Understanding providers' perspectives using patient-reported outcomes in a pain management setting: a pilot study.

This pilot study evaluated an electronic patient-reported outcomes collection system in pain management to understand providers' experiences using the data, and how it affects their patient interaction and guides their clinical decision-making. Using stratified convenience sampling, nine semi-structured interviews were conducted with consented pain physicians. The transcribed, de-identified interviews were coded and analyzed.

Social determinants of health: modeling and targeting patient propensity to attend pain clinic appointments.

We sought to investigate the impact of social determinants of health on pain clinic attendance. Retrospective data were collected from the Pain Center at Montefiore Medical Center from 2016 to 2020 and analyzed with multivariable logistic regression. African-Americans were less likely to attend appointments compared with White patients (odds ratio [OR]: 0.

Medicare Part D Coverage Restrictions and Patient Cost-Sharing for Opioids Commonly Used for Cancer Pain, 2015-2021.

Purpose: Nation-wide rapid declines in prescription opioid dispensing gave rise to concerns regarding restricted access to effective pain management for patients with cancer-related pain. One important mechanism for such restrictions could be through more restrictive insurance coverage for opioids. This study aims to assess recent changes in Medicare Part D formulary designs for opioids commonly used for cancer-related pain.

Robust Prescription Monitoring Programs and Abrupt Discontinuation of Long-term Opioid Use.

Introduction: This study assesses the associations between the recent implementation of robust features of state Prescription Drug Monitoring Programs and the abrupt discontinuation of long-term opioid therapies.

Methods: Data were from a national commercial insurance database and included privately insured adults aged 18-64 years and Medicare Advantage enrollees aged ≥65 years who initiated a long-term opioid therapy episode between Quarter 2 of 2011 and Quarter 2 of 2017. State Prescription Drug Monitoring Programs were characterized as nonrobust, robust, and strongly robust.

The effect of obesity on pain severity and pain interference.

Obesity is one of the most prevalent comorbidities associated with chronic pain, which can severely interfere with daily living and increase utilization of clinical resources. We hypothesized that a higher level of obesity, measured by BMI, would be associated with increased pain severity (intensity) and interference (pain related disability). Participant data was pulled from a multisite chronic pain outpatient database and categorized based on BMI.

Black Race as a Social Determinant of Health and Outcomes After Lumbar Spinal Fusion Surgery: A Multistate Analysis, 2007 to 2014.

Study Design: A retrospective analysis of patient hospitalization and discharge records.

Objective: To examine the association between race and inpatient postoperative complications following lumbar spinal fusion surgery.

Summary Of Background Data: Racial disparities in healthcare have been demonstrated across a range of surgical procedures.

Sociodemographic Characteristics Predict Readmission Rates After Lumbar Spinal Fusion Surgery.

Objective: To evaluate the impact of social determinants of health (race/ethnicity, household income, insurance) and hospital surgical volume on 30- and 90-day readmissions after lumbar spinal fusion surgery.

Methods: A retrospective review of the State Inpatient Databases (SID) Healthcare Cost and Utilization Project (HCUP) included all patients age ≥18 years who underwent an index lumbar spinal fusion procedure and met inclusion criteria in California (2007-2011), Maryland (2012-2014), Florida, and New York (2007-2014). Primary outcomes were unadjusted rates and adjusted odds of readmission at 30 and 90 days postoperatively.

First Opioid Prescription and Subsequent High-Risk Opioid Use: a National Study of Privately Insured and Medicare Advantage Adults.

Background: National guidelines make recommendations regarding the initial opioid prescriptions, but most of the supporting evidence is from the initial episode of care, not the first prescription.

Objective: To examine associations between features of the first opioid prescription and high-risk opioid use in the 18 months following the first prescription.

Design: Retrospective cohort study using data from a large commercial insurance claims database for 2011-2014 to identify individuals with no recent use of opioids and follow them for 18 months after the first opioid prescription.

Patient-Reported Outcomes and Opioid Use in Outpatients With Chronic Pain.

Unlabelled: The Weill Cornell Medical College Pain Registry database contains patient characteristics, treatments, and outcomes for a prospective cohort of 1,159 chronic pain patients who were seen at the Weill Cornell Medical College Pain Medicine outpatient clinic from July 8, 2011 to December 10, 2014. Patients aged 45 to 64 years comprised 43% followed by age ≥ 65 years at 37%. Fifty-eight percent were female.

Pain Assessment, Management, and Control Among Patients 65 Years or Older Receiving Hospice Care in the U.S.

Context: Knowledge is limited regarding pain assessment and management practices, as well as pain-related outcomes in hospice care.

Objectives: To generate national estimates of pain assessment and management practices and outcomes of pain control among patients 65 years or older receiving hospice care in the U.S.

Using Chronic Pain Outcomes Data to Improve Outcomes.

Standardization of care that is derived from analysis of outcomes data can lead to improvements in quality and efficiency of care. The outcomes data should be validated, standardized, and integrated into ongoing patient care with minimal burden on the patient and health care team. This article describes the organization and workflow of a chronic pain clinic registry designed to collect and analyze patient data for quality improvement and dissemination.

Usefulness of the opioid risk tool to predict aberrant drug-related behavior in patients receiving opioids for the treatment of chronic pain.

Objective: The purpose of this study was to determine if the opioid risk tool (ORT) was clinically useful in guiding physician decision making during chronic opioid therapy and to determine whether there were differences between the patient-completed and physician-completed ORT.

Design: Retrospective review of prospectively collected data.

Setting: A single-center tertiary care outpatient pain management center.

Can assessing chronic pain outcomes data improve outcomes?

Objective: This manuscript reviews how patient-reported outcomes data can be used to guide efforts to improve patient outcomes.

Design: Review Manuscript.

Setting: The clinical management of chronic, non-cancer pain.

Abscess after a laparoscopic appendectomy presenting as low back pain in a professional athlete.

A professional baseball player presented to the orthopaedic clinic for a preseason assessment because of continued lumbar spine and flank pain. He had a laparoscopic appendectomy for a perforated appendix 8 months before his presentation. He was able to finish the previous season with only mild limitation.

Horizontal maxillary osteotomy with interpositional fibula flap.

Horizontal maxillary osteotomy with an interpositional fibula flap for maxillary deficiency offers several advantages over conventional techniques for maxillary reconstruction. Maxillary deficiencies in all 3 planes, vertical, anterior-posterior, and transverse, can be corrected with a long-term stable construct while simultaneously restoring bony and soft tissue deficiencies. We conducted a retrospective review of patients with maxillary hypoplasia who underwent Horizontal maxillary osteotomy with interpositional osteoseptocutaneous fibula flaps.

Kullback-Leibler clustering of continuous wavelet transform measures of heart rate variability.

Power spectral analysis of beat-to-beat heart rate variability (HRV) has provided a useful means of understanding the interplay between autonomic and cardiovascular functionality. Despite their utility, commonly employed frequency-domain techniques are limited in their prerequisite for stationary signals and their inability to account for temporal changes in the power spectral and/or frequency properties of signals. The purpose of this study is to develop an algorithm that utilizes continuous wavelet transform (CWT) parameters as inputs to a Kohonen self-organizing map (SOM), providing a method of clustering subjects with similar wavelet transform signatures.