January 2013 Briefing - Pain Management

Here are what the editors at HealthDay consider to be the most important developments in Pain Management for January 2013. This roundup includes the latest research news from journal articles, as well as the FDA approvals and regulatory changes that are the most likely to affect clinical practice.

Early Palliative Care in Lung CA Focuses on Coping, Symptoms

WEDNESDAY, Jan. 30 (HealthDay News) -- Early palliative care (PC) clinic visits, integrated with standard oncologic care for patients with metastatic lung cancer, emphasize symptom management, coping, and psychosocial aspects of illness, according to research published online Jan. 28 in JAMA Internal Medicine.

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Parents Not Too Concerned About Child Abuse of Pain Meds

WEDNESDAY, Jan. 30 (HealthDay News) -- Parents are not that concerned about misuse of narcotic pain medicines by their children and teens, according to the University of Michigan's Mott Children's Hospital National Poll on Children's Health.

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Physicians Commonly Report Unsafe Hospital Workloads

TUESDAY, Jan. 29 (HealthDay News) -- Physicians say they often face unsafe hospital workloads, according to a study published online Jan. 28 in JAMA Internal Medicine.

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Back Pain Researchers Identify Current Priorities

TUESDAY, Jan. 29 (HealthDay News) -- Low back pain (LBP) primary care researchers indicate that the identification and management of specific subgroups of patients and translation of research into clinical practice should be the most important current priorities, according to a study published in the Jan. 15 issue of Spine.

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Brain Scans Show Doctors Empathize With Patients

TUESDAY, Jan. 29 (HealthDay News) -- Physicians who empathize with a patient in pain and feel relief when the patient receives effective treatment show activity in brain regions associated with pain relief and reward, according to a study published online Jan. 29 in Molecular Psychiatry.

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FDA Panel Votes for Tougher Restrictions on Hydrocodone

FRIDAY, Jan. 25 (HealthDay News) -- A U.S. Food and Drug Administration advisory panel met Thursday and Friday to discuss the fate of certain painkillers that contain the opioid known as hydrocodone, concluding in a vote in favor of moving hydrocodone combination products into the more restrictive Schedule II category of controlled substances.

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Tofacitinib Slows Joint Damage in Rheumatoid Arthritis

FRIDAY, Jan. 25 (HealthDay News) -- Tofacitinib slows the progression of joint damage and improves disease activity in patients with rheumatoid arthritis (RA), according to a study published online Jan. 24 in Arthritis & Rheumatism.

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ACPE Survey Finds Skepticism Relating to Online Doc Ratings

THURSDAY, Jan. 24 (HealthDay News) -- Physicians are skeptical of online ratings, and believe that few patients use them, according to a survey published by the American College of Physician Executives (ACPE).

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Back Pain Intensity Most Influential in Fusion Decision

THURSDAY, Jan. 24 (HealthDay News) -- Patients seeing a spine surgeon are most influenced by low back pain intensity when considering whether to proceed with spinal fusion surgery, according to a study published in the Jan. 15 issue of Spine.

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Physician Education Ups Communication for New Meds

THURSDAY, Jan. 24 (HealthDay News) -- A physician-targeted education session improves physician communication about newly-prescribed medications, according to a study published in the January/February issue of the Annals of Family Medicine.

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Exposure to Triggers Causes Migraine With Aura in Only a Few

THURSDAY, Jan. 24 (HealthDay News) -- For patients who suffer from migraine with aura (MA), provocation with natural self-reported trigger factors causes migraine in only a small subgroup, according to a study published online Jan. 23 in Neurology.

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Large Teaching Hospitals Face More Readmission Penalties

WEDNESDAY, Jan. 23 (HealthDay News) -- Large hospitals, teaching hospitals, and safety-net hospitals (SNHs) are more likely than other hospitals to be penalized under the Centers for Medicare & Medicaid Services' Hospital Readmissions Reduction Program (HRRP), according to a research letter published in the Jan. 23/30 issue of the Journal of the American Medical Association.

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Care Transition Initiative Decreases Rehospitalizations

WEDNESDAY, Jan. 23 (HealthDay News) -- Communities instituting quality improvement initiatives for care transitions see significant declines in the rate of 30-day rehospitalizations and hospitalizations, according to a study published in the Jan. 23/30 issue of the Journal of the American Medical Association.

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High BMI Increases Risk of Chronic Low Back Pain Later

WEDNESDAY, Jan. 23 (HealthDay News) -- High body mass index (BMI) significantly increases the risk of chronic low back pain later, according to a study published in the Jan. 15 issue of Spine.

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Poor Arthritis Outcome Risk Up in Overweight Black Women

WEDNESDAY, Jan. 23 (HealthDay News) -- Overweight African-American women with or at risk of knee osteoarthritis are at higher risk than overweight white women of poor functional outcomes, according to a study published in the January issue of Arthritis Care & Research.

