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March 2013 Briefing - Pain Management

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

Many Uninsured Vets Will Be Eligible for Medicaid Under ACA

FRIDAY, March 29 (HealthDay News) -- A large proportion of uninsured veterans and their spouses will be eligible for Medicaid or new subsidies for coverage under the Affordable Care Act (ACA), according to a report published by the Robert Wood Johnson Foundation.

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Regional Variation Noted in Prevalence of Delayed Care

THURSDAY, March 28 (HealthDay News) -- There is considerable county-wide variation in the prevalence of delayed care, with high prevalence linked to a weaker health care infrastructure, according to a letter published in the March 28 issue of the New England Journal of Medicine.

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Using Internet Search Logs Can Help Identify Drug Interactions

THURSDAY, March 28 (HealthDay News) -- Search logs can be used to inexpensively mine for anonymized signals that may alert authorities to potential drug interactions and add new Web-scale pharmacovigilance capabilities, according to research published online March 6 in the Journal of the American Medical Informatics Association.

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Study: Primary Care Extension Program Should Be Funded

THURSDAY, March 28 (HealthDay News) -- The Primary Care Extension Program (PCEP) has the potential to transform primary care and needs to be funded, according to a study published in the March/April issue of the Annals of Family Medicine.

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Submitting Peer-Review Reports Could Expedite Process

WEDNESDAY, March 27 (HealthDay News) -- Attaching previous peer-review reports during the next submission of the same paper to a different journal could optimize the peer-review process, according to research published in the March/April issue of the Annals of Family Medicine.

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Majority of Lumbar Spine MRIs Are Inappropriately Ordered

WEDNESDAY, March 27 (HealthDay News) -- There is substantial overuse of lumbar magnetic resonance imaging (MRI) scans, according to a research letter published online March 25 in JAMA Internal Medicine.

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MRI Detects Cortical Brain Abnormalities for Migraines

WEDNESDAY, March 27 (HealthDay News) -- Patients with migraines have cortical thickness and surface area abnormalities that may represent both a predisposition to the condition as well as disease-related processes, according to a study published online March 26 in Radiology.

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Residency Reforms Reduced Duty Hours, Increased Sleep

TUESDAY, March 26 (HealthDay News) -- Additional residency reforms implemented in 2011 have reduced duty hours and increased sleep duration, but with perceived reductions in quality of patient care, according to research published online March 25 in JAMA Internal Medicine.

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White Matter Diffusivity Linked to Gulf War Illness Symptoms

MONDAY, March 25 (HealthDay News) -- Fatigue, pain, and hyperalgesia are associated with increased axial diffusivity in the right inferior fronto-occipital fasciculus in veterans with Gulf War Illness, according to a study published online March 20 in PLOS ONE.

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Mobility Impaired May Have Difficulty Accessing Docs

FRIDAY, March 22 (HealthDay News) -- Many U.S. subspecialty practices cannot accommodate patients with mobility impairment, according to a study published in the March 19 issue of the Annals of Internal Medicine.

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Impact of Budget Sequestration on Health Care Discussed

THURSDAY, March 21 (HealthDay News) -- The impact of sequestration will have far-reaching consequences in health care, according to a perspective piece published online March 20 in the New England Journal of Medicine.

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Effect of Immigration Status on Medicaid Eligibility Discussed

WEDNESDAY, March 20 (HealthDay News) -- Under the Affordable Care Act, a considerable proportion of low-income uninsured adults will be ineligible for Medicaid coverage due to their immigration status, and their main providers are likely to be safety-net health care providers, according to a March report published by the State Health Access Data Assistance Center.

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Manual Osteopathic Treatment Improves Chronic Back Pain

WEDNESDAY, March 20 (HealthDay News) -- Treatment of nonspecific chronic low back pain with osteopathic manual treatment (OMT) is associated with moderate or substantial improvements in low back pain, according to a study published in the March/April issue of the Annals of Family Medicine.

