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December 2013 Briefing - Pain Management

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

Troubled Launch of ACA Tops Health News for 2013

TUESDAY, Dec. 31, 2013 (HealthDay News) -- As 2013 nears to a close, the year's top health news story -- the fumbled debut of the Affordable Care Act continues to grab headlines. President Barack Obama, in November, said he was "sorry" to hear that some Americans were being dropped from their health plans due to the advent of reforms -- even though he had repeatedly promised that this would not happen.

CDC: More Than One in 10 Kids Diagnosed With ADHD
FDA Urges Tighter Controls on Certain Prescription Painkillers
CDC: Evocative Campaign Motivates Smokers to Quit
Lower Microbial Diversity for Infants Who Develop Colic
Low Gut Bacterial Richness Linked to Obesity
Donor Fecal Infusion Effective for C. difficile Infection
Full Article - 2013 Top Health News

What Yoga Can and Can't Do for You

TUESDAY, Dec. 31, 2013 (HealthDay News) -- Results from medical research on yoga are mixed, according to the U.S. National Center for Complementary and Alternative Medicine, though the findings tend to be more positive than negative.

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Extra Steps Urged for Regulating Compounding Pharmacies

MONDAY, Dec. 30, 2013 (HealthDay News) -- Additional steps are needed for regulating compounding pharmacies, according to a perspective piece published online Dec. 25 in the New England Journal of Medicine.

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Mortality Up in Postmenopausal Women With Anti-CCP+ RA

MONDAY, Dec. 30, 2013 (HealthDay News) -- Mortality rates are higher in postmenopausal women with rheumatoid arthritis (RA) who have anti-cyclic citrullinated peptide (anti-CCP) antibodies, according to research published online Dec. 23 in Arthritis & Rheumatism.

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Uncertainty Noted in Seemingly Stable Medical Liability Climate

MONDAY, Dec. 30, 2013 (HealthDay News) -- Although the medical liability climate seems stable, the impact of health care reform on the market is uncertain, according to an article based on two reports published by the American Medical Association (AMA).

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Surge in Federal Health Insurance Exchange Enrollments

MONDAY, Dec. 30, 2013 (HealthDay News) -- More than 1.1 million people enrolled in a qualified health plan through the federally operated marketplace, or exchange, from Oct. 1 through Dec. 24, government officials said Sunday. More than 975,000 of those enrollments came in December, Marilyn Tavenner, administrator for the Centers for Medicare & Medicaid Services, said in a blog post.

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Fewer Opioid Treatment Centers Offering HIV, STI Testing

FRIDAY, Dec. 27, 2013 (HealthDay News) -- Fewer U.S. opioid treatment programs are offering on-site testing for HIV and sexually transmitted infections (STIs), according to a research letter published in the Dec. 25 issue of the Journal of the American Medical Association.

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AMA IDs Five Issues Relating to Progress in SGR Repeal

FRIDAY, Dec. 27, 2013 (HealthDay News) -- The implications of progress toward repeal of the Medicare sustained growth rate (SGR) formula are discussed in a report published by the American Medical Association (AMA).

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Changes in Pain Noted for Many Ambulatory Cancer Patients

FRIDAY, Dec. 27, 2013 (HealthDay News) -- For ambulatory patients with solid tumors, pain is prevalent and changes over time, according to a study published online Dec. 23 in the Journal of Clinical Oncology.

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Addition of Cognitive Therapy Benefits Youth With Migraine

FRIDAY, Dec. 27, 2013 (HealthDay News) -- Cognitive behavioral therapy (CBT) is superior to headache education, when combined with amitriptyline, for the treatment of chronic migraine in children and adolescents, according to research published in the Dec. 25 issue of the Journal of the American Medical Association.

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Meniscus Tear Surgery No Better Than Sham Surgery

FRIDAY, Dec. 27, 2013 (HealthDay News) -- Outcomes after arthroscopic partial meniscectomy are no better than outcomes after sham surgery in patients with knee symptoms due to an apparent degenerative medial meniscus tear, according to a study published in the Dec. 26 issue of the New England Journal of Medicine.

