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Access and intensity of use of prescription analgesics among older Manitobans.

https://arctichealth.org/en/permalink/ahliterature150665
Source
Can J Clin Pharmacol. 2009;16(2):e322-30
Publication Type
Article
Date
2009
Author
Cheryl A Sadowski
Anita G Carrie
Ruby E Grymonpre
Colleen J Metge
Phillip St John
Author Affiliation
Faculty of Pharmacy & Pharmaceutical Sciences, University of Alberta, Edmonton, Alberta, Canada. csadowski@pharmacy.ualberta.ca
Source
Can J Clin Pharmacol. 2009;16(2):e322-30
Date
2009
Language
English
Publication Type
Article
Keywords
Age Factors
Aged
Aged, 80 and over
Analgesics, Non-Narcotic - therapeutic use
Analgesics, Opioid - administration & dosage - therapeutic use
Chronic Disease
Cross-Sectional Studies
Drug Utilization - statistics & numerical data
Female
Health Services Accessibility
Humans
Male
Manitoba - epidemiology
Pain - drug therapy - epidemiology
Physician's Practice Patterns
Prescription Drugs
Residence Characteristics
Rural Population
Sex Factors
Urban Population
Abstract
Under-treatment of pain is frequently reported, especially among seniors, with chronic non-cancer pain most likely to be under-treated. Legislation regarding the prescribing/dispensing of opioid analgesics (including multiple prescription programs [MPP]) may impede access to needed analgesics.
To describe access and intensity of use of analgesics among older Manitobans by health region.
A cross-sectional study of non-Aboriginal non-institutionalized Manitoba residents over 65 years of age during April 1, 2002 to March 31, 2003 was conducted using the Pharmaceutical Claims data and the Cancer Registry from the province of Manitoba. Access to analgesics (users/1000/Yr) and intensity of use (using defined daily dose [DDD] methodology) were calculated for non-opioid analgesics, opioids, and multiple-prescription-program opioids [MPP-opioids]. Usage was categorized by age, gender, and stratified by cancer diagnosis. Age-sex standardized rates of prevalence and intensity are reported for the eleven health regions of Manitoba.
Thirty-four percent of older Manitobans accessed analgesics during the study period. Female gender, increasing age, and a cancer diagnosis were associated with greater access and intensity of use of all classes of analgesics. Age-sex standardized access and intensity measures revealed the highest overall analgesic use in the most rural / remote regions of the province. However, these same regions had the lowest use of opioids, and MPP-opioids among residents lacking a cancer diagnosis.
This population-based study of analgesic use suggests that there may be variations in use of opioids and other analgesics depending on an urban or rural residence. The impact of programs such as the MPP program requires further study to describe its impact on analgesic use.
PubMed ID
19483264 View in PubMed
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An 18-year follow-up of patients admitted to methadone treatment for the first time.

https://arctichealth.org/en/permalink/ahliterature90117
Source
J Addict Dis. 2009;28(1):39-52
Publication Type
Article
Date
2009
Author
Davstad Ingrid
Stenbacka Marlene
Leifman Anders
Romelsjö Anders
Author Affiliation
Stockholm Addiction Centre, Karolinska Hospital, Stockholm, Sweden. ingrid.davstad@sll.se
Source
J Addict Dis. 2009;28(1):39-52
Date
2009
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Cause of Death
Criminology - statistics & numerical data
Diagnosis, Dual (Psychiatry)
Female
Follow-Up Studies
HIV Infections - epidemiology
Humans
Incidence
Male
Mental Disorders - epidemiology
Methadone - therapeutic use
Mortality
Narcotics - therapeutic use
Opioid-Related Disorders - epidemiology - psychology - rehabilitation - virology
Registries
Regression Analysis
Substance Abuse Treatment Centers - methods - statistics & numerical data
Sweden - epidemiology
Treatment Outcome
Young Adult
Abstract
An 18-year addiction career, 1985-2003, for 157 heroin dependent subjects (73% men; 49% human immunodeficiency virus seropositive) admitted for the first time to Stockholm's Methadone Maintenance Treatment program during 1989 to 1991 was analyzed with data from seven official registers and patient records. Regression analyses and incidence rates for various outcomes were calculated for subjects in first methadone maintenance treatment at the end of the observation period, discharged from first methadone maintenance treatment, in second methadone maintenance treatment, and discharged from second methadone maintenance treatment. Being human immunodeficiency virus positive (HR = 3.8), lodging (HR = 1.9) and prison sentence (HR = 1.7) predicted mortality for the 45% deceased. Approximately 70% of living subjects participated in methadone maintenance treatment at some period each year. Subjects in first or second methadone maintenance treatment had less criminality and had spent more time in methadone maintenance treatment (70% to 100%) than those discharged from first or from second methadone maintenance treatment (50%). Efforts and interventions should be intensified to increase time in treatment also for those with high problem severity.
PubMed ID
19197594 View in PubMed
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Analgesic prescribing patterns in Norwegian nursing homes from 2000 to 2011: trend analyses of four data samples.

