Prescription Medication for Posttraumatic Headache Following Concussion: A Critically Appraised Topic

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2020-0060 ◽

2021 ◽

pp. 1-4

Author(s):

Karlee Burns ◽

Ryan Tierney ◽

Jane McDevitt

Keyword(s):

Cognitive Function ◽

Prescription Medication ◽

Prescription Medications ◽

Clinical Question ◽

Long Term Outcomes ◽

Bottom Line ◽

Posttraumatic Headache

Clinical Question: In individuals with posttraumatic headache following concussion, what impact does medication have? Clinical Bottom Line: Prescription medications may be beneficial for those suffering posttraumatic headache following concussion by decreasing headache symptoms and improving cognitive function, though long-term outcomes were similar between those taking and not taking medications.

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The Effectiveness of Cervical Traction and Exercise in Decreasing Neck and Arm Pain for Patients With Cervical Radiculopathy: A Critically Appraised Topic

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2016-0096 ◽

2017 ◽

Vol 22 (5) ◽

pp. 4-11

Author(s):

Shelby E. Baez ◽

Johanna M. Hoch ◽

Timothy L. Uhl

Keyword(s):

Cervical Radiculopathy ◽

Future Research ◽

Clinical Question ◽

Long Term Outcomes ◽

Bottom Line ◽

Arm Pain ◽

High Quality Evidence ◽

Strengthening Exercises ◽

Cervical Traction

Clinical Question:Is there evidence to suggest intermittent cervical traction with cervical and scapular strengthening exercises is more effective in decreasing neck and arm pain when compared with cervical and scapular strengthening exercises alone in nonoperative patients with cervical radiculopathy?Clinical Bottom Line:There is currently inconsistent, high-quality evidence that suggests that the use of intermittent cervical traction in addition to strengthening exercises is more effective at decreasing pain in nonoperative patients with cervical radiculopathy when compared with strengthening alone. Future research should continue to examine long-term outcomes associated with cervical radiculopathy patients who use intermittent cervical traction as an intervention.

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Immigrant Usage Patterns of Natural Health Products: Role in Pharmacoeconomics

Current Nutrition & Food Science ◽

10.2174/1573401315666181206120420 ◽

2020 ◽

Vol 16 (1) ◽

pp. 45-55

Author(s):

Dalya Abdulla

Keyword(s):

English Language ◽

Prescription Medication ◽

Natural Health Products ◽

Prescription Medications ◽

Natural Health ◽

Short Term ◽

Long Term Conditions ◽

Health Products ◽

Usage Patterns

Background: Understanding patterns and drivers for natural health product (NHP) usage among immigrants is essential in the provision of appropriate health care; many studies have elucidated NHP utilization among immigrants; however, few have considered impacts of concurrent NHP and prescription medication usage. Objective: The study aims to determine new immigrant NHP usage patterns (including concurrent usage with prescription medications) and to discern economic impacts driving concurrent usage. Methods: A survey questionnaire was administered to local new immigrants during English Language Training classes. Results: Most participants understood the NHP definition and would take an NHP for the same disease or condition they would normally take a prescription medication for. Many participants agreed that NHPs are not safe however were unable to provide robust examples of unsafe NHP usage. With regard to purchases of medicines for short and long term illnesses, a high percentage of participants would purchase the prescription medication for a short term illness over the NHP; however this percentage decreases in the event of a long term illness, with more participants relying on NHPs to remedy their long term illness symptoms. Conclusion: Pharmacoeconomics tends to be a major driver for immigrant utilization of NHPs, and is a stronger influencer of use compared to ethnicity or parenteral usage of such products. This pharmacoeconomic correlation in the preference to use NHPs over prescription medications tends to be more observable for chronic and long term conditions (compared to short term illnesses).

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Prescription medication use after congenital heart surgery

Cardiology in the Young ◽

10.1017/s1047951121005060 ◽

2022 ◽

pp. 1-8

Author(s):

Alireza Raissadati ◽

Jari Haukka ◽

Tommi Pätilä ◽

Heta Nieminen ◽

Eero Jokinen

Keyword(s):

General Population ◽

Congenital Heart ◽

Heart Surgery ◽

Medication Use ◽

Prescription Medication ◽

Congenital Heart Surgery ◽

Hazard Ratio ◽

Prescription Medications

Abstract Background: Improvements in mortality after congenital heart surgery have necessitated a shift in focus to postoperative morbidity as an outcome measure. We examined late morbidity after congenital heart surgery based on prescription medication use. Methods: Between 1953 and 2009, 10,635 patients underwent congenital heart surgery at <15 years of age in Finland. We obtained 4 age-, sex-, birth-time, and hospital district-matched controls per patient. The Social Insurance Institution of Finland provided data on all prescription medications obtained between 1999 and 2012 by patients and controls. Patients were assigned one diagnosis based on a hierarchical list of cardiac defects and dichotomised into simple and severe groups. Medications were divided into short- and long-term based on indication. Follow-up started at the first operation and ended at death, emigration, or 31 December, 2012. Results: Totally, 8623 patients met inclusion criteria. Follow-up was 99.9%. In total, 8126 (94%) patients required prescription medications. Systemic anti-bacterials were the most common short-term prescriptions among patients (93%) and controls (88%). Patients required betablockers (simple hazard ratio 1.9, 95% confidence interval 1.7–2.1; severe hazard ratio 6.5, 95% confidence interval 5.3–8.1) and diuretics (simple hazard ratio 3.2, 95% CI 2.8–3.7; severe hazard ratio 38.8, 95% CI 27.5–54.7) more often than the general population. Both simple and severe defects required medication for cardiovascular, gastrointestinal, psychiatric, neurologic, metabolic, autoimmune, and infectious diseases more often than the general population. Conclusions: The significant risk for postoperative cardiovascular and non-cardiovascular disease warrants close long-term follow-up after congenital heart surgery for all defects.

