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March 2014 Briefing - Pain Management

Here are what the editors at HealthDay consider to be the most important developments in Pain Management for March 2014. 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.

Topamax Approval for Migraines Expanded to Younger Users

MONDAY, March 31, 2014 (HealthDay News) -- U.S. Food and Drug Administration approval of the drug Topamax (topiramate) to prevent migraine headaches has been expanded to include adolescents 12 years to 17 years, the agency said Friday.

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Risk-Stratified Care Improves Outcomes in Low Back Pain

MONDAY, March 31, 2014 (HealthDay News) -- Use of risk-stratified care in a primary care setting for patients with low back pain improved outcomes without increasing health care costs, according to research published in the March/April issue of the Annals of Family Medicine.

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Pre-Op Pregabalin Best for Pain in Spinal Surgery

FRIDAY, March 28, 2014 (HealthDay News) -- Preoperative pregabalin is superior to either gabapentin or placebo for the relief of pain in patients undergoing lumbar discectomy, according to a study published in the March 15 issue of Spine.

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NCHS Estimates Health Insurance Coverage for 2013

THURSDAY, March 27, 2014 (HealthDay News) -- In the first nine months of 2013, 6.7 percent of children and 20.5 percent of adults were uninsured, according to a study published online March 27 by the National Center for Health Statistics (NCHS).

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White House Extends Affordable Care Act Enrollment Deadline

WEDNESDAY, March 26, 2014 (HealthDay News) -- Americans who've started applying for health insurance under the Affordable Care Act but can't complete the process by the March 31 enrollment deadline will be given an extension.

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AAN Releases Alternative Medicine Guide for MS

WEDNESDAY, March 26, 2014 (HealthDay News) -- The American Academy of Neurology (AAN) has released evidence-based recommendations for complementary and alternative medicine (CAM) for multiple sclerosis (MS). The guideline was published in the March 25 issue of Neurology.

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AMA Introduces Medical Education Initiative

WEDNESDAY, March 26, 2014 (HealthDay News) -- The American Medical Association's (AMA) Accelerating Change in Education initiative is being introduced in 11 medical schools in an effort to shift the focus of education toward real-world practice and competency assessment, according to an AMA report.

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Americans Seem Unprepared for Health Insurance Exchanges

WEDNESDAY, March 26, 2014 (HealthDay News) -- Individuals in the United States seem not to be sufficiently informed about the health insurance exchanges established by the Affordable Care Act (ACA), according to a study published online March 24 in the Proceedings of the National Academy of Sciences.

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More Global Disability for Low Back Pain Than Other Ailments

TUESDAY, March 25, 2014 (HealthDay News) -- Low back pain (LBP), including that arising from ergonomic exposures at work, is associated with considerable global disability and burden, according to two studies published online March 24 in the Annals of the Rheumatic Diseases.

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Opioid Prescriptions in the Emergency Room Rising

TUESDAY, March 25, 2014 (HealthDay News) -- Prescriptions for opioid analgesics in the emergency department have risen dramatically over the last decade, according to a study published in the March issue of Academic Emergency Medicine.

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Patient Request Impacts Doc Prescribing Behavior

MONDAY, March 24, 2014 (HealthDay News) -- Patients requesting specific medications are more likely to be prescribed those medications, according to research published in the April issue of Medical Care.

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Practices Can Take Steps to Improve Care Transitions

FRIDAY, March 21, 2014 (HealthDay News) -- Implementation of a rigorous process can improve transitions of care, according to an article published March 10 in Medical Economics.

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Rx Expenditures Expected to Rise in 2014

MONDAY, March 17, 2014 (HealthDay News) -- Drug costs are projected to rise 3 to 5 percent across all care settings in 2014, according to a study published in the March 15 issue of the American Journal of Health-System Pharmacy.

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Insurers Must Offer Same-Sex Couples Spousal Benefits

MONDAY, March 17, 2014 (HealthDay News) -- Health plans that offer benefits for heterosexual couples must do the same for same-sex married couples, the Obama administration says.

