Opioid Prescribing: Where you live matters

Source: Opioid Prescribing: Where you live matters

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The amount of opioids prescribed in the US peaked in 2010 and then decreased each year through 2015. However, prescribing remains high and vary widely from county to county. Healthcare providers began using opioids in the late 1990s to treat chronic pain (not related to cancer), such as arthritis and back pain. As this continued, more opioid prescriptions were written, for more days per prescription, in higher doses. Taking opioids for longer periods of time or in higher doses increases the risk of addiction, overdose, and death. In 2015, six times more opioids per resident were dispensed in the highest-prescribing counties than in the lowest-prescribing counties. County-level characteristics, such as rural versus urban, income level, and demographics, only explained about a third of the differences. This suggests that people receive different care depending on where they live.  Healthcare providers have an important role in offering safer and more effective pain treatment.

Healthcare providers can:

  • Follow the CDC Guideline for Prescribing Opioids for Chronic Pain, which includes recommendations such as:
    • Use opioids only when benefits are likely to outweigh risks.
    • Start with the lowest effective dose of immediate-release opioids.  For acute pain, prescribe only the number of days that the pain is expected to be severe enough to require opioids.
    • Reassess benefits and risks if considering dose increases.
  • Use state-based prescription drug monitoring programs (PDMPs) which help identify patients at risk of addiction or overdose.

Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with ID

To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.

Source: Knowledge and expectations of direct support professionals towards effects of psychotropic drug use in people with intellectual disabilities – Kuijper – 2017 – Journal of Applied Research in Intellectual Disabilities – Wiley Online Library

Abstract

Background/Introduction

In this study, we investigated intellectual disability support professionals’ knowledge and expectations towards effects of psychotropic drug use on behaviour and drug use in their clients, because shortcomings may lead to misinterpretations of behavioural symptoms and inappropriate drug use.

Methods

Two self-designed questionnaires were used to measure the knowledge and expectations of 194 support professionals in 14 residential facilities regarding psychotropic drug use and effects of antipsychotics on behavioural, cognitive and mental functioning of people with intellectual disability. The psychometric properties of both questionnaires were adequate.

Results

A majority of the professionals had unrealistic expectations regarding the positive effects of antipsychotics on cognitive and behavioural functioning, and 94% scored below the cut-off scores regarding knowledge; 60% indicated they needed education and training.

Conclusions

To achieve sufficient collaboration of intellectual disability support professionals in reducing inappropriate psychotropic drug use of clients, vocational educational training is needed.

Study finds $200 billion in avoidable health care costs | American Pharmacists Association

Source: Study finds $200 billion in avoidable health care costs | American Pharmacists Association

Medication misuse, non-adherence, errors contribute to wasteful spending

Health care costs caused by improper and unnecessary use of medications exceeded $200 billion in 2012, amounting to an estimated 10 million hospital admissions, 78 million outpatient treatments, 246 million prescriptions, and 4 million emergency department visits annually, according to a new report from the IMS Institute for Healthcare Informatics.

This amount, representing 8% of the nation’s health care spending that year, “could pay for the health care of more than 24 million currently uninsured U.S. citizens,” said Murray Aitken, IMS Executive Director, in a news release announcing the report, Avoidable Costs in U.S. Healthcare: The $200 Billion Opportunity from Using Medicines More Responsibly.

These avoidable costs arose when patients failed to receive the right medications at the right time or in the right way, or received them but failed to take them, according to the report. Improvement is necessary in six areas: medication nonadherence, lag in adoption of evidence-based treatment practice, misuse of antibiotics, medication errors, suboptimal use of generics, and mismanaged polypharmacy in older adults.

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