Review of Opioid Prescribing in the Osteopathic and Ambulatory Setting.

Review of Opioid Prescribing in the Osteopathic and Ambulatory Setting. J Am Osteopath Assoc. 2019 Dec 01;119(12):820-832 Authors: Hussein AI, Bekampis CF, Jermyn RT Abstract The opioid epidemic in the United States is one of the largest modern health crises in the nation's history. The crisis has been cultivated in academic journals, driven by the medical-pharmaceutical complex, and fueled by campaigns representing the most prestigious health care organizations and advocacy groups. Comprehensive guidelines for proper prescribing have been released in addition to state-sponsored prescription drug-monitoring programs (PDMPs) in response to overprescribing habits. When considering opioid treatment for a patient, physicians should document a thorough history of pain, give an appropriate physical examination, and complete a risk assessment using the proper diagnostic tools. Considering the osteopathic philosophy and approach to chronic pain, physicians should account for an integrative treatment approach for improved patient outcomes when considering applying the osteopathic philosophy to chronic pain management. A successful treatment plan can integrate cognitive behavioral therapy and promote self-healing by treating somatic dysfunctions with osteopathic manipulative treatment. This literature review discusses how to treat patients with chronic pain and how to properly use and prescribe opioids. The researchers analyzed the history and current status of the...
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research

Related Links:

AbstractThe United States is in the midst of an opioid overdose epidemic, with a significant portion of the burden associated with prescription opioids. In response, the CDC released aGuideline for Prescribing Opioids for Chronic Pain, which promotes access to treatment for opioid use disorder. Decades of research have linked childhood adversity to negative health and risk behavior outcomes, including substance misuse. Our present study builds upon this work to examine the relationship between adverse childhood experiences (ACEs) and prescription opioid misuse. We compiled data from the Behavioral Risk Factor Surveillance ...
Source: The Journal of Primary Prevention - Category: Sleep Medicine Source Type: research
Guidelines for safe opioid prescribing practices have largely excluded palliative care populations and there is a general lack of evidence for appropriate risk mitigation measures in this population. In lieu of such guidelines many have recommended using a “universal precautions” approach using tools from the chronic pain arena.
Source: Journal of Pain and Symptom Management - Category: Palliative Care Authors: Source Type: research
AbstractPurpose of ReviewGiven the growing challenges in chronic pain management coupled with the ongoing consequences of the opioid epidemic, pain management practitioners are looking into more effective, innovative, and safer alternatives to treat pain. Cannabis-based medicine had been described for hundreds of years but only recently have we seen the more scientific, evidence-based approach to its use, and ongoing investigations continue to explore its potential medical benefits. While historically more attention has been paid to the psychoactive component of the cannabis plant Δ9-tetrahydrocannabinol (THC), there...
Source: Current Pain and Headache Reports - Category: Neurology Source Type: research
If we can say anything for certain about caring for persons in pain over the past decade is that it has prompted concern and confusion on how to provide the best care. Consider the following: Do we have an opioid epidemic or an opioid crisis in the United States? Does the difference in these words matter? What about the “other” less publicized public health crisis; chronic pain; where did that conversation go? Are opioid analgesics good or bad to treat people in pain? Should nurses be prepared in pain care, addiction care or both? What are the differences in state policies that govern and guide nursing practice...
Source: Pain Management Nursing - Category: Nursing Authors: Tags: Editorial Source Type: research
This article summarizes the evolution of an opioid management toolkit using a quality improvement (QI) approach to improve prescribing. Methods: The authors developed a list of opioid-prescribing best practices and offered in-office, team-based QI projects to ambulatory clinics, updated and tested over 3 trials in the form of a toolkit. Outcome measures included pre- and postproject surveys on provider and staff satisfaction, toolkit completion, and process measures. The toolkit supports workflow planning, redesign, and implementation. Results: Ten clinics participated in trial 1, completing the QI project on average in ...
Source: Journal of the American Board of Family Medicine - Category: Primary Care Authors: Tags: Original Research Source Type: research
Conclusion: The Lewin and 7S models of change can be helpful guides to creating and maintaining a foundation of office-wide culture and structural support to meet the twin goals of safe opioid prescribing and treating patients with OUD.
Source: Journal of the American Board of Family Medicine - Category: Primary Care Authors: Tags: Special Communication Source Type: research
DISCUSSION: These qualitative data document practical issues that should be considered in the development of implementation plans for safer opioid prescribing practices. Specifically, healthcare systems may need to provide opioid-relevant communication strategies and training, education on key topics such as naloxone prescribing, resources for referrals to appropriate nonpharmacologic treatments, and innovative IT solutions. Future research is needed to establish that such measures will be effective in producing better outcomes for patients on opioids for chronic pain. PMID: 31850509 [PubMed - in process]
Source: Journal of Opioid Management - Category: Addiction Tags: J Opioid Manag Source Type: research
Raghu S Thota, Seshadri Ramkiran, Rakesh Garg, Jyotsna Goswami, Vaibhavi Baxi, Mary ThomasJournal of Anaesthesiology Clinical Pharmacology 2019 35(4):441-452 The epidemic of opioid crisis started getting recognised as a public health emergency in view of increasing opioid-related deaths occurring due to undetected respiratory depression. Prescribing opioids at discharge has become an independent risk factor for chronic opioid use, following which, prescription practices have undergone a radical change. A call to action has been voiced recently to end the opioid epidemic although with the pain practitioners still strugglin...
Source: Journal of Anaesthesiology Clinical Pharmacology - Category: Anesthesiology Authors: Source Type: research
Conclusion: Safer prescribing policies may take multiple years to fully implement and need to be employed across the jurisdiction to minimize doctor-shopping and adverse effects on patients with chronic pain. Approaching pain management through the social-ecological model can address potential root causes of addiction and establish a framework for doctors to provide compassionate care, community leadership, and advocacy for these patients. PMID: 31790125 [PubMed - in process]
Source: Journal of the American Osteopathic Association - Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research
Conclusion: This pilot study demonstrates that increasing residency education in managing chronic pain and opioid use disorder is feasible, and no longer needs to be postponed due to lack of time or faculty expertise. PMID: 31757179 [PubMed - as supplied by publisher]
Source: Substance Use and Misuse - Category: Addiction Tags: Subst Use Misuse Source Type: research
More News: Academia | Chronic Pain | Complementary Medicine | Epidemics | Epidemiology | Health Management | Pain | Pain Management | USA Health