Other Health Highlights: March 17, 2014

Improving EHR Interoperability Is a National Priority: HHS

FRIDAY, March 14, 2014 (HealthDay News) -- Interoperability of electronic health record (EHR) systems is a national priority of the Office of the National Coordinator for Health Information Technology, according to an article published March 4 in Medical Economics.

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IOM Recommends Definitions for 'Gulf War' Multisymptom Illness

THURSDAY, March 13, 2014 (HealthDay News) -- Two definitions for chronic multisymptom illness should be used to identify cases of Gulf War illness among Gulf War veterans, according to a report published by the Institute of Medicine.

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Glucosamine Fails to Prevent Knee Cartilage Deterioration

THURSDAY, March 13, 2014 (HealthDay News) -- Oral glucosamine supplementation is not associated with a decrease in knee cartilage deterioration among individuals with chronic knee pain, according to a study published online March 10 in Arthritis & Rheumatology.

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Multiple 60-Minute Massage Sessions Effective for Neck Pain

THURSDAY, March 13, 2014 (HealthDay News) -- Multiple 60-minute massage sessions are effective for neck dysfunction and pain among patients with chronic neck pain, according to a study published in the March/April issue of the Annals of Family Medicine.

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AMA: CMS Wants Physician Input on Practice Transformation

WEDNESDAY, March 12, 2014 (HealthDay News) -- Physicians are being given the opportunity to describe what resources they need in order to transition to value-based models of care, according to a report published by the American Medical Association (AMA).

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FDA Approves First Device to Prevent Migraines

TUESDAY, March 11, 2014 (HealthDay News) -- The U.S. Food and Drug Administration on Tuesday approved the first device aimed at preventing migraines. The device, called Cefaly, is also the first transcutaneous electrical nerve stimulation device specifically authorized for use prior to the onset of pain, according to the FDA.

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White House: More Than Four Million Have Signed Up for ACA

TUESDAY, March 11, 2014 (HealthDay News) -- More than four million Americans have signed up for health coverage through state and federal insurance marketplaces established by the Affordable Care Act, the Obama administration announced Tuesday.

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Medicare Drug Plan Changes Withdrawn by White House

TUESDAY, March 11, 2014 (HealthDay News) -- Proposed changes to the Medicare prescription drug program have been withdrawn by the Obama administration after strong opposition from patient groups.

Other Health Highlights: March 11, 2014

Discrepancies ID'd in Studies on ClinicalTrials.gov, Journals

TUESDAY, March 11, 2014 (HealthDay News) -- Nearly all clinical trials reported on ClinicalTrials.gov and published in high-impact journals report at least one discrepancy in cohort, intervention, or results, according to a research letter published in the March 12 issue of the Journal of the American Medical Association.

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Keeping Salaries Secret Harms Worker Performance

MONDAY, March 10, 2014 (HealthDay News) -- Keeping salaries secret hurts worker performance and increases turnover of top talent, according to a study published online Jan. 13 in the Academy of Management Journal.

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Consultant Offers Tips for Evaluating Staff Pay

MONDAY, March 10, 2014 (HealthDay News) -- Setting salaries and dealing with raises for a practice's staff can be tricky, according to an article published Feb. 24 in Medical Economics.

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AMA Grants Curriculum Efforts to Address Health Disparities

FRIDAY, March 7, 2014 (HealthDay News) -- Medical schools are beginning to change their curriculum to address ways to eliminate health disparities, according to the American Medical Association (AMA).

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Physicians Better Able to Recall Narratives About Rx Guidelines

FRIDAY, March 7, 2014 (HealthDay News) -- Physicians show better recall after reading evidence-based narratives, rather than summaries, of opioid prescribing guidelines, according to a study published online Feb. 20 in Academic Emergency Medicine.

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Gender Gap Exists in Domestic Duties of Working Physicians

FRIDAY, March 7, 2014 (HealthDay News) -- Gender differences exist in domestic activities among career-oriented academic physicians with children, according to a study published online March 3 in the Annals of Internal Medicine.

