Clinical Pharmacogenetics Implementation Consortium (CPIC) guideline for CYP2D6 , OPRM1 , and COMT genotype and select opioid therapy

2021 ◽  
Author(s):  
Kristine R. Crews ◽  
Andrew A. Monte ◽  
Rachel Huddart ◽  
Kelly E. Caudle ◽  
Evan D. Kharasch ◽  
...  
Keyword(s):  
Opioid Therapy ◽  
Comt Genotype

Guidelines Seek Tighter Opioid Therapy Control

2007 ◽  
Vol 35 (5) ◽  
pp. 42
Author(s):  
JANE SALODOF MACNEIL
Keyword(s):  
Opioid Therapy ◽  
Therapy Control

scholarly journals Predictors of Chronic Opioid Use: A Population-level Analysis of North Carolina Cancer Survivors Using Multi-Payer Claims

2021 ◽  
Author(s):  
Devon K Check ◽  
Christopher D Bagett ◽  
KyungSu Kim ◽  
Andrew W Roberts ◽  
Megan C Roberts ◽  
...  
Keyword(s):  
North Carolina ◽  
Substance Use ◽  
Cancer Survivors ◽  
Low Income ◽  
Opioid Therapy ◽  
Adjusted Relative Risk ◽  
Opioid Use ◽  
Chronic Opioid Therapy ◽  
Increased Risk ◽  
Chronic Opioid Use

Abstract Background No population-based studies have examined chronic opioid use among cancer survivors who are diverse with respect to diagnosis, age group, and insurance status. Methods We conducted a retrospective cohort study using North Carolina (NC) cancer registry data linked with claims from public and private insurance (2006–2016). We included adults with non-metastatic cancer who had no prior chronic opioid use (N = 38,366). We used modified Poisson regression to assess the adjusted relative risk of chronic opioid use in survivorship (>90-day continuous supply of opioids in the 13–24 months following diagnosis) associated with patient characteristics. Results Only 3.0% of cancer survivors in our cohort used opioids chronically in survivorship. Predictors included younger age (adjusted risk ratio [aRR], 50–59 vs 60–69 = 1.23, 95% confidence interval [CI] = 1.05–1.43), baseline depression (aRR = 1.22, 95% CI = 1.06–1.41) or substance use (aRR = 1.43, 95% CI = 1.15–1.78) and Medicaid (aRR vs Private = 1.93, 95% CI = 1.56–2.40). Survivors who used opioids intermittently (vs not at all) before diagnosis were twice as likely to use opioids chronically in early survivorship (aRR = 2.62, 95% CI = 2.28–3.02). Those who used opioids chronically (vs intermittently or not at all) during active treatment had a nearly 17-fold increased likelihood of chronic use in survivorship (aRR = 16.65, 95 CI = 14.30–19.40). Conclusions Younger and low-income survivors, those with baseline depression or substance use, and those who require chronic opioid therapy during treatment are at increased risk for chronic opioid use in survivorship. Our findings point to opportunities improve assessment of psychosocial histories and to engage patients in shared decision-making around long-term pain management, when chronic opioid therapy is required during treatment.

Tapentadol results in less deterioration of gastrointestinal function and symptoms than standard opioid therapy in healthy male volunteers

2021 ◽  
Author(s):  
Esben Bolvig Mark ◽  
Rasmus Bach Nedergaard ◽  
Tine Maria Hansen ◽  
Thomas Dahl Nissen ◽  
Jens Brøndum Frøkjær ◽  
...  
Keyword(s):  
Opioid Therapy ◽  
Gastrointestinal Function ◽  
Healthy Male ◽  
Healthy Male Volunteers ◽  
Male Volunteers

scholarly journals Opioid-Induced Respiratory Depression in Pediatric Palliative Care Patients with Severe Neurological Impairment—A Scoping Literature Review and Case Reports

Children ◽  
2020 ◽  
Vol 7 (12) ◽  
pp. 312
Author(s):  
Maximilian David Mauritz ◽  
Carola Hasan ◽  
Larissa Alice Dreier ◽  
Pia Schmidt ◽  
Boris Zernikow
Keyword(s):  
Risk Factors ◽  
Palliative Care ◽  
Young Adults ◽  
Scoping Review ◽  
Pediatric Patients ◽  
Case Reports ◽  
Neurological Impairment ◽  
Opioid Therapy ◽  
Pediatric Palliative Care ◽  
Severe Neurological Impairment

