Pain — Optimal Management of Pain in Hospitalized Patients - Opioid Tolerant Populations.
Citation(s)
Anderegg SV, Wilkinson ST, Couldry RJ, Grauer DW, Howser E Effects of a hospitalwide pharmacy practice model change on readmission and return to emergency department rates. Am J Health Syst Pharm. 2014 Sep 1;71(17):1469-79. doi: 10.2146/ajhp130686.
Apfelbaum JL, Chen C, Mehta SS, Gan TJ Postoperative pain experience: results from a national survey suggest postoperative pain continues to be undermanaged. Anesth Analg. 2003 Aug;97(2):534-540. doi: 10.1213/01.ANE.0000068822.10113.9E.
Bell JR Australian trends in opioid prescribing for chronic non-cancer pain, 1986-1996. Med J Aust. 1997 Jul 7;167(1):26-9. doi: 10.5694/j.1326-5377.1997.tb138759.x.
Bot AG, Bekkers S, Arnstein PM, Smith RM, Ring D Opioid use after fracture surgery correlates with pain intensity and satisfaction with pain relief. Clin Orthop Relat Res. 2014 Aug;472(8):2542-9. doi: 10.1007/s11999-014-3660-4. Epub 2014 Apr 29.
Brown EG, Burgess D, Li CS, Canter RJ, Bold RJ Hospital readmissions: necessary evil or preventable target for quality improvement. Ann Surg. 2014 Oct;260(4):583-9; discussion 589-91. doi: 10.1097/SLA.0000000000000923.
Herzig SJ, Rothberg MB, Cheung M, Ngo LH, Marcantonio ER Opioid utilization and opioid-related adverse events in nonsurgical patients in US hospitals. J Hosp Med. 2014 Feb;9(2):73-81. doi: 10.1002/jhm.2102. Epub 2013 Nov 13.
Kessler ER, Shah M, Gruschkus SK, Raju A Cost and quality implications of opioid-based postsurgical pain control using administrative claims data from a large health system: opioid-related adverse events and their impact on clinical and economic outcomes. Pharmacotherapy. 2013 Apr;33(4):383-91. doi: 10.1002/phar.1223.
Lembke A Why doctors prescribe opioids to known opioid abusers. How cultural attitudes and financial disincentives affect the prescribing habits of physicians. Minn Med. 2013 Mar;96(3):36-7. No abstract available.
Pavon JM, Zhao Y, McConnell E, Hastings SN Identifying risk of readmission in hospitalized elderly adults through inpatient medication exposure. J Am Geriatr Soc. 2014 Jun;62(6):1116-21. doi: 10.1111/jgs.12829. Epub 2014 May 6.
Pugely AJ, Martin CT, Gao Y, Mendoza-Lattes S Causes and risk factors for 30-day unplanned readmissions after lumbar spine surgery. Spine (Phila Pa 1976). 2014 Apr 20;39(9):761-8. doi: 10.1097/BRS.0000000000000270.
Tayne S, Merrill CA, Shah SN, Kim J, Mackey WC Risk factors for 30-day readmissions and modifying postoperative care after gastric bypass surgery. J Am Coll Surg. 2014 Sep;219(3):489-95. doi: 10.1016/j.jamcollsurg.2014.03.054. Epub 2014 May 20.
Torrance N, Elliott AM, Lee AJ, Smith BH Severe chronic pain is associated with increased 10 year mortality. A cohort record linkage study. Eur J Pain. 2010 Apr;14(4):380-6. doi: 10.1016/j.ejpain.2009.07.006. Epub 2009 Sep 1.
Volkow ND, Frieden TR, Hyde PS, Cha SS Medication-assisted therapies--tackling the opioid-overdose epidemic. N Engl J Med. 2014 May 29;370(22):2063-6. doi: 10.1056/NEJMp1402780. Epub 2014 Apr 23. No abstract available.
Interventional studies are often prospective and are specifically tailored to evaluate direct impacts of treatment or preventive measures on disease.
Observational studies are often retrospective and are used to assess potential causation in exposure-outcome relationships and therefore influence preventive methods.
Expanded access is a means by which manufacturers make investigational new drugs available, under certain circumstances, to treat a patient(s) with a serious disease or condition who cannot participate in a controlled clinical trial.
Clinical trials are conducted in a series of steps, called phases - each phase is designed to answer a separate research question.
Phase 1: Researchers test a new drug or treatment in a small group of people for the first time to evaluate its safety, determine a safe dosage range, and identify side effects.
Phase 2: The drug or treatment is given to a larger group of people to see if it is effective and to further evaluate its safety.
Phase 3: The drug or treatment is given to large groups of people to confirm its effectiveness, monitor side effects, compare it to commonly used treatments, and collect information that will allow the drug or treatment to be used safely.
Phase 4: Studies are done after the drug or treatment has been marketed to gather information on the drug's effect in various populations and any side effects associated with long-term use.