Essential Updates: Comp Medical News for November

Welcome to this month’s Comp Medical News update. The power of music, older opioids and cash incentives for exercise are your headlines.


First, opioids, the patients who use them, and the doctors who prescribe them remain at the forefront of the conversation:


Combining Music and Painkillers May Improve Efficacy

A new review of the medical literature suggests that adding music to a pain medication regimen may improve pain reduction for both acute and chronic conditions. According to a Reuters report, researchers reviewed 97 randomized controlled trials conducted between 1995 and 2014 that included a total of 9,147 participants. The trials examined those effects on participants’ self-reported pain intensity, emotional distress from pain, vital signs and amount of pain relief medication taken. Overall, people getting the music intervention in their trial rated their pain intensity about one point lower on a zero to 10 scale. Further, seven of the studies found a significant decrease in anesthetic use in music groups compared to non-music groups. There were similar small but significant differences in studies examining use of opioid and non-opioid painkillers.

Read more here.

Pain Experts Suggest Early Opioid Levorphanol Could be Better than Current Options

Levorphanol dates back to the 40s and is still on the market, now, a new literature review concludes that increased usage of the drug could be beneficial for some pain patients. According to a report in Pain Medicine News, levorphanol (LevoCap ER, Relmada), which was approved by the FDA in 1953, is a “mu-opioid receptor agonist that also acts on other important opioid receptors such as delta and kappa.” The drug also works like some antidepressants commonly used in pain management, inhibiting the reuptake of both norepinephrine and serotonin. Further, studies of levorphanol’s pharmacokinetics show it is quickly absorbed orally, and has a longer half-life (11-16 hours) and a longer duration of analgesia (six to 15 hours) than most opioids.

Read more here.

ERs Responding to Opioid Crisis By Creating Treatment Programs

In the face of a swarm of patients associated with narcotics, emergency rooms are developing programs to get people help not only if they’ve overdosed, but also if they want addiction treatment. Boston Medical Center (BMC) last month announced the launch of its Faster Paths to Treatment Opioid Urgent Care Center. The effort is supported by a $2.9 million grant from the Massachusetts Department of Public Health and “rapidly links patients to an enhanced and integrated system of addiction healthcare delivery through inpatient and outpatient treatment services, detoxification, and follow-up care,” according to an announcement from BMC. The program will involve intake triage, referrals to addiction treatment and primary care, overdose education, “naloxone rescue kits,” as well as transportation and community support services.

Read further coverage from MedPage Today here.


Next, the weaknesses of some wellness efforts are exposed:


AARP Sues the Federal Government Over Workplace Wellness

The AARP, which represents older Americans, filed suit against the Obama administration last month, claiming that regulations for programs designed to rein in employee health care costs will subject workers to invasions of their medical privacy. The plaintiffs argue that rules approved by the Equal Employment Opportunity Commission (which itself has a history of fighting corporate wellness plans) will force workers to choose between hefty financial penalties or revealing sensitive health information to employers. The EEOC rules, which take effect next year, say employers can offer workers incentives worth up to 30 percent of the cost of their cheapest individual health insurance plans, or 60 percent for couples, to participate in wellness programs without violating federal anti-discrimination laws. The AARP counters that such incentives are basically just veiled penalties for workers who are leery of sharing their medical information and render the programs involuntary in violation of federal law.

Read more from Reuters here.

Activity Trackers Fail, But Cash Succeeds to Spur Exercise

Cash incentives have some effect over the short term to encourage people to exercise, but activity trackers do not. Researchers at Duke-NUS Medical School in Singapore sought to determine how these devices affect health and whether adding other kinds of incentives can help increase activity levels. They collected data on 800 employees from 13 organizations in Singapore. The study team divided people into four groups of about 200 each: those who received only a basic model Fitbit, those who got the same Fitbit and would also receive cash incentives tied to activity goals, those who got the Fitbit and earned charity donations, and people who got no tracker or incentives and served as a comparison group. At the start of the study, about two thirds of participants were considered to be too inactive, while about a third were considered active. A majority of participants were overweight or obese and around 10 percent had high blood pressure. At six months, the group wearing no trackers was getting slightly less moderate to vigorous exercise per week than at the start of the study, while the tracker-plus-cash group was doing about 29 minutes more than them and the tracker-plus-donations group was logging 21 minutes more than the no-tracker group.

Read full details via Reuters here.


Finally outpatient costs, already a concern in workers’ comp, emerge as a mainstream issue:


Quality of U.S. Outpatient Care Has Not Improved

A new study from Brigham and Women’s Hospital and Harvard University in Boston found that the quality of outpatient care hasn’t changed much in the U.S. over the past decade despite a variety of local, regional and national efforts to encourage improvements. During the study period from 2003 to 2013, the percentage of patients receiving recommended medical treatment rose from 36 percent to 42 percent. Other measures including counseling and communication also improved. However, the percentage of cases when patients avoided inappropriate medical care such as opioids for headaches or MRIs for back pain declined from 92 percent to 89 percent. Skipping unnecessary antibiotic use for things like the flu or acute bronchitis dropped from 50 percent to 44 percent.

More details via Reuters here.


Image Credit: WebMD



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