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FDA: First Skin Patch Approved to Treat Migraines

TUESDAY, Jan. 22 (HealthDay News) -- Zecuity, a sumatriptan iontophoretic single-use, battery-powered transdermal system, has been approved by the U.S. Food and Drug Administration for acute treatment of migraine with or without aura in adults.

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Early Predictors of Occupational Back Reinjury Identified

TUESDAY, Jan. 22 (HealthDay News) -- About 25 percent of workers with back injury report reinjury after returning to work, with risk factors including male sex, previous similar injury, and having health insurance, according to a study published in the Jan. 15 issue of Spine.

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Efforts Failed to Up Primary Care, Rural Resident Training

FRIDAY, Jan. 18 (HealthDay News) -- The 2005 redistribution of graduate medical education (GME) funds did little to train more residents in primary care and in rural areas, according to a study published in the January issue of Health Affairs.

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Even Brief Interruptions Dramatically Increase Errors

WEDNESDAY, Jan. 16 (HealthDay News) -- Even momentary interruptions of two to four seconds can significantly affect a person's ability to accurately complete a task requiring considerable thought, according to research published online Jan. 7 in the Journal of Experimental Psychology: General.

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Family Docs Are Early Adopters of Electronic Health Records

WEDNESDAY, Jan. 16 (HealthDay News) -- Family practice physicians are adopting electronic health record (EHR) systems at a fast pace, with 68 percent using an EHR system by 2011, and 80 percent expected to be users by 2013, according to research published in the January/February issue of the Annals of Family Medicine.

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Certain Online Behaviors of Docs Warrant Investigation

MONDAY, Jan. 14 (HealthDay News) -- There is high consensus among state medical boards regarding the likelihood of probable investigations for certain online behaviors, according to a study published in the Jan. 15 issue of the Annals of Internal Medicine.

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Top Five Issues for Docs and Patients Identified for 2013

MONDAY, Jan. 14 (HealthDay News) -- The top five issues that will impact physicians and patients in 2013 have been identified, according to a report published Dec. 10 by The Physicians Foundation.

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Radiation Therapy Use Low in End-Stage Cancer

FRIDAY, Jan. 11 (HealthDay News) -- Although the overall use of radiation treatment among elderly end-stage cancer patients is low during their final month of life, many receive more than 10 days of treatment, according to a study published in the Jan. 1 issue of the Journal of Clinical Oncology.

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National U.S. Health Care Spending Relatively Stable

FRIDAY, Jan. 11 (HealthDay News) -- The growth in national U.S. health care spending was relatively stable in 2011, but growth in personal health care spending accelerated, according to a study published in the January issue of Health Affairs.

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CDC: Rare Blood Disorder Found in Intravenous Drug Users

THURSDAY, Jan. 10 (HealthDay News) -- In 2012, 15 intravenous drug users within a relatively small geographic area developed thrombotic thrombocytopenic purpura (TTP), possibly due to reformulating and injecting an oral pain reliever, according to a report published in the Jan. 11 issue of the U.S. Centers for Disease Control and Prevention's Morbidity & Mortality Weekly Report.

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High Unawareness of Distal Sensorimotor Polyneuropathy

THURSDAY, Jan. 10 (HealthDay News) -- A high percentage of older adults with diabetes and prediabetes are unaware of having clinical distal sensorimotor polyneuropathy (DSPN), according to a study published online Dec. 28 in Diabetes Care.

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Rate of Non-Medical Use of Rx Pain Meds 4.6 Percent

THURSDAY, Jan. 10 (HealthDay News) -- The rate of non-medical use of prescription pain relievers in the past year among individuals aged 12 years and older is estimated at 4.6 percent nationally, with considerable variation between states, according to a study published online Jan. 8 by the Substance Abuse and Mental Health Services Administration (SAMHSA).

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Lumbar Extensor Training Improves Chronic Back Pain

THURSDAY, Jan. 10 (HealthDay News) -- An exercise regimen can improve functional status for men with chronic nonspecific low back pain (CNSLBP) without improving low back muscular morphology, according to a study published in the Dec. 15 issue of Spine.

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SPIRIT 2013 Clinical Trial Protocol Guidelines Issued

THURSDAY, Jan. 10 (HealthDay News) -- A panel of experts, including trial investigators, trial coordinators, and representatives from ethics and regulatory agencies, has developed the Standard Protocol Items: Recommendations for Interventional Trials (SPIRIT) 2013 guidelines for the minimum content of a clinical trial, according to a statement published online Jan. 8 in the Annals of Internal Medicine.

