Around one in seven Medicare beneficiaries with a high body mass index (BMI) may be newly eligible for semaglutide treatment after Medicare allowed Part D plans to cover the drug for patients with a BMI ≥ 27 and a history of cardiovascular disease (CVD), regardless of their diabetes status.
METHODOLOGY:
- In March 2024, Medicare approved the coverage of semaglutide by Part D plans for patients with a high BMI and existing CVD, irrespective of their diabetes status. This decision follows the SELECT trial results, showing that semaglutide lowered the risk for cardiovascular events in some patients without diabetes.
- This study aimed to describe the Medicare beneficiaries most likely to be newly eligible for semaglutide treatment and estimated maximum costs to Medicare Part D.
- The researchers included 5111 individuals aged ≥ 65 years with self-reported Medicare enrollment in the National Health and Nutrition Examination Survey between 2011 and 2020, all of whom had a BMI ≥ 27 and were likely to benefit from semaglutide treatment.
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A decade ago, federal officials drafted a plan to discourage Medicare Advantage health insurers from overcharging the government by billions of dollars — only to abruptly back off amid an "uproar" from the industry, newly released court filings show.
The Centers for Medicare & Medicaid Services published the draft regulation in January 2014. The rule would have required health plans, when examining patient's medical records, to identify overpayments by CMS and refund them to the government.
But in May 2014, CMS dropped the idea without any public explanation. Newly released court depositions show that agency officials repeatedly cited concern about pressure from the industry.
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Psychological factors are critical in determining the success of neuromodulation procedures. By addressing these factors, healthcare professionals can significantly improve patient outcomes, reduce postoperative complications, and enhance overall well-being. Our guidelines offer evidence-based strategies to integrate psychological care throughout the neuromodulation process.
Who is it for?
These guidelines are intended for healthcare professionals, including psychologists, neurosurgeons, pain specialists, and multidisciplinary teams. Hospitals and clinics providing neuromodulation services can also benefit by adopting these guidelines to ensure the highest standards of psychological care for their patients.
What’s new?
Key recommendations include a structured approach to multidisciplinary assessments, integrating psychological evaluations into treatment planning, and strategies for enhancing collaboration between medical and psychological professionals.
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Virtual
September 28, October 26,
November 9 & December 14
Click here for the complete list of upcoming exams.
ABIPP Part I; ABIPP Path - Combined DCCPM/CSM virtual exam;
ABIPP Competency Exam in IPM; ABIPP Competency Exam in Regenerative Medicine;
CSM Competency Exam; DCCPM Competency Exam
In Person
October 18, 2024
ABIPP Part II - Practical Examination
Lab Venue: MERI, 44 S. Cleveland Street, Memphis, TN 38104
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A smartphone app that delivers acceptance and commitment therapy (ACT), a type of cognitive behavioral therapy, improves overall well-being and reduces the severity of pain, fatigue, sleep issues, and depression to a greater extent than daily symptom tracking in patients with fibromyalgia.
METHODOLOGY:
- Researchers conducted the phase 3 PROSPER-FM trial at 25 community sites in the United States to assess the efficacy and safety of digital ACT for patients with fibromyalgia.
- A total of 275 adult patients aged 22-75 years with fibromyalgia were randomly assigned to either the digital ACT group (n = 140) or the active control group (n = 135) for 12 weeks.
- Patients in the digital ACT group received a self-guided, smartphone-delivered program in which they learned and practiced the core ACT skills of acceptance, values, mindfulness, defusion, self as context, and willingness and committed action to build psychologic flexibility, while the control group underwent daily symptom tracking and received educational materials.
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Registration is open for
ASIPP's 2025 Annual Meeting
We would love it if you would register and join us in Orlando!
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The first nalmefene hydrochloride (HCl) auto-injector (Zurnai) brings a new tool to the fight against the opioid overdose epidemic but is not without controversy.
As reported earlier this month, the US Food and Drug Administration (FDA) approved Purdue Pharma's abbreviated new drug application for a prefilled, single 1.5-mg dose of nalmefene auto-injector for the emergency treatment of opioid overdose in people aged 12 years or older.
Nalmefene HCl injection was first approved in 1995 (Revex) but discontinued for commercial reasons in 2008 by Baxter Healthcare. The FDA granted approval of nalmefene injection to Purdue in 2022 and approved the first nalmefene nasal spray (Opvee), sold by drugmaker Indivior, in 2023.
