Article
Anesthesiology
Stephen L. Luther, Dezon K. Finch, Lina Bouayad, James McCart, Ling Han, Steven K. Dobscha, Melissa Skanderson, Samah J. Fodeh, Bridget Hahm, Allison Lee, Joseph L. Goulet, Cynthia A. Brandt, Robert D. Kerns
Summary: This study used rule-based natural language processing algorithms to extract pain care quality indicators from documents of Veterans Health Administration primary care providers. The patterns and frequency of these indicators were described. The study found that the most commonly documented indicators were pain presence, etiology or source, and pain site, while the least commonly documented were sensation, pain's impact, and pain relief factors. The study also calculated a PCQ indicator score for each visit and found the scores to be highly stable across patient characteristics and healthcare facilities.
Article
Pharmacology & Pharmacy
Han Xie, Xinyi Chen, Min Xue, Huaying Li, Yonghan Ge, Weihong Ge
Summary: This study aimed to construct a pharmaceutical care mode for cancer pain patients in primary care and analyze its effect on drug therapy treatment. The results showed that under the scientific and reasonable mode of pharmaceutical care, the pain assessment rate and reasonable rate of pain assessment were significantly higher, while the pain score and incidence of adverse reactions were significantly lower.
FRONTIERS IN PHARMACOLOGY
(2023)
Article
Medicine, General & Internal
Jessica Mooney, Roger Yau, Haseeb Moiz, Farah Kidy, Andrew Evans, Sarah Hillman, Dan Todkill, Saran Shantikumar
Summary: This study investigated the correlation between socioeconomic deprivation and the rate of prescribing of individual pharmaceutical drugs and drug classes in primary care in England. The results revealed novel associations between prescribing and deprivation, with some drugs showing higher prescribing rates in more deprived areas and others in more affluent areas. Further research is needed to identify the underlying reasons for these associations and develop appropriate interventions to address healthcare inequality.
POSTGRADUATE MEDICAL JOURNAL
(2022)
Review
Immunology
Sandhya Jinesh, Justin Kullgren, Gollapudi S. Shankar, Rajan Radhakrishnan
Summary: Neuropathic pain is a chronic condition affecting around 1% of the general population globally, with various underlying causes and challenging treatment options. Non-traditional analgesics are commonly used to treat this condition, with opioids being effective in some cases but carrying risks of addiction and adverse effects. Future prospects for the treatment of neuropathic pain involve further research and exploration.
INFLAMMOPHARMACOLOGY
(2022)
Article
Rheumatology
Dahai Yu, George Peat, Kelvin P. Jordan, James Bailey, Daniel Prieto-Alhambra, Danielle E. Robinson, Victoria Y. Strauss, Karen Walker-Bone, Alan Silman, Mamas Mamas, Steven Blackburn, Stephen Dent, Kate Dunn, Andrew Judge, Joanne Protheroe, Ross Wilkie
Summary: By collecting patient-reported measures of pain experience, function, and health status, and utilizing routine electronic health records, it is feasible to estimate population levels of musculoskeletal patients effectively.
Review
Medicine, General & Internal
Phillip O. Coffin, Rebecca S. Martinez, Brian Wylie, Bunny Ryder
Summary: The United States saw a significant increase in opioid prescribing from 1990 to 2010, followed by initiatives to manage opioid use and reduce prescribing. Opioids are no longer the first choice for most chronic pain conditions, and alternative treatments should be considered. Individualized management is necessary for patients on long-term opioid therapy.
ANNALS OF MEDICINE
(2022)
Article
Medicine, General & Internal
Stefania Di Gangi, Giuseppe Pichierri, Stefan Zechmann, Thomas Rosemann, Andreas Plate
Summary: In the Swiss primary care setting, approximately two-thirds of patients with acute low back pain were treated with pain medications. The prescribing patterns were conservative, with limited use of strong opioids and co-medications.
JOURNAL OF CLINICAL MEDICINE
(2021)
Review
Health Care Sciences & Services
Sarah Cercone Heavey, Jacob Bleasdale, Eve A. Rosenfeld, Gregory P. Beehler
Summary: This systematic review examines the application of collaborative care management (CCM) in addressing pain-related outcomes and opioid-related behaviors. The findings suggest that CCM shows promise in improving pain-related outcomes and facilitating buprenorphine treatment for opioid use disorder. However, further research is needed to better understand the effectiveness of different aspects of CCM and enhance intervention outcomes.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2023)
Article
Medicine, General & Internal
Tonje R. Johannessen, Dan Atar, Odd Martin Vallersnes, Anne Cecilie K. Larstorp, Ibrahimu Mdala, Sigrun Halvorsen
Summary: In a primary care emergency setting, a single hs-cTnT strategy was superior to the HEART score in ruling out AMI. This rapid and safe approach may enhance the assessment of patients with chest pain outside of hospitals.
