Abstract:
OBJECTIVE:Opioids with abuse-deterrent properties may reduce widespread abuse, misuse, and diversion of these products. This study aimed to quantify misuse, abuse, dependence, and health resource use of extended-release morphine sulfate with sequestered naltrexone hydrochloride (ER-MSN; EMBEDA®), compared with non-abuse-deterrent extended-release morphine (ERM) products in Medicaid non-cancer patients. METHODS:Administrative medical and pharmacy claims data were analyzed for 10 Medicaid states from 1 January 2015, to 30 June 2016. Patients were included if they received a prescription for ER-MSN or any oral, non-abuse-deterrent ERM. Index date was the date of first prescription for an ER-MSN or ERM. Abuse/dependence, non-fatal overdose, emergency department (ED) visits, and ED/inpatient readmissions were determined for each participant. An overall measure of misuse and abuse was also calculated. To account for differences in follow-up, all counts are expressed per 100 patient-years. RESULTS:There were 4,857 patients who received ER-MSN and 10,357 who received an ERM. The average age in the two cohorts was approximately 45 years old. From pre-index to follow-up, the number of patients per 100 patient-years with a diagnosis code indicating abuse or dependence increased by 0.91 (95% confidence interval [CI]: 0.85, 0.97) in the ER-MSN cohort and 2.23 (95% CI: 2.14, 2.32) in the ERM cohort. The number of patients per 100 patient-years with an opioid-related non-fatal overdose increased by 0.05 (95% CI: 0.04, 0.06) in the ER-MSN cohort compared with 0.11 (95% CI: 0.09, 0.13) in the ERM cohort. The opioid abuse overall composite score increased by 1.36 (95% CI: 1.24, 1.48) in the post-index period in the ER-MSN cohort compared to 3.21 (95% CI: 3.10, 3.32) in the ERM cohort. CONCLUSION:Misuse, abuse, and dependence events were numerically lower in patients receiving ER-MSN compared with those receiving ERM products.
journal_name
Postgrad Medjournal_title
Postgraduate medicineauthors
Cicero TJ,Mendoza M,Cattaneo M,Dart RC,Mardekian J,Polson M,Roland CL,Schnoll SH,Webster LR,Park PWdoi
10.1080/00325481.2019.1585688subject
Has Abstractpub_date
2019-04-01 00:00:00pages
225-229issue
3eissn
0032-5481issn
1941-9260journal_volume
131pub_type
杂志文章abstract:OBJECTIVES:As the prevalence of peripheral artery disease (PAD) increases there is growing concern about the associated healthcare burden. This burden has not been well-characterized in high-risk patients with concurrent diabetes and/or acute coronary syndrome (ACS). The objective of this analysis was to assess comorbi...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.2016.1144447
更新日期:2016-01-01 00:00:00
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1976.11714412
更新日期:1976-07-01 00:00:00
abstract:BACKGROUND:Prescription opioids have substantial abuse potential. This study compared the positive subjective drug effects of a newly developed extended-release (ER) oxycodone (OC)/acetaminophen (acetyl-para-aminophenol [APAP]) formulation with those of immediate-release (IR) OC/APAP. METHODS:This randomized, double-b...
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pub_type: 杂志文章,随机对照试验
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更新日期:2014-07-01 00:00:00
abstract::The primary care physician can often delineate the cause of chest pain in a patient under 21 years of age after a thoughtful, careful, and thorough history and physical examination. Occasionally, an ECG and a chest x-ray film may be helpful. Noncardiac causes for the chest pain should be explored, and if found, the ch...
journal_title:Postgraduate medicine
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abstract:BACKGROUND:The use of 2-way audiovisual (AV) technology for delivery of acute stroke evaluation and management, termed "telestroke," is supported by a rapidly growing literature base. A systematic review that provides a comprehensive, easily digestible overview of telestroke science and practice is lacking. PURPOSE:To...
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abstract:OBJECTIVES:Our aim was to investigate the association of liver fibrosis and necroinflammation with HS in untreated young patients with chronic hepatitis B (CHB). MATERIALS AND METHODS:A retrospective study was conducted in a military hospital in Turkey. A total of 254 subjects with CHB were included in this study. The...
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abstract::Although low-dose oral corticosteroid therapy cannot be considered remittive, it has earned a place in the therapeutic armamentarium for rheumatoid arthritis. Major clinical trials of a group using corticosteroid compared with a control group have not been done since the 1950s. One of these three large trials showed s...
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pub_type: 临床试验,杂志文章,评审
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更新日期:1987-10-01 00:00:00
abstract::Abdominal aortic aneurysms are believed to result from several factors, one probably being inflammation that leads to dilatation, plaque deposition, and degeneration of the arterial wall. Most of these aneurysms are asymptomatic, but abdominal or back pain, shock, and a pulsatile abdominal mass indicate rupture. Initi...