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FDA: Draft Guidance Issued on Abuse-Deterrent Opioids

WEDNESDAY, Jan. 9 (HealthDay News) -- The U.S. Food and Drug Administration has issued a draft guidance document to assist the pharmaceutical industry in developing new formulations of opioid drugs with abuse-deterrent properties.

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Acetaminophen Cuts Post-Op Morphine Use in Infants

WEDNESDAY, Jan. 9 (HealthDay News) -- For infants undergoing major surgery, intermittent use of intravenous acetaminophen is associated with a significant reduction in morphine requirements over 48 hours, according to a study published in the Jan. 9 issue of the Journal of the American Medical Association.

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Vitamin D Does Not Improve Knee OA Progression, Symptoms

WEDNESDAY, Jan. 9 (HealthDay News) -- For adults with symptomatic knee osteoarthritis (OA), vitamin D supplementation for two years does not reduce knee pain or cartilage volume loss compared to placebo, according to a study published in the Jan. 9 issue of the Journal of the American Medical Association.

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Pain Starting at Delivery Is Rare Six, 12 Months Later

WEDNESDAY, Jan. 9 (HealthDay News) -- Pain beginning at delivery is rarely reported six to 12 months after delivery; and the postpartum period seems to protect from chronic hypersensitivity to peripheral nerve injury in rats, according to two studies published in the January issue of Anesthesiology.

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Health Care Use Dropped Among All During Recession

TUESDAY, Jan. 8 (HealthDay News) -- Health care use declined significantly among all races and ethnicities during the recession from 2007 to 2009, with the only ethnic disparity being fewer physician visits by Hispanics compared with whites, according to a study published online Jan. 7 in JAMA Internal Medicine.

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Study Questions Effect of Disc Replacement on Low Back Pain

MONDAY, Jan. 7 (HealthDay News) -- Although total disc replacement for chronic low back pain due to degenerative disc disease yields statistically significant improvements compared to conventional fusion, the clinical relevance is unclear and conclusions regarding effectiveness are hampered by low quality evidence and short follow-up, according to a study published in the Jan. 1 issue of Spine.

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Web-Based QoL Tool Beneficial in Juvenile Idiopathic Arthritis

MONDAY, Jan. 7 (HealthDay News) -- Children with arthritis who use a Web-based application to monitor health-related quality of life (HRQoL) have more discussions with their rheumatologist about psychosocial issues, and their physicians are more satisfied with the care provided during consultations, according to a study published online Jan. 6 in Pediatrics.

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Shared Savings May Promote Care Coordination Entity Use

MONDAY, Jan. 7 (HealthDay News) -- Use of shared savings could encourage individuals who are dually eligible for Medicare and Medicaid to enroll in state-designed care coordination entities (CCEs), according to a perspective piece published online Jan. 2 in the New England Journal of Medicine.

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Nurse-Led Monitoring Improves Cancer-Related Fatigue

FRIDAY, Jan. 4 (HealthDay News) -- For patients with advanced cancer, nurse-led monitoring and optimized treatment of physical symptoms significantly improves cancer-related fatigue, according to research published online Jan. 2 in the Journal of Clinical Oncology.

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Association Between Health Care Cost, Quality Inconsistent

THURSDAY, Jan. 3 (HealthDay News) -- The direction of the association between health care cost and quality is unclear, with inconsistent evidence indicating positive, negative, mixed, and indeterminate associations, according to a review published in the Jan. 1 issue of the Annals of Internal Medicine.

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Direct Costs for Low Back Pain Care in U.K. Are Substantial

THURSDAY, Jan. 3 (HealthDay News) -- The financial burden of caring for patients with chronic low back pain (CLBP) in the United Kingdom is twice that of caring for patients without CLBP, according to a study published in the Jan. 1 issue of Spine.

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Surgery Consultation Common After MRI of the Spine

WEDNESDAY, Jan. 2 (HealthDay News) -- Almost half of patients whose primary care physicians recommend a lumbosacral or cervical spine magnetic resonance imaging (MRI) scan go on to receive a surgical consultation, but few end up undergoing spinal surgery, according to research published in the Jan. 1 issue of Spine.

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Fibromyalgia May Be Underdiagnosed, More So in Men

WEDNESDAY, Jan. 2 (HealthDay News) -- Fibromyalgia may be underdiagnosed in the general population, particularly in men, according to research published online Nov. 30 in Arthritis Care & Research.

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House Joins Senate to Avert Medicare Cuts

WEDNESDAY, Jan. 2 (HealthDay News) -- The House of Representatives settled on an 11th-hour agreement late Tuesday night that has averted the widespread tax increases and spending cuts that would have gone into effect January 1. This agreement occurred 21 hours after the U.S. Senate did its part to steer the country clear of the "fiscal cliff."

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Physician's Briefing