Here are what the editors at HealthDay consider to be the most important developments in Pain Management for August 2018. 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.
Medical Bills in Collections Decrease With Patient Age
FRIDAY, Aug. 31, 2018 (HealthDay News) — Medical collections decrease substantially with age, possibly because of increased health insurance coverage and incomes, according to a study published in the August issue of Health Affairs.
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14.6 Percent of U.S. Adults Used Marijuana in Past Year
FRIDAY, Aug. 31, 2018 (HealthDay News) — Overall, 14.6 percent of U.S. adults report marijuana use in the past year, according to a research letter published online Aug. 28 in the Annals of Internal Medicine.
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Preemptive Analgesia May Cut Post-Op Pain in Anorectal Surgery
FRIDAY, Aug. 31, 2018 (HealthDay News) — Preemptive pain medication is safe and reduces pain in the early postoperative period for patients undergoing anorectal surgery, according to a study published in the July issue of Diseases of the Colon & Rectum.
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No Meaningful Increase in Physician Compensation Last Year
THURSDAY, Aug. 30, 2018 (HealthDay News) — There was no meaningful increase in physician compensation in 2017, and a decline in productivity was noted, according to the results of a survey conducted by AMGA Consulting.
Press Release
Survey (subscription or payment may be required)
U.S. Opioid Use Not Declining, Despite Focus on Abuse
WEDNESDAY, Aug. 29, 2018 (HealthDay News) — Rates of opioid use in the United States do not appear to be declining, according to a study published online Aug. 1 in The BMJ.
Marketplace Premiums Increase More With Monopolist Insurers
WEDNESDAY, Aug. 29, 2018 (HealthDay News) — Affordable Care Act Marketplace premiums increase more in areas with monopolist insurers, according to a study published in the August issue of Health Affairs.
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PT Better After Hip Surgery Than Opioids in Younger Adults
WEDNESDAY, Aug. 29, 2018 (HealthDay News) — Physical therapy management is associated with better outcomes for young patients undergoing arthroscopic hip surgery, compared to primary or exclusive opioid treatment, according to a study recently published in Physical Therapy.
FDA Warning Letters Target Illegal Online Sales of Opioids
TUESDAY, Aug. 28, 2018 (HealthDay News) — Four more online networks that operate 21 websites illegally selling potentially dangerous, unapproved, and misbranded versions of opioid pain medications have been told to immediately stop their sales, the U.S. Food and Drug Administration says. The order was made in warning letters sent to the networks.
Medical Practices Should Address Negative Online Reviews
TUESDAY, Aug. 28, 2018 (HealthDay News) — Medical practice staff can effectively handle negative online reviews by staying calm and positive, looking for solutions, apologizing, and thanking the reviewers, according to an article published in Physicians Practice.
Buprenorphine/Naloxone Rx Fills Up With Medicaid Expansion
TUESDAY, Aug. 28, 2018 (HealthDay News) — There was an increase in buprenorphine with naloxone fills in expansion versus nonexpansion counties after Medicaid expansion, according to a study published online Aug. 17 in JAMA Network Open.
Artificial Intelligence Holds Promise in Medicine
TUESDAY, Aug. 28, 2018 (HealthDay News) — Artificial intelligence (AI) in health care offers opportunities for early detection and triage, diagnostics and personalized medicine, and medical decision-making, according to an article published in Managed Healthcare Executive.
Alcohol Is Leading Risk Factor for Global Disease Burden
TUESDAY, Aug. 28, 2018 (HealthDay News) — Globally, alcohol use is a leading risk factor for disease burden, according to research published online Aug. 23 in The Lancet.
Experts Address Loss of the National Guideline Clearinghouse
TUESDAY, Aug. 28, 2018 (HealthDay News) — The demise of the National Guideline Clearinghouse (NGC) in July 2018 is likely to impact evidence-based health care around the world, according to an Ideas and Opinions piece published online Aug. 28 in the Annals of Internal Medicine.
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Bigger Drop in Opioid Prescribing After CDC Guideline Release
MONDAY, Aug. 27, 2018 (HealthDay News) — Release of the U.S. Centers for Disease Control and Prevention Guideline for Prescribing Opioids for Chronic Pain in March 2016 corresponded to greater increases in several opioid prescribing patterns, according to a study published online Aug. 28 in the Annals of Internal Medicine.
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Most Research Participants Not Concerned About Data Sharing
MONDAY, Aug. 27, 2018 (HealthDay News) — Few participants in clinical trials have strong concerns about the risks of data sharing, according to a special article recently published in the New England Journal of Medicine.