https://arctichealth.org/en/permalink/ahliterature276993
Source
Age Ageing. 2016 Jan;45(1):54-60
Publication Type
Article
Date
Jan-2016
Author
Reidun Sandvik
Geir Selbaek
Oyvind Kirkevold
Dag Aarsland
Bettina Sandgathe Husebo
Source
Age Ageing. 2016 Jan;45(1):54-60
Date
Jan-2016
Language
English
Publication Type
Article
Keywords
Acetaminophen - therapeutic use
Age Factors
Aged
Aged, 80 and over
Aging - psychology
Analgesics - therapeutic use
Analgesics, Non-Narcotic - therapeutic use
Analgesics, Opioid - therapeutic use
Chi-Square Distribution
Cognition
Dementia - psychology
Drug Prescriptions
Drug Utilization Review
Female
Homes for the Aged - trends
Humans
Logistic Models
Male
Multivariate Analysis
Norway
Nursing Homes - trends
Observational Studies as Topic
Odds Ratio
Practice Patterns, Physicians' - trends
Randomized Controlled Trials as Topic
Time Factors
Abstract
the analgesic drug use has been reported to increase in general in nursing home patients. However, there is insufficient evidence in terms of what agents are used, variations of use over time and to whom these drugs are prescribed.
we investigated the prescribing patterns of scheduled analgesic drugs in Norwegian nursing home patients from 2000 to 2011, with the association to age, gender, cognitive function and type of nursing home unit.
secondary analyses of four study samples (three observational studies and one randomised controlled trial).
nursing home patients included in study samples from 2000 (n = 1,926), 2004 (n = 1,163), 2009 (n = 850) and 2011 (n = 1,858) located in 14 Norwegian counties.
trend analyses of analgesic drug prescriptions. Percentages were described using t-test, ?(2) and Mann-Whitney U test and multivariate logistic regression.
the odds ratio for receiving any pain medication in 2011 compared with 2000 was 2.6 (95% CI 2.23-2.91), this is corresponding to a 65% increase from 34.9 to 57.6%. The paracetamol prescription increased by 113%, from 22.7% in 2000 to 48.4% in 2011. Strong opioids (fentanyl, buprenorphine, morphine, oxycodone) increased from 1.9% in 2000 to 17.9% in 2011 (P
Notes
Comment In: Age Ageing. 2016 Jan;45(1):7-826764389
Erratum In: Age Ageing. 2016 Mar;45(2):32326941355
PubMed ID
26764395 View in PubMed
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Antiretroviral adherence and HIV treatment outcomes among HIV/HCV co-infected injection drug users: the role of methadone maintenance therapy.