Article
Primary Health Care
Noureen A. Shivji, Adam W. A. Geraghty, Hollie Birkinshaw, Tamar Pincus, Helen Johnson, Paul Little, Michael Moore, Beth Stuart, Carolyn A. Chew-Graham
Summary: This study explores the understanding and management of pain-related distress and depression from the perspectives of patients with persistent musculoskeletal pain and general practitioners. The findings indicate that many patients face challenges in distinguishing between distress and depression, but they also employ strategies to make this distinction. Some general practitioners express uncertainty about the cause of pain and how to manage patients with pain and distress, but others describe how they can help patients move forward by identifying and building on optimism.
BRITISH JOURNAL OF GENERAL PRACTICE
(2022)
Article
Multidisciplinary Sciences
Karin Hek, Tim Boogaerts, Robert A. Verheij, Hans De Loof, Liset van Dijk, Alexander L. N. van Nuijs, Willemijn M. Meijer, Hilde Philips
Summary: This study investigated the prescribing of weak and strong opioids at out-of-hours primary care services in Flanders and the Netherlands from 2015 to 2019. The results showed that opioids were prescribed in approximately 2.5% of out-of-hours contacts in both regions. The prescribing rate of strong opioids was higher in the Netherlands compared to Flanders, and a larger proportion of strong opioids were prescribed to elderly patients in the Netherlands.
Review
Medicine, General & Internal
Susana Tinoco Duarte, Carla Nunes, Daniela Costa, Helena Donato, Eduardo B. Cruz
Summary: Low back pain is a common musculoskeletal condition that causes high healthcare costs. Models of care are considered effective solutions to address this issue. This scoping review aims to summarize the existing evidence on the implementation of models of care for low back pain in primary healthcare.
Article
Anesthesiology
Pooja Lagisetty, Colin Macleod, Jennifer Thomas, Stephanie Slat, Adrianne Kehne, Michele Heisler, Amy S. B. Bohnert, Kipling M. Bohnert
Summary: Many primary care clinics are resistant to accepting new patients taking prescription opioids for chronic pain, particularly those perceived to have aberrant opioid use. The study found that this resistance could limit access to primary care for patients using opioids long-term, especially for those with histories suggestive of aberrant use.
Article
Psychology, Multidisciplinary
Catarina Tome-Pires, Enric Aragones, Concepcion Rambla, German Lopez-Cortacans, Elisabet Sanchez-Rodriguez, Antonia Caballero, Jordi Miro
Summary: This study aimed to explore patients' perceptions of a group-based psychoeducational intervention for the management of chronic musculoskeletal pain and depression. The perceived barriers included lack of motivation, time constraints, pain, depression, ineffectiveness of pain-relief strategies, and activity avoidance. The facilitators were having a supportive family/friends, the positive effects of self-management, high motivation, and being a proactive patient, as well as peer support and identification, the positive effect of sessions, and free expression.
FRONTIERS IN PSYCHOLOGY
(2023)
Article
Medicine, General & Internal
Helen M. Poole, Bernhard Frank, Emma Begley, Aimee Woods, Andreia Ramos-Silva, Mike Merriman, Roisin McCulough, Catharine Montgomery
Summary: This study aims to investigate the effectiveness and feasibility of reducing high doses of opioids through a tapering protocol, education, and support for patients with chronic pain. The study will randomly allocate patients to either a tapering group or a tapering with support group to assess the impact of these interventions on pain and quality of life.
Article
Substance Abuse
Corey J. Hayes, Erin E. Krebs, Chenghui Li, Joshua Brown, Teresa Hudson, Bradley C. Martin
Summary: This study found that discontinuing chronic opioid therapy is associated with decreased diagnoses of opioid-related adverse outcomes, but the association with substance use disorders remains inconclusive.
Editorial Material
Emergency Medicine
Erin E. Krebs
AMERICAN JOURNAL OF EMERGENCY MEDICINE
(2022)
Article
Health Care Sciences & Services
Marc R. Larochelle, Ricardo Cruz, Sarah Kosakowski, Doug L. Gourlay, Daniel P. Alford, Ziming Xuan, Erin E. Krebs, Shapei Yan, Karen E. Lasser, Jeffrey H. Samet, Jane M. Liebschutz
Summary: This study found that 37% of patients receiving opioids for chronic pain may have clinical concerns regarding substance misuse based on expert adjudication of UDT results, with an additional 35% having uncertain results. The study also identified reasons for concerning UDT results, such as non-detection of prescribed substances or detection of non-prescribed substances.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Clinical Neurology
Corey J. Hayes, Erin E. Krebs, Joshua Brown, Chenghui Li, Teresa Hudson, Bradley C. Martin
Summary: This study assessed pain intensity changes among Veterans transitioning from long-term opioid therapy to intermittent therapy or discontinuation. Results showed that pain intensity decreased after transitioning to intermittent therapy or discontinuing opioids, with no increase in pain intensity observed in those continuing long-term opioid therapy.
