HEAL Initiative: Integrated Approach to Pain and Opioid Use in Hemodialysis Patients: The Hemodialysis Opioid Prescription Effort (HOPE) Consortium - Scientific and Data Research Center (U01 Clinical Trial Required)

Pain is a common problem in Medicare End-Stage Renal Disease (ESRD) Hemodialysis (HD) patients, but its prevalence varies widely by geography, dialysis unit, and possibly, ethnicity. Perception of pain has been linked to decreased quality of life, lack of social support, depressed mood and other mental health disorders. Chronic opioid prescription has been identified in approximately 20% of US ESRD HD patients, far higher than the rate in Medicare comparison populations. Opioid doses prescribed to HD patients exceed Centers for Disease Control and Prevention (CDC) recommendations. Prescription and dose level have been associated with increased hospitalizations and mortality in this population. Interventions including behavioral modification techniques such as Cognitive Behavioral/Group Therapy and social media platforms for sharing information and enhancing social support have not been employed to reduce the rate of opioid prescription and opioid use, as well as addressing comorbid related issues such as depression, anxiety and pain in the HD population.Medical interventions such as use of naloxone and buprenorphine have not been evaluated by randomized controlled trials in HD patients who use opioids. The ESRD HD population, because of its continuous longitudinal participation in monitored treatment and the availability of data resources is an ideal population in which to launch and monitor interventions. The Hemodialysis Opioid Prescription Effort (HOPE) Consortium, compose...
Source: NIDDK Funding Opportunities - Category: Endocrinology Source Type: funding

Related Links:

Conclusion: The most commonly affected domains were usual activities (79%), pain (76.20%) and anxiety/depression (71.91%). Factors such as age (>65 yrs.), BMI (Underweight and Obese), educational background (Illiterate), Unemployment, domiciliary status (Rural), number of medications (>11) had significant association with EQ–5D index and VAS scores (p–0.000). It was found that QoL was impaired in stage 5D compared to other stages (p–0.000).
Source: Clinical Epidemiology and Global Health - Category: Epidemiology Source Type: research
Conclusion and Future Directions G protein bias may either be affinity/potency-dominant or efficacy-dominant (Table 1). A potential concern is that, despite using the same cellular assays, variations in agonist potency were determined by different, or even the same labs, potentially due to differences in expression levels of the receptor and signaling proteins that occurred during cell passaging. For example the reported arrestin recruitment potency for U69,593 has been reported to be as low as 67.7 nM (Spetea et al., 2017) and as high as 410 nM (Dunn et al., 2018), similarly for U50,488 potency has ranged from 36 to 1000...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
CONCLUSIONS: Caring for a child with CKD is an intense experience, with negative consequences, due to uncertainties about the future and the very care these children require. We need to do something to help these caregivers better manage care, as well as cope with their own feelings. PMID: 30806443 [PubMed - as supplied by publisher]
Source: Jornal Brasileiro de Nefrologia - Category: Urology & Nephrology Tags: J Bras Nefrol Source Type: research
Abstract INTRODUCTION: Patients on chronic hemodialysis suffer from a myriad of problems associated with dialysis including increased cardiovascular disease, deconditioning, fatigue, sleep disturbances, anxiety and depression, and decreased health related quality of life. Yoga has been reported to have positive effects on distress and functional performance in patients with chronic diseases. The effect of yoga in patients on chronic hemodialysis is unknown. For the purpose of this study, papers were reviewed to determine the effect of intradialysis yoga on distress and functional performance in patients undergoing...
Source: Complementary Therapies in Clinical Practice - Category: Complementary Medicine Authors: Tags: Complement Ther Clin Pract Source Type: research
Funding Opportunity RFA-DK-18-030 from the NIH Guide for Grants and Contracts. Pain is a common problem in Medicare End-Stage Renal Disease (ESRD) Hemodialysis (HD) patients, but its prevalence varies widely by geography, dialysis unit, and possibly, ethnicity. Pain has been linked to decreased quality of life, lack of social support, depressed mood and other mental health disorders. Chronic opioid prescription has been identified in approximately 20% of US ESRD HD patients, far higher than in Medicare comparison populations. Opioid doses prescribed to HD patients exceed Centers for Disease Control and Prevention (CDC) re...
Source: NIH Funding Opportunities (Notices, PA, RFA) - Category: Research Source Type: funding
Funding Opportunity RFA-DK-18-031 from the NIH Guide for Grants and Contracts. Pain is a common problem in Medicare End-Stage Renal Disease (ESRD) Hemodialysis (HD) patients, but its prevalence varies widely by geography, dialysis unit, and possibly, ethnicity. Perception of pain has been linked to decreased quality of life, lack of social support, depressed mood and other mental health disorders. Chronic opioid prescription has been identified in approximately 20% of US ESRD HD patients, far higher than the rate in Medicare comparison populations. Opioid doses prescribed to HD patients exceed Centers for Disease Control ...
Source: NIH Funding Opportunities (Notices, PA, RFA) - Category: Research Source Type: funding
Pain is a common problem in Medicare End-Stage Renal Disease (ESRD) Hemodialysis (HD) patients, but its prevalence varies widely by geography, dialysis unit, and possibly, ethnicity. Pain has been linked to decreased quality of life, lack of social support, depressed mood and other mental health disorders. Chronic opioid prescription has been identified in approximately 20% of US ESRD HD patients, far higher than in Medicare comparison populations. Opioid doses prescribed to HD patients exceed Centers for Disease Control and Prevention (CDC) recommendations. Prescription and dose level have been associated with increased h...
Source: NIDDK Funding Opportunities - Category: Endocrinology Source Type: funding
Conclusion The results obtained from this research shows, in general, the fragility in the social and political infrastructure necessary to improve the living conditions of populations, particularly those that depend on family agriculture in drought prone areas. The conditions of social, economic and environmental vulnerabilities presented in the region can be amplified by the drought process, and can aggravate the impacts resulting drought events, thus disadvantaging the population of this region, as shown in the Fig. 1. The general perception of the interviewees of the health sector shows an agreement with what is found...
Source: PLOS Currents Disasters - Category: International Medicine & Public Health Authors: Source Type: research
Conclusions: Chronic pain, although common among hemodialysis patients, did not lower survival. Depressive symptoms are an important predictor for all-cause mortality in hemodialysis patients, with the relationship independent of nutritional or inflammatory status. PMID: 29593798 [PubMed]
Source: Archives of Medical Science - Category: Biomedical Science Tags: Arch Med Sci Source Type: research
This study aims to determine the prevalence and risk factors of insomnia in our chronic hemodialysis (HD) patients. This is a cross-sectional study conducted in three HD units in Morocco. To assess the prevalence of insomnia, we used a specific questionnaire. Patients complaining of difficulty in falling asleep and/or nocturnal awakenings occurring seven nights a week during the last month were included in the group "insomnia;" the other patients were used as controls. Clinical, biological, and dialysis data were recorded for each patient. Sleep disorders and their subjective causes were also identified. Eighty-n...
Source: Saudi Journal of Kidney Diseases and Transplantation - Category: Urology & Nephrology Authors: Tags: Saudi J Kidney Dis Transpl Source Type: research
More News: Anxiety | Centers for Disease Control and Prevention (CDC) | Chronic Pain | Clinical Trials | Depression | Dialysis | Endocrinology | Funding | Hemodialysis | Medicare | Men | Pain | Suboxone