https://arctichealth.org/en/permalink/ahliterature170216
Source
Drug Alcohol Depend. 2006 Sep 15;84(2):188-94
Publication Type
Article
Date
Sep-15-2006
Author
Anita Palepu
Mark W Tyndall
Ruth Joy
Thomas Kerr
Evan Wood
Natasha Press
Robert S Hogg
Julio S G Montaner
Author Affiliation
Centre for Health Evaluation and Outcome Sciences, St. Paul's Hospital, University of British Columbia, BC, Canada. anita@hivnet.ubc.ca
Source
Drug Alcohol Depend. 2006 Sep 15;84(2):188-94
Date
Sep-15-2006
Language
English
Publication Type
Article
Keywords
Adult
Anti-Retroviral Agents - blood - therapeutic use
British Columbia - epidemiology
Cohort Studies
Comorbidity
Demography
Female
Follow-Up Studies
HIV Infections - drug therapy - epidemiology
Hepatitis C - epidemiology
Humans
Male
Methadone - therapeutic use
Narcotics - therapeutic use
Patient Compliance - statistics & numerical data
Prevalence
Questionnaires
Risk-Taking
Substance Abuse, Intravenous - epidemiology - rehabilitation
Abstract
We examined the association of methadone maintenance therapy (MMT) with highly active antiretroviral therapy (HAART) adherence and HIV treatment outcomes among a cohort of HIV/HCV co-infected injection drug users (IDUs).
We obtained demographic, drug use, and addiction care history from the Vancouver Injection Drug User Study (VIDUS), which is an open cohort study of IDUs. The questionnaires were longitudinally linked to the British Columbia HIV/AIDS Drug Treatment Program to obtain HAART adherence and HIV treatment outcome data. There were 278 VIDUS participants who accessed HAART from August 1, 1996 to November 24, 2003. We constructed longitudinal logistic models using generalized estimating equations to examine the independent associations between methadone maintenance therapy and the following outcomes: HAART adherence; plasma HIV-1 RNA suppression; and CD4 cell rise of 100cells/mm(3).
Among participants who reported at least weekly heroin use, MMT was independently associated with lower odds of subsequent weekly heroin use during the follow-up period (adjusted odds ratio; 95% confidence interval [AOR; 95% CI]: 0.24; 0.14-0.40). We also found that MMT was positively associated with adherence (AOR 1.52; 95% CI 1.16-2.00), HIV-1 RNA suppression (AOR 1.34; 95% CI 1.00-1.79), and CD4 cell count rise (AOR 1.58; 95% CI 1.26-1.99).
Among HIV/HCV co-infected IDUs on HAART, enrollment in MMT was associated with reduced heroin use, and improved adherence, HIV-1 RNA suppression and CD4 cell count response. Integrating opiate addiction care and HIV care may provide improved health outcomes for this vulnerable population and should be further explored.
PubMed ID
16542797 View in PubMed
Less detail
Source
Tidsskr Nor Laegeforen. 2009 Nov 5;129(21):2260-1
Publication Type
Article
Date
Nov-5-2009
Author
Bengt Eide-Olsen
Author Affiliation
Stiftelsen Bergensklinikkene Hjellestad, Flyen 30, 5259 Hjellestad, Norway. eide_olsen_bengt@hotmail.com
Source
Tidsskr Nor Laegeforen. 2009 Nov 5;129(21):2260-1
Date
Nov-5-2009
Language
Norwegian
Publication Type
Article
Keywords
Buprenorphine - therapeutic use
Health Policy
Humans
Methadone - therapeutic use
Narcotics - therapeutic use
Norway
Opioid-Related Disorders - rehabilitation
Patient Rights
PubMed ID
19898579 View in PubMed
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Assessment and management of children's pain in community hospitals.

https://arctichealth.org/en/permalink/ahliterature214158
Source
J Adv Nurs. 1995 Oct;22(4):638-45
Publication Type
Article
Date
Oct-1995
Author
S. Caty
J. Tourigny
I. Koren
Author Affiliation
School of Nursing, Laurentian University, Ontario, Canada.
Source
J Adv Nurs. 1995 Oct;22(4):638-45
Date
Oct-1995
Language
English
Publication Type
Article
Keywords
Analgesics - therapeutic use
Child
Child, Preschool
Decision Making
Health Knowledge, Attitudes, Practice
Humans
Infant
Inservice training
Judgment
Narcotics - therapeutic use
Nonverbal Communication
Nursing Staff, Hospital
Ontario
Pain - drug therapy - nursing
Pain Management
Pain Measurement - methods
Pain, Postoperative - drug therapy
Parents
Social Support
Abstract
Registered nurses (n = 72) working in 10 paediatric units in community hospitals in north-eastern Ontario, Canada, participated in a descriptive study investigating how nurses assess and manage pain in children. A four-part questionnaire was used to collect the self-reported data. Twenty-five (36%) of the respondents defined pain as an individual and personal experience and another 25 (36%) respondents defined pain as a more or less localized sensation or discomfort resulting from the stimulation of specialized nerve endings. In response to three different clinical situations, the subjects' mean pain ratings were: 5.72 for an infant; 7.34 for a 3-year-old; and 7.29 for a 12-year-old child. The criterion 'nurses' judgment' was cited as being used frequently in both the assessment and decision making process; however, there was indication that some of the current knowledge in the assessment and management of pain in children was not known or being used.
PubMed ID
8708181 View in PubMed
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Background pain in burn patients: routine measurement and recording of pain intensity in a burn unit.

