according to a study published in a recent issue of Arthritis & Rheumatology.

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In 2016, Proportion of Uninsured Americans Down to 10 Percent

TUESDAY, Sept. 25, 2018 (HealthDay News) -- From 2013 to 2016 there was a reduction in uninsurance among Americans from 17 to 10 percent, according to a report published in September by the Robert Wood Johnson Foundation (RWJF) and the Urban Institute.

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Physician-Group ACOs Generate Medicare Savings

TUESDAY, Sept. 25, 2018 (HealthDay News) -- Physician-group accountable care organizations (ACOs) participating in the Medicare Shared Savings Program (MSSP) generated significantly more savings for Medicare that grew from 2012 to 2015 compared with hospital-integrated ACOs, according to research published in the Sept. 20 issue of the New England Journal of Medicine.

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MRI Indicates Sacroiliitis in Some Healthy Individuals

MONDAY, Sept. 24, 2018 (HealthDay News) -- Magnetic resonance imaging (MRI) positive for sacroiliitis is seen in a considerable number of healthy individuals without back pain, according to a study recently published in Arthritis & Rheumatology.

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Mortality for Unintentional Drug Poisonings Up Since 1979

MONDAY, Sept. 24, 2018 (HealthDay News) -- Since at least 1979, there has been an exponential increase in the overall mortality rate for unintentional drug poisonings, according to a research article published online Sept. 21 in Science.

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Some Clinicians, Patients Record Clinic Visits for Patient Use

FRIDAY, Sept. 21, 2018 (HealthDay News) -- A considerable proportion of clinicians and patients report having recorded a clinic visit for the patient's personal use, according to a study published in the September issue of the Journal of Medical Internet Research.

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Dozens of Medical Groups Join Forces to Improve Diagnoses

FRIDAY, Sept. 21, 2018 (HealthDay News) -- Every nine minutes, a patient in a U.S. hospital dies because a diagnosis was wrong or delayed -- resulting in 80,000 deaths a year. That sobering estimate comes from the Society to Improve Diagnosis in Medicine (SIDM).

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Research Links Doctor Burnout to Patient Safety Incidents

THURSDAY, Sept. 20, 2018 (HealthDay News) -- Physician burnout is associated with increased risk of patient safety incidents, poorer quality of care due to low professionalism, and reduced patient satisfaction, according to a review published online Sept. 4 in JAMA Internal Medicine.

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Editorial (subscription or payment may be required)

Hospitals Charge 479 Percent of Cost of Drugs on Average

THURSDAY, Sept. 20, 2018 (HealthDay News) -- On average, hospitals mark up drugs by 479 percent of their cost, according to a report from The Moran Company, commissioned by the Pharmaceutical Research and Manufacturers of America (PhRMA).

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Residents Should Take Advantage of Paid Time Off

THURSDAY, Sept. 20, 2018 (HealthDay News) -- Although there are many demands on residents, taking advantage of paid vacation time is one of the perks and should be maximized, according to an article published in the American Medical Association's AMA Wire.

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20% of Children, Adolescents Use Prescription Medications

WEDNESDAY, Sept. 19, 2018 (HealthDay News) -- Almost 20 percent of children and adolescents used prescription medications in 2013 to 2014, and 8.2 percent of concurrent users of prescription medications in 2009 to 2014 were at risk for a potentially major drug-drug interactions (DDIs), according to a study published in the September issue of Pediatrics.

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Patient Health Information Often Shared Electronically

WEDNESDAY, Sept. 19, 2018 (HealthDay News) -- The most common electronically sent and received types of patient health information (PHI) include laboratory results and medication lists, according to a report published Aug. 15 by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Opioid Deaths 1999 to 2015 May Be Dramatically Underestimated

WEDNESDAY, Sept. 19, 2018 (HealthDay News) -- States may be greatly underestimating the effect of opioid-related overdose deaths because of incomplete cause-of-death reporting, according to a study recently published in Public Health Reports.

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Global Prevalence of Insufficient Activity 27.5 Percent

WEDNESDAY, Sept. 19, 2018 (HealthDay News) -- In 2016 the age-standardized prevalence of insufficient physical activity was 27.5 percent, according to a study published in the October issue of The Lancet Global Health.

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U.S. Senate Passes Opioids Bill

TUESDAY, Sept. 18, 2018 (HealthDay News) -- The Senate on Monday passed on a 99-1 vote legislation aimed at curbing the nation's ongoing opioid addiction crisis.

CBS News Article

Scribes Improve Physician Workflow, Patient Interaction

TUESDAY, Sept. 18, 2018 (HealthDay News) -- Use of medical scribes is associated with decreased physician documentation burden, improved work efficiency, and improved patient interactions, according to a study published online Sept. 17 in JAMA Internal Medicine.

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Drug Prices Increase More Than Expected After Shortages

TUESDAY, Sept. 18, 2018 (HealthDay News) -- Prices for drugs under shortage increase more than twice as quickly as expected in the absence of a shortage, according to a research letter published online Sept. 18 in the Annals of Internal Medicine.