Pediatric Palliative Care (PPC) addresses children, adolescents, and young adults with a broad spectrum of underlying diseases. A substantial proportion of these patients have irreversible conditions accompanied by Severe Neurological Impairment (SNI). For the treatment of pain and dyspnea, strong opioids are widely used in PPC. Nonetheless, there is considerable uncertainty regarding the opioid-related side effects in pediatric patients with SNI, particularly concerning Opioid-Induced Respiratory Depression (OIRD). Research on pain and OIRD in pediatric patients with SNI is limited. Using scoping review methodology, we performed a systematic literature search for OIRD in pediatric patients with SNI. Out of n = 521 identified articles, n = 6 studies were included in the review. Most studies examined the effects of short-term intravenous opioid therapy. The incidence of OIRD varied between 0.13% and 4.6%; besides SNI, comorbidities, and polypharmacy were the most relevant risk factors. Additionally, three clinical cases of OIRD in PPC patients receiving oral or transdermal opioids are presented and discussed. The case reports indicate that the risk factors identified in the scoping review also apply to adolescents and young adults with SNI receiving low-dose oral or transdermal opioid therapy. However, the risk of OIRD should never be a barrier to adequate symptom relief. We recommend careful consideration and systematic observation of opioid therapy in this population of patients.

Prevalence of long-term opioid therapy in spine center outpatients the spinal pain opioid cohort (SPOC)

2021 ◽  
Author(s):  
Claus Manniche ◽  
Lonny Stokholm ◽  
Sophie L. Ravn ◽  
Tonny A. Andersen ◽  
Lars Brandt ◽  
...  
Keyword(s):  
Spinal Pain ◽  
Opioid Therapy

scholarly journals COMT Genotype Influences the Effect of Alcohol on Blood Pressure: Results From the COMBINE Study

2009 ◽  
Vol 22 (1) ◽  
pp. 87-91 ◽  
Author(s):  
S. H. Stewart ◽  
G. Oroszi ◽  
P. K. Randall ◽  
R. F. Anton
Keyword(s):  
Blood Pressure ◽  
Comt Genotype ◽  
Combine Study

scholarly journals Predictors of chronic opioid therapy in Medicaid beneficiaries with HIV who initiated antiretroviral therapy

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
GYeon Oh ◽  
Emily S. Brouwer ◽  
Erin L. Abner ◽  
David W. Fardo ◽  
Patricia R. Freeman ◽  
...  
Keyword(s):  
Regression Models ◽  
Opioid Therapy ◽  
Chronic Obstructive ◽  
Chronic Opioid Therapy ◽  
Hepatitis C Infection ◽  
Antipsychotic Therapy ◽  
Obstructive Pulmonary Disease ◽  
Logistic Regression Models ◽  
Factors Associated ◽  
Medicaid Beneficiaries

AbstractThe factors associated with chronic opioid therapy (COT) in patients with HIV is understudied. Using Medicaid data (2002–2009), this retrospective cohort study examines COT in beneficiaries with HIV who initiated standard combination anti-retroviral therapy (cART). We used generalized estimating equations on logistic regression models with backward selection to identify significant predictors of COT initiation. COT was initiated among 1014 out of 9615 beneficiaries with HIV (male: 10.4%; female: 10.7%). Those with older age, any malignancy, Hepatitis C infection, back pain, arthritis, neuropathy pain, substance use disorder, polypharmacy, (use of) benzodiazepines, gabapentinoids, antidepressants, and prior opioid therapies were positively associated with COT. In sex-stratified analyses, multiple predictors were shared between male and female beneficiaries; however, chronic obstructive pulmonary disease, liver disease, any malignancy, and antipsychotic therapy were unique to female beneficiaries. Comorbidities and polypharmacy were important predictors of COT in Medicaid beneficiaries with HIV who initiated cART.

Sign in / Sign up

Export Citation Format

Share Document