Practice Management
With more pharmaceutical products on the market for children, parents may be wary of having their kids take more than one drug at a time. A recent study in Pediatrics found 21.4% of children receiving Medicaid in the United States who took multiple prescription drugs in 2019 experienced adverse events stemming from drug interactions. Researchers studied drug-drug interactions (DDIs) for 781,019 patients under age 18 who took 2 or more outpatient prescriptions. The drugs most …
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Urgent message: Low-dose naltrexone (LDN) is becoming more common as a treatment option for pain and thus will be increasingly prevalent in patients presenting to the urgent care setting. A thorough medication history, prioritization of non-opioid treatment options, and timely referral or transfer for severe uncontrolled pain are important considerations in the management of patients using low-dose naltrexone. Ting-Hsuan Chiang, MD; Kenneth Schmitt, BS; Ariana Nelson, MD INTRODUCTION Naltrexone is an opioid receptor antagonist approved …
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As researchers and legislators in some states consider restrictions on physicians to write prescriptions for opioid pain medications, new research indicates there could be a way to continue prescribing safely—albeit a way that is likely to raise some eyebrows. First, in Indiana, the state hospital association, medical association, and health department have pooled their resources to create guidelines for physicians in the state. In a nutshell, they’re advising physicians to cut back on prescribing opioids …
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Kaiser Permanente in Southern California reports that using computer alerts to inform physicians when antibiotics may not be the best course of treatment for sinusitis reduced the chance of an antibiotic being prescribed—with some qualifiers. The study, published recently in the American Journal of Managed Care, tracked nearly 22,000 cases of acute sinusitis in adults in primary care and urgent care offices. Researchers found that clinical decision support was associated with a 22% decrease in …
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The FDA may have limited authority to reduce the number of opioid medications in circulation at any given time, but its commissioner, Scott Gottlieb, MD, is appealing to urgent care physicians, and prescribers everywhere, to take action. For starters, he said, the agency would like to construct “expert guidelines” informed by the medical community, with the idea that those guidelines could ultimately be reflected in drug labeling (over with the FDA does have authority). Speaking …
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The need to reduce access to opioid pain medications is pretty well accepted at this point, though much of the outcry is vague and often geared toward echoing statistics about the very real epidemic of addiction and death. However, Intermountain Health, which operates InstaCare urgent care centers in Utah and Idaho, has gone a step further by crunching its own numbers and devising a plan to cut opioid prescriptions across its systems by 40% by …
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It’s been more than a year since the Centers for Disease Control and Prevention recommended that opioids not be used to treat chronic back pain. Unfortunately, too many prescribers have yet to get the message, according to new data from an NPR-Truven Health Analytics Health Poll. The data, reflecting the experiences of 3,002 patients participating in a telephone survey, show that 40% of the visits to a doctor for low back pain ended with a …
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With the opioid addiction crisis hanging over their heads, physicians are constantly weighing the risk vs benefit of prescribing narcotics for patients in extreme pain. This can be especially tough when treating younger patients who’ve sustained an injury, such as those increasingly common in youth sports. Many physicians who specialize in sports medicine have started using a multimodal approach that employs counseling, physical therapy, and even nerve blocks. Some states have launched efforts (and even …
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Alaska is the latest of many states marching toward adoption of new telehealth bills, but legislators there has been typically “maverick” in their approach to adopting such new technologies. The interesting thing about that state’s soon-to-be signed law is that physicians won’t have to be in-state in order to prescribe for Alaskans. In addition to removing in-state presence requirements for prescribing via telemedicine, SB 74 will pave the way for patients to connect with occupational …
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Use a prescription pad in New York, go to jail—potentially, anyway, as the state becomes only the second state to require electronic prescribing and the first to establish penalties, which include fines, loss of license, and even jail time, for noncompliance. Paper and telephone prescriptions will be exempted for emergency situations, however. Proponents reason that e-prescribing is a big step toward eliminating prescribing errors and long wait times at the pharmacy, and that it reduces …
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