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Impact of Planned Medicaid Expansion Discussed

THURSDAY, Dec. 26, 2013 (HealthDay News) -- The planned expansion of Medicaid will offer benefits to those in participating states, according to an article published online Dec. 24 in the Annals of Internal Medicine.

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ACA Success Hinges on Young Adult Enrollment

THURSDAY, Dec. 26, 2013 (HealthDay News) -- Enrollment of young adults is a crucial component of the viability of the Affordable Care Act (ACA), according to a health policy brief published Dec. 16 in Health Affairs.

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Toxic Employees Are Damaging to Medical Practices

THURSDAY, Dec. 26, 2013 (HealthDay News) -- Toxic behavior can harm medical practices and should not be tolerated, according to an article published Dec. 10 in Medical Economics.

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Evidence-Based Guidelines Developed for Disc Herniation

THURSDAY, Dec. 26, 2013 (HealthDay News) -- Evidence-based clinical guidelines have been developed for management of lumbar disc herniation with radiculopathy; the guidelines have been published in the Jan. 1 issue of The Spine Journal.

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Public Tends to Follow Celebrities Even on Medical Issues

MONDAY, Dec. 23, 2013 (HealthDay News) -- Celebrities have credibility as sources of medical advice, even if they are ill-informed or are spreading potentially harmful information, according to research published online Dec. 17 in BMJ.

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New Rule May Exempt Many From Health Plan Penalty

FRIDAY, Dec. 20, 2013 (HealthDay News) -- Consumers whose individual health insurance policies have been cancelled for failing to meet the minimum requirements of the Affordable Care Act may now apply for a "hardship exemption," Obama administration officials announced late Thursday.

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High Patient Satisfaction With Patient-Centered Medical Homes

FRIDAY, Dec. 20, 2013 (HealthDay News) -- A significant majority of patients report experiencing a high quality of care at federally-supported health centers, according to a study published in the November/December issue of the Annals of Family Medicine.

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Morphine Diminishes, Delays Effects of Clopidogrel

FRIDAY, Dec. 20, 2013 (HealthDay News) -- Morphine interaction reduces the effectiveness of clopidogrel, according to a small study published online Dec. 4 in the Journal of the American College of Cardiology.

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Docs Must Help Patients Take Responsibility for Medical Costs

FRIDAY, Dec. 20, 2013 (HealthDay News) -- Given that increasing numbers of patients have high-deductible health insurance, doctors and practice staff need to help patients assume financial responsibility for costs relating to medical services and procedures, according to an article published Dec. 10 in Medical Economics.

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Physicians Must Be Proactive in Risk Management

THURSDAY, Dec. 19, 2013 (HealthDay News) -- Risk is inherent in the practice of medicine, but physicians can take steps to prevent patient injury and avoid lawsuits, according to an article published Dec. 10 in Medical Economics.

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Pre-Op Depression Linked to Narcotic Use Before Spinal Sx

THURSDAY, Dec. 19, 2013 (HealthDay News) -- For patients undergoing spinal surgery for a structural lesion, preoperative depression and anxiety are associated with increased preoperative narcotic use, according to a study published in the Dec. 1 issue of Spine.

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Few Residency Programs Teach Cost-Conscious Medicine

WEDNESDAY, Dec. 18, 2013 (HealthDay News) -- Few residency programs have a formal cost-conscious care curriculum, according to a research letter published online Dec. 16 in JAMA Internal Medicine.

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CDC Highlights Achievements of 2013, Goals for 2014

WEDNESDAY, Dec. 18, 2013 (HealthDay News) -- The top five gains made in improving health security at home and around the world in 2013, and the top five areas for improvement in 2014 have been highlighted in an end-of-year report from the U.S. Centers for Disease Control and Prevention.

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GlaxoSmithKline to End Payments to Prescribing Doctors

TUESDAY, Dec. 17, 2013 (HealthDay News) -- GlaxoSmithKline (GSK) says it will stop paying doctors to market its drugs at conferences and will no longer reward sales agents whose physician customers write the most prescriptions. Monday's announcement is apparently a first for a major drug company. But other companies may be considering similar moves, The New York Times reported.

