Arthritis care & research
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Arthritis care & research · Sep 2012
Impact of Medicare Part D for Medicare-age adults with arthritis: prescription use, prescription expenditures, and medical spending from 2005 to 2008.
To evaluate the impact of Medicare Part D on medication utilization, drug expenditures, and medical expenditures in patients with arthritis. ⋯ Medicare Part D resulted in increased medication utilization and significant reductions in OOP drug and OOP medical expenditures among beneficiaries with arthritis 3 years after its implementation. Part D was not associated with significant differences in total medical spending.
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Arthritis care & research · Aug 2012
Identifying generic predictors of outcome in patients presenting to primary care with nonspinal musculoskeletal pain.
To identify which generic prognostic factors, such as pain intensity, levels of disability, and psychological factors, are most strongly associated with outcome from musculoskeletal pain, regardless of the location of pain. We tested the hypothesis that pain location does not add predictive value to these generic prognostic models, and that such prognostic factors are equally important across different pain locations. ⋯ Generic factors appear to play an important role in the prognosis of acute and chronic nonspinal musculoskeletal pain, regardless of the location of pain.
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Arthritis care & research · Aug 2012
Association of herbal cannabis use with negative psychosocial parameters in patients with fibromyalgia.
Patients with chronic pain, including fibromyalgia (FM), may seek treatments outside of mainstream medicine. Medicinal cannabinoids are popularly advocated for pain relief but with limited evidence for efficacy in FM. The extent of use of cannabinoids in FM is unknown. ⋯ Cannabinoids were used by 13% of patients referred with a diagnosis of FM. The association of herbal cannabis use with negative psychosocial parameters raises questions regarding the motive for this self-medication practice. Although cannabinoids may offer some therapeutic effect, caution regarding any recommendation should be exercised pending clarification of general health and psychosocial problems, especially for those self-medicating.
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Arthritis care & research · Aug 2012
Dysregulation of the autonomic nervous system and its association with the presence and intensity of chronic widespread pain.
To test the hypotheses that dysregulation of the autonomic nervous system (ANS) is associated with the presence of chronic widespread pain (CWP), and that dysregulation of the ANS is associated with higher pain intensity in CWP. ⋯ Lower parasympathetic activity, as assessed with SDNN and RSA, is associated with higher pain intensity in subjects with CWP. This large and well-controlled study does not provide evidence for an association between dysregulation of the ANS and the presence of CWP.
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Low back pain (LBP) affects most people at some stage in life. However, the burden on the health care system is unclear. We studied: 1) the 1-year consultation prevalence, 2) the rate of first-time consultation for LBP and the relationship of the frequency to other musculoskeletal conditions, and 3) the health care utilization of patients with LBP compared to the general population. ⋯ LBP, diagnosed in every sixth patient who consulted due to a musculoskeletal problem, is a public health concern that needs structured management. Patients with LBP consume close to twice as much health care as the general population and this warrants more awareness.