Controlled Substance Prescribing Patterns — Prescription Behavior Surveillance System, Eight States, 2013

Paulozzi, Leonard J.; Strickler, Gail K.; Kreiner, Peter; Koris, Caitlin M.

doi:10.15585/mmwr.ss6409a1

Cited by 172 publications

(147 citation statements)

References 28 publications

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“…Similar to other pain conditions, the unemployed [41,56] and older individuals [57,58] were more likely to report opioid use. Contrary to existing literature showing that women are prescribed [25,57,59,60] and use [57] opioids more frequently than men, in our sample of MFS individuals we found no differences in opioid use between sexes. This may be explained by previous findings that, in contrast with numerous pain conditions, no reported sex differences in pain severity exist in MFS [6,8].…”

Section: Physical and Psychological Burden In Opioid Userscontrasting

confidence: 99%

Survey of Pain Therapies in Marfan Syndrome

Speed¹

2017

J Musculoskelet Disord Treat

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Objective: Pain in Marfan syndrome is common, although frequently under diagnosed and undertreated. Few studies have investigated the treatment of pain symptoms in Marfan syndrome and no study has reported on the use of opioid therapy in this patient population. This study aims to characterize the use of pain treatment interventions, including opioid use in individuals with Marfan syndrome. We hypothesize that opioid use would be associated with worse pain and greater psychological burden and that pain-related disability would moderate opioid use.Methods: Individuals with Marfan syndrome completed an online questionnaire assessing pain severity, psychological burden, and pain management therapies. The sample reporting pain (N = 218) were 74.5% female, average age ranging from 35 to 44 years, predominantly white (91%), and majority are employed (53%).Results: Participants frequently use a combination of pharmacological and non-pharmacological therapies, and the most commonly used treatments are over the counter medications and opioid medications. Use of opioids, and non-opioid medications, but not non-pharmacological treatments, increases with pain severity. Individuals who use opioids (34%) report more severe and frequent pain compared to non-opioid users, perceive greater pain-related disability and psychological burden, and more frequently utilize the emergency department. Conclusion:Pharmacological and non-pharmacological treatment for pain in Marfan syndrome is common, although psychotherapeutic interventions are significantly underutilized. Further studies are needed to address pain management in Marfan syndrome. Pain therapies should be multimodal and include adjunctive interventions that reduce pain and suffering, improve function, and enhance quality of life in this patient population.

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Section: Physical and Psychological Burden In Opioid Userscontrasting

confidence: 99%

Survey of Pain Therapies in Marfan Syndrome

Speed¹

2017

J Musculoskelet Disord Treat

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“…[2] In 2013, the mean total MME/day in 8 states was 57.8 to 82.1 MME/day; 8.1% to 16.0% got >100 MME /day. [3] However, prior to the opioid epidemic, some physicians definitely tended toward opioid-phobia and inadequate treatment of pain, especially chronic pain. Under-medicating of expressed pain with opioid analgesics was deemed a pervasive problem, even after decades of attention to the problem.…”

Section: Introductionmentioning

confidence: 99%

Survey of Physician Perspective towards Management of Pain for Chronic Conditions in the Emergency Department

Sop¹,

Smith²,

Alsalman³

et al. 2017

MCMR

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Abstract. Sickle cell disease (SCD) pain is often acute-on-chronic, likening it to other chronic acuteon-chronic pain conditions. Pain treatment of SCD was already reported as inadequate prior to the current opioid epidemic, but attitudes underlying treatment were understudied. Understanding these attitudes prior to the current epidemic would be revealing. Therefore in 1997, before the current opioid epidemic, we surveyed physicians' attitudes toward pain management and treatment preferences for acute pain exacerbations in the Emergency Department in SCD versus those of chronic pancreatitis and chronic low back pain, two other acute-on-chronic pain diseases. Thirty-nine residency trainees were surveyed in a level one triage hospital. Resident estimates of the rate of opioid addiction in SCD were higher than estimates in both chronic pancreatitis and chronic low back pain. Most residents relied on their personal clinical experience rather than external sources of data or knowledge as the most important driver when they managed chronic pain. This survey research shows that, predating the current opioid epidemic, there was both a backdrop of opioidphobia and a bias against treating SCD pain compared to other chronic pain conditions among our sample. Repeating this survey research among current training physicians, along with surveys of other attitudes, would provide useful comparisons.

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“…This may have contributed to the increase in visits for this demographic as some studies have found the majority of unintentional ingestions involve analgesics, particularly opioids [25,26]. In addition, prescription of high-risk medications such as benzodiazepines has also increased [27]. There was also a large decrease in the use of gastrointestinal decontamination using activated charcoal and whole bowel irrigation, following the trend of gastric lavage for poisoning patients in the USA [28].…”

Section: Discussionmentioning

confidence: 99%

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

et al. 2016

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In recent years, there has been an increase in poisoning-related emergency department (ED) visits. This study examines trends in ED resource utilization for poisoning-related visits over time. A retrospective review of data from the National Hospital Ambulatory Medical Care Survey, 2003-2011, was conducted. All ED visits with a reason for visit or ICD-9 code related to poisoning were included. We examined the number of ED visits and resources used including diagnostic studies and procedures performed, medications provided, admission rates, and length of stay. The proportion of visits involving resource use was tabulated and trends analyzed using survey-weighted logistic regression, grouping into 2-year periods to ensure adequate sample size. Of an estimated 843 million ED visits between 2003 and 2011, 8 million (0.9 %) were related to poisoning. Visits increased from 1.8 million (0.8 %) visits in [2003][2004] to 2.9 million (1.1 %) visits in 2010-2011, p = 0.001. Use of laboratory studies, EKGs, plain radiographs, and procedures remained stable across the study period. CT use was more than doubled, increasing from 5.2 to 13.7 % of visits, p = 0.001. ED length of stay increased by 35.5 % from 254 to 344 min, p = 0.001. Admission rates increased by 45.3 %, from 15.0 to 21.8 %, p = 0.046. Over the entire study period, 52.0 % of poisoned patients arrived via ambulance, and 3.0 % of patients had been discharged from the hospital within the previous 7 days. Poisoning-related ED visits increased over the 8-year study period; poisonings are resource-intensive visits and require increasingly longer lengths of ED stay or hospital admission.

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Controlled Substance Prescribing Patterns — Prescription Behavior Surveillance System, Eight States, 2013

Cited by 172 publications

References 28 publications

Survey of Pain Therapies in Marfan Syndrome

Survey of Pain Therapies in Marfan Syndrome

Survey of Physician Perspective towards Management of Pain for Chronic Conditions in the Emergency Department

Trends in Emergency Department Resource Utilization for Poisoning-Related Visits, 2003–2011

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