The Perils of Polypharmacy

In the context of large loss workers compensation claims and the treatment of pain in injured workers, polypharmacy is typically associated with the use of four or more medications. As a result, polypharmacy creates an environment where several complications can occur. Here we delve into some critical issues affecting the injured worker as a result of polypharmacy: compliance, drug interaction and risk of addiction.

Dosage Compliance & Drug Interactions

To put it simply, compliance is taking medications the way they are intended to be taken. The lack of compliance with a prescribed treatment regimen is most often unintentional. A patient may inadvertently take the wrong dosage, miss a dosage entirely or mix dangerous combinations of drugs. Further, even though the right dosages may be administered, drug interaction poses yet another harmful risk for the injured worker. Treating physicians may not be communicating with each other and therefore are unaware of existing medications or treatment regimens which may affect quality of care. For example, MAO inhibitors and blood thinners can actually counteract or reduce another medication's effectiveness.

Possible Addiction & Overdose

Addiction and overdose are both related to treatment and dosage compliance. An unfortunate lack in monitoring a patient’s treatment program and progress may result in missed warning signs and missed opportunities to modify a treatment program based on patient’s recovery. Quite often addiction is not self-imposed but rather, factors such as duplicate therapies, inappropriate treatments and excessive dosages of opioids set the stage. Pain treatment through highly addictive opioids, coupled with a lack of patient education on the risks and dangers of these drugs, subjects injured workers to a path of drug addiction which may hinder or prevent recovery.

How Can ANS Solutions Pharmacotherapy Review Help?

Our Pharmacotherapy review program can help uncover possible risks that could have a dramatic impact on the person's health. Typically, Pharmacotherapy Review uncovers major issues including duplicate therapies, dangerous or deadly drug interactions, or behaviors related to drug addiction. All of which may contribute to a longer recovery time, no recovery or even death for an injured worker. By bringing these issues to light and recommending a more appropriate course of action our program can enhance the quality of life for the injured worker while also increasing financial cost for Payers.

To find out more about our Pharmacotherapy Review Program visit the website today at http://www.ans-solutions.com.

This post was originally published at http://ans-solutions.com/the-perils-of-polypharmacy/

6 Benefits of ANS Legal Nurse Consulting Services

The specialized skill-set of legal nurse consultants can play a crucial role in claim settlement and medical legal cases. Here we review six benefits of the services provided by ANS’s highly credentialed and experienced legal nurse consultants:

1) Critical Analysis

Through the critical analysis of medical records, our nurse experts summarize critical events in a case’s history to identify issues such as causality, scope of damages, and standards of care. By analyzing medical causation and exposure they effectively gauge merits of alleged injuries while identifying any missing medical information that may prove valuable to a claim.

2) Collaboration

Multiple parties must be engaged to successfully determine a modified course of treatment, and ensure compliance to the new course of treatment. Legal nurse consultants play an instrumental role in securing the collaboration between prescribing physicians, attorneys and injured workers which optimizes the negotiation and settlement of a claim.

3) Strategic Assessment

Through the exhaustive and strategic assessment of each case, ANS nurse experts uncover causation, mitigating factors, unreasonable medical charges and inappropriate patterns of care while also potentially exposing unnecessary or unrelated care issues. There assessments lead to a recommended course of action that not only improves the living conditions of the injured worker but reduces pharma costs by 25% or more.

4) Legal Support  

Attorneys may call legal nurse consulting experts as witnesses at trial to provide facts, data and opinions based on case evidence. If needed, legal nurse consultants may also locate and retain expert witnesses with specialized insight and knowledge relevant to the circumstances of a case.

5) Education

In the process of deciphering a case, legal nurse consultants educate attorneys regarding medical facts, timelines, treatments, nursing terminology and other relevant health care information. Furthermore, their legal nurse consultant degree and experience gives them the background to bridge the gap between law and medicine.

6) Research

Research is encompassed in every aspect of legal nurse consulting. The research support generated by legal nurse consultants can provide an extraordinarily powerful legal instrument in the negotiation of a claim.

ANS Legal Nurse Consulting

With a background in professional nursing education, training, and clinical experience to the assessment of standards of care, causation, and damages, the support of ANS legal nurse consultants can significantly optimize medical legal case and claim outcomes. To find out more about how an ANS nurse expert can impact your bottom line contact us today or visit www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/6-benefits-of-ans-legal-nurse-consulting-services/.

No Proven Benefit for the Use of Opioids in Chronic Pain

Millions are addicted to or dependent on prescription opioids. Worse than the dependency, over 200,000 deaths are attributable to prescription opioids, as well as hundreds of thousands of overdoses. What’s the biggest contributor to the epidemic, you ask? Most commonly, it’s the inappropriate prescription of opioids for the treatment of issues like musculoskeletal disorders, chronic low back pain, headaches, and other issues.

