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June 2013 Briefing - Pain Management

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

Avoidable Health Care Costs Exceed $200 Billion in 2012

FRIDAY, June 28 (HealthDay News) -- In 2012, avoidable health care costs in the United States exceeded $200 billion, according to a report published by the IMS Institute for Healthcare Informatics.

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Lasting Symptom Relief With Class IV Laser in Epicondylitis

FRIDAY, June 28 (HealthDay News) -- Treatment with a dual wavelength 10 W class IV laser correlates with long-term relief of the symptoms associated with chronic epicondylitis, according to a study published in the July issue of Lasers in Surgery and Medicine.

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Bipartisan Recommendations Can Strengthen Health System

THURSDAY, June 27 (HealthDay News) -- Leaders of the Bipartisan Policy Center Health Care Cost Containment Initiative have developed a series of recommendations to strengthen the U.S. health care system, according to a sounding board piece published online June 26 in the New England Journal of Medicine.

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Study Examines Opiate Use in Orthopedic Trauma Patients

THURSDAY, June 27 (HealthDay News) -- Orthopedic trauma patients with isolated musculoskeletal injuries are significantly more likely than the general population to have used prescription opiates prior to injury, and pre-injury use predicts prolonged postoperative use, according to a study published in the June 19 issue of The Journal of Bone & Joint Surgery.

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Adults With Chronic Conditions Earn C+ for Meds Adherence

WEDNESDAY, June 26 (HealthDay News) -- On average, adults with chronic conditions earn a C+ for medication adherence, according to a report published June 25 by the National Community Pharmacists Association (NCPA).

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Hospital Teaching Intensity Affects Readmission Rates

WEDNESDAY, June 26 (HealthDay News) -- Hospital teaching intensity significantly affects readmission rates for the most common inpatient diagnoses, particularly for safety-net hospitals, according to a study published in the July issue of Medical Care.

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HHS Launches Insurance Marketplace Website, Call Center

WEDNESDAY, June 26 (HealthDay News) -- The U.S. Department of Health and Human Services (HHS) has launched the Health Insurance Marketplace education effort, with a consumer-focused website and a consumer call center, to help Americans prepare for enrollment in the new Health Insurance Marketplace.

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8.5 Million Enrollees to Receive Health Insurance Rebates

WEDNESDAY, June 26 (HealthDay News) -- About 8.5 million enrollees will receive a rebate of about $100 per family as part of the Affordable Care Act "80/20" rule, according to a report published by the U.S. Department of Health and Human Services.

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MRI Findings Linked to Effect of Lumbar Spine Surgery

WEDNESDAY, June 26 (HealthDay News) -- Certain findings on magnetic resonance imaging (MRI) are linked with surgical outcome in patients with lumbar intervertebral disc herniation, according to research published in the June 15 issue of Spine.

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Publicly Reported Mortality Predicts Hospital Performance

TUESDAY, June 25 (HealthDay News) -- Hospital performance on publicly reported medical conditions is indicative of overall hospital mortality rates, according to a study published online June 24 in JAMA Internal Medicine.

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Growing Mismatch in Med School Graduates, GME Places

TUESDAY, June 25 (HealthDay News) -- Although the number of medical school enrollees and graduates is increasing, the number of U.S. graduate medical education (GME) programs has not increased at the same rate, and consequently physician shortages are likely to become more apparent, according to a perspective piece published online June 19 in the New England Journal of Medicine.

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Fewer Reoperations Seen With Cervical Disc Replacement

TUESDAY, June 25 (HealthDay News) -- Total disc replacement (TDR) is associated with a lower reoperation rate and longer time to reoperation compared with anterior cervical fusion (ACF), according to a study published in the June 15 issue of Spine.

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AH: Most Acute Care Costs Not Avoidable for High-Cost Patients

MONDAY, June 24 (HealthDay News) -- For high-cost Medicare beneficiaries, only a small percentage of costs are related to preventable emergency department visits and hospitalizations, according to a study published online June 24 in the Journal of the American Medical Association to coincide with presentation at the Annual Research Meeting of AcademyHealth, held from June 23 to 25 in Baltimore.

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Survival of England's National Health Service Questioned

MONDAY, June 24 (HealthDay News) -- Recent criticism of England's National Health Service (NHS) has called its survival into question, according to a perspective piece published online June 19 in the New England Journal of Medicine.

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Guide Issued for Tying Primary Care to Regional Organizations

MONDAY, June 24 (HealthDay News) -- The Agency for Healthcare Research and Quality has developed a new guide to help primary care practices to assess readiness for connecting electronic health records (EHRs) to regional health information organizations (RHIOs).

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Spine Surgeons Vary Considerably in Imaging Practices

FRIDAY, June 21 (HealthDay News) -- Spinal surgeons show considerable variability in imaging practices for elective lumbar spine surgery, according to a study published in the June 15 issue of Spine.

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AMA Awards Grants for Medical Education Innovation

FRIDAY, June 21 (HealthDay News) -- The American Medical Association (AMA) has awarded funding to 11 U.S. medical schools in response to their proposals regarding educational innovations aimed at transforming how future physicians are trained.

