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      Quantification of Opioid Prescription Practice Changes Due to Hydrocodone Combination Product Rescheduling in an Academic Pain Clinic

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          Abstract

          Purpose

          To determine the effect of rescheduling on prescription practices in a large academic hospital-based multidisciplinary practice comprising anesthesiologist-trained pain physicians.

          Patients and Methods

          We examined the number of HCP prescriptions written and quantity of tablets prescribed during a 6-month period prior to rescheduling and compared this with a 6-month period 1 year after rescheduling. We also examined the changes in prescription of tramadol and acetaminophen with codeine from one period to the next.

          Results

          Our pain clinic conducted 3,320 office visits during the 6-month period prior to HCP rescheduling and 6,003 office visits in the 6-month period 1 year after rescheduling. The charted data from each of these visits were used for our analysis. The mean number of tablets of HCPs prescribed per patient decreased from 318.48 in the pre-period to 242.27 tablets in the post-period, while the mean number of HCP prescriptions per patient decreased from 2.24 to 1.84. The mean number of acetaminophen with codeine tablets prescribed per patient increased from 3.46 to 15.27 in the pre- and post-period. Similarly, the mean number of tramadol tablets per patient increased from 47.33 to 61.97 in the pre- and post-period. The mean number of acetaminophen with codeine and tramadol prescriptions per patient increased from 0.02 to 0.15 and 0.38 to 0.51 in the pre- and post-period, respectively. In the 6-month post-period, fewer new patients were started on opioids compared to the 6-month pre-period, 16% and 27%, respectively.

          Conclusion

          Our study showed a significant decrease in the mean number of HCP prescriptions written per patient, as well as a decrease in the mean number of HCP tablets prescribed. Pain physicians in our clinic increased the number of prescriptions for the non-HCPs. The number of acetaminophen with codeine and tramadol tablets prescribed significantly increased. Therefore, the rescheduling of HCPs has profoundly impacted practices within this academic pain clinic.

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          Most cited references 16

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          Trends in Opioid Analgesic-Prescribing Rates by Specialty, U.S., 2007-2012.

          Opioid analgesic prescriptions are driving trends in drug overdoses, but little is known about prescribing patterns among medical specialties. We conducted this study to examine the opioid-prescribing patterns of the medical specialties over time.
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            Clinical Pharmacology of Tramadol

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              Is Open Access

              Comprehension of Top 200 Prescribed Drugs in the US as a Resource for Pharmacy Teaching, Training and Practice

              Pharmacists have access to a plethora of information related to drugs. Online compendia concerning top 200 prescribed drugs are readily-accessible, comparatively-easy to search. While these resources provide some information about the commonly prescribed drugs, they lack in furnishing in-depth knowledge to pharmacy students, pharmacists and other healthcare professionals. The aim of this paper is to present the relevant details of top 200 most prescribed drugs in the United States. The names and therapeutic classes of top 200 prescribed drugs were compiled from online resources. The pharmacological actions of drugs, any reported adverse reactions and black box warnings are collected from drug bank resources, such as AccessPharmacy and Lexicomp. The paper provides comprehensive information about top 200 prescribed drugs, which includes generic names, pharmacological action, route of administration and adverse reaction profile including black box warning when applicable. Overall, the drug list may serve as an easy access of ideas for pharmacists, researchers and other healthcare professionals interested in developing new strategies for treating patients with various ailments.
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                Author and article information

                Journal
                J Pain Res
                J Pain Res
                jpr
                jpainres
                Journal of Pain Research
                Dove
                1178-7090
                25 August 2020
                2020
                : 13
                : 2163-2168
                Affiliations
                [1 ]Department of Anesthesiology and Pain Management, University of Texas Medical Branch , Galveston, TX, USA
                [2 ]Center for Addiction Research, University of Texas Medical Branch , Galveston, TX, USA
                [3 ]Department of Anesthesiology and Pain Management, University of Florida , Gainesville, FL, USA
                [4 ]Department of Anesthesia, Mcgaw Northwestern University Medical Center , Chicago, IL, USA
                [5 ]Department of Anesthesia, University of Washington , Seattle, WA, USA
                Author notes
                Correspondence: Denise Wilkes Department of Anesthesiology and Pain Management, University of Texas , Medical Branch, 301 University Blvd, Galveston, TX77555, USATel +1 409-772-1221Fax +1 409-747-0011 Email dwilkes@utmb.edu
                Article
                251386
                10.2147/JPR.S251386
                7457870
                © 2020 Ngo et al.

                This work is published and licensed by Dove Medical Press Limited. The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License ( http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. For permission for commercial use of this work, please see paragraphs 4.2 and 5 of our Terms ( https://www.dovepress.com/terms.php).

                Page count
                Figures: 3, Tables: 4, References: 19, Pages: 6
                Categories
                Original Research

                Anesthesiology & Pain management

                hydrocodone, tramadol, acetaminophen, schedule, reschedule

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