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Funding for Medical Communication Firms Analyzed

TUESDAY, Dec. 17, 2013 (HealthDay News) -- Medical communication companies (MCCs), responsible for medical education programs, may receive substantial financial support from pharmaceutical and medical device companies, according to research published in the Dec. 18 issue of the Journal of the American Medical Association.

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Many Physicians Will Stop Practicing Due to ACA

TUESDAY, Dec. 17, 2013 (HealthDay News) -- About half of physicians say that they plan to practice medicine for a shorter time or leave as soon as feasibly possible due to the Affordable Care Act (ACA), according to an article published Nov. 29 in Medical Economics.

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Physician Access Challenges Up for Those With Public Insurance

TUESDAY, Dec. 17, 2013 (HealthDay News) -- Adverse experiences with physician availability are more likely among those with public insurance, and almost 15 percent of people in the United States were uninsured in the first half of 2013, according to two December data briefs issued by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

Report - Gindi
Report - Martinez and Cohen

FDA Questions Effectiveness, Safety of Antibacterial Soap

TUESDAY, Dec. 17, 2013 (HealthDay News) -- The U.S. Food and Drug Administration has issued a proposed rule requiring antibacterial soap manufacturers to demonstrate that their products are both effective at preventing illness and safe for long-term daily use.

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Bills for SGR Repeal Pass Senate, House Committees

MONDAY, Dec. 16, 2013 (HealthDay News) -- The U.S. House Ways and Means Committee and the U.S. Senate Finance Committee have passed their versions of the bill to repeal Medicare's failed sustainable growth rate (SGR) formula, according to a report from the American Medical Association (AMA).

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FDA Approves First Device to Treat Migraine With Aura

MONDAY, Dec. 16, 2013 (HealthDay News) -- The first device to treat migraine pain when the headache is preceded by an aura has been approved by the U.S. Food and Drug Administration.

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Word of Mouth Still Tops Ways People Find Physicians

MONDAY, Dec. 16, 2013 (HealthDay News) -- Roughly three-quarters of young adults use personal recommendations to select a physician, according to an article published in Medical Economics.

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Medicare's Graduate Medical Education Spending Imbalanced

MONDAY, Dec. 16, 2013 (HealthDay News) -- There is an "imbalance" in how Medicare distributes its $10 billion a year for graduate medical education (GME), according to a study published in the November issue of Health Affairs.

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Determinants of Patient Loyalty to Provider Identified

MONDAY, Dec. 16, 2013 (HealthDay News) -- Determinants of patient loyalty have been identified and include confidence in care provider and coordination of care, according to a report published by Press Ganey.

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New Rule Tweaks Affordable Care Act Deadline

FRIDAY, Dec. 13, 2013 (HealthDay News) -- The Obama administration is taking steps to prevent consumers who buy health plans sold through state and federal exchanges from experiencing any gap in coverage this January. Under new rules, health insurers must accept payment up until Dec. 31 for coverage that begins the following day. Earlier guidance did not establish a payment deadline, allowing insurers to set their own dates. "And we're recommending that insurers extend this deadline further," U.S. Health and Human Services (HHS) Secretary Kathleen Sebelius said during a Thursday news conference to announce the changes.

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Surgery Found to Be Marginally Better for Discogenic Pain

FRIDAY, Dec. 13, 2013 (HealthDay News) -- Surgical patients demonstrate greater improvement at one year compared to patients utilizing nonsurgical treatment for discogenic pain, although success rates for either group are only fair, according to a study published in the November issue of The Spine Journal.

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Study Quantifies Male Dominance in Scientific Production

FRIDAY, Dec. 13, 2013 (HealthDay News) -- Men dominate scientific production worldwide, accounting for a higher percentage of authorships and greater impact, according to research published in the Dec. 12 issue of Nature.

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Injunction Stops Insurer From Dropping Physicians

THURSDAY, Dec. 12, 2013 (HealthDay News) -- United Healthcare has been given a last-minute temporary restraining order preventing it from removing thousands of physicians from its Medicare Advantage networks in Connecticut, according to an article published Dec. 6 in Medical Economics.

