Browsing by Subject "opioid analgesics"

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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 1]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 2]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 3]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 4]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Achieving balance in federal and state pain policy: a guide to evaluation (Evaluation guide 2006). [Part 5]
    (2006-09) University of Wisconsin. School of Medicine and Public Health. Pain & Policy Studies Group.
    Assesses federal and state policies regarding the use of controlled substances for pain management, palliative care and end-of-life care. Part 1 contains Sections I - VII of the report, and the federal profile of Section VIII. Part 2 contains state profiles for Alabama - Illinois. Part 3 contains state profiles for Indiana - Michigan. Part 4 contains state profiles for Minnesota - South Dakota. Part 5 contains state profiles for Tennessee - Wyoming, Section IX and the appendices.
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    Design, recruitment outcomes, and sample characteristics of the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial
    (Elsevier, 2017-11) Krebs, Erin E.; Jensen, Agnes C.; Nugent, Sean; DeRonne, Beth; Rutks, Indulis; Leverty, David; Gravely, Amy; Noorbaloochi, Siamak; Bair, Matthew J.; Kroenke, Kurt; Department of Medicine, School of Medicine
    This manuscript describes the study protocol, recruitment outcomes, and baseline participant characteristics for the Strategies for Prescribing Analgesics Comparative Effectiveness (SPACE) trial. SPACE is a pragmatic randomized comparative effectiveness trial conducted in multiple VA primary care clinics within one VA health care system. The objective was to compare benefits and harms of opioid therapy versus non-opioid medication therapy over 12 months among patients with moderate-to-severe chronic back pain or hip/knee osteoarthritis pain despite analgesic therapy; patients already receiving regular opioid therapy were excluded. Key design features include comparing two clinically-relevant medication interventions, pragmatic eligibility criteria, and flexible treat-to-target interventions. Screening, recruitment and study enrollment were conducted over 31 months. A total of 4491 patients were contacted for eligibility screening; 53.1% were ineligible, 41.0% refused, and 5.9% enrolled. The most common reasons for ineligibility were not meeting pain location and severity criteria. The most common study-specific reasons for refusal were preference for no opioid use and preference for no pain medications. Of 265 enrolled patients, 25 withdrew before randomization. Of 240 randomized patients, 87.9% were male, 84.1% were white, and age range was 21–80 years. Past-year mental health diagnoses were 28.3% depression, 17% anxiety, 9.4% PTSD, 7.9% alcohol use disorder, and 2.6% drug use disorder. In conclusion, although recruitment for this trial was challenging, characteristics of enrolled participants suggest we were successful in recruiting patients similar to those prescribed opioid therapy in usual care.
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    Opioid Use as a Predictor of Health Care Use and Pain Outcomes: Analysis of Clinical Trial Data
    (Oxford, 2016-07) Krebs, Erin E.; Kroenke, Kurt; Wu, Jingwei; Bair, Matthew J.; Kozak, Mary Ann; Yu, Zhangsheng; Medicine, School of Medicine
    Objective . To examine effects of pre-enrollment opioid use on outcomes of a 12-month collaborative pain care management trial. We hypothesized that participants with opioid use would have worse pain at baseline; use more health care services and analgesics; and have worse pain outcomes during the trial. Design . Secondary analysis of randomized controlled trial data. Setting . Veterans Affairs (VA) primary care. Subjects . Patients age 18-65 years with chronic pain of at least moderate severity who were enrolled in a 12-month pragmatic trial of a telephone-based collaborative care intervention for chronic musculoskeletal pain. Methods . Participants were categorized as opioid users (n = 84) or non-users (n = 166) at baseline and trial randomization was stratified by opioid use. We used logistic regression to examine cross-sectional associations with baseline opioid use and mixed-effect models for repeated measures to examine baseline opioid use as a predictor of Brief Pain Inventory (BPI) scores over 12 months. Results . At baseline, 33.6% reported use of prescribed opioids. Baseline opioid users had higher baseline BPI scores and higher health-related disability than non-users. Baseline opioid users also had more outpatient visits (15.0 vs. 10.1; p = 0.001) and received more analgesics (p < 0.001) during the trial. In the final multivariable model examining effects of baseline opioid use on BPI over 12 months, opioid users and nonusers had a non-significant difference of 0.25 points (p = 0.098). In conclusion, although baseline opioid users had worse pain at baseline and used more health care during the study, response to the intervention was not significantly modified by pre-existing opioid therapy.