Analgesic prescribing trends in a national sample of older veterans with osteoarthritis: 2012-2017

Few investigations examine patterns of opioid and nonopioid analgesic prescribing and concurrent pain intensity ratings before and after institution of safer prescribing programs such as the October 2013 Veterans Health Administration system-wide Opioid Safety Initiative (OSI) implementation. We conducted a quasi-experimental pre–post observational study of all older U.S. veterans (≥50 years old) with osteoarthritis of the knee or hip. All associated outpatient analgesic prescriptions and outpatient pain intensity ratings from January 1, 2012 to December 31, 2016, were analyzed with segmented regression of interrupted time series. Standardized monthly rates for each analgesic class (total, opioid, nonsteroidal anti-inflammatory drug, acetaminophen, and other study analgesics) were analyzed with segmented negative binomial regression models with overall slope, step, and slope change. Similarly, segmented linear regression was used to analyze pain intensity ratings and percentage of those reporting pain. All models were additionally adjusted for age, sex, and race. Before OSI implementation, total analgesic prescriptions showed a steady rise, abruptly decreasing to a flat trajectory after OSI implementation. This trend was primarily due to a decrease in opioid prescribing after OSI. Total prescribing after OSI implementation was partially compensated by continuing increased prescribing of other study analgesics as well as a significant rise in acetaminophen prescriptio...
Source: Pain - Category: Anesthesiology Tags: Research Paper Source Type: research

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CONCLUSION: circRNAs in TMJ synovial tissue participate in the progression of TMJOA and may become a potential therapeutic target. The highly up-regulated has_circ_0000448 probably promotes TNF-α secretion of synovium through CeRNA mechanism in TMJOA. PMID: 31632516 [PubMed]
Source: American Journal of Translational Research - Category: Research Tags: Am J Transl Res Source Type: research
Publication date: Available online 21 October 2019Source: Epilepsy &BehaviorAuthor(s): Ramin Goudarzi, Golnaz Zamanian, Alireza Partoazar, Ahmadreza DehpourAbstractArthrocen, an avocado/soy unsaponifiable (ASU)-containing agent, is now used in the clinic and has potentially to decrease joint inflammation and pain associated with mild to severe osteoarthritis. Phytosterols are the major component of Arthrocen with documented anti-inflammatory properties, antioxidant, and analgesic effects.Here, we evaluated ASU anticonvulsant effect by its oral administration in pentylenetetrazole (PTZ)-induced seizure threshold and Max...
Source: Epilepsy and Behavior - Category: Neurology Source Type: research
CONCLUSIONS: PCS scores fluctuated in response to injury and ACLR. Preoperative PCS scores were not related with 6M outcomes; however, 6M PCS scores correlated with pain and function at 6M. High pain catastrophizing appears to be a natural response immediately following acute ACL injury and ACLR, but may not be indicative of a poor postoperative result. PCS scores 6-months following ACLR may provide useful information regarding self-reported pain and function. PMID: 31628272 [PubMed - as supplied by publisher]
Source: Journal of Sport Rehabilitation - Category: Sports Medicine Tags: J Sport Rehabil Source Type: research
ConclusionDespite the recovery of patients after ACL reconstruction during long-term follow-up in athletes, return to sport activity similar to pre-injury in female, older peoples, overweight patients and athletes with chondral lesion were lower. However, these conditions do not apply to the meniscus rupture.
Source: Journal of Clinical Orthopaedics and Trauma - Category: Orthopaedics Source Type: research
SUNDAY, Oct. 20, 2019 -- Osteoarthritis is the most common form of arthritis, affecting about 31 million Americans, and is the leading cause of disability among adults. Known as OA, it causes pain and other symptoms in joints, which can affect the...
Source: Drugs.com - Daily MedNews - Category: General Medicine Source Type: news
Authors: Ghouri A, Conaghan PG Abstract Osteoarthritis (OA) is a debilitative, painful condition with significant global burden. Pharmacological options have limited analgesic efficacy and their side-effects often restrict their use. Novel pharmacological options are needed to relieve patient symptoms and their consequent disease impact. A variety of pharmacological options have been investigated in treating OA, including existing therapies previously used for treating other arthritides (such as colchicine and hydroxychloroquine) and new therapies targeting pain (including monoclonal antibodies to nerve growth fact...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Authors: Carlesso LC, Neogi T Abstract Knee pain in osteoarthritis is complex and complicated by the fact that osteoarthritis is considered to be a disorder of multiple phenotypes. This complexity challenges our understanding as to why some people remain relatively symptom-free, while others progress to persistent pain. One approach to understanding the mechanisms underlying the transition to persistent pain is by identifying pain susceptibility phenotypes in people with or at risk of knee osteoarthritis. Using variables representative of the multidimensional nature of pain in people who were free of persistent pai...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Authors: Pincus T, Castrejon I, Yazici Y, Gibson KA, Bergman MJ, Block JA Abstract Osteoarthritis (OA) may be associated with substantial work disability, morbidity, costs, and increased mortality rates, often similar to rheumatoid arthritis (RA), documented in many published reports over the last 4 decades. However, OA generally has been viewed as less severe than RA. This discrepancy may be explained in part by:a) RA may have been considerably more severe in the past, prior to effective therapies.b) most older individuals have radiographic joint damage, which often is not associated with clinical symptoms.c) RA i...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Authors: Pincus T, Schmukler J, Castrejon I Abstract A patient history generally provides the most important information in diagnosis and management of patients with most rheumatic diseases, including osteoarthritis (OA). Patient history components can be expressed as quantitative, structured, "scientific" data, rather than "subjective" narrative descriptions, using patient self-report questionnaires. The Western Ontario McMaster (WOMAC) questionnaire is used in all OA clinical trials, and the health assessment questionnaire (HAQ) in all rheumatoid arthritis (RA) clinical trials, as "diseas...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
Low socioeconomic status and patient questionnaires in osteoarthritis: challenges to a "biomedical model" and value of a complementary "biopsychosocial model". Clin Exp Rheumatol. 2019 Sep-Oct;37 Suppl 120(5):18-23 Authors: Pincus T, Castrejon I Abstract Modern medical care is based largely on a paradigm known as a "biomedical model," in which "objective," high-technology biomarkers guide clinical care, and most health outcomes are determined by health professionals rather than individuals, using drugs as the primary therapy. The biomedical model is spectacularly...
Source: Clinical and Experimental Rheumatology - Category: Rheumatology Tags: Clin Exp Rheumatol Source Type: research
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