https://arctichealth.org/en/permalink/ahliterature204695
Source
Burns. 1998 Aug;24(5):448-54
Publication Type
Article
Date
Aug-1998
Author
C E Jonsson
A. Holmsten
L. Dahlström
K. Jonsson
Author Affiliation
Burn Center, Department of Surgical Sciences, Karolinska Hospital, Stockholm, Sweden.
Source
Burns. 1998 Aug;24(5):448-54
Date
Aug-1998
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Aged
Aged, 80 and over
Analgesics, Non-Narcotic - therapeutic use
Analgesics, Opioid - administration & dosage
Burn Units
Burns - complications
Dose-Response Relationship, Drug
Drug Administration Schedule
Female
Humans
Injury Severity Score
Male
Middle Aged
Pain - drug therapy - etiology - physiopathology
Pain Measurement
Pain threshold
Prognosis
Sweden
Time Factors
Treatment Outcome
Abstract
It goes without saying that pain following a burn must be treated but it is not so evident to measure and document the intensity of pain and the efficacy of treatment. Since 1994 the authors have routinely measured background pain, that is, at rest, along with temperature and pulse rate. For analysis and quality assessment a relational database programme is used in the ward. In this paper the authors' experience is reported from a consecutive series of 98 patients with burn injuries who assessed the intensity of pain on a visual analogue scale. There were great intra- and inter-individual variations in pain intensity. Highest values were found during the first week of treatment when female patients experienced pain more intensively than male. For other time periods there was no statistical significant difference between the sexes. Pain intensity and severity of burn was not related except during the second week when patients with major burns had a tendency to express more pain than moderate burns. Measurement of background pain along with other routine registrations is easy and not time-consuming. Patients needing intensified pain treatment can be identified. For research and quality assessment a computerized patient register is of great help.
PubMed ID
9725686 View in PubMed
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Balancing pain and analgesic treatment in the home-dwelling elderly.

https://arctichealth.org/en/permalink/ahliterature176975
Source
Ann Pharmacother. 2005 Jan;39(1):11-6
Publication Type
Article
Date
Jan-2005
Author
Sirpa A Hartikainen
Pekka T Mäntyselkä
Kirsti A Louhivuori-Laako
Raimo O Sulkava
Author Affiliation
Division of Geriatrics, Department of Public Health and General Practice, University of Kuopio, Kuopio, Finland. Sirpa.Hartikainen@uku.fi
Source
Ann Pharmacother. 2005 Jan;39(1):11-6
Date
Jan-2005
Language
English
Publication Type
Article
Keywords
Acetaminophen - therapeutic use
Aged
Aged, 80 and over
Analgesics - therapeutic use
Analgesics, Non-Narcotic - therapeutic use
Analgesics, Opioid - therapeutic use
Anti-Inflammatory Agents, Non-Steroidal - therapeutic use
Drug Utilization
Female
Finland - epidemiology
Humans
Male
Pain - drug therapy - epidemiology
Residence Characteristics
Abstract
In elderly persons, pain is a common problem, and analgesic medicines are among the most frequently used drugs.
To describe the use of analgesic medication and its relation to daily pain and morbidity in home-dwelling elderly people aged at least 75 years.
A random sample of 700 subjects aged at least 75 years was drawn from the total population of Kuopio, Finland. A geriatrician and nurse carried out structured clinical examinations and interviews with 601 persons, 523 of whom were living at home.
Seventy percent (n = 364) of the elderly people were taking at least one analgesic, including most of those who suffered from daily interfering pain (85%) and nearly all of those experiencing daily pain at rest (93%). Nonsteroidal antiinflammatory drugs (NSAIDs; n = 226, 51%) and acetaminophen (n = 118, 23%) were the most commonly used analgesics. The use of opioids became more common with age, accounting for 16% of the drugs in the oldest patients (> or =85 y) and 6% among those aged 75-79 years. Analgesics were mainly taken when needed. Only 13% of NSAID users, 18% of acetaminophen users, and 21% of opioid users took these preparations regularly.
Although analgesics are commonly used by elderly patients, it appeared that many patients were still experiencing daily interfering pain and pain at rest.
PubMed ID
15598966 View in PubMed
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The Beck Depression Inventory in patients undergoing opiate agonist maintenance treatment.