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Provider reasons for discontinuing long-term opioid therapy following aberrant urine drug tests differ based on the type of substance identified

Journal of Opioid Management ◽

10.5055/jom.2018.0461 ◽

2018 ◽

Vol 14 (4) ◽

pp. 295-303

Author(s):

Jessica J. Wyse, PhD ◽

Benjamin J. Morasco, PhD ◽

Steven K. Dobscha, MD ◽

Michael I. Demidenko, BS ◽

Thomas H. A. Meath, MPH ◽

...

Keyword(s):

Drug Testing ◽

Prescription Medication ◽

Opioid Therapy ◽

Prescription Medications ◽

Department Of Veterans Affairs ◽

Urine Drug ◽

Va Health Care System ◽

Record Review ◽

Illicit Substances

Objective: Urine drug testing (UDT) is increasingly performed as a means of identifying aberrant behavior that may be grounds for discontinuation of long-term opioid therapy (LTOT). Little is known, however, about the ways in which positive UDT results may differentially inform decisions to discontinue LTOT based on the type of substance for which the UDT screened positive. The aim of this study was to examine the likelihood of clinician-initiated discontinuation of LTOT attributed to positive UDT results across three discrete categories of substances: (1) cannabis, (2) alcohol or illicit substances (excluding cannabis), and (3) controlled prescription medications that were not prescribed.Design: This retrospective study utilized the US Department of Veterans Affairs (VA) Health Care System. Corporate Data Warehouse to assemble a sample of 600 patients with substance use disorders and matched controls who were discontinued from LTOT in 2012. Comprehensive manual medical record review identified UDT results in the year prior to discontinuation and reason(s) for discontinuation.Patients, Participants: Patients with one or more UDTs positive for a single substance (N = 185) comprised the study sample.Main Outcome Measure(s): Likelihood of clinician-initiated discontinuation attributed to a positive UDT across the three categories. Results: Patients with one or more UDTs positive for cannabis were more likely to be discontinued from opioid therapy as a result of the positive UDT compared to those with one or more UDTs positive for nonprescribed prescription medication (adjusted odds ratio [OR] = 18.05, 95% CI = 7.29-44.66). Similarly, patients with UDTs positive for alcohol or illicit substances were more likely to be discontinued for the positive UDTs relative to patients who tested positive for nonprescribed prescription medications (adjusted OR = 13.10, 95% CI = 4.81-35.68). No difference in UDT-related discontinuation decisions was evident between patients with UDTs positive for alcohol/illicit substances versus cannabis (adjusted OR = 1.47, 95% CI = 0.57-3.77). Conclusions: High odds of UDT-related discontinuation were found in patients who tested positive for cannabis, alcohol, or illicit substances, relative to nonprescribed prescription medications.

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The Efficacy of a Passive Stretching Intervention for Overhead Athletes: A Critically Appraised Topic

International Journal of Athletic Therapy & Training ◽

10.1123/ijatt.2019-0142 ◽

2020 ◽

pp. 1-5

Author(s):

Michelle A. Sandrey

Keyword(s):

Range Of Motion ◽

Moderate Level ◽

Clinical Question ◽

Bottom Line ◽

Overhead Athletes ◽

Passive Stretching ◽

Posterior Shoulder ◽

Posterior Shoulder Tightness ◽

Level 2

Focused Clinical Question: Does a passive stretching protocol, whether immediate or long-term, improve range of motion and decrease posterior shoulder tightness in overhead athletes? Clinical Bottom Line: There is moderate level 2 evidence to support the incorporation of passive stretching for overhead athletes to increase range of motion or decrease posterior shoulder tightness.

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Traumatic Brain Injury: A Trauma Surgeon's Perspective

Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders ◽

10.1044/nnsld22.3.82 ◽

2012 ◽

Vol 22 (3) ◽

pp. 82-89

Author(s):

Oscar D. Guillamondegui

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Multidisciplinary Approach ◽

Trauma Team ◽

The United States ◽

Long Term Outcomes ◽

Term Care ◽

Injured Brain ◽

The Moment

Traumatic brain injury (TBI) is a serious epidemic in the United States. It affects patients of all ages, race, and socioeconomic status (SES). The current care of these patients typically manifests after sequelae have been identified after discharge from the hospital, long after the inciting event. The purpose of this article is to introduce the concept of identification and management of the TBI patient from the moment of injury through long-term care as a multidisciplinary approach. By promoting an awareness of the issues that develop around the acutely injured brain and linking them to long-term outcomes, the trauma team can initiate care early to alter the effect on the patient, family, and community. Hopefully, by describing the care afforded at a trauma center and by a multidisciplinary team, we can bring a better understanding to the armamentarium of methods utilized to treat the difficult population of TBI patients.

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