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Compliance With Requirement to Report Results on EUCTR Is Poor

TUESDAY, Sept. 18, 2018 (HealthDay News) -- Half of trials on the European Union Clinical Trials Register (EUCTR) are non-compliant with the European Commission's requirement that all trials post results to the registry within 12 month of completion, according to a study published online Sept. 13 in The BMJ.

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Many RA Patients' Pain Related to Central Nervous System

MONDAY, Sept. 17, 2018 (HealthDay News) -- Centralized pain pathways may coexist with more established peripheral inflammation-driven pathways in some patients with rheumatoid arthritis (RA), according to a study published in the July issue of Arthritis & Rheumatology.

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Potentially Inappropriate Opioid Prescribing Tied to Overdose

MONDAY, Sept. 17, 2018 (HealthDay News) -- Potentially inappropriate prescribing (PIP) of opioids is associated with increased risk of all-cause mortality and fatal and nonfatal overdose, according to a study published in the September issue of the Journal of General Internal Medicine.

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Association Health Plans Can Help Small Businesses Offer Coverage

MONDAY, Sept. 17, 2018 (HealthDay News) -- Association health plans (AHPs) will provide small businesses with more choices, access, and coverage options, although critics warn that they may undermine the Affordable Care Act (ACA) marketplace, according to an article published in Managed Healthcare Executive.

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Situation Framing, Language Can Influence Decision-Making

FRIDAY, Sept. 14, 2018 (HealthDay News) -- How a situation is framed and the language used to describe risks can influence patients' decision-making, according to an article published in Physicians Practice.

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Opioid Refills Rare After Rhinoplasty

FRIDAY, Sept. 14, 2018 (HealthDay News) -- For patients undergoing rhinoplasty, postoperative opioid refills are extremely rare, according to a research letter published online Sept. 6 in JAMA Facial Plastic Surgery.

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CDC: About One in Five U.S. Adults Have Chronic Pain

THURSDAY, Sept. 13, 2018 (HealthDay News) -- About 20.4 percent of U.S. adults have chronic pain and 8.0 percent have high-impact chronic pain, according to research published in the Sept. 14 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Pharmacovigilance Needed for Rheumatology Patients

THURSDAY, Sept. 13, 2018 (HealthDay News) -- Recommendations have been developed for pharmacovigilance in rheumatology, emphasizing the need for continued monitoring of new drugs, according to a position statement issued by the American College of Rheumatology (ACR).

ACR Position Statement

Gains in Insurance Coverage Seen for Lesbian, Gay, Bisexual Adults

THURSDAY, Sept. 13, 2018 (HealthDay News) -- Lesbian, gay, and bisexual (LGB) adults report continued problems affording care despite coverage gains offered by the Affordable Care Act, according to a study published in the August issue of Health Affairs.

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Highest Opioid-Related Mortality Seen in Construction Jobs

WEDNESDAY, Sept. 12, 2018 (HealthDay News) -- Proportional mortality ratios (PMRs) for heroin-related overdose deaths and methadone-related overdose deaths from 2007 to 2012 were highest among construction workers, according to research published in the Aug. 24 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

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Six-Step Analysis Can Help Improve Practice Logistics

WEDNESDAY, Sept. 12, 2018 (HealthDay News) -- A six-step analysis can help redesign and improve the outpatient health care process, according to a study recently published in the Journal of Evaluation in Clinical Practice.

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Residents Working Long Hours Can Increase Alertness

WEDNESDAY, Sept. 12, 2018 (HealthDay News) -- Medical residents can take steps to maintain their energy and alertness during long shifts, according to an article published in the American Medical Association's AMA Wire.

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Medicaid Work Requirements Don't Impact Many Enrollees

TUESDAY, Sept. 11, 2018 (HealthDay News) -- Medicaid work requirements will only impact a small proportion of persons and may only generate minimal savings, according to two research letters published online Sept. 10 in JAMA Internal Medicine.

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Opioids Often Prescribed in the Absence of Pain Diagnosis

TUESDAY, Sept. 11, 2018 (HealthDay News) -- Many outpatient opioid prescriptions have no documented medical indication, according to a research letter published online Sept. 11 in the Annals of Internal Medicine.

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Data Age in Clinical Trials Is About Three Years at Publication

TUESDAY, Sept. 11, 2018 (HealthDay News) -- The median data age in clinical trials in journals with a high impact factor is about three years at publication, according to a study published in the Aug. 10 issue of JAMA Network Open.

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Many Opportunities for Doctors Using Twitter

MONDAY, Sept. 10, 2018 (HealthDay News) -- Doctors can use Twitter to build networks and learn more about research in real time, according to a blog post published by Penn Medicine News.

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FDA Approves New Treatment for Opioid Dependence

MONDAY, Sept. 10, 2018 (HealthDay News) -- Cassipa (buprenorphine and naloxone), a film designed to be placed under the tongue, has been approved to treat opioid dependence, the U.S. Food and Drug Administration said in a news release.

