Pain Management

According to a recent study, people with migraines may have altered connections between the somatosensory cortex and the frontal lobe compared with people who do not experience migraines.

A group of researchers systematically reviewed previously published literature about psychological treatment in primary headache and its effectiveness. The results were published in The Journal of Headache and Pain.

An FDA program to prevent the inappropriate use of immediate-release fentanyl did not meet its goals of preventing off-label use or to patients who were not already using opioids, a JAMA study reported Tuesday.

Nonsteroidal anti-inflammatories (NSAIDs) have passed opioids as the most common drug group prescribed to injured workers in California, while payment data show that both dermatological medications and anticonvulsants now rank ahead of opioids in terms of total reimbursements, according to a report examining trends between 2009 and 2018.

In 2010, OxyContin was reformulated and an abuse-deterrent version was introduced, leading to an increase in heroin use and subsequent rise in hepatitis C infection rates.

Chronic pain accounted for 62.2% of all patient-reported qualifying conditions under which US patients sought medical marijuana, according to a new paper in Health Affairs.

Research and regulatory gaps in the use of marijuana will only grow unless the scientific community and policy leaders fill the void, according to a commentary series in Annals of Internal Medicine on marijuana’s rising availability.

Opioids can be effective in the right population, but there needs to be greater awareness among providers and health plans on which patients are not appropriate to start on opioids, said Elizabeth Stringer, PhD, chief science and clinical officer of axialHealthcare.

Michigan’s plan to require Medicaid beneficiaries to show workforce engagement was approved by the Trump administration, while attorneys continue to challenge Arkansas’ own Medicaid work requirements; a new report from the Government Accountability Office has highlighted serious deficiencies with how the FDA administers the Orphan Drug Act; the FDA has granted tentative approval to a weekly and monthly treatment for moderate-to-severe opioid use disorder (OUD), but cannot grant final approval until another treatment’s exclusivity period ends.

Primary care clinics are beginning to integrate more patient-reported outcomes into practice, especially with implementation of the Patient-Reported Outcome Measurement Information System. However, little is known about whether patients perceive reporting these outcome measures as useful.

Jeff White, PharmD, MS, staff vice president, Anthem, discusses what role Anthem has in addressing the opioid epidemic, as well as how important collaboration with other stakeholders is for addressing the epidemic.

Low back pain is a common cause of disability globally and represents a significant economic burden for patients. According to a recent study, digital versions of pain assessments, such as mobile applications, may be as effective and reliable as paper methods that are currently used to assess pain.

While opioids tend to cost very little, they lead to overutilization downstream, so patients with opioid use disorder should be treated in a comprehensive manner that includes behavioral health and social support, said Elizabeth Stringer, PhD, chief science and clinical officer of axialHealthcare.

The CDC reported the number of drug overdose deaths per year increased 54% from 2011 to 2016, with the synthetic drug fentanyl involved in most overdoses in 2016, although actual numbers of all overdose deaths may be underreported. The report also showed how multiple drugs are typically involved in overdose deaths.

Jeff White, PharmD, MS, staff vice president, Anthem, outlines best practices for preventing opioid misuse.

Patients who visit the emergency department for pain are often asked to categorize their pain level using a visual scale of numbered faces. However, a recent study suggests the efficacy of a more empirical approach, through the use of an electroencephalography (EEG)-based test, that would be beneficial for both patients and physicians.

The increase in healthcare utilization and expenditures associated with the transition to chronic opioid therapy places increased burden on payers and patients.

There are a number of nonopioid options, as well as nondrug options, for pain management, explained Jeff White, PharmD, MS, staff vice president, Anthem.

Chronic pain affects many patients worldwide and often leads to opioid prescribing, thereby increasing the risk of opioid misuse. A position statement by the Association of Academic Physicians, published by the American Journal of Physical Medicine & Rehabilitation, reflects experts’ call for a new, comprehensive national strategy to include a functional approach to the diagnosis and treatment of pain.

Back pain is a leading cause of disability, and the proportion of adults over age 65 who have back pain is increasing in the United States, particularly among women. Now, research has demonstrated that persistent back pain is also linked with an increased risk of death in older women.

During a joint meeting of the FDA’s Anesthetic and Analgesic Drug Products Advisory Committee and Drug Safety and Risk Management Advisory Committee, members voted in favor of approval for Mallinckrodt’s MNK-812, an abuse-deterrent formulation of oxycodone.

There are more similarities between patients with opioid dependency and patients with opioid misuse and abuse than physicians have been led to believe, said Elizabeth Stringer, PhD, chief science and clinical officer of axialHealthcare.

The quantity of opioid prescribed after surgery is associated with higher patient-reported opioid consumption, according to a recent study.

A pharmacist-led intervention that targeted patients undergoing joint replacement surgery led to a significant reduction in post-surgical opioid use among hip replacement patients, according to a Kaiser Permanente study published today in The American Journal of Managed Care®.

This pharmacist-led, patient-directed intervention demonstrated a reduction in opioid dispensings in the 90 days following hip replacement but not knee replacement.

The Global Burden of Disease Study has ranked low back pain as a leading cause of disability worldwide, and the Lancet Low Back Pain Series Working Group has recommended that researchers and policy makers develop and implement strategies to identify and educate patients with low back pain who are at risk of persistence of pain and disability.

A cancer pain control program for inpatients based on electronic health record–based automatic screening provided effective pain relief and achieved high satisfaction among patients and physicians.

Individuals who suffer from knee pain also may suffer from neuropathic-like knee pain (NKP)—a result of localized damage to the nervous system and nerve fibers around a joint. Recent research aimed to determine the prevalence and risk factors of NKP, finding that NKP is driven by central risk factors and may require unique prevention and treatment strategies.

The FDA has approved a new sublingual formulation of sufentanil, Dsuvia, for the management of acute pain in adults in medically supervised healthcare settings, such as hospitals, surgical centers, and emergency departments. The drug is supplied in a 30 microgram tablet in a single-dose, prefilled applicator for administration by a healthcare professional, and it will not be available in retail pharmacies or for outpatient use.

Recent research evaluating the impact of implementing a new standardized pain care bundle to reduce postoperative opioids after outpatient general surgical procedures found that the bundle decreased opioid prescribing and often eliminated opioid use.