Articles: opioid.
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Little is known about how primary care clinicians (PCCs) approach chronic pain management in the current climate of rapidly changing guidelines and the growing body of research about risks and benefits of opioid therapy. ⋯ PCC beliefs about opioid therapy generally align with the clinical evidence, but may have some important gaps. These findings suggest the potential value of interventions that include improved access to research findings; organizational changes to support PCCs in spending time with patients to develop rapport and trust, elicit information about pain, and manage patient expectations; and the need for innovative clinical cognitive support.
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Following surgery there is often a need for ongoing pain management after the patient is discharged from hospital. This can be made easier if the patient has an appropriate discussion before leaving hospital about what pain they can expect, and they are given a management plan Paracetamol and non-steroidal anti-inflammatory drugs are suitable for most patients. ⋯ Like opioids, they have a risk of misuse The surgeon should be consulted if the patient develops new pain or the postoperative pain becomes more severe Most postsurgical pain will resolve within three months. If not, it is deemed persistent pain that may warrant specialist assessment
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To examine opioid prescribing following cataract surgery among patients who did or did not receive Omidria (phenylephrine and ketorolac intraocular solution 1.0%/0.3%) referred to as "P/K". ⋯ Patients without recent opioid use who received P/K during cataract surgery, despite greater incidence of preoperative comorbidities and higher risk for surgical complexity, were prescribed fewer opioid pills following surgery than patients who did not receive P/K.
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Opioid and psychotropic prescriptions are common during pregnancy. Little is known about coprescriptions of both medications in this setting. ⋯ None.
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The Veterans Health Administration (VHA) has taken a multifaceted approach to addressing opioid safety and promoting system-wide opioid stewardship. ⋯ VHA's integrated health care system provides a model for opioid stewardship and interdisciplinary pain care.