Controlled Substances and Pain Management: Regulatory Oversight, Formularies, and Cost Decisions

1996 ◽  
Vol 24 (4) ◽  
pp. 310-316 ◽  
Author(s):  
Douglas J. Pisano
Keyword(s):  
Health Care ◽  
Pain Management ◽  
Integrated System ◽  
Regulatory Control ◽  
Treatment Modalities ◽  
Drug Abuse Prevention ◽  
Regulatory Oversight ◽  
Controlled Substances ◽  
Economic Decision Making ◽  
Personnel Practice

Pharmacists, physicians, and other health care personnel practice within an integrated system of laws and regulations that influence many treatment modalities. Capitation, managed care, and other controls strain these relationships by mandating greater oversight of how health care is delivered. From a pharmacists’s perspective, any use of medication requites knowledge of three omnipresent factors: regulatory control, formularies (product selection), and economic decision making. My objective is to raise awareness of these issues as they relate to the prescription of pain medication and to pain management generally.All practice-oriented drug law and regulation is based on the federal Controlled Substances Act of 1970. The Act, also known as Title II, is part of a much larger piece of legislation, the Comprehensive Drug Abuse Prevention and Control Act of 1970 (CSA). CSA was enacted to regulate the manufacturing, distribution, dispensing, and delivery of drugs or substances that are subject to, or have the potential for, abuse or physical or psychological dependence.

scholarly journals Plain Language Summary: Opioid Prescribing for Analgesia After Common Otolaryngology Operations

2021 ◽  
Vol 164 (4) ◽  
pp. 704-711
Author(s):  
Samantha Anne ◽  
Sandra A. Finestone ◽  
Allison Paisley ◽  
Taskin M. Monjur
Keyword(s):  
Health Care ◽  
Decision Making ◽  
Clinical Practice ◽  
Pain Management ◽  
Health Care Providers ◽  
Clinical Practice Guideline ◽  
Shared Decision ◽  
Care Providers ◽  
Plain Language ◽  
Opioid Prescribing

This plain language summary explains pain management and careful use of opioids after common otolaryngology operations. The summary applies to patients of any age who need treatment for pain within 30 days after having a common otolaryngologic operation (having to do with the ear, nose, or throat). It is based on the 2021 “Clinical Practice Guideline: Opioid Prescribing for Analgesia After Common Otolaryngology Operations.” This guideline uses available research to best advise health care providers, and it includes recommendations that are explained in this summary. Recommendations may not apply to every patient but can be used to facilitate shared decision making between patients and their health care providers.

scholarly journals Rapid identification of health care–associated infections with an integrated fluorescence anisotropy system

2016 ◽  
Vol 2 (5) ◽  
pp. e1600300 ◽  
Author(s):  
Ki Soo Park ◽  
Chen-Han Huang ◽  
Kyungheon Lee ◽  
Yeong-Eun Yoo ◽  
Cesar M. Castro ◽  
...  
Keyword(s):  
Health Care ◽  
Fluorescence Anisotropy ◽  
Bacterial Species ◽  
Rapid Identification ◽  
Integrated System ◽  
Clinical Samples ◽  
Drug Resistant ◽  
Polarization Anisotropy ◽  
Major Health ◽  
Health Care Associated Infections

Health care–associated infections (HAIs) and drug-resistant pathogens have become a major health care issue with millions of reported cases every year. Advanced diagnostics would allow clinicians to more quickly determine the most effective treatment, reduce the nonspecific use of broad-spectrum antimicrobials, and facilitate enrollment in new antibiotic treatments. We present a new integrated system, polarization anisotropy diagnostics (PAD), for rapid detection of HAI pathogens. The PAD uses changes of fluorescence anisotropy when detection probes recognize target bacterial nucleic acids. The technology is inherently robust against environmental noise and economically scalable for parallel measurements. The assay is fast (2 hours) and performed on-site in a single-tube format. When applied to clinical samples obtained from interventional procedures, the PAD determined the overall bacterial burden, differentiated HAI bacterial species, and identified drug resistance and virulence status. The PAD system holds promise as a powerful tool for near-patient, rapid HAI testing.

scholarly journals Awareness of parents towards Teething

1970 ◽  
Vol 11 (1) ◽  
pp. 40-43 ◽  
Author(s):  
K Bhavneet
Keyword(s):  
Health Care ◽  
Child Health ◽  
General Health ◽  
Deciduous Tooth ◽  
Treatment Modalities ◽  
Child Health Care ◽  
Statistical Software ◽  
Relationship Of ◽  
The Relationship ◽  
Structured Questionnaire

Objective: The relationship of the first deciduous tooth eruption and the general health of an infant has always been a subject of curiosity. The enigma of teething although historical, continues to pervade contemporary child health care due to many unexplained teething myths. The treatment modalities used in teething have been diverse. The objective of this study was to evaluate the awareness, beliefs and knowledge of parents towards teething symptoms. Materials and method: Hundred parents were randomly selected from two kindergarten schools and were interviewed according to a structured questionnaire. Collected data was analyzed by a statistical software known as SPSS. Results: Results revealed that though parents knew about teething but there was lack of awareness regarding diverse treatment modalities and the teething myths and realities. Conclusions: More educative programs should be initiated to make parents aware of teething myths and realities. DOI: http://dx.doi.org/10.3329/bjms.v11i1.9822 BJMS 2012; 11(1): 40-43

scholarly journals Perception of Iranian Patients with Cancer, Their Relatives, and Health Care Professionals Towards Length of Life and Quality of Life: A Local Survey