Prescription Drug Monitoring Program May Not Cut Opioid Use
MONDAY, Aug. 27, 2018 (HealthDay News) — Implementation of a mandatory prescription drug monitoring program (PDMP) does not necessarily reduce the overall rate of opioid prescribing or the mean number of pills prescribed for patients undergoing general surgical procedures, according to a study published online Aug. 22 in JAMA Surgery.
AMA Adopts Policy Promoting Health Equity As a Goal
FRIDAY, Aug. 24, 2018 (HealthDay News) — The American Medical Association (AMA) House of Delegates has adopted a policy that sets health equity as a goal for the U.S. health care system, according to a report published in the organization’s AMA Wire.
Hydrocodone Schedule Change Affected Post-Op Opioid Rx
FRIDAY, Aug. 24, 2018 (HealthDay News) — Hydrocodone’s change from schedule III to schedule II in 2014 was associated with an increase in the amount of opioids filled in the initial prescription after surgery, according to a study published online Aug. 22 in JAMA Surgery.
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Small Practices Also at Risk for Data Breaches
WEDNESDAY, Aug. 22, 2018 (HealthDay News) — Data breaches can happen to small medical practices, but staff can take steps to prevent them, according to an article published in Medical Economics.
Strategy Outlined for Shooter Incident in Health Care Facility
WEDNESDAY, Aug. 22, 2018 (HealthDay News) — Adhering to a “secure, preserve, fight” strategy is recommended for health care professionals working with a vulnerable patient population, according to a Medicine and Society piece published in the Aug. 9 issue of the New England Journal of Medicine.
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National Provider Identifiers Are Vulnerable to Theft
WEDNESDAY, Aug. 22, 2018 (HealthDay News) — National Provider Identifiers (NPIs) are vulnerable to identity theft, according to an article published in Physicians Practice.
Advantages for HDHP Enrollees in Large Versus Small Firms
WEDNESDAY, Aug. 22, 2018 (HealthDay News) — Workers in small firms are more likely to have higher deductible levels and lack employer contributions to help pay for out-of-pocket expenses compared to workers in larger firms, according to a study published in the August issue of Health Affairs.
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Spinal Manipulation Plus Exercise Effective for Teen Low Back Pain
WEDNESDAY, Aug. 22, 2018 (HealthDay News) — Twelve weeks of spinal manipulative therapy (SMT) combined with exercise therapy (ET) is more effective than ET alone over a one-year period for adolescents with chronic low back pain (LBP), according to a study published in the July issue of PAIN.
Doctors Often Not Discussing Risk Factors With Patients
TUESDAY, Aug. 21, 2018 (HealthDay News) — Patients report that doctors are routinely not discussing known risk factors for common causes of death, according to a survey conducted by ImagineMD.
Patient Education Urged to Prevent Opioid OD After Sobriety
TUESDAY, Aug. 21, 2018 (HealthDay News) — The American Medical Association (AMA) encourages patient education to raise awareness of the risks associated with opioid use after a prolonged period of sobriety, according to a report in the organization’s AMA Wire.
Hypnosis Doesn’t Cut Post-Op Pain in Breast Cancer Surgery
TUESDAY, Aug. 21, 2018 (HealthDay News) — Hypnosis before general anesthesia does not reduce postoperative breast pain among patients undergoing minor breast cancer surgery, according to a study published online Aug. 17 in JAMA Network Open.
Pennsylvania Case Could Affect Evidence for Malpractice Defense
TUESDAY, Aug. 21, 2018 (HealthDay News) — The Pennsylvania Supreme Court has agreed to hear a case that could affect what evidence physicians may present in defense during medical malpractice suits, according to an article published in the American Medical Association’s AMA Wire.
Odds of Death Up With Exposure to Pregabalin, Opioids
MONDAY, Aug. 20, 2018 (HealthDay News) — Concomitant exposure to pregabalin and opioids is associated with increased odds of opioid-related death, according to a research letter published online Aug. 21 in the Annals of Internal Medicine.
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NYU Becomes First Medical School to Cover All Tuition
MONDAY, Aug. 20, 2018 (HealthDay News) — The NYU School of Medicine has announced that it is offering full-tuition scholarships to all current and future students in its M.D. degree program, regardless of need or merit.
Experts Offer Tips for Provider Appeal of Denied Medical Claims
MONDAY, Aug.20, 2018 (HealthDay News) — Knowing payer policies and regulatory requirements is critical to appealing denials, according to an article published in Medical Economics.
