Essential Updates: Comp Medical News for September

Welcome to this month’s edition of Comp Medical News, an essential update series. High tech painkillers, Alzheimer’s in the office, and the growth of telemedicine services are your headlines leading into September.

First, evidence mounts that more and more Americans are living with chronic pain, as narcotic treatments and associated risks remain a national epidemic:

NIH Analysis Reveals that 40 Million Adults Live with “Severe” Pain

A new analysis of data from the 2012 National Health Interview Survey (NHIS) has found that Americans report experiencing pain in increasing levels of intensity and duration. Among the major points were the estimated 25.3 million adults (11.2 percent) that had pain every day for the preceding 3 months. Further, nearly 40 million adults (17.6 percent) reported experiencing severe levels of pain. Severe pain was associated with poorer overall health status. The analysis was funded by the National Institutes of Health’s National Center for Complementary and Integrative Health (NCCIH) and was published in The Journal of Pain.

Read complete coverage from Workers’ Compensation Institute 360 here.

NSAIDs and Opioids Carry Basically Equal Risk for Development of Chronic Pain After Vehicular Accidents

Researchers from Alpert Medical School at Brown University, presenting at the American Pain Society’s 2015 meeting, found that there was no significant difference between giving nonsteroidal anti-inflammatory drugs (NSAIDs) or opioids to patients in the emergency department (ED) with regard to their risk for developing chronic pain after motor vehicle accidents. Such accident victims are very prone to the development of chronic pain, with some studies placing the prevalence at 40 percent. The team was able to obtain data from 859 patients. They found that 49 percent of patients receiving NSAID prescriptions and 56 percent of patients receiving opioid prescriptions reported moderate or severe musculoskeletal pain. Lead author Francesca L. Beaudoin, MD, MS explained that the results could be taken as further evidence questioning narcotics prescribing patterns and point to the need for best practices guidelines for powerful painkillers.

Read more from Pain Medicine News here.

Next, medical technology gains traction, but not without concerns as to testing and larger public health issues:

High-Risk Medical Devices Need Sufficient Postmarket Outcomes Data, Experts Say

A new analysis that looked at all 28 high-risk devices approved in 2010 and 2011 by the FDA Premarket Approval pathway found that most had only one study proving their safety and efficacy before going to market. “High-risk” devices are those that sustain human life or pose a potential risk to it. Of the 28 such devices granted initial marketing approval by the FDA during the study period, ten were later recalled.

Researchers (publishing in the Journal of the American Medical Association) used public data to determine that there had been 286 clinical studies of the 28 devices, including 82 before the devices were approved and 204 after they were on the market. The FDA relied on roughly one study per device to determine market approval, and there were 33 FDA-required postmarket studies for the 28 devices. Only six of those required studies had been completed by October 2014. Five devices had no postmarket studies, and 13 others had three or fewer postmarket studies. The study authors note that although the U.S. health system’s standards for medical devices are more rigorous than other countries’, the lack of a comprehensive, singular electronic health records system makes it harder to track problems down the line than in such places as the U.K.

Read more from Reuters here.

Stanford Bioengineers Create Novel Opioids out of Yeast Instead of Poppies

A team of scientists at Stanford University has patented a rapid method of creating potent painkilling opioids using bioengineered baker’s yeast instead of poppies, however, it will likely be several years before the process is commercially viable. The researchers, which include both bioengineering and chemistry scholars, altered the yeast’s genetic make-up in a way that coaxed the cells to convert sugar into two opioids – hydrocodone and thebaine – in three to five days. Current processes for manufacturing drugs such as hydrocodone and oxycodone use opium poppies and take about a year in total time. Although the Stanford method is obviously much faster, it requires about 4,400 gallons of bioengineered yeast to yield a single dose of the medication. Fine-tuning the efficiency of the yeast is the next step. The researchers, led by associate professor Christina Smolke, acknowledged that they understand how speeding up manufacturing could be perceived as contributing to the opioid abuse problem, but note that most of the world outside of the U.S. lacks safe and adequate pain medication.

Read further details from Reuters here.

Telemedicine Visits for Minor Issues Surge in Popularity

Telehealth services are increasingly being offered as a part of health programs offered by insurers and employers, especially for minor concerns and common ailments like pinkeye or sinus infections. Typically, an “e-visit” can start within minutes of being requested and costs between $40-50. The increase in efficiency, quick availability of prescriptions, and relatively low price has made the option popular with consumers, especially millennials and parents with young children. However, some industry analysts have questioned the quality of such visits in light of evidence that medications such as antibiotics are overprescribed in the sector compared with traditional office visits. In the comp arena, CorVel recently launched its claimant telemed app.

Read more from the Los Angeles Times here.

Last, Alzheimer’s, dementia and other cognitive illnesses in the workplace are spotlighted in a BBC special feature:

BBC Capital: A Silent Struggle in the Workplace

As baby boomers age in a still uncertain global economy, many will remain in the workforce past typical retirement age, creating the need for workplace accommodations that allow them to continue working. Part of this effort includes coping with dementia in the workplace. BBC Capital explores methods, stats and stories of both simple and more complex ways that employers can manipulate an employee’s existing role and retain their expertise, even if that employee should no longer perform higher risk elements of their job which may depend upon short term memory.

Read the feature here.


Image Credit: A field of poppies in Afghanistan via The Golden Assay

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