Article
Psychiatry
Kurt Kroenke, Timothy E. Stump, Jacob Kean, Erin E. Krebs, Teresa M. Damush, Matthew J. Bair, Patrick O. Monahan
Summary: The study aimed to compare the diagnostic performance of PROMIS depression scales with the PHQ-9 in detecting major depression. The results showed that PROMIS scales of various lengths had similar diagnostic operating characteristics, with high sensitivity and specificity. The optimal screening cutpoints for PROMIS raw scores on 4-, 6-, and 8-item scales were identified, and the average sensitivity and specificity for major depression were comparable to the PHQ-9.
JOURNAL OF PSYCHOSOMATIC RESEARCH
(2021)
Article
Substance Abuse
Corey J. Hayes, Erin E. Krebs, Joshua Brown, Chenghui Li, Teresa Hudson, Bradley C. Martin
Summary: There was no consistent association between transitioning patients from long-term opioid therapy to intermittent opioid therapy and the risk of substance use disorders and opioid-related adverse outcomes.
DRUG AND ALCOHOL DEPENDENCE
(2022)
Editorial Material
Health Care Sciences & Services
Diana J. Burgess, Erin E. Krebs, Craig S. Roth
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Public, Environmental & Occupational Health
Elisheva R. Danan, Julian Brunner, Alicia Bergman, Michele Spoont, Catherine Chanfreau, Ismelda Canelo, Erin E. Krebs, Elizabeth M. Yano
Summary: Contrary to expectations, a history of sexual assault was not significantly associated with reduced completion of cervical cancer screening. Despite potential barriers, three- to five-year screening intervals may provide sufficient time to complete screening. The trauma-sensitive care practices promoted in the Veterans Health Administration may help women overcome distress and discomfort to complete necessary screenings.
JOURNAL OF WOMENS HEALTH
(2022)
Review
Medicine, General & Internal
Keith Humphreys, Chelsea L. Shover, Christina M. Andrews, Amy S. B. Bohnert, Margaret L. Brandeau, Jonathan P. Caulkins, Jonathan H. Chen, Mariano-Florentino Cuellar, Yasmin L. Hurd, David N. Juurlink, Howard K. Koh, Erin E. Krebs, Anna Lembke, Sean C. Mackey, Lisa Larrimore Ouellette, Brian Suffoletto, Christine Timko
Article
Health Care Sciences & Services
Benjamin J. Morasco, Melissa H. Adams, Elizabeth R. Hooker, Patricia E. Maloy, Erin E. Krebs, Travis Lovejoy, Somnath Saha, Steven K. Dobscha
Summary: The multicomponent intervention ISOT did not reduce the risk of prescription opioid misuse, but it did increase the likelihood of discontinuing prescription opioids. More powerful interventions may be needed to impact treatment outcomes.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Review
Health Care Sciences & Services
Natalie B. Connell, Pallavi Prathivadi, Karl A. Lorenz, Sophia N. Zupanc, Sara J. Singer, Erin E. Krebs, Elizabeth M. Yano, Hong-nei Wong, Karleen F. Giannitrapani
Summary: This study aimed to identify key features of interdisciplinary team structures and processes associated with improved pain outcomes for patients experiencing chronic pain in primary care settings. The results suggest that interventions incorporating teamwork and teaming can improve patient-reported pain outcomes, with care managers and mechanisms for patient follow-up being important factors.
JOURNAL OF GENERAL INTERNAL MEDICINE
(2022)
Article
Medicine, Research & Experimental
Erin E. Krebs, William C. Becker, David Nelson, Beth M. DeRonne, Sean Nugent, Agnes C. Jensen, Erin C. Amundson, Jennifer K. Manuel, Brian Borsari, Allyson M. Kats, Karen H. Seal
Summary: The Veterans' Pain Care Organizational Improvement Comparative Effectiveness (VOICE) study is a 12-month trial conducted at ten United States Veterans Affairs (VA) health care sites, aiming to test interventions to improve pain while reducing opioid use among VA patients. The study faced challenges from opioid prescribing trends and the COVID-19 pandemic but successfully recruited eligible patients. The results will provide limited evidence for interventions to improve pain and reduce opioid use.
CONTEMPORARY CLINICAL TRIALS
(2023)
Article
Public, Environmental & Occupational Health
Elizabeth S. Goldsmith, Erin E. Krebs, Marizen R. Ramirez, Richard F. MacLehose
Summary: This study examines the potential bias in opioid-related mortality estimates due to misclassification in death certificates. By eliciting the opinions of primary care physicians and applying probabilistic bias analysis, the study finds that opioid-related mortality rates may be substantially underestimated, particularly among older adults. The findings highlight the importance of addressing misclassification in cause-of-death data for accurate public health assessments.
Editorial Material
Medicine, General & Internal
Erin E. Krebs, Elizabeth S. Goldsmith
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
(2022)
Article
Medicine, General & Internal
Salomeh Keyhani, Samuel Leonard, Amy L. Byers, Tauheed Zaman, Erin Krebs, Peter C. Austin, Tristan Moss-Vazquez, Charles Austin, Friedhelm Sandbrink, Dawn M. Bravata
Summary: This study found that cannabis use among adults receiving opioid analgesic medications was not directly associated with mortality risk but was associated with a small increased risk of adverse outcomes, particularly among older adults receiving long-term treatment.