مقاله انگلیسی رایگان در مورد رویکردها در روزهای ارائه داروها در بیمه ها (الزویر)

Increasing abuse of opioid pain medications and mortality due to opioid overdose is a major public health concern. (Dart et al., 2015) In 2014, there were about 19,000 opioid-related deaths, representing a 20% increase from 2013. (CDC, 2016) Although there has not been a dramatic change in the amount of pain that Americans report over the past two decades, the number of opioid prescription drugs sold in the United States has nearly quadrupled since 1999. (CDC, 2016, Chang et al., 2014, Daubresse et al., 2013) An estimated 20% of patients presenting to physician offices with noncancer pain symptoms or pain-related diagnoses (including acute and chronic pain) receive an opioid prescription. (Daubresse et al., 2013) In 2012, health care providers wrote 259 million prescriptions for opioid pain medication. (Paulozzi et al., 2014) In March 2016, the CDC issued opioid prescribing guidelines recommending that opioids should not be the first-line therapy for chronic pain because of their risks and limited evidence of longterm efficacy. (Dowell et al., 2016) Further, the CDC recommended that opioid prescribing for acute pain should not be provided “just in case” and should be limited to the expected duration of pain severe enough to require opioids (typically 3–7 days) to minimize unintentional initiation of long-term opioid use. Guidelines for the number of pills prescribed (or days supplied) are intended to minimize unintentional or intentional diversion, which is a greater issue when there are leftover pills. In an effort to reduce the risks of addiction and diversion, states have implemented limits on the number of days supplied under a prescription. (CDC, 2015) For example, Connecticut recently passed legislation limiting prescriptions for pain medications to a 7-day supply except for certain circumstances, such as chronic pain, cancer pan, and palliative care. (Connecticut General Assembly, 2016).