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pub_type: 杂志文章,评审
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abstract::Objectives: The commonest types of peripheral neuropathy in the context of Coeliac Disease (CD) and gluten sensitivity (GS) are length-dependent symmetrical sensorimotor neuropathies and sensory ganglionopathies. In patients with such neuropathy, (gluten neuropathy), peripheral neuropathic pain is prevalent suggesting...
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journal_title:Postgraduate medicine
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doi:10.1080/00325481.1976.11714449
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abstract::Difficult or painful coitus is a symptom, not a pathologic entity. It may be caused by a congenital anomaly, an organic lesion, or a functional disorder of the vulva or vagina, or it may be psychic in origin. Although its cause can usually be determined relatively easily, a conditioned reflex created by a preexisting ...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1983.11697774
更新日期:1983-02-01 00:00:00
abstract::Preview Drug-induced aseptic meningitis is an unusual adverse reaction associated with a number of medications. In this report, the authors present a case related to use of trimethoprim- sulfamethoxazole and summarize the available data regarding various proposed mechanisms of drug-induced meningitis. The usual clinic...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1994.11945926
更新日期:1994-12-01 00:00:00
abstract::There are three key goals in current management of the diabetic pregnancy. Normal diabetes control before conception and during the first trimester in an attempt to reduce the incidence of congenital abnormalities. This implies that all diabetic women of childbearing age should have counseling before pregnancy. Routin...
journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1985.11698879
更新日期:1985-02-01 00:00:00
abstract::In the evaluation of male and female infertility the history, family history, physical examination, and endocrine and gonadal functional evaluations are the most informative measures. The cause of the infertility is never found in some 17.5% of couples and in almost one fourth of males. In over one third of cases male...
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pub_type: 杂志文章
doi:10.1080/00325481.1979.11715204
更新日期:1979-07-01 00:00:00
abstract::Theophylline has long been a cornerstone of bronchodilator therapy for asthma and chronic obstructive lung disease, but until recently its use carried the risk of serious, even fatal, toxicity. With recent advances in understanding of this drug's pharmacologic properties and pharmacokinetic characteristics, serious to...
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pub_type: 杂志文章
doi:10.1080/00325481.1984.11698651
更新日期:1984-06-01 00:00:00
abstract::What clinical circumstances call for aggressive treatment of jaundice in newborns? Is cessation of breast-feeding necessary to help bring down the high bilirubin concentration? When should phototherapy be started--and stopped? The authors address these and other questions in this thorough guide to differential diagnos...
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pub_type: 杂志文章,评审
doi:
更新日期:1996-03-01 00:00:00
abstract::A 65-year-old woman presented to the hospital with weight loss and diarrhea. A diagnosis of thyroid storm was established by the presence of fever, lethargy, tachycardia, heart failure (HF), and abnormal thyroid function tests. An acute coronary syndrome (ACS) was suspected because of anteroseptal ST-segment elevation...
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更新日期:2009-05-01 00:00:00
abstract::Human sexuality is a lifelong process with biologic, psychosocial, and moral consequences. During adolescence, coping with sexual feelings and controlling sexual drive become urgent tasks that are made more difficult by today's society. Recent studies document a dramatic increase in the frequency of sexual activity am...
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更新日期:2010-11-01 00:00:00
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更新日期:1997-04-01 00:00:00
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更新日期:2001-02-01 00:00:00
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更新日期:2019-01-01 00:00:00
abstract::Infective endocarditis refers to infection of the endocardium or heart valves by microbes, resulting in tissue destruction. Clinical presentation is quite variable, and a high level of suspicion is essential for recognition. Diagnosis is dependent on identification of the causative agent in blood cultures. Cultures th...
journal_title:Postgraduate medicine
pub_type: 杂志文章,评审
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更新日期:1993-04-01 00:00:00
abstract::Anemia of chronic disease (ACD) is a prevalent condition commonly observed in patients with chronic infections, cancer, trauma, and inflammatory disorders. In this article, Dr Andrews examines new research findings that enhance the understanding of the pathophysiologic mechanisms of ACD. After a brief review of iron h...
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journal_title:Postgraduate medicine
pub_type: 杂志文章
doi:10.1080/00325481.1988.11700344
更新日期:1988-07-01 00:00:00
abstract::Colonic cancer remains a major cause of death because diagnosis is usually delayed. Improved methods for earlier detection will maximize the patient's chances for survival. At present, surgery offers the greatest possibility of cure, but even in those instances where less than definitive resection is possible, there i...
journal_title:Postgraduate medicine
pub_type: 杂志文章
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更新日期:1975-04-01 00:00:00
abstract::Triglyceride (TG) levels can increase for numerous reasons, including a sedentary lifestyle, an unhealthy diet, especially one rich in refined carbohydrates, and comorbidities. According to the National Cholesterol Education Program (NCEP), the normal TG level is < 150 mg/dL. Patients with very high TG (VHTG) levels (...
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pub_type: 杂志文章,评审
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更新日期:2009-07-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2014-09-01 00:00:00
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更新日期:2014-05-01 00:00:00