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AHRQ Offers Strategies to Prevent Adverse Drug Events

FRIDAY, June 21 (HealthDay News) -- Strategies to prevent adverse drug events (ADEs) have been recommended and published in a report by the Agency for Healthcare Research and Quality (AHRQ).

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Obesity Is a Disease, Says American Medical Association

THURSDAY, June 20 (HealthDay News) -- The American Medical Association has adopted policy that recognizes obesity as a disease, a step that the association hopes will help focus more attention on treatment and prevention efforts, and that some suggest may lead to greater acceptance by insurance providers to cover treatment.

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CMS Implementing Physician Quality Reporting System

THURSDAY, June 20 (HealthDay News) -- To promote the reporting of quality information by eligible professionals, the Physician Quality Reporting System is being implemented, according to a report from the Centers for Medicare & Medicaid Services (CMS).

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Practices Are Not Prepared for Implementation of ICD-10

THURSDAY, June 20 (HealthDay News) -- Physician practices have made little progress in preparing for implementation of the 10th revision of the International Classification of Diseases (ICD-10), according to a report published by the Medical Group Management Association (MGMA).

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EHR Implementation First Step Toward Quality Improvement

WEDNESDAY, June 19 (HealthDay News) -- Implementation of electronic health records (EHRs) is a first step toward quality improvement and should be accompanied by use of new payment models to allow physicians to see a return on their investments, according to Farzad Mostashari, M.D., of the Office of the National Coordinator for Health Information Technology, who was recently interviewed by the American Academy of Family Physicians.

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New Rule Proposes Insurance Program Integrity Guidelines

WEDNESDAY, June 19 (HealthDay News) -- A new proposed rule, which provides program integrity guidelines for Affordable Insurance Exchanges, or Health Insurance Marketplaces (Marketplaces), has been released by the U.S. Department of Health and Human Services (HHS).

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Potential of Mobile Remote-Presence Devices Discussed

WEDNESDAY, June 19 (HealthDay News) -- Mobile remote-presence devices have the potential to increase access to and improve delivery of health care in the developed and developing world, according to an innovations report published online June 17 in CMAJ, the Journal of the Canadian Medical Association.

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State-Based Health Care Price Websites Lacking

TUESDAY, June 18 (HealthDay News) -- State-based, patient-oriented websites reporting health care prices need to be improved, according to a research letter published in the June 19 issue of the Journal of the American Medical Association.

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MRI Screening Identifies Undiagnosed Spinal Infections

TUESDAY, June 18 (HealthDay News) -- About a fifth of patients who have received a spinal injection of fungus-contaminated methylprednisolone but have not sought medical care are likely to be infected, according to a study published in the June 19 issue of the Journal of the American Medical Association.

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Unauthorized Immigrants Make Up 1.4% U.S. Medical Spending

TUESDAY, June 18 (HealthDay News) -- Unauthorized immigrants have substantially lower health care expenditures than legal residents, naturalized citizens, and U.S. natives, according to a study published online June 12 in Health Affairs.

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Racial Disparities Exist in Outcomes of Spinal Surgery

TUESDAY, June 18 (HealthDay News) -- The rate of complications, length of stay, and costs associated with surgery for lumbar spinal stenosis differ for African-American patients compared with white patients, according to research published in the May 15 issue of Spine.

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About 15 Percent of People Currently Uninsured in U.S.

TUESDAY, June 18 (HealthDay News) -- In 2012, nearly 15 percent of U.S. people of all ages were currently uninsured, according to a data brief published online June 18 by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Neurological Testing Limited in Diagnosing Disc Herniation

MONDAY, June 17 (HealthDay News) -- Neurological testing procedures have limited diagnostic accuracy for detecting disc herniation with suspected radiculopathy, according to a review and meta-analysis published in the June issue of The Spine Journal.

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FDA Discusses Cybersecurity for Medical Devices, Hospitals

MONDAY, June 17 (HealthDay News) -- Medical device manufacturers and health care facilities should ensure appropriate safeguards are in place to reduce the potential harms that may result from cyberattacks, according to a safety communication issued by the U.S. Food and Drug Administration.

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Marked Variability Seen in Total Knee Arthroplasty Indications

FRIDAY, June 14 (HealthDay News) -- There is considerable variability associated with total knee arthroplasty (TKA) recommendations, according to a report published in the May issue of Pain Medicine News.

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Duloxetine Moderately Cost-Effective for Treating Back Pain

FRIDAY, June 14 (HealthDay News) -- Duloxetine is a moderately cost-effective treatment for chronic low back pain (CLBP) compared with other post-first-line oral medications, according to research published in the May 15 issue of Spine.

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New Treatments Outperforming Placebo Becoming Less Common

FRIDAY, June 14 (HealthDay News) -- The efficacy of new medical treatments compared with placebo has sharply declined over the last few decades, suggesting that comparative effectiveness studies are needed, according to a study published in the June issue of Health Affairs.

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Fusion Rate Up for Lumbar Spinal Stenosis, 2004 to 2009

THURSDAY, June 13 (HealthDay News) -- For patients hospitalized for lumbar spinal stenosis (LSS), the rate of fusions significantly increased and the rate of decompressions significantly decreased from 2004 to 2009 in the United States, according to a study published in the May 15 issue of Spine.

