Opioid and Nonopioid Analgesic Prescribing Patterns of Hepatologists for Medicare Beneficiaries.

Introduction: Opioids are commonly prescribed to patients with chronic liver disease, but little is known regarding medication prescribing patterns of hepatologists. Opioid use increased until national guidelines limited opioid prescriptions in early 2016. We aimed to describe rates of opioid and nonopioid analgesics to Medicare beneficiaries by hepatologists from 2013 to 2017 and identify demographic characteristics associated with higher prescribing.

Prescription pain medications for disorders of gut-brain interaction: Comparing usage patterns with clinical practice recommendations.

Treatment of gastrointestinal pain remains a significant challenge in the management of many disorders of gut-brain interaction (DGBI). Pharmacologic agents and various behavioral therapies are among the potential therapeutic options for pain-predominant DGBI such as irritable bowel syndrome, functional dyspepsia, functional heartburn, and centrally mediated abdominal pain syndrome. In the retrospective study published in this journal, Luo et al.

High Opioid Prescribing Profiles Among Gastroenterologists: A Nationwide Analysis.

Chronic opioid use is associated with adverse effects on the gastrointestinal (GI) tract and increased morbidity. Despite efforts to de-escalate opioid use, 10% of outpatient GI visits are associated with an opioid prescription. Although we previously described declining opioid prescriptions to Medicare patients by most gastroenterologists, opioid prescriptions for GI conditions have increased.

A survey of gastroenterologists in the United States on the use of central neuromodulators for treating irritable bowel syndrome.

Background: Central neuromodulators are an effective treatment for irritable bowel syndrome (IBS) but may be used less frequently than other therapies.

Aims: To survey gastroenterologists in the United States (US) about their use of neuromodulators in patients with IBS.

Methods: A 23-question survey was distributed to gastroenterologists in the United States.

Increasing Rates of Opioid Prescriptions for Gastrointestinal Diseases in the United States.

Introduction: Pain control is an important management approach for many gastrointestinal conditions. Because of the ongoing opioid crisis, public health efforts have focused on limiting opioid prescriptions. This study examines national opioid prescribing patterns and factors associated with opioid prescriptions for gastrointestinal conditions.

Cost Savings Associated With Palliative Care Among Older Adults With Advanced Cancer.

Background: There is inconsistent evidence that palliative care intervention decreases total healthcare expenditure at end-of-life for oncology patients. This inconsistent evidence may result from small sample sizes at single institution studies and disparate characterization of costs across studies. Comprehensive studies in population-based datasets are needed to fully understand the impact of palliative care on total healthcare costs.

Nutritional approaches for gastroparesis.

Patients with gastroparesis often have signs and symptoms including nausea, vomiting, epigastric discomfort, and early satiety, thus leading to inadequate food intake and a high risk of malnutrition. There is a considerable scarcity of data about nutritional strategies for gastroparesis, and current practices rely on extrapolated evidence. Some approaches include the modification of food composition, food consistency, and food volume in the context of delayed gastric emptying.

Effect of Palliative Care on Aggressiveness of End-of-Life Care Among Patients With Advanced Cancer.

Purpose: Palliative care's role in oncology has expanded, but its effect on aggressiveness of care at the end of life has not been characterized at the population level.

Methods: This matched retrospective cohort study examined the effect of an encounter with palliative care on health-care use at the end of life among 6,580 Medicare beneficiaries with advanced prostate, breast, lung, or colorectal cancer. We compared health-care use before and after palliative care consultation to a matched nonpalliative care cohort.