Conventional approaches to treatment of opioid-induced constipation include the use of treatment modalities that address non-opioid-related constipation as well as new medications that target the OIC mechanism of action.
To shed light on issues of cybersecurity in medical practices, MPR spoke to Michael J Sacopulos, JD, CEO of Medical Risk Institute (MRI), a firm that provides “proactive counsel” to the healthcare community to identify where liability risks originate and to reduce or remove those risks.
This rise in prescribing of prescription opioids in the last 2 decades of the 20th century occurred at a time during which medical professionals were urged to resort to prescription opioids to manage untreated and chronic noncancer pain.
There are many procedural treatments for migraine that are effective and safe, including peripheral nerve blocks, trigger point injections, botulinum toxin injections, and sphenopalatine ganglion blocks.
A study by the National Survey of Drug Use and Health (NSDUH) found that from 2002-2014 the proportion of adults aged 50 to 64 who reported cannabis use in the past year more than tripled from 2.9% to 9.0%. Among adults age 65 or older, there was more than a ten-fold increase (from 0.2% to 2.1%).
The guideline formulated by the Centers for Disease Control and Prevention in an effort to curb opioid overdose-related deaths included a recommendation for steep reductions in opioid doses for patients taking high doses of the drug for chronic pain.
When alcohol and opioid addiction occur together, managing them concomitantly becomes challenging. Whereas some patients may not need medication for alcohol addiction, opioid abuse does require pharmacotherapy.
The perioperative management of pain in patients with opioid use disorders presents multiple challenges to clinicians. A recent review offered clinical guidance for various subgroups of these individuals.
Up to 85% of amputees experience phantom limb pain: sensations in the missing limb that patients may describe as burning, cramping, tingling, itching, stabbing, throbbing, or a feeling of “pins and needles.”
Emerging evidence indicates that the placebo effect can in some instances reduce patients’ pain. The current debate is whether clinicians need to disclose to patients that they are using placebos instead of active ingredients.
Bipolar disorder is often comorbid with substance use disorders, with alcohol being the top substance. Clinicians should take a thorough history to uncover substance use disorder because it will guide the management of both disorders.
Chronic, noninflammatory pain in children and adolescents encompasses a wide range of pain syndromes. Clinicians need to consider not only the physical manifestations of pain but also the psychosocial and academic impact of the child’s pain and impairment.
Adults who received pharmacologic treatment for opioid use disorder following a non-fatal overdose may have a reduced risk for opioid-related and all-cause mortality in the subsequent 12 months compared with adults who did not receive medication-assisted treatment.
Abuse-deterrent opioid formulations have not yet been widely accepted despite their proposed value in reducing opioid abuse and related mortality. Many of the current barriers to broader use are related to their higher cost compared with conventional formulations.
Although there is a scarcity of evidence pertaining to the management of postoperative pain medication in the ambulatory setting, some findings suggest an approach similar to that used for the treatment of acute pain.
Functional restoration is a multimodal approach to chronic pain and depression, and includes psychoeducation about pain, biofeedback, mindfulness training, physical and occupational therapy, and detoxification of narcotics.
Although all of the guidelines acknowledge that there are emergent situations in which providing care for a family member or friend is not only permissible but also essential, other situations are frowned upon.
Ranking or otherwise gauging physician quality isn’t just a way to assign bragging rights — performance metrics can be used to set reimbursement levels, tailor insurance, and identify physicians who are falling behind.
Airplane cockpits have a lot in common with operating rooms: both host a small team that’s trusted to perform an extraordinarily complex task with the clear understanding that any misstep could spell doom.
It is important for clinicians to quickly and accurately determine potential underlying causes and to prescribe treatments that take into account comorbidities and medications that older patients may be taking for them.
John M. Davis III, MD, MS, from the Mayo Clinic in Rochester, Minnesota, and Jennifer Gorman, MD, MPH, from The Polyclinic in Seattle, Washington, discuss the evolving collaborative care therapy model in RA.
Given the unique challenges presented by aging, new cases of headache in older adults should be evaluated carefully for a differential diagnosis of primary headache and to exclude underlying causes of secondary headache.
Although peripheral neuropathy is one of the most common neurologic problems seen in the primary care setting, recognizing and evaluating peripheral neuropathy in a patient can be challenging due to its diverse presentations.
Many studies attempt to quantify the effect of the various malpractice claim regulations on physician practice by linking it to the prevalence of defensive medicine, which is when a physician alters his or her clinical approach for the purpose of reducing malpractice exposure.
Although current guidelines define remission as the absence of clinical and laboratory evidence of significant inflammatory disease,the parameters against which axial spondyloarthritis is assessed to demonstrate clinical remission are unclear.
There’s only one way to resolve the dissonance between personal beliefs and professional obligations: remembering that physicians take an oath pledging fealty to patients’ health, not their own belief systems.
The adoption of telehealth technology continues to expand, but requires further research to fully realize the potential it has to address socially desirable goals such as improving the patient experience of care.
Dike Drummond, MD, and CEO of The Happy MD, an organization focused on physician burnout prevention and leadership, shares his insights on how to tackle compassion fatigue and burnout in the emergency department.