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Survey Examines Physician Satisfaction With EHRs

THURSDAY, June 13 (HealthDay News) -- About three-quarters of physicians report that their practice either has a fully implemented electronic health record (EHR), uses a hospital or corporate EHR, or is in the process of implementing an EHR, according to a technology survey published by Physicians Practice.

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Use of EHRs Can Enhance Doc-Patient Communication

WEDNESDAY, June 12 (HealthDay News) -- Electronic health records (EHRs) can be used during clinical encounters to enhance the physician-patient relationship, encouraging communication during the clinical encounter, according to a viewpoint published in the June 12 issue of the Journal of the American Medical Association.

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Doctors Do Not Spend Enough Time Planning Their Finances

TUESDAY, June 11 (HealthDay News) -- Physicians do not spend enough time reviewing their finances, and half are behind in their retirement planning, according to a report published by the American Medical Association (AMA) Insurance Agency.

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Most Doctors Feel They Are Under-Using Mobile Apps

TUESDAY, June 11 (HealthDay News) -- Most physicians feel they are not maximizing use of mobile applications, and would utilize additional electronic health record (EHR) functionalities if they were available, according to poll conducted by Black Book Market Research.

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Lumbar Epidural Steroid Injections Up Risk of Spinal Fx

MONDAY, June 10 (HealthDay News) -- In patients with radiculopathy or neurogenic claudication due to compression of spinal nerves, lumbar epidural steroid injections (LESIs) increase the risk of vertebral fractures, according to a study published in the June 5 issue of The Journal of Bone & Joint Surgery.

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Weather Differentially Affects Women With Fibromyalgia

THURSDAY, June 6 (HealthDay News) -- Female patients with fibromyalgia appear to be differentially sensitive to certain weather conditions rather than subject to a uniform influence of weather on daily pain and fatigue, according to a study published online June 4 in Arthritis Care & Research.

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HHS: Marketplaces Open New Insurance Options for Consumers

THURSDAY, June 6 (HealthDay News) -- Health Insurance Marketplaces, due to be introduced in October 2013, will increase the coverage options for many consumers, according to a memo released by the U.S. Department of Human & Health Services.

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Surgical Methods Compared for Degenerative Spondylolisthesis

WEDNESDAY, June 5 (HealthDay News) -- For patients with multilevel lumbar stenosis and single-level degenerative spondylolisthesis (DS), surgical outcomes are not significantly different with decompression and single-level or multilevel fusion, according to a study published in the May 1 issue of Spine.

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Profitability Index Checks Financial Health of Practices

WEDNESDAY, June 5 (HealthDay News) -- An overall downward trend in profitability has been identified based on a practice profitability index, developed to assess the financial health of U.S. physician practices, according to a report published by CareCloud.

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Few Physicians Meeting Meaningful Use in Early 2012

WEDNESDAY, June 5 (HealthDay News) -- In early 2012, few physicians met meaningful use criteria, and using electronic health records (EHRs) for patient panel management was difficult, according to research published in the June 5 issue of the Annals of Internal Medicine.

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CDC: Small Drop in Those With Difficulty Paying Medical Bills

TUESDAY, June 4 (HealthDay News) -- There has been a slight decrease in the percentage of individuals aged younger than 65 years who are in a family with difficulty paying their medical bills, according to a June data brief issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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MRI Identifies Compression Fractures Before Cementing

TUESDAY, June 4 (HealthDay News) -- In patients with suspected vertebral compression fractures, the addition of magnetic resonance imaging (MRI) reduces the rate of misdiagnosis of acute lesions and hidden lesions before percutaneous cement augmentation procedures, according to a study published in the May issue of the Journal of Spinal Disorders & Techniques.

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Pre-Op Depression Skews Satisfaction After Lumbar Sx

TUESDAY, June 4 (HealthDay News) -- Preoperative depression influences self-reported patient satisfaction after revision lumbar surgery, independent of the surgery's effectiveness, according to a study published in the May issue of The Spine Journal.

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Dextrose Prolotherapy Can Improve Knee Osteoarthritis

TUESDAY, June 4 (HealthDay News) -- For adults with knee osteoarthritis, dextrose prolotherapy is associated with greater improvements in pain, function, and stiffness compared with saline injections or at-home exercise, according to a study published in the May/June issue of the Annals of Family Medicine.

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Independent Payment Advisory Board's Future Questioned

MONDAY, June 3 (HealthDay News) -- Established as a part of the efforts of Affordable Care Act (ACA) to contain health care costs, the Independent Payment Advisory Board (IPAB) has been surrounded by controversy, and still has no members, according to a perspective piece published online May 29 in the New England Journal of Medicine.

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Health of Nation Reviewed With Focus on Emergency Care

MONDAY, June 3 (HealthDay News) -- Recent trends in the health of the nation are described, with particular focus on emergency care, in the 36th annual report published by the National Center for Health Statistics (NCHS) and the U.S. Centers for Disease Control and Prevention.

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