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BMI Not Linked to Pain After Exercise Rehab for Back Pain

THURSDAY, Dec. 12, 2013 (HealthDay News) -- For individuals with chronic low back pain (cLBP), body mass index (BMI) is not significantly associated with self-reported pain and disability, according to a study published in the Dec. 1 issue of Spine.

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Physician Practices Often Do Not Plan for Future

WEDNESDAY, Dec. 11, 2013 (HealthDay News) -- Most physician practices do not treat their practices as businesses and plan for the future, but they should develop and follow a strategic plan, according to an article published Nov. 10 in Medical Economics.

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Factors in Choice of Opioid for Abuse Analyzed

WEDNESDAY, Dec. 11, 2013 (HealthDay News) -- The choice of hydrocodone versus oxycodone as a primary drug of abuse is based on multiple factors, according to a study published in the December issue of PAIN.

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CDC: Health Insurance Among Young Increased After ACA

WEDNESDAY, Dec. 11, 2013 (HealthDay News) -- Since the Affordable Care Act extended dependent health coverage to young adults up to 26 years old, the percentage of this age group with private health insurance has increased and the percentage with gaps in insurance coverage has decreased, according to a December data brief published by the U.S. Centers for Disease Control and Prevention's National Center for Health Statistics (NCHS).

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Weekend Spine Surgery Linked to Longer Stays, Higher Costs

WEDNESDAY, Dec. 11, 2013 (HealthDay News) -- Patients admitted to the hospital on weekends for cervical spine fusion resulting from trauma have a greater length of stay and total hospital costs than their weekday counterparts, according to a study published in the Dec. 1 issue of Spine.

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Pain, Often in Multiple Sites, Is Common in Elderly in U.S.

TUESDAY, Dec. 10, 2013 (HealthDay News) -- In older adults pain is common and is associated with clinically significant declines in physical function, according to a study published in the December issue of PAIN.

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Outpatient Docs Report More Burnout Than Inpatient Docs

TUESDAY, Dec. 10, 2013 (HealthDay News) -- Outpatient physicians report more emotional exhaustion than inpatient physicians, according to a review published in the November issue of the Journal of Hospital Medicine.

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ACP Provides Guidance for Addressing Rx Drug Abuse

TUESDAY, Dec. 10, 2013 (HealthDay News) -- Recommendations to effectively address the problem of prescription drug abuse are presented in a policy position paper from the American College of Physicians (ACP), published online Dec. 10 in the Annals of Internal Medicine.

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Health Information Technology May Cut Demand for Physicians

MONDAY, Dec. 9, 2013 (HealthDay News) -- Health information technology (IT) may cut demand for physicians in the future, according to a review published in the November issue of Health Affairs.

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Arthrodesis Ups Complications, Costs for Spondylolisthesis

MONDAY, Dec. 9, 2013 (HealthDay News) -- For patients with lumbar spondylolisthesis, decompressive laminectomy and spinal arthrodesis is associated with lower reoperation rates, but with higher complication rates and higher overall costs than laminectomy alone, according to a study published in the Nov. 6 issue of The Journal of Bone & Joint Surgery.

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With Looming ACA Uncertainty, Budget Exercise Necessary

MONDAY, Dec. 9, 2013 (HealthDay News) -- Constructing a budget for 2014 is critical for physicians even with the uncertainties surrounding the Affordable Care Act, according to an article published Nov. 10 in Medical Economics.

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CMS Finalizes 2014 Physician Payment Rates, Policies

MONDAY, Dec. 9, 2013 (HealthDay News) -- The final payment rules for 2014 include a proposal to support care management outside the routine office interaction and policies to promote high quality care and efficiency, according to a report from the Centers for Medicare & Medicaid Services (CMS).

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Medical Students Find Mind-Body Regulation Training Helpful

FRIDAY, Dec. 6, 2013 (HealthDay News) -- A practical approach may be used to offer mind-body regulation training to medical students, according to research published in the Fall issue of the Annals of Behavioral Science and Medical Education.

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Issues Surround Hospital Readmissions Reduction Program

FRIDAY, Dec. 6, 2013 (HealthDay News) -- Concerns surround implementation of the Medicare Hospital Readmissions Reduction Program (HRRP), according to a policy brief published online Nov. 12 in Health Affairs.