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ASIPP State Society Meeting: | |
- ASIPP Members Only Site Information - | |
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To log in for the first time you will need to click “forgot password” at the bottom of the login window.
- Check your email and then log in as directed.
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If you have problems logging into your account, click here.
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Pain Medicine Case Reports (PMCR) and Editor-in-Chief Alaa Abd-Elsayed, MD, PhD would like to invite you to submit case reports and case series to the PMCR journal. Your article will be published free of charge.
Open access journals are freely available online for immediate worldwide open access to the full text of published articles. There is no subscription fee for open access journals. Open access journals are no different from traditional subscription-based journals: they undergo the same peer review and quality control as any other scholarly journal.
Interested in becoming a member of the PMCR Editorial Board?
Editorial board members are asked to review 2-6 manuscripts per year. Please submit your most up-to-date CV to sgold@asipp.org for consideration.
For more information or to submit your articles, click here.
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Robin Mata, DO, Lorenzo Diaz, DO, and Chane Price, MD
Abstract
BACKGROUND: Calcium pyrophosphate crystal deposition (CPPD) also known as “pseudogout” is a lesser-known cause of radicular pain that can occur in the spine after surgical intervention. Crystals may deposit extradurally in the ligamentum flavum, facet joints, and intervertebral discs causing symptoms ranging from mild-to-intractable radicular pain or cauda equina syndrome.
CASE REPORT: A 60-year-old man with a history of multiple lumbar surgeries and recent right L2-L3 hemilaminectomy/facetectomy presented with severe, radicular pain. Physical exam demonstrated decreased left L5 dermatome sensation. Postop imaging confirmed worsening foraminal encroachment at L5-S1 compared to preop imaging. The patient failed steroid taper, neuropathic agents, nonsteroidal anti-inflammatory drugs, physical therapy, and 3 L5-S1 epidural steroid injections. He ultimately underwent L5-S1 microdiscectomy where numerous crystalline deposits were identified and sent for pathology, revealing CPPD with foamy histiocytes.
CONCLUSIONS: Clinicians should consider CPPD in at-risk patients with radicular pain following surgery to expedite appropriate workup and rheumatologic management.
KEY WORDS: Case report, pseudogout, CPPD, lumbar radiculopathy
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Amanda Jankelovits, MS, Robert M. Chow, MD, Paragi Rana, MD, and Kanishka Rajput, MD
Abstract
BACKGROUND: The gender bias in academic anesthesiology is well known. Women are not only a minority in the field but also underrepresented in leadership positions. Reported reasons for this underrepresentation include barriers to career advancement, lack of mentorship, and differences in compensation, among others. Interventional pain, a competitive procedural subspecialty of anesthesiology, sees the trickle-down effects of this disparity. According to a report from the ACGME that sorted medical subspecialties by number of female trainees, pain medicine ranked in the bottom quartile across all disciplines from 2008-2016.
OBJECTIVES: To better understand the landscape for women physicians in the field of pain medicine, we undertook this investigation to review the knowledge about the topic and what questions remain unanswered.
STUDY DESIGN: This study is a review of the current literature and aims to summarize and describe the landscape of pain medicine for women physicians.
SETTING: All literature review and manuscript preparation took place at the Yale University School of Medicine.
METHODS: We performed a comprehensive search using the PubMed, Scopus, and Cochrane databases for the combined terms “gender disparity,” “pain medicine,” and “anesthesiology,” limiting our search to the year 2000 onward for the most recent literature on the topic. Our initial search retrieved 38 articles. All relevant articles pertaining to this perspective piece were collated. The available literature is discussed below.
RESULTS: Women are underrepresented in interventional pain. The grim scarcity of female pain physicians is unlikely to improve soon, since while the number of Accreditation Council for Graduate Medical Education pain fellowship programs continues to grow, women trainees comprise only between 22-25% of all pain medicine fellows. Additionally, although studies have compared the numbers of male interventional pain faculty to their female counterparts in academic hospitals and shown the ratio to range from 71.84-82% to 18-28.52%, respectively, no studies have truly explored the landscape for women physicians in private practice. Patients prefer and have better experiences with physicians who are racially and ethnically like themselves. In fact, the preference for and the lack of female clinicians have been associated with delayed pursuit of care and adverse health outcomes. The consequences of the burnout and attrition caused by the gender disparity, especially in a field like pain medicine, cannot be understate.
LIMITATIONS: The review might not have been comprehensive, and relevant studies might not have been included.
