scholarly journals Prescribing of opioid analgesics and related mortality before and after the introduction of long-acting oxycodone

2009 ◽  
Vol 181 (12) ◽  
pp. 891-896 ◽  
Author(s):  
I. A. Dhalla ◽  
M. M. Mamdani ◽  
M. L.A. Sivilotti ◽  
A. Kopp ◽  
O. Qureshi ◽  
...  
Keyword(s):  
Opioid Analgesics ◽  
Before And After ◽  
Long Acting ◽  
Related Mortality

scholarly journals Purchases of medical therapy recommended for coronary artery disease before and after elective revascularisation

2019 ◽  
Vol 76 (1) ◽  
pp. 81-88
Author(s):  
Jari Heiskanen ◽  
Juha Hartikainen ◽  
Janne Martikainen ◽  
Heikki Miettinen ◽  
Mikko Hippeläinen ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Medical Therapy ◽  
Coronary Bypass ◽  
University Hospital ◽  
Blocking Agents ◽  
Before And After ◽  
Artery Disease ◽  
Long Acting ◽  
Cabg Patients

Abstract Aims We studied the purchases of medical therapy recommended for coronary artery disease patients before and after elective revascularisation (percutaneous coronary intervention (PCI) or coronary bypass grafting (CABG)). Methods All patients who underwent an elective PCI (N = 1557) or CABG (N = 1768) at the Heart Center, Kuopio University hospital between 2007 and 2014 were included. Data were collected from the hospital’s coronary register and national registers, and obtained for 3 years before and 1 year after the revascularisation. Results Altogether 85.2% of PCI patients and 88.1% of CABG patients had purchased lipid-modifying agents before the procedure, and 94.9% and 96.8% during the post-procedure follow-up year, respectively. Beta-blocking agents were purchased by 84.9% of PCI patients before and by 87.9% after the procedure and by 86.3% of CABG patients before and 97.1% after the operation. Of PCI patients, 64.3% had purchased organic long-acting nitrates before the procedure and 54.4% also after the procedure. Among CABG patients, the purchase of organic long-acting nitrates fell from 59.7% before to 10.1% after the operation. The use of ADP receptor blocking agents increased in PCI patients (26.3 to 83.9%) and the use of warfarin in CABG patients (9.4 to 21.3%). Medication purchases were more common among those who had greater use of hospital services before and after the procedures. Conclusions In both PCI and CABG patients, the use of medical therapy before and after revascularisation procedure complied with current guidelines. Purchases of long-acting nitrates were common in the PCI group even after the procedure.

Short-acting antipsychotics or long-acting injectables? A treatment comparison in patients with schizophrenia

2020 ◽  
Vol 25 (03) ◽  
pp. 170-178 ◽  
Author(s):  
Helena Thiem ◽  
Here Folkerts ◽  
Lukas Völkel
Keyword(s):  
Length Of Stay ◽  
Average Length ◽  
Psychiatric Institute ◽  
Real World Data ◽  
Short Acting ◽  
Treatment Comparison ◽  
Average Length Of Stay ◽  
Before And After ◽  
Oral Antipsychotic ◽  
Long Acting

Abstract Aim This research aims to compare the efficacy and direct costs of short-acting oral antipsychotics and aripiprazole once-monthly (AOM) in the context of the treatment of patients with schizophrenia based on real-world data in Germany. Method Results are based on a single-armed, retrospective, non-interventional pre-post comparison study evaluating data from 132 patients with schizophrenia before and after switching from oral antipsychotics to AOM treatment (6 months each). Socio-demographics, as well as parameters of indication, efficacy and resource consumption were analyzed and statistically evaluated. Results The switch from an oral antipsychotic medication to AOM led to a distinct improvement in all clinically relevant parameters, including a reduction in hospitalization rates (55.1 % vs. 14.0 %), length of stay (43.5 d vs. 34.8 d) and percentage of patients with multiple hospitalizations (13.6 % vs. 3.8 %). There was also a reduction in schizophrenic episodes for patients with ≥ 1 episode (2.9 vs. 1.4) and of the percentage of patients with ≥ 1 (88.0 % vs. 29.3 %) as well as ≥ 2 (60.0 % vs. 8.1 %) schizophrenic episodes. The proportion of patients requiring a visit to day clinics or psychiatric institute outpatient clinics (PIA) decreased (39.5 % vs. 8.4 %) for patients with AOM treatment, as did the average length of stay in day clinics or PIAs (116.8 d vs. 86.4 d) for patients with ≥ 1 stay. The cost saving potential of AOM compared to the treatment with oral antipsychotics ranged between 1,729.32 € and 5,048.53 € per patient for a six-month observation period. Conclusion Our results suggest that AOM treatment of patients with schizophrenia is more effective (reduction in schizophrenic episodes, hospitalizations, stays in day clinics, psychiatrist visits, losses in productivity) and generates lower costs for the statutory health insurance (SHI) in Germany than treatment with oral antipsychotics and should therefore not be regarded as only a last-resort treatment option for schizophrenia.

scholarly journals Is paliperidone palmitate more effective than other long-acting injectable antipsychotics?

