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February 2013 Briefing - Pain Management

Here are what the editors at HealthDay consider to be the most important developments in Pain Management for February 2013. 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.

CMS Issues Final Rule on Physician Sunshine Act

THURSDAY, Feb. 28 (HealthDay News) -- The Centers for Medicare and Medicaid Services (CMS) have issued a final rule requiring drug and device manufacturers and group purchasing organizations (GPOs) to report payment or gifts of more than $10 to physicians, hospitals, and other providers, and necessitating manufacturers and GPOs to report ownership or investment interests held by physicians or their family members.

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ACR Releases Five 'Don'ts' for Rheumatologists

WEDNESDAY, Feb. 27 (HealthDay News) -- As part of the Choosing Wisely campaign, the American College of Rheumatology (ACR) has issued a list of the top five tests and treatments commonly misordered by rheumatologists; the list has been published in the March issue of Arthritis Care & Research.

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FDA Approves Osphena for Dyspareunia Post-Menopause

WEDNESDAY, Feb. 27 (HealthDay News) -- The U.S. Food and Drug Administration has approved the once-daily pill Osphena (ospemifene) to treat postmenopausal women experiencing moderate-to-severe pain during sexual intercourse.

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Preparation Underway for Implementation of ACA in 2014

TUESDAY, Feb. 26 (HealthDay News) -- As the implementation of the Affordable Care Act (ACA) nears, states are preparing for some of its provisions, including expanded access to Medicaid and the Children's Health Insurance Program (CHIP) and the use of information technology, according to a report issued by the Kaiser Family Foundation.

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Mental Health and Substance Use Disorder Benefits Expanded

FRIDAY, Feb. 22 (HealthDay News) -- In a final rule, which will make purchasing health coverage easier for consumers, mental health and substance use benefits will be expanded to 62 million Americans, according to a report published Feb. 20 by the U.S. Department of Health and Human Services.

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CMS Proposes Payment and Policy Updates for 2014

THURSDAY, Feb. 21 (HealthDay News) -- Payment and policy updates have been proposed for 2014, according to the Centers for Medicare and Medicaid Services (CMS) Advanced Notice and draft Call Letter published Feb. 15.

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FDA: Codeine After Surgery Puts Children At Risk

THURSDAY, Feb. 21 (HealthDay News) -- Even when given in recommended amounts, codeine can be dangerous, perhaps deadly, in children, according to the U.S. Food and Drug Administration.

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Report Discusses Impact of ACGME 2011 Requirements

THURSDAY, Feb. 21 (HealthDay News) -- Although many residency program directors approve of individual components within the Accreditation Council for Graduate Medical Education (ACGME) Common Program Requirements introduced in 2011, less than half express overall approval, according to a perspective piece published in the Feb. 21 issue of the New England Journal of Medicine.

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Pros, Cons of Medical Marijuana for Metastatic Cancer Explored

WEDNESDAY, Feb. 20 (HealthDay News) -- Some physicians favor while others advocate against the use of medical marijuana, according to a case vignette published online Feb. 20 in the New England Journal of Medicine.

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Faster Adoption of Electronic Health Records Needed

WEDNESDAY, Feb. 20 (HealthDay News) -- The adoption of electronic health records (EHRs) by health providers for Medicare is increasing, but not quickly enough to avoid penalties in 2015, according to a letter published in the Feb. 21 issue of the New England Journal of Medicine.

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Opioids Involved in Most Medical Overdose Deaths

WEDNESDAY, Feb. 20 (HealthDay News) -- Opioid analgesics are involved in the majority of pharmaceutical-related overdose deaths, frequently involving drugs prescribed for mental health conditions, according to a research letter published in the Feb. 20 issue of the Journal of the American Medical Association.

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Multimodality Approach Needed to Reengineer Health Care

TUESDAY, Feb. 19 (HealthDay News) -- A multimodality approach focusing on reengineering the U.S. health care system may provide a way to improve quality and reduce costs, according to a viewpoint published in the Feb. 20 issue of the Journal of the American Medical Association.

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CMS: Unnecessary Medicare Regulations to Be Reformed

TUESDAY, Feb. 19 (HealthDay News) -- Medicare regulations which are unnecessary, obsolete, or excessively burdensome on hospital or health care providers will be reformed, according to a rule proposed by the Centers for Medicare & Medicaid Services (CMS) in response to the President's instructions in Executive Order 13563.

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Artificial Intelligence Can Improve Patient Care

TUESDAY, Feb. 19 (HealthDay News) -- Use of an artificial intelligence (AI) framework can improve patient outcomes at one-third of the costs of the current standard of care, according to a study published online Jan. 2 in Artificial Intelligence in Medicine.

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Racial Disparities Observed in Opioid Monitoring

MONDAY, Feb. 18 (HealthDay News) -- For patients receiving opioids for non-cancer pain, racial disparities exist in opioid monitoring and follow-up treatment practices, according to a study published in the January issue of Pain.