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ER Discharge Dx/Disposition Discordant With Chief Complaint

TUESDAY, March 19 (HealthDay News) -- A considerable proportion of patients with emergency department visits with the same presenting complaint as those ultimately given a primary care-treatable diagnosis require immediate emergency care or hospital admission, according to a study published in the March 20 issue of the Journal of the American Medical Association.

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Conflict-of-Interest Disclosures Common at 2011 AAOS Meeting

TUESDAY, March 19 (HealthDay News) -- At the 2011 American Academy of Orthopaedic Surgeons (AAOS) annual meeting, voluntarily disclosed conflicts of interest were common, especially for featured symposia, according to a study published in the March 6 issue of The Journal of Bone & Joint Surgery.

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Final Rule in Notice of Benefit, Payment Parameters Issued

FRIDAY, March 15 (HealthDay News) -- The final rule of the Department of Health and Human Services (HHS) Notice of Benefit and Payment Parameters for 2014, which expands on existing standards, has been released.

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Health Insurance Exchanges Will Mainly Be Run by Feds

FRIDAY, March 15 (HealthDay News) -- More than half of the states within the United States will allow the federal government to establish health insurance exchanges, according to a report issued by the Henry J. Kaiser Family Foundation.

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Pharmaceutical Companies Are Reducing Promotional Spending

FRIDAY, March 15 (HealthDay News) -- Pharmaceutical companies have been reducing the amount of money they spend on promotion to consumers and providers over the past decade and spend much less to promote biologics compared with small molecule drugs, according to a study published online March 4 in PLOS ONE.

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Exercise, Counseling Cut Days Off From Back Pain in Recruits

FRIDAY, March 15 (HealthDay News) -- Neuromuscular exercise and counseling decrease the number of days off due to low back pain (LBP) among young men serving in the military, according to a study published in the March 1 issue of Spine.

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Medicare Patients Enrolled in Hospice Receive Better Care

THURSDAY, March 14 (HealthDay News) -- Medicare patients who enroll in hospice care receive better care at a lower cost, with the greatest savings if they enroll 15 to 30 days before death, according to a study published in the March issue of Health Affairs.

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MRI Assessment Doesn't ID Recurrent Sciatica at One Year

WEDNESDAY, March 13 (HealthDay News) -- For patients treated for sciatica and lumbar-disc herniation, magnetic resonance imaging (MRI) performed at one year does not distinguish between those with and without favorable outcome, according to a study published in the March 14 issue of the New England Journal of Medicine.

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AMA Files Brief Contesting Insurer's Payment Practices

WEDNESDAY, March 13 (HealthDay News) -- A landmark case examining the question of whether physicians can bring a class arbitration against a health insurer who has underpaid them is currently before the U.S. Supreme Court, in a brief filed by the Litigation Center of the American Medical Association and State Medical Societies and the Medical Society of New Jersey.

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Neck Injuries Tied to Higher Costs for Patients, Spouses

WEDNESDAY, March 13 (HealthDay News) -- Neck injuries are associated with significant health, social, and economic consequences for patients and their spouses, according to research published in the March 1 issue of Spine.

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$120 Million to Be Sequestered From Health Centers in 2013

TUESDAY, March 12 (HealthDay News) -- Budget sequestration, which is expected to reduce federal spending, is likely to result in a $120 million loss in grant funding for the nation's 1,200 community health centers in 2013, according to a report published by the Geiger Gibson/ RCHN Community Health Foundation Research Collaborative.

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FDA Encourages Opioid Prescribers to Pursue Training

MONDAY, March 11 (HealthDay News) -- Prescribers of extended-release/long-acting (ER/LA) opioid analgesics are encouraged to participate in continuing medical education (CME) provided by manufacturers of these analgesics, according to an open letter published March 1 by the U.S. Food and Drug Administration.

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Little Evidence Red Flags Are Useful in Detecting Spinal Woes

FRIDAY, March 8 (HealthDay News) -- Researchers have doubts as to the diagnostic accuracy or usefulness of red flag indicators to detect or exclude spinal malignancy in patients with low back pain (LBP), according to research published online Feb. 28 in The Cochrane Library.