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Relative Value Units Useful In Evaluating Practice Finances

THURSDAY, March 6, 2014 (HealthDay News) -- The Relative Value Unit (RVU) is a useful tool for managing practice finances, according to an article published Feb. 25 in Medical Economics.

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Web-Based Mental Health Screening Feasible, Acceptable

THURSDAY, March 6, 2014 (HealthDay News) -- For patients in general hospital settings, a routine web-based mental health screening is feasible and acceptable, according to a study published in General Hospital Psychiatry.

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Drop in Compensation Gap for Primary Care Docs, Specialists

THURSDAY, March 6, 2014 (HealthDay News) -- From 2012 to 2013, there was a 5.7 percent increase in the median total cash compensation for primary care physicians, with a smaller gap seen for medical and surgical specialists, according to the results of a recent survey from SullivanCotter.

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Pre-Op Pain Patterns Affect Stenosis Surgery Outcomes

THURSDAY, March 6, 2014 (HealthDay News) -- For patients with spinal stenosis without degenerative spondylolisthesis, predominance of back pain (BP) versus leg pain (LP) is associated with worse surgical outcomes, according to a study published in the Feb. 1 issue of Spine.

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Value-Based Insurance Plans Can Up Rx Adherence

WEDNESDAY, March 5, 2014 (HealthDay News) -- Value-based insurance design (VBID) plans with certain features aside from solely lowering cost sharing can increase medication adherence, according to a study published in the March issue of Health Affairs.

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Marijuana Not Recommended for Rheumatic Conditions

WEDNESDAY, March 5, 2014 (HealthDay News) -- Health care professionals should currently discourage rheumatology patients from using herbal cannabis as a therapy, according to a review published online March 3 in Arthritis Care & Research.

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WHO Program Improves U.S. Medical Facility Hand Hygiene

WEDNESDAY, March 5, 2014 (HealthDay News) -- For U.S. health care facilities, participation in the World Health Organization (WHO) global campaign to improve hand hygiene practices is associated with improved hand hygiene, according to a study published in the March issue of the American Journal of Infection Control.

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Gap in Regulatory Coverage Affects 5 to 16 Percent of Trials

WEDNESDAY, March 5, 2014 (HealthDay News) -- Human subjects protections (HSP) policies do not provide regulatory coverage for all clinical trials, while up to about a quarter of trials are considered overlap trials, according to a research letter published in the March 5 issue of the Journal of the American Medical Association.

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Opioid-Related Overdose Death Tied to High-Risk Rx Patterns

TUESDAY, March 4, 2014 (HealthDay News) -- The risk of opioid-related overdose death is associated with certain opioid-prescribing patterns, and nonmedical opioid sources vary with the frequency of use, according to a study and research letter, respectively, published online March 3 in JAMA Internal Medicine.

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Women-Specific Research Is Still Inadequate

MONDAY, March 3, 2014 (HealthDay News) -- Women are still underrepresented in medical science and research, and sex differences are often ignored, according to a report published March 3 by the Brigham and Women's Hospital.

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Catastrophizing Can Predict Low Back Pain, Disability

MONDAY, March 3, 2014 (HealthDay News) -- For patients treated for low back pain, catastrophizing may predict the degree of pain and disability, according to a review published in the Feb. 1 issue of Spine.

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Persistent Post-Cardiac Surgery Pain Seen at 24 Months

MONDAY, March 3, 2014 (HealthDay News) -- For patients undergoing cardiac surgery, persistent postoperative pain decreases over time and is 9.5 percent at 24 months after surgery, according to a study published online Feb. 24 in CMAJ, the journal of the Canadian Medical Association.

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CMS: No More Delays to ICD-10 Implementation Deadline

MONDAY, March 3, 2014 (HealthDay News) -- There will be no more delays to the Oct. 1, 2014, deadline for implementation of the International Classification of Diseases, 10th Revision (ICD-10), according to an article published Feb. 27 in Medical Economics.

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