2017 ◽  
Vol 48 (10) ◽  
pp. 1616-1623 ◽  
Author(s):  
R. Patel ◽  
E. Chesney ◽  
M. Taylor ◽  
D. Taylor ◽  
P. McGuire
Keyword(s):  
Rate Ratio ◽  
Hospital Admissions ◽  
Incidence Rate Ratio ◽  
Psychiatric Inpatient ◽  
The Other ◽  
Paliperidone Palmitate ◽  
Before And After ◽  
Long Acting ◽  
Few Data ◽  
The Uk

AbstractBackgroundPaliperidone palmitate is one of the most widely prescribed long-acting injectable (LAI) antipsychotics in the UK. However, it is relatively expensive and there are few data comparing its effectiveness to that of other LAI antipsychotics. We sought to address this issue by analyzing a large anonymized electronic health record (EHR) dataset from patients treated with LAI antipsychotics.MethodsEHR data were obtained from 1281 patients in the South London and Maudsley NHS Foundation Trust (SLaM) who started treatment with a LAI antipsychotic between 1 April 2011 and 31 January 2015. The number of days spent as a psychiatric inpatient and the number of admissions to a psychiatric hospital were analyzed in each of the 3 years before and after LAI prescription.ResultsPatients treated with paliperidone palmitate (n = 430; 33.6%) had a greater number of inpatient days and a greater number of admissions in the year prior to treatment than those treated with other LAI antipsychotics. Nevertheless, in the 3 years after initiation there were no significant differences between paliperidone and the other LAI antipsychotics in the number of days as an inpatient (B coefficient 5.4 days, 95% confidence interval (CI) −57.3 to 68.2, p = 0.86) or number of hospital admissions (Incidence rate ratio 1.07, 95% CI 0.62 to 1.83, p = 0.82).ConclusionPaliperidone palmitate was more likely to be prescribed in patients with more frequent and lengthy hospital admissions prior to initiation. However, the absence of differences in outcomes after initiation indicates that paliperidone palmitate was not more effective than other cheaper LAI antipsychotics.

Opioid Pharmacotherapies for Chronic Pain (DRAFT)

2018 ◽  
Author(s):  
Thien C. Pham ◽  
Courtney Kominek ◽  
Abigail Brooks ◽  
Jeffrey Fudin
Keyword(s):  
Chronic Pain ◽  
Extended Release ◽  
Opioid Analgesics ◽  
Chronic Pain Management ◽  
Opioid Use ◽  
Daily Dose ◽  
Long Acting ◽  
Conversion Tool ◽  
Morphine Equivalent

Chronic pain management employing opioids is divided into subtopics, including: risk–benefit balance; a review of the mode of action of opioid analgesics (Chap. 8); the suitability of synthetic opioids for neuropathic pain; endocrinopathy proceeding from opioid use; the use of the morphine-equivalent daily dose as a conversion tool for managing multiple opioids; the place of extended-release and long-acting opioids; current technology in abuse deterrence; and an overview of the challenges entailed in prescribing. This last section details the complex components of a decision to prescribe opioids for chronic pain. A table is provided of the classification of common opioid analgesics and their duration of activity. A text box gives the table of contents of Appendix B, supportive tables and figures therein for this chapter; there is also a text box listing additional resources.

scholarly journals Naloxone dosage for opioid reversal: current evidence and clinical implications

2017 ◽  
Vol 9 (1) ◽  
pp. 63-88 ◽  
Author(s):  
Rachael Rzasa Lynn ◽  
JL Galinkin
Keyword(s):  
Hospital Setting ◽  
The United States ◽  
Current Evidence ◽  
Opioid Overdose ◽  
Inadequate Response ◽  
Duration Of Effect ◽  
Emergency Personnel ◽  
Long Acting ◽  
Opioid Withdrawal Syndrome ◽  
Related Mortality

Opioid-related mortality is a growing problem in the United States, and in 2015 there were over 33,000 opioid-related deaths. To combat this mortality trend, naloxone is increasingly being utilized in a pre-hospital setting by emergency personnel and prescribed to laypersons for out-of-hospital administration. With increased utilization of naloxone there has been a subsequent reduction in mortality following an opioid overdose. Reversal of opioid toxicity may precipitate an opioid-withdrawal syndrome. At the same time, there is a risk of inadequate response or re-narcotization after the administration of a single dose of naloxone in patients who have taken large doses or long-acting opioid formulations, as the duration of effect of naloxone is shorter than that of many opioid agonists. As out-of-hospital use of this medication is growing, so too is concern about effective but safe dosing.

Sign in / Sign up

Export Citation Format

Share Document