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Opioid Guidelines for ER Docs Help, But More Study Needed

FRIDAY, March 8 (HealthDay News) -- Local recommendations like those recently released in New York City aimed at improving opioid prescribing are good first steps but unlikely on their own to address the full problem, according to a viewpoint published in the March 6 issue of the Journal of the American Medical Association.

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Double-Jointed Adolescents Risk Musculoskeletal Pain

THURSDAY, March 7 (HealthDay News) -- Joint hypermobility (JH) increases the risk of musculoskeletal pain in adolescence, particularly in the shoulder, knee, and ankle/foot, according to a study published online Feb. 28 in Arthritis & Rheumatism.

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Coordinated Care Model Suggested for Palliative Care

THURSDAY, March 7 (HealthDay News) -- To deal with the increasing demand for palliative care services, a coordinated palliative care model is proposed, according to a perspective piece published online March 6 in the New England Journal of Medicine.

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Most Docs Report Information Overload in EHR-Setting

WEDNESDAY, March 6 (HealthDay News) -- Primary care practitioners (PCPs) using electronic health records (EHRs) are susceptible to information overload and feel that the EHR notification system makes it possible to miss test results, according to a research letter published online March 4 in JAMA Internal Medicine.

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Two Drug Classes Found Effective for Restless Legs Syndrome

WEDNESDAY, March 6 (HealthDay News) -- In patients with restless legs syndrome, dopamine agonists and calcium channel alpha-2-delta ligands are effective in reducing symptoms and improving sleep and quality of life, although adverse events are common and often lead to treatment withdrawals, according to a review published online March 4 in JAMA Internal Medicine.

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Clinical Trials Published Almost Two Years After Completion

WEDNESDAY, March 6 (HealthDay News) -- Clinical trials are published, on average, almost two years after completion, with time to publication affected by the funding source, number of trial participants, and journal impact factor, according to a research letter published online March 4 in JAMA Internal Medicine.

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U.K. Health Performance Worse Than Comparable Countries

TUESDAY, March 5 (HealthDay News) -- The United Kingdom has worse health performance than other comparable countries, according to a study published online March 5 in The Lancet.

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Proportion of Black Males in U.S. Medical Schools Dropping

MONDAY, March 4 (HealthDay News) -- The proportion of black males in medical school is decreasing, according to a report published by the Association of American Medical Colleges (AAMC).

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Panel Recommends 10 Patient Safety Strategies

MONDAY, March 4 (HealthDay News) -- An expert panel is strongly encouraging the immediate adoption of 10 patient safety strategies and encouraging the adoption of a further 12, according to a supplement published in the March 5 issue of the Annals of Internal Medicine.

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Steroid Injections May Worsen Spinal Stenosis Outcomes

MONDAY, March 4 (HealthDay News) -- The use of epidural steroid injections (ESIs) may be linked to worse outcomes over four years in patients with lumbar spinal stenosis whether they are treated surgically or nonsurgically, according to a study published in the Feb. 15 issue of Spine.

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CMS Reports on Progress Toward Improved Health Care

MONDAY, March 4 (HealthDay News) -- Considerable progress has already been made toward improving the quality and delivery of health care, according to a Centers for Medicare and Medicaid Services (CMS) bulletin published online Feb. 28.

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Computerized Provider Order Entry System Cuts Rx Errors

MONDAY, March 4 (HealthDay News) -- Electronic prescribing through computerized provider order entry (CPOE) systems can substantially reduce medication errors in inpatient acute-care settings, according to a study published online Feb. 20 in the Journal of the American Medical Informatics Association.

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Sequestration to Impact Health Care-Related Programs

FRIDAY, March 1 (HealthDay News) -- The $85 billion of mandatory cuts in federal spending that take effect March 1 as part of sequestration will be felt across health care and related programs, with cuts to Medicare providers and to the budgets of federal agencies.

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