Articles: opioid.
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Comparative Study
Association between sex and perioperative opioid prescribing for total joint arthroplasty: a retrospective population-based study.
Scarce data exist on differential opioid prescribing between men and women in the pre-, peri-, and postoperative phases of care among patients undergoing total hip/knee arthroplasty (THA/TKA). ⋯ We found sex-based differences in opioid prescribing across all phases of care for THA/TKA. The results highlight temporal opportunities for targeted interventions to improve outcomes after total joint arthroplasty, particularly for women, and to decrease chronic opioid prescribing.
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J Pain Palliat Care Pharmacother · Jun 2021
Case ReportsSpiritual Healing in a Hospice Veteran Led to a Successful Opioid Taper: A Case Report.
Addressing "total pain" is a concept commonly practiced in palliative care. Spiritual healing in a Navy Veteran led to a significant improvement in pain allowing a voluntary taper of opioid medication. ⋯ A reduction in opioid morphine equivalent daily doses (MEDD) were 87.5% without any symptoms from the clinical opioid withdrawal scale (COWS). The Veteran died peacefully during an opioid taper in hospice care.
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J Pain Palliat Care Pharmacother · Jun 2021
A Quality Improvement Pilot of Pharmacist-Led Identification of an Inpatient Population for Opioid Stewardship and Pain Management.
The Joint Commission standards now include identification and monitoring patients at high-risk for adverse outcomes of opioid use. Our institution does not have a method to identify at-risk patients. This pilot aimed to assess feasibility of pharmacist-led identification of a population for pain management and opioid stewardship. ⋯ Potential regimen adjustments based on the primary investigator's judgment were categorized. Mean number of patients identified per day to receive stewardship was 13, and 18.6 potential interventions per day were identified. Based on results of this pilot, pharmacist-led identification of inpatients warranting pain and opioid stewardship is feasible at our institution.
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Palliative medicine · Jun 2021
Randomized Controlled TrialHealthcare professionals' views of the use of oral morphine and transmucosal diamorphine in the management of paediatric breakthrough pain and the feasibility of a randomised controlled trial: A focus group study (DIPPER).
Oral morphine is frequently used for breakthrough pain but the oral route is not always available and absorption is slow. Transmucosal diamorphine is administered by buccal, sublingual or intranasal routes, and rapidly absorbed. ⋯ There were perceived advantages to transmucosal diamorphine, but there is a need for access to a safe preparation. A clinical trial would be feasible provided barriers were overcome.
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J Pain Palliat Care Pharmacother · Jun 2021
Naloxone prescribing and education in outpatient pain management and palliative care.
Over the past two decades, opioid use and overdose have increased substantially. Naloxone, an opioid overdose reversal agent, has been one of many risk mitigation strategies for preventing mortality due to overdose. Most literature describing naloxone utilization has been about populations of illicit drug users and patients in hospitals, primary care, and pharmacies. ⋯ Seven patients reported picking up their naloxone prescription from the pharmacy, and none reported using it within two weeks of the initial education. This intervention was deemed successful within the clinic, but small sample size and the pharmacist role may not be replicable within other pain and palliative care settings. It encourages further research of overdose risk and prevention in pain management and palliative care.