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Oxycontin's Maker Now Selling Drug to Curb Opioid Addiction

MONDAY, Sept. 10, 2018 (HealthDay News) -- Purdue Pharma, the maker of Oxycontin who some have blamed for the epidemic of opioid painkiller addictions, has patented a medicine aimed at curbing those disorders.

CBS News Article

Chronic Pain May Be Contributor to Suicide

MONDAY, Sept. 10, 2018 (HealthDay News) -- Chronic pain may be an important contributor to suicide, with 8.8 percent of suicide decedents having evidence of chronic pain, according to a study published online Sept. 11 in the Annals of Internal Medicine.

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Naloxone Rarely Administered by Layperson in Opioid Deaths

MONDAY, Sept. 10, 2018 (HealthDay News) -- From July 2016 to June 2017, bystanders were documented in 44 percent of opioid overdose deaths, but naloxone was rarely administered by a layperson, according to a study published Aug. 31 in Morbidity and Mortality Weekly Report.

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Maternal Holding With Glucose or Breastfeeding Best Analgesic

MONDAY, Sept. 10, 2018 (HealthDay News) -- Maternal holding of newborns, combined with oral glucose and in breastfeeding, is associated with the greatest analgesic effect in infants, according to a study published in the September issue of Pediatrics.

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Docs, Consumers Agree on Benefits of Virtual Care

MONDAY, Sept. 10, 2018 (HealthDay News) -- Physicians and consumers agree on the benefits of virtual care, but physician adoption of virtual care technologies is low, according to a report on the Deloitte 2018 Survey of U.S. Physicians.

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Physician Burnout Rates Vary by Medical Specialty

MONDAY, Sept. 10, 2018 (HealthDay News) -- Nearly half of physicians report being burned out, but rates vary substantially by medical specialty, according to an article published in AMA Wire.

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Personalized Weighting Could Enhance Hospital Rating Tools

FRIDAY, Sept. 7, 2018 (HealthDay News) -- The weighting systems that underlie hospital performance rating tools should incorporate the needs, values, and preferences of patients, according to a perspective article published in the Aug. 30 issue of the New England Journal of Medicine.

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With New Persistent Opioid Use, Most Early Scripts From Surgeons

FRIDAY, Sept. 7, 2018 (HealthDay News) -- Among surgical patients who develop new persistent opioid use, surgeons provide the majority of opioid prescriptions in the first few months after surgery, but by nine to 12 months post-surgery, most prescriptions are from primary care providers, according to a study recently published in the Journal of General Internal Medicine.

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Opioid Maker to Pay for Overdose Antidote Development

THURSDAY, Sept. 6, 2018 (HealthDay News) -- A $3.4 million grant to help a non-profit company develop a less expensive opioid overdose antidote was announced by Purdue Pharma, which makes the opioid painkiller OxyContin.

AP News Article
Purdue Pharma News Release

Hospital Groups Launch Own Generic Drug Company

THURSDAY, Sept. 6, 2018 (HealthDay News) -- Three U.S. health care foundations and seven hospital groups have formed a generic drug company to combat high prices and chronic shortages of medicines.

AP News Article

Better Training Needed to Boost LGBTQ Patient Health Care

THURSDAY, Sept. 6, 2018 (HealthDay News) -- High-quality health care needs to be provided to lesbian, gay, bisexual, transgender, and queer (LGBTQ) patients, and improved training is necessary to deliver that care, according to a report published in the American Medical Association's AMA Wire.

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Public Service Loan Forgiveness Program Has Uncertain Future

WEDNESDAY, Sept. 5, 2018 (HealthDay News) -- Uncertainty surrounds the future of the Public Service Loan Forgiveness (PSLF) program, according to an Ideas and Opinions article published online Aug. 28 in the Annals of Internal Medicine.

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Patient Distressed by Overturn of California End of Life Option Act

TUESDAY, Sept. 4, 2018 (HealthDay News) -- The decision to overturn the End of Life Option Act has added stress and anxiety to terminally ill patients, including those with amyotrophic lateral sclerosis (ALS), according to a patient testimonial published online Sept. 4 in the Annals of Internal Medicine.

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Enrollment in High-Deductible Health Plans Up From '07 to '17

TUESDAY, Sept. 4, 2018 (HealthDay News) -- Enrollment in high-deductible health plans (HDHPs) has increased among adults with employment-based insurance coverage, according to an August data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics.

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Nalbuphine Can Relieve Opioid-Induced Urine Retention

TUESDAY, Sept. 4, 2018 (HealthDay News) -- Nalbuphine can relieve opioid-induced urine retention, according to a case report published online Sept. 4 in the Annals of Internal Medicine.

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Self-Injury Tops Diabetes As Cause of Death in United States

TUESDAY, Sept. 4, 2018 (HealthDay News) -- In the United States, self-injury mortality (SIM) exceeded diabetes as a cause of death in 2015, with the gap expanding in 2016, according to a study published online Aug. 27 in Injury Prevention.

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