https://arctichealth.org/en/permalink/ahliterature79535
Source
Br J Clin Psychol. 2006 Sep;45(Pt 3):417-25
Publication Type
Article
Date
Sep-2006
Author
Hesse Morten
Author Affiliation
Centre for Alcohol and Drug Research, Aarhus University, Copenhagen, Denmark. mortenhesse@crf.dk
Source
Br J Clin Psychol. 2006 Sep;45(Pt 3):417-25
Date
Sep-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Alcoholism - psychology - rehabilitation
Buprenorphine - therapeutic use
Comorbidity
Denmark
Depressive Disorder - diagnosis - psychology
Female
Follow-Up Studies
Humans
Male
Methadone - therapeutic use
Middle Aged
Narcotics - therapeutic use
Opioid-Related Disorders - psychology - rehabilitation
Outcome Assessment (Health Care) - statistics & numerical data
Personality Inventory - statistics & numerical data
Prognosis
Prospective Studies
Psychometrics - statistics & numerical data
Reproducibility of Results
Street Drugs
Substance Abuse Treatment Centers
Treatment Refusal - psychology
Abstract
BACKGROUND AND OBJECTIVES: The Beck Depression Inventory (BDI) is a widely used measure of depression severity in both research and clinical contexts. This study aimed at assessing its stability and associations with ongoing drug use in a sample of patients in opiate agonist maintenance treatment who were not abstinent from illicit drugs. DESIGN AND METHOD: The study was a prospective, naturalistic study. Subjects in enhanced or standard psychosocial services along with opiate agonist maintenance treatment were administered the BDI and the European Addiction Severity Index (EuropASI) twice by research technicians, approximately 2 weeks after intake and at 18 months follow-up. FINDINGS: There were rather small mean changes from intake to follow-up in the BDI, and mean-level stability in subjects was rather high as evidenced by a high intra-class correlation between intake score and follow-up score. The stability of the BDI was reduced at high levels of drug use severity at intake, and BDI was a moderate predictor of drug use severity at follow-up. CONCLUSIONS: The BDI measures a construct that is both stable and of predictive validity in a sample of non-abstinent opiate agonist maintenance patients, although very severe drug use at baseline appeared to reduce the stability of the BDI.
PubMed ID
17147106 View in PubMed
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Behind the scenes: the justifications for opioid maintenance treatment in Finland.

https://arctichealth.org/en/permalink/ahliterature107990
Source
Subst Use Misuse. 2013 Aug;48(11):954-65
Publication Type
Article
Date
Aug-2013
Author
Riikka Perälä
Matilda Hellman
Anna Leppo
Author Affiliation
University of Helsinki Centre for Research in Addiction, Control and Governance (CEACG), Department of Social Research, University of Helsinki, Helsinki, Finland. riikka.perala@helsinki.fi
Source
Subst Use Misuse. 2013 Aug;48(11):954-65
Date
Aug-2013
Language
English
Publication Type
Article
Keywords
Finland
Health Policy
Humans
Narcotics - therapeutic use
Opiate Substitution Treatment
Opioid-Related Disorders - drug therapy
Abstract
Opioid maintenance treatment (OMT) has been developed within drug dependency treatment in Finland over the last 20 years. This study, based on interviews with 15 stakeholders and content analysis of 174 newspaper texts, draws on Boltanski and Thévenot's theory of justification to explore ways in which OMT has been justified and identifies the main actors contributing to its development. Multiple factors, involving different actors, have influenced the development process, reflecting the ethos of contemporary Finnish welfare and health policy. Currently, the main justifications for choosing OMT treatment seem to emerge from a neoliberal frame of understanding.
Notes
Comment In: Subst Use Misuse. 2013 Aug;48(11):1067-823952519
PubMed ID
23952508 View in PubMed
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107 records – page 1 of 11.