Declines in Life Expectancy in Many High-Income Countries
MONDAY, Aug. 20, 2018 (HealthDay News) — Life expectancy has declined in recent years in some high-income countries, and in the United States, midlife mortality has increased due to several causes, according to two studies published online Aug. 15 in The BMJ.
Abstract/Full Text – Ho and Hendi
Abstract/Full Text – Woolf
Editorial
Comments Open on End of NIH Review for Gene Therapy Studies
FRIDAY, Aug. 17, 2018 (HealthDay News) — A U.S. National Institutes of Health oversight panel will no longer review all applications for gene therapy experiments. Instead, the panel will assume an advisory role, while the U.S. Food and Drug Administration will assess gene therapy experiments and products as it does with other treatments and drugs. The proposed change will take effect after a public comment period which runs through Oct. 16.
AP News Article
NIH Statement
Comment on Regulations
Psych Screening Beneficial in Pediatric Abdominal Pain
FRIDAY, Aug. 17, 2018 (HealthDay News) — Systematic screening for anxiety, disability, and pain can increase psychological referral rates among pediatric patients with abdominal pain, according to a study published in the August issue of Pediatrics.
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Residents’ Sleep Deteriorates During Training
FRIDAY, Aug. 17, 2018 (HealthDay News) — First-year residents experience worsening sleep duration and quality as well as daytime sleepiness, according to a study published in the June issue of the Journal of General Internal Medicine.
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Editorial (subscription or payment may be required)
Practice Names, Logos Should Be Carefully Designed
THURSDAY, Aug. 16, 2018 (HealthDay News) — Practice names and logos should be carefully designed to emphasize what is unique about a practice, according to a blog post published in Physicians Practice.
NIH Panel Will No Longer Review Gene Therapy Experiments
THURSDAY, Aug. 16, 2018 (HealthDay News) — A U.S. National Institutes of Health oversight panel will no longer review all applications for gene therapy experiments, according to a perspective piece published online Aug. 15 in the New England Journal of Medicine.
Abstract/Full Text
NIH Statement
Steps Provided for Discharging Patient From Practice
THURSDAY, Aug. 16, 2018 (HealthDay News) — Certain steps should be taken when discharging a patient for failure or inability to meet financial obligations, according to an article published in Physicians Practice.
Patient Portals Don’t Appear to Have Much Traction
THURSDAY, Aug. 16, 2018 (HealthDay News) — Patient portals have not taken off as expected, according to an article published in Medical Economics.
Liposomal Bupivacaine Block No Aid for Cesarean Pain
THURSDAY, Aug. 16, 2018 (HealthDay News) — A liposomal bupivacaine incisional block at the time of cesarean delivery does not improve pain scores in the first 48 hours postoperatively, according to a study published in the July issue of Obstetrics & Gynecology.
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Opioid Dependence More Common Before Spine Surgery
THURSDAY, Aug. 16, 2018 (HealthDay News) — Opioid dependence is more likely to occur in patients with degenerative spondylolisthesis (DS) before surgery than afterward, according to a study recently published in the Journal of Neurosurgery: Spine.
ACA Coverage Gains Include Workers Without Insurance
THURSDAY, Aug. 16, 2018 (HealthDay News) — After the expanded coverage provisions of the Affordable Care Act (ACA) were implemented in 2014, self-employed individuals and wage earners without employer-sponsored health coverage offers had coverage gains equal to or greater than those of people not employed, according to a report published in the August issue of Health Affairs.
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Health Professionals Have Role in Warning About Impaired Driving
WEDNESDAY, Aug. 15, 2018 (HealthDay News) — Physicians, pharmacists, and public health officials play an important role in educating individuals about the risks of impaired driving caused by marijuana or opioids, according to a report from the Governors Highway Safety Association (GHSA) funded by the Foundation for Advancing Alcohol Responsibility.
Integration of Opioid, Infectious Disease Treatment Needed
Ultrasound-Guided Hydrodissection Yields Improvements in Carpal Tunnel 
Physical Therapist-Supervised Exercise Improves Outcomes After ACL Reconstruction 
2013 to 2024 Saw Decrease in Benzodiazepine Prescribing 
2016 to 2024 Saw Increase in Patients Using Medical Cannabis 
Financial Incentives Boost Tobacco Abstinence in Underserved Adults 
Nearly 1 in 10 Older Adults Used Cannabis in the Past Year 
Childhood Cancer Survivors Often Have Mental Distress in Adulthood 
Sugar Exposure in Early Life Linked to Anxiety in Adulthood 
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