After years of reducing their contact with pharmaceutical sales representatives, healthcare providers and their patients now face unintended consequences. According to a new study, practitioners who rarely meet with pharma reps — or who do not meet with them at all — are much slower to stop prescribing medicines with “black box” warnings and to adopt first-in-class therapies that may benefit patients. Concerns about undue pharmaceutical industry influence may be driving clinical practice in the wrong direction.
According to the study, published May 21, 2012, in The Journal of Clinical Hypertension, clinicians whose access to pharmaceutical sales representatives is limited can take more than 4 times longer to change prescribing practices based on new information than their peers who have more frequent contact [Chressanthis et al. 2012]. And, this longer response time holds true whether the physicians are responding to “positive news” related to an innovative therapy or “negative news” related to a newly discovered medicine risk.
Working at a computer for long hours, whether a desktop or laptop, can bring about serious back or neck pain, eye strain, headaches, and even carpal tunnel syndrome. Better attention to ergonomics can often help to prevent or relieve these ailments, and a series of short video presentations tells how. This is important for both healthcare providers and their patients.
The latest genetic and biological research shows that migraine is most likely a neurological, not a vascular, disorder and newer treatments in development target peripheral and central nervous systems, according to David Dodick, MD, speaking at American Pain Society's 31st Annual Scientific Meeting in mid-May 2012. Migraine is generally an inherited disorder characterized by physiological changes in the brain involving central neuronal modulation, as well as structural brain changes if attacks occur frequently; so, it is essential that practitioners help patients to utilize preventive strategies.
Although nonspecific low-back pain is a highly prevalent condition, its clinical course over time remains uncertain. A large-scale meta-analysis of available research suggests that seeking treatment sooner rather than later can be important for pain relief and reduced disability; however, residual effects still may linger for a year or longer.
Sex hormone deficiencies, or hypogonadism, can be a common adverse effect of ongoing opioid use in both men and women. A newly reported study found that this problem was less prevalent in a sample of men taking short-acting rather than long-acting opioid analgesics for chronic pain. However, this was a preliminary investigation and study limitations should be taken into account. Furthermore, hypogonadism is an effect that can be medically managed and need not automatically require discontinuation of opioids or a change of formulation.
A recent national poll found that persons with neuropathy face delayed diagnoses, inadequate pain care, and distressing life changes due to their painful disorders. Peripheral neuropathy affects nearly 7% of Americans and from 2% to 8% of populations worldwide. The many types of neuropathy pose diverse challenges for patients, their families, and healthcare providers, yet relatively few resources are devoted to research and treatment of these disorders.
A nationwide study found that 3 in 5 patients may be noncompliant with prescribed drug regimens, as detected by urine drug testing. The findings further suggest a majority of persons treated for pain may be misusing medications in ways that pose health risks; from missing doses to taking unauthorized drugs. However, there are many factors that might account for these outcomes and should be considered before leaping to conclusions about patient misbehavior.
Persons with pain across America, and worldwide, lost a leading ally in the War on Pain. After 15 years, and without warning, the American Pain Foundation closed-down operations. And so, the lights went out on the largest national advocacy organization serving people living with pain, their caregivers and healthcare providers, and allied organizations. Who will fill the void?
According to a just-released large survey from the Gallup organization, nearly half (47%) of American adults reported having some type of chronic pain in 2011, which would amount to at least 111 million persons. This incredible prevalence of pain appears to confirm earlier estimates by the U.S. Institute of Medicine; although, despite the dissent of some doubters, the numbers actually may be underestimates.
Part 12 – How Critical Thinking Goes Awry
Featured Items: rotigotine transdermal system (Neupro) approved for RLS; adalimumab (Humira) European approval for colitis; fentanyl patch safety alert; proton pump inhibitor (PPI) alert for C. difficile-associated diarrhea; Savella and Neurontin added to FDA Watch list; morphine sulfate injectable recall. — All brand names are trademarks of their respective manufacturers. Compiled by Winnie Dawson, MA, RN, BSN.
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