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Race Affects Physical Activity Levels in Knee Osteoarthritis

MONDAY, Feb. 18 (HealthDay News) -- In persons with or at risk for radiographic knee osteoarthritis (RKOA), African-Americans are 72 to 76 percent less likely than whites to meet the 2008 United States Department of Health and Human Services (DHHS) Physical Activity Guidelines aerobic component, according to a study published in the February issue of Arthritis Care & Research.

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Two-Step Irradiance OK for Superficial Skin Cancer Lesions

MONDAY, Feb. 18 (HealthDay News) -- A two-step irradiance protocol with topical δ-aminolevulinic acid (ALA) and photodynamic therapy (PDT) minimizes pain while maintaining comparable clinical outcomes for the treatment of non-melanoma skin cancer lesions, according to a study published online Feb. 6 in Lasers in Surgery and Medicine.

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General Anesthesia Ups Knee Replacement Complications

FRIDAY, Feb. 15 (HealthDay News) -- For patients undergoing total knee arthroplasty, use of general anesthesia is associated with a significant increase in complications compared with spinal anesthesia, according to a study published in the Feb. 6 issue of The Journal of Bone & Joint Surgery.

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Self-Rated Health Measure Can Predict Outcomes in Knee OA

FRIDAY, Feb. 15 (HealthDay News) -- For patients with symptomatic knee osteoarthritis (OA), a single-item measure of self-rated health can be used to predict mental and social health outcomes, according to a study published in the February issue of Arthritis Care & Research.

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IOM Urges International Action to Eradicate Fake Drugs

THURSDAY, Feb. 14 (HealthDay News) -- Falsified and substandard medications pose public health problems around the world, and international action should be taken to combat the phenomenon, according to a report published Feb. 13 by the Institute of Medicine (IOM).

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Psychological, Sexual Impact of Female Breadwinners Explored

THURSDAY, Feb. 14 (HealthDay News) -- For couples in which the wife earns more than the husband, there may be psychological and sexual implications, according to a study published in the March issue of the Personality and Social Psychology Bulletin.

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Oregon Experiment Will Provide Insight Into ACO-Based Reform

WEDNESDAY, Feb. 13 (HealthDay News) -- The outcome of the Oregon experiment, an ambitious program centered on a model of an accountable care organization (ACO), will offer important lessons for the wider implementation of ACOs as cost-saving mechanisms, according to a perspective piece published online Feb. 13 in the New England Journal of Medicine.

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In Veterans With RA, PTSD Worsens Disease Activity

WEDNESDAY, Feb. 13 (HealthDay News) -- For U.S. veterans with rheumatoid arthritis (RA), a diagnosis of posttraumatic stress disorder (PTSD) is associated with worse patient-reported outcomes and tender joint counts, according to a study published online in the February issue of Arthritis Care & Research.

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Health Insurance Exchanges Are Top Priority on U.S. Agenda

WEDNESDAY, Feb. 13 (HealthDay News) -- The public's health care agenda places creation of a health insurance exchange or marketplace as a top priority, according to a report published by the Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health.

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Naltrexone Linked to Reduction in Pain in Fibromyalgia

TUESDAY, Feb. 12 (HealthDay News) -- Low-dose naltrexone treatment is associated with significant reductions in pain in patients with fibromyalgia, according to a study published in the February issue of Arthritis & Rheumatism.

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Obtaining Price Estimate for Hip Arthroplasty Found Difficult

TUESDAY, Feb. 12 (HealthDay News) -- Obtaining a price estimate for a total hip arthroplasty (THA) procedure from U.S. hospitals is difficult, and there is considerable variation in the prices, according to a study published online Feb. 11 in JAMA Internal Medicine.

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ACR Supports Patients' Access to Treatments Act of 2013

TUESDAY, Feb. 12 (HealthDay News) -- The American College of Rheumatology (ACR) has joined the Coalition for Accessible Treatments, in support of the Patients' Access to Treatments Act of 2013, which will reduce the out-of-pocket expenses for medications, including biologics.

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Progressive Exercise Training May Benefit Diabetic Neuropathy

MONDAY, Feb. 11 (HealthDay News) -- In a rat model of diabetes, exercise is associated with decreased diabetes-associated neuropathic pain, which correlates with increased expression of heat shock protein 72 (Hsp72), according to a study published in the February issue of Anesthesia & Analgesia.

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Increasing Patient Activation Tied to Lower Health Care Costs

MONDAY, Feb. 11 (HealthDay News) -- Patient activation is associated with improved outcomes and lower health care costs, according to a review published in the February issue of Health Affairs.

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Brain Activity Linked to TNF Inhibitor Response in RA

MONDAY, Feb. 11 (HealthDay News) -- Patients with rheumatoid arthritis who respond to tumor necrosis factor inhibitors (TNFi) show changes in activity in pain-related areas of the brain before clinical signs of improvement are observed, according to a study published in the February issue of Arthritis & Rheumatism.