CONCLUSION: While the gender disparity in academia is well documented for both anesthesiology and pain medicine, the reasons for this disparity have not been fully explored. Moreover, it is also unknown whether the minority of female physicians who select pain medicine as a subspecialty gravitate toward an academic or a private-practice path. To address the existing gender disparity, it is necessary to explore the landscape of interventional pain medicine in both academic and private practices and understand pain physicians’ beliefs and sentiments regarding their subspecialty.
KEY WORDS: Anesthesiology, pain medicine, interventional pain medicine, gender disparity, gender bias, women physicians, academic medicine, private practice
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Alan D. Kaye, MD, PhD, Jonathan S. Okereke, BS, Cameron A. Howe, BS, Angela Nguyen, BS, Charles P. Daniel, BS, Grant E. Borne, BS, Brook Girma, MD, Varsha Allampalli, MD, Sahar Shekoohi, PhD, Brian Bernhardt, MD, and Azem A. Chami, MD
Abstract
BACKGROUND: Chronic sacroiliitis has variable etiologies with numerous treatments of varying efficacy. In recent years, a novel posterior approach utilizing bone matrix has been developed although to date, there is limited data in the literature regarding efficacy and safety through this approach. Benefits described include reduced adverse outcomes and quicker recovery when compared to the lateral approach.
OBJECTIVE: The present investigation focused on sacroiliac joint fusion through the posterior approach and outcomes including disability, pain, and use of analgesics post-surgery.
STUDY DESIGN: This retrospective, single-center study was conducted evaluating safety and efficacy of sacroiliac fusion allograft implants (LinQ Implant System from PainTEQ; PsiF System from Omnia Medical).
METHODS: A total of 72 posterior approach sacroiliac joint fusions were performed. Fifty-three individuals were enrolled and followed at LSU Health Shreveport as the sole investigational site between August 2020 and June 2024. Selected participant age ranged between 28 and 79 years, with a mean age of 53.4 years. The LinQ Implant System was the primary surgical hardware selected for implantation (83.0%), with the PsiF System chosen in the remaining cases.
OUTCOME MEASURES: VAS Scores, disability changes, adverse outcomes, and analgesic use were compared after sacroiliac joint fusion via the posterior approach.
RESULTS: Mean VAS Scores for SIJ Pain Intensity significantly decreased by 3.6 cm from a baseline score of 9.5 cm by the Specified End (June 1st, 2024). In this regard, 65.4% of patients experienced a 20% or greater improvement in pain, 38.5% of patients experienced a 50% or greater improvement in pain, and 26.9% of patients experienced a 70% or greater improvement in pain. Zero (0) procedure-related adverse events nor intra- or post-operative complications occurred throughout the duration of the investigation.
LIMITATIONS: Retrospective nature of the study without a control group. Fifty-four percent (39 of 72) completed minimum one year follow up. Further, the withdrawal rate was 26%.
CONCLUSION: The results of the present investigation demonstrated effective outcomes with minimal adverse effects and improvements in disability over a three-year period in the largest single center study to date involving posterior approach sacroiliac joint fusion.
KEY WORDS: Sacroiliac joint fusion, posterior approach, sacroiliitis, pain, disability, lower back pain
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ASIPP is now in collaboration with Curi Medical Liability Program
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Since this malpractice insurance program officially launched in November 2018, ASIPP has signed up hundreds of providers with an average savings of 30%. This is professional liability insurance tailored to our specialty and will stand up for us and defend our practices.
Curi is a full-service advisory firm that serves physicians and their practices. Their valued advice is grounded in your priorities and elevated in your outcomes. They are driven by a deep understanding of your specific circumstances in medicine, business, and life. To read a few important points to keep in mind about the program, including discounts, administrative defense, cyber coverage, aggressive claims handling, and complimentary risk management CME activities, visit our website.
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Group Purchasing Organization Offer Better Pricing and Creates Added Value
ASIPP has formed a partnership with Henry Schein and PedsPal, a national GPO that has a successful history of negotiating better prices on medical supplies and creating value-added services for independent physicians. Working with MedAssets, PedsPal provides excellent pricing on products like contrast media that alleviate some of the financial pressures you experience today.
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ASIPP, Fedora Billing,
and Revenue Cycle Management Partnership
ASIPP is now offering our members the benefit of a unique revenue cycle management/ billing service.
We have received a tremendous amount of interest in the ASIPP® billing and coding program.
Click here to learn more about the negotiated rate for practices and more!
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up-to-date news related to you, your practice, and your patients!
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