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Final Rule Aims to Lower Costs, Simplify Outpatient Payments

FRIDAY, Dec. 6, 2013 (HealthDay News) -- The final hospital outpatient and ambulatory surgical center (ASC) payment rule will give hospitals and ASCs the ability to lower costs, according to a report from the Centers for Medicare & Medicaid Services (CMS).

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Study Quantifies Substance Use Disorder Among Residents

THURSDAY, Dec. 5, 2013 (HealthDay News) -- Substance use disorder (SUD) is seen among a proportion of anesthesiology residents during training and is associated with a high rate of relapse, according to a study published in the Dec. 4 issue of the Journal of the American Medical Association, a theme issue on medical education.

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Handoff Program Cuts Medical Errors, Adverse Events

THURSDAY, Dec. 5, 2013 (HealthDay News) -- Implementation of a multifaceted handoff program can reduce medical errors and preventable adverse events, according to a study published in the Dec. 4 issue of the Journal of the American Medical Association, a theme issue on medical education.

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AMA's RUC Committee to Work on Improving Transparency

WEDNESDAY, Dec. 4, 2013 (HealthDay News) -- The 31-member Relative Value Scale Update Committee (RUC) of the American Medical Association will begin publishing minutes, dates and locations of meetings, and votes for individual current procedural codes, according to an article published Nov. 11 in Medical Economics.

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Financial Interest May Motivate Higher Knee MRI Referral

WEDNESDAY, Dec. 4, 2013 (HealthDay News) -- Patients referred for magnetic resonance imaging (MRI) of the knee by physician groups with a financial interest (FI) in MRI equipment are significantly more likely to have negative images than those referred by physicians with no FI (NFI), according to a study published in the December issue of Radiology.

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Investment Program Can Cut Global Health Disparities by 2035

WEDNESDAY, Dec. 4, 2013 (HealthDay News) -- Global health disparities could be reduced considerably by 2035 using an investment framework, according to a report published Dec. 3 in The Lancet.

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Health Reform in Mass. Didn't Change ICU Utilization

WEDNESDAY, Dec. 4, 2013 (HealthDay News) -- Initiation of health care reform in Massachusetts correlated with a reduction in intensive care unit (ICU) patients without insurance but did not significantly change ICU use or mortality among ICU patients, according to a study published online Nov. 22 in Critical Care Medicine.

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Disability Decreased in Arthritis Patients Over Past 20 Years

WEDNESDAY, Dec. 4, 2013 (HealthDay News) -- Patients with rheumatoid arthritis experience significantly less psychological stress and physical disability compared with two decades ago, which may be partially due to a reduction in disease activity, according to a study published online Dec. 3 in Arthritis Care & Research.

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Modest Increases in Minority Faculty Seen at Med Schools

TUESDAY, Dec. 3, 2013 (HealthDay News) -- Underrepresented minority faculty made only modest gains in increasing their presence at U.S. medical schools from 2000 to 2010, according to a study published in the Journal of the American Medical Association, a theme issue on medical education.

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Physician Texting While 'Doctoring' May Be Hazardous

TUESDAY, Dec. 3, 2013 (HealthDay News) -- Physician texting while doctoring could be hazardous, according to an ideas and opinions piece published in the Dec. 3 issue of the Annals of Internal Medicine.

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FDA Starts Regulating Compounding Pharmacies

TUESDAY, Dec. 3, 2013 (HealthDay News) -- The U.S. Food and Drug Administration on Monday began the process of regulating compounding pharmacies. Under the Drug Quality and Security Act, signed into law Nov. 27 by President Barack Obama, these pharmacies are being encouraged to register with the FDA. The agency will then classify them as outsourcing pharmacies, enabling them to sell bulk drugs to hospitals and other health care facilities.

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Volunteering Overseas Revives Physicians' Outlooks

MONDAY, Dec. 2, 2013 (HealthDay News) -- Physician volunteer programs can revive doctors' passion for medicine, according to an article published Nov. 11 in Medical Economics.

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