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Final HIPAA Omnibus Rule Goes Into Effect March 26

FRIDAY, Feb. 8 (HealthDay News) -- The final omnibus rule, which makes changes to the Health Insurance Portability and Accountability Act (HIPAA) of 1996, goes into effect March 26, and physicians must be in compliance by Sept. 23.

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Long-Acting Daily Opioids Increase Risk of Hypogonadism

FRIDAY, Feb. 8 (HealthDay News) -- For men with chronic pain taking opioids on a daily basis, hypogonadism occurs significantly more frequently in those taking long-acting opioids (LAOs) compared with short-acting opioids (SAOs), according to a study published online Jan. 24 in the Clinical Journal of Pain.

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Supraorbital Transcutaneous Stimulator Prevents Migraines

THURSDAY, Feb. 7 (HealthDay News) -- Treatment with a supraorbital transcutaneous stimulator seems safe and effective for preventing migraine headaches, according to a study published online Feb. 6 in Neurology.

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Minimally Invasive, Open Hemilaminectomy Equivalent

WEDNESDAY, Feb. 6 (HealthDay News) -- Minimally invasive (MIS) and open multilevel hemilaminectomy are similar with respect to cost and improved quality of life measures for the treatment of degenerative lumbar spinal stenosis, according to a study published in the February issue of the Journal of Spinal Disorders & Techniques.

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Ramipril Improves Walking in Peripheral Artery Disease

WEDNESDAY, Feb. 6 (HealthDay News) -- For elderly patients with peripheral artery disease and intermittent leg pain during walking, ramipril treatment for six months improves pain-free walking times and improves quality of life, according to a study published in the Feb. 6 issue of the Journal of the American Medical Association.

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Review Finds Limited Value for Spinal Manipulation in Acute LBP

WEDNESDAY, Feb. 6 (HealthDay News) -- Spinal manipulative therapy (SMT) is no more effective a treatment for acute low back pain than inert interventions, sham SMT, or as adjunct therapy, according to the results of an updated systematic literature review published in the Feb. 1 issue of Spine.

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Physicians' Pay for Existing Patients Dropped in 2012

TUESDAY, Feb. 5 (HealthDay News) -- Physicians' pay for existing patients dropped considerably in 2012, according to the results of the Fee Schedule Survey published Jan. 31 in Physicians Practice.

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Corticosteroids Worsen Long-Term Epicondylalgia Outcomes

TUESDAY, Feb. 5 (HealthDay News) -- Patients with unilateral lateral epicondylalgia have worse long-term outcomes after injection with a corticosteroid compared with placebo, according to a study published in the Feb. 6 issue of the Journal of the American Medical Association.

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Pre-Op Physiatry Consultation Reduces Spinal Surgery Rates

TUESDAY, Feb. 5 (HealthDay News) -- Requiring patients interested in spinal surgery to first see a rehabilitation physician reduces the number of spinal surgeries, reduces costs, and leaves patients largely satisfied, according to a study published in the Feb. 1 issue of Spine.

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Self-Rated Low Physical Capacity Tied to Low Back Pain

MONDAY, Feb. 4 (HealthDay News) -- Women health care workers who rate their physical capacity as low are significantly more likely to develop non-chronic and persistent low back pain (LBP) compared with those who assess their physical capacity as high, according to research published in the Feb. 1 issue of Spine.

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Single-Question Low Back Pain Severity Assessment Accurate

MONDAY, Feb. 4 (HealthDay News) -- Patient-reported chronic low-back pain (CLBP) severity, based on answering a single question, provides an accurate indicator of patient-reported health status, according to a study published in the February issue of the Journal of Spinal Disorders & Techniques.

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FSMB: Approaches Explored for Expediting Multi-State Licenses

MONDAY, Feb. 4 (HealthDay News) -- New approaches are being explored for streamlining physician multi-state licensure to accommodate the use of telemedicine in the delivery of health care, according to a report from a meeting held from Jan. 16 to 17 by the Federation of State Medical Boards (FSMB).

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More Complications for Inpatient Lumbar Discectomy

MONDAY, Feb. 4 (HealthDay News) -- Patients undergoing inpatient lumbar discectomy have significantly higher overall complication rates than those treated as outpatients, according to a study published in the Feb. 1 issue of Spine.

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Knowing Cost of Imaging Tests Doesn't Cut Utilization

FRIDAY, Feb. 1 (HealthDay News) -- Physicians do not order fewer imaging tests if they are aware of the costs, according to a study published online Jan. 2 in the Journal of the American College of Radiology.

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Bystander Rescue Training Cuts Opioid Overdose Deaths

FRIDAY, Feb. 1 (HealthDay News) -- State-supported opioid overdose education and nasal naloxone distribution (OEND) programs are associated with a reduction in the adjusted rate ratio for annual deaths related to opioid overdose, according to a study published online Jan. 31 in BMJ.

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