2021 ◽  
Vol In Press (In Press) ◽  
Author(s):  
Negin Nourbakhsh ◽  
Bahareh Tahani ◽  
Azadeh Moghaddas
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Survival Time ◽  
Health Care Professionals ◽  
Treatment Modalities ◽  
Cancer Center ◽  
Treatment Choices ◽  
Patients With Cancer ◽  
Length Of Life

Background: Recently, therapeutic decision-making in oncology is changed to a big challenge for both patients and involved oncologists due to an increase in available treatment modalities with a variety of benefits or adverse effects. Objectives: The current study aimed at comparing the perception of treatment priorities regarding lengthening of survival time or maintenance of the quality of life (QoL) among patients with cancer by health care professionals (HCPs). Methods: The current cross-sectional study was conducted on patients with cancer, their relatives, and healthcare professionals in the referral cancer center of Omid affiliated to Isfahan University of Medical Sciences. To identify treatment choices, priority, and related variables influencing their opinions, all participants were interviewed using a standard and valid questionnaire in Persian. The collected data were analyzed using the SPSS software version 20, and the P-value less than 0.05 was considered statistically significant. Results: A total of 299 participants, including 100 patients, 109 relatives, and 90 HCPs (74.2% nurses, 20.2% physicians, 5.6% others) participated in the study. The priority of treatment between survival time (66.1% for relatives vs. 47.9% for patients and 21.3% for HCP) and QoL (33.9% vs.52.1% and 78.7%) was significantly different between the three groups (P < 0.001). Most of the HCPs, patients, and their relatives believed that the physician is the only person who should accept the responsibility of treatment choices and process (98.9% vs. 100% and 98%, respectively; P = 0.002). Conclusions: Among the Iranian population, both the length of life and QoL were valuable; however, it was observed that patients with cancer and HCPs preferred mostly to expand the QoL, while the length of life was more valuable for relatives. Also, all patients, their relatives, and HCPs preferred to choose the physicians as the decision-makers. The results of the study can be helpful in choosing treatment regimens and designing clinical trials.

scholarly journals PAIN MANAGEMENT IN PRIMARY DYSMENORRHOEA AND ENDOMETRIOSIS- AYURVEDIC PERSPECTIVE

2021 ◽  
pp. 84-88
Author(s):  
Asitha.H
Keyword(s):  
Pain Management ◽  
Treatment Modalities ◽  
Clear View ◽  
Unpleasant Sensation ◽  
Primary Dysmenorrhoea ◽  
Adolescent Period ◽  
Experience Pain

Pain is generally described as an unpleasant sensation and a universally understood sign of disease. Around 80% of women experience pain during periods from adolescent period right up to menopause. Dysmenorrhoea literally means painful menstruation. Primary dysmenorrhoea is one where there is no identifiable pelvic pathology. The pain begins a few hours before or just with the onset of menstruation and lasts for 24-48 hours. Secondary dysmenorrhoea is normally considered to be menstruation –associated pain occurring in the presence of pelvic pathology. Pain starts 7-8 days before menstruation. Endometriosis is one of the main causes of secondary dysmenorrhoea. Dysmenorrhoea can be correlated to Udavarta and endometriosis to Vatiki. In Udavarta, Sanga and Vimargagamana of Vata and derangement of Kapha pitta is responsible for pain. In Vatiki there is Apana vata vimargagamana, Vyana vata and Pitta vitiation causes Artava dusti and Dusta artava sthana samsraya in Kha vaigunya sites. So administration of drugs and treatment modalities crackling these factors involved in the etiopathogenesis do the work. Ayurvedic classic textbook along with available modern literatures were referred to make a clear view regarding the concept of pain and the main Yonirogas causing pain during menstruation and its management.

Real-World Evidence in the Real World: Beyond the FDA

2018 ◽  
Vol 44 (2-3) ◽  
pp. 161-179 ◽  
Author(s):  
Joan H. Krause ◽  
Richard S. Saver
Keyword(s):  
Health Care ◽  
Health Care System ◽  
Real World ◽  
Regulatory Oversight ◽  
The Real ◽  
Health Care Fraud ◽  
Fda Approval ◽  
Real World Evidence ◽  
Potential Benefits ◽  
Care System

The 21st Century Cures Act (“Cures Act”) relies on the concept of real-world evidence (“RWE”) to improve the Food and Drug Administration (“FDA”) approval process. This has amplified interest and furthered momentum in applying RWE more broadly, beyond FDA regulation. In this article, we discuss the understandable appeal of RWE's pragmatic application and its many potential benefits. But we also caution that claims about RWE's wide-ranging, ameliorative impact on the health care system are likely overstated.The real world of RWE is messy and uncertain. Successfully incorporating RWE into regular health care system decision-making, beyond the FDA, faces considerable obstacles and limitations. We review the reasons to be wary about RWE as a game-changer. These concerns including data reliability, insufficient incentives for stakeholders to generate and engage with high-quality RWE, and lack of comprehensive regulatory oversight. In addition, the push for RWE may impact the enforcement of the health care fraud and abuse laws, perhaps not in necessarily positive ways. Increased reliance on RWE may have significant implications for off-label fraud enforcement, further conflating the distinction between claims that are false for reimbursement rather than for scientific purposes.

Sign in / Sign up

Export Citation Format

Share Document