Characterizing acute and postsurgical pain management in patients receiving buprenorphine or buprenorphine/naloxone.

Background: There is currently a clinical dilemma in treating acute pain in patients receiving long-term buprenorphine products.

Methods: This is a retrospective cohort review involving patients receiving long-term buprenorphine therapy who either underwent a surgical procedure or presented to an emergency department (ED) for acute pain between January 1, 2012 and January 1, 2022. Patients were excluded if opioids were prescribed 30 days before the index date.

Deprescribing electronic case reviews for older veterans at risk for falls: Effects on drug burden and falls.

Background: Falls are the most common medication-related safety event in older adults. Deprescribing fall risk-increasing drugs (FRIDs) may mitigate fall risk. This study assesses the effects of an innovative deprescribing program in reducing FRID burden and falls-related acute visits over 1 year.

Resident involvement in cataract surgery at the Veterans Health Administration: complications, case complexity, and the role of experience.

Purpose: To characterize intraoperative complications, case complexity, and changes in complication rates with surgical experience for cataract surgeries involving residents at the Veterans Health Administration (VHA).

Setting: All VHA facilities where cataract surgery was performed.

Design: Multicenter, retrospective cohort study.

Role of memantine in the prophylactic treatment of episodic migraine: A systematic review.

Objective: The purpose of this systematic review is to assess the efficacy and safety of memantine for the prophylactic treatment of episodic migraine.

Background: Migraine is a prevalent chronic disease with significant costs to the health care system. Although various prophylactic treatment options are available, these medications have limitations based on efficacy, potential side effects, and patient preference.

Effects of anticholinergic and sedative medication use on fractures: A self-controlled design study.

Background/objectives: Unintentional falls are a leading cause of injury for older adults, and evidence is needed to understand modifiable risk factors. We evaluated 1-year fall-related fracture risk and whether dispensing of medications with anticholinergic/sedating properties is temporally associated with an increased odds of these fractures.

Design: A retrospective cohort study with nested self-controlled analyses conducted between January 1, 2014, and December 31, 2016.

Quantifying cumulative anticholinergic and sedative drug load among US Medicare Beneficiaries.

Purpose: Medications with anticholinergic and sedative properties are widely used among older adults despite strong evidence of harm. The drug burden index (DBI), a pharmacological screening tool, measures these properties across drug classes, and higher DBI drug exposure (DBI > 1) has been associated with certain physical function-related adverse events. Our aim was to quantify mean daily DBI drug exposure among older adults in the United States (US).

Impact of Supervised Exercise on One-Year Medication Use in Older Veterans with Multiple Morbidities.

Exercise is touted as the ideal prescription to treat and prevent many chronic diseases. We examined changes in utilization and cost of medication classes commonly prescribed in the management of chronic conditions following participation in 12-months of supervised exercise within the Veterans Affairs Gerofit program. Gerofit enrolled 480 veterans between 1999 and 2017 with 12-months participation, with 453 having one or more active prescriptions on enrollment.

The role of suvorexant in the prevention of delirium during acute hospitalization: A systematic review.

Purpose: To assess the efficacy and safety of suvorexant for the prevention of delirium during acute hospitalization.

Materials And Methods: Pubmed (1946 to December 2019) and Embase (1947 to December 2019) were queried using the search term combination: delirium, confusion, cognitive defect, encephalopathy, critically ill patient, critical illness, or hospitalization and suvorexant or orexin receptor antagonist. Studies analyzed for relevance evaluated clinical outcomes of patients treated with suvorexant for prevention of delirium.

Effects of Acetaminophen, NSAIDs, Gabapentinoids, and Their Combinations on Postoperative Pulmonary Complications After Total Hip or Knee Arthroplasty.

Objective: Multimodal analgesia has gained popularity in total hip arthroplasty (THA) and total knee arthroplasty (TKA), but large multicenter studies evaluating specific analgesic combinations are lacking.

Design: A retrospective study using the Premier Healthcare Database (2009-2014).

Subjects: Adults who underwent elective primary THA or TKA.

Description of Pharmacist Recommendations in the Caring for Older Adults and Caregivers at Home (COACH) Program.

To describe recommendations made by geriatric clinical pharmacists within an innovative care model focusing on patients with dementia living at home. Retrospective chart review. Outpatients in a tertiary care Veterans Affairs health care system.

Dose-Dependent Association of Gabapentinoids with Pulmonary Complications After Total Hip and Knee Arthroplasties.

Background: Gabapentinoids are commonly prescribed in perioperative multimodal analgesia protocols. Despite widespread use, the optimal dose to reduce opioid consumption while minimizing risks is unknown. We assessed dose-dependent effects of gabapentinoids on opioid consumption and postoperative pulmonary complications following total hip or knee arthroplasty (THA or TKA).

Adjunctive memantine for opioid use disorder treatment: A systematic review.

Memantine is commonly used for the treatment of moderate-to-severe Alzheimer's disease. Due to its antagonism of the N-methyl-d-aspartate (NMDA) receptor, which has been shown to block rewarding and reinforcing effects of morphine, memantine has been investigated for potential utilization in opioid use disorder (OUD). The objective of this systematic review is to assess the evidence available to determine the safety and efficacy of memantine as treatment for OUD.

Trends in Chronic Opioid Use Around Inpatient Surgery Within the Veterans Health Administration.

This study assesses outcomes of veterans who have undergone inpatient surgery since the Veterans Health Administration’s opioid safety initiative was initiated.

Impact of an Opioid Safety Initiative on Patients Undergoing Total Knee Arthroplasty: A Time Series Analysis.

Background: The Opioid Safety Initiative decreased high-dose prescriptions across the Veterans Health Administration. This study sought to examine the impact of this intervention (i.e.

New Persistent Opioid Use After Postoperative Intensive Care in US Veterans.

This study uses medical records of more than 800 000 US veterans treated in the intensive care unit after surgery to determine the rate at which these patients developed new persistent opioid use.

Association 'Between Gabapentinoids on the Day of Colorectal Surgery and Adverse Postoperative Respiratory Outcomes.

Objective: The aim of this study was to determine the association between gabapentinoids on the day of surgery and adverse postoperative outcomes in patients undergoing colorectal surgery in the United States.

Background: Gabapentinoids, gabapentin and pregabalin, are recommended in multimodal analgesia protocols for acute postoperative pain management after colorectal surgery. However, current literature focuses on the efficacy in reducing opioid consumption, but provides limited information about adverse risks.

Freedom From Opioids After Total Knee Arthroplasty.

Background: In the United States, opioids are commonly prescribed to treat knee pain after total knee arthroplasty (TKA). While surgery leads to decreased pain in most patients, a sizable minority continue to experience severe pain and consume opioids chronically after TKA. We sought to determine the population-level effect of TKA on opioid consumption by detailing the pattern of opioid prescriptions before and after surgery.