Insights from a Leading Pain Expert

A recent study conducted by leading pain expert Gary Franklin, MD, MPH, V.P. of Physicians for Responsible Opioid Prescribing, provides substantial evidence that prescribing opioids for chronic pain offers no real benefit. Franklin has been striving to shed light on this issue which is believed to be contributing in large part to the prescription opioid abuse epidemic sweeping the nation. Opioids such as hydrocodone and oxycodone have increased in prescription from around 76 million in 1991 to nearly 207 million in 2013, making the U.S. the biggest global consumer for these products at nearly 100% of word consumption for hydrocodone, 81% for oxy. Most notably, Dr. Franklin’s research found clear evidence of dose-dependent risk for serious harm:

• A dramatic increase in death with opioids administered at a dose of 100mg MED (morphine equivalent dose).
• A risk of overdose 2-5 times higher when the above MED runs between 50-99mg.
• Doses lower than 100mg MED still result in overdose – even without long-term therapy.
• Opioids administered in combination with benzodiazepines, sedative-hypnotics, or muscle relaxants dramatically increase the risk for harm.
• Double the risk of remaining on disability 1 year for those treated with opioids for at least 7 days (cumulative dose: 150mg MED).

Reversing the Trend

Believed to be the direct result of poor research and outdated teaching practices, the most important step toward reversing the opioid epidemic is simple- putting a stop to improperly prescribed opioids particularly for chronic pain. To aid this effort, t­he American Academy of Neurology and a number of states have produced product guidelines advising against the use of opioids for the treatment of musculoskeletal conditions, headache, or fibromyalgia, and additionally advising physicians to proceed with caution when initiating opioid therapy for pain or long-term use. (Since released, the guidelines created as a result of the drug utilization review have effected a 30% sustained decline in overdose deaths and a substantial decline in injured workers on chronic opioids in Washington State.)

Evidence-based Alternatives

Opioid therapy is not necessarily the only answer to treating chronic pain. Drug utilization review programs such as ANS Pharmacotherapy Review can provide alternative therapy recommendations. ANS deploys an exceptionally credentialed network of nurse experts to deliver recommendations in face-to-face meetings with treating physicians. These recommended treatment options are equally, if not more effective than opioids. Better still, they offer improved quality of care and quality of life for the injured worker.

If the pitfalls of opioid therapies are taking over your workers’ comp claim settlements, the proven drug utilization review protocols at ANS Solutions can show you a better path. Optimized outcomes for the injured worker are possible. Contact ANS today or visit www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/no-proven-benefit-for-the-use-of-opioids-in-chronic-pain/

Medical Cost Containment Does Not Mean Compromised Care

The existing way that the workers’ compensation industry handles large loss claims has been contributing to diminished quality in care for injured workers, increased costs associated with treatments, and poorly coordinated care. Care delivery within workers’ compensation programs is arguably even more inefficient than in general healthcare but it does NOT have to be this way. Payers can have the best of both worlds with medical cost containment strategies that provide quantifiable outcomes that positively impact the patient’s health while also driving down associated treatment costs.

How does Medical Cost Containment Improve the Quality of Care for Injured Workers?

Interventions with prescribers can be instrumental in improving the quality of life and treatment for patients. ANS PharmaIntervention is designed to help treating physicians detect and correct underlying problems, promote functional improvement and reduce narcotic usage. Our legal nurse experts conduct comprehensive reviews of a patient’s medical history often uncovering risk factors and other considerations that can be overlooked by treating physicians. They are then able to collaborate with treating physicians to improve the current treatment plan based on actionable, evidence based recommendations. The benefits to the injured worker include but are not limited to:

• Reduced risk for prescription opioid painkiller addiction.
• A modified treatment program based on recovery.
• A modified treatment program based on the availability of alternative treatments and therapies that may be more effective, and have fewer side effects.

All of which contributes to measurable improvements in quality of care and life for the injured worker- even increasing the likelihood of returning to work sooner.

How Does Medical Cost Containment Positively Impact Your Bottom Line?

Ensuring injured workers receive the right care at the right time from treating physicians, minimizes the financial impact of catastrophic injuries. The goal of ANS PharmIntervention is to improve quality of care by applying expert clinical knowledge and experience to recommend, where appropriate, alternative treatments and therapies. The financial benefits of the ANS PharmIntervention strategy stem from its ability to aid treating physicians in:

• Improving opioid painkiller practices.
• Avoiding unnecessary or inappropriate pharmaceutical and medical treatments.
• Avoiding duplicate therapies in the event of multiple treating physicians.

When done correctly, medical cost containment ensures that patients receive the highest quality of care balanced with the necessary cost controls.

Care without Compromise

ANS Legal Nurse Consultants provide comprehensive reviews of large loss claims while delivering optimized financial results and quality of care for injured workers. To learn more about our medical cost containment strategies visit our website at www.ans-solutions.com.
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What Role does the Doctor-Patient Relationship Play in the Opioid Epidemic?

According to the DEA, sales of prescription painkillers in the United States have quadrupled since 1999. If that isn’t enough to raise eyebrows, consider the following: almost twice as many people abuse prescription drugs as the number of people abusing cocaine, heroin, hallucinogens and inhalants combined. And if that’s that enough, the U.S. Center for Disease Control and Prevention has stated that prescription drug overdose death rates in the United States have more than tripled since 1990 and have never been higher. These statistics have raised serious concerns, triggering efforts to build competency around opioid prescription practices in the treatment of chronic pain.

The Doctor-Patient Relationship

The doctor-patient relationship must extend beyond merely establishing a treatment program. It should be treated as an intersection between education, treatment, intervention, and compliance that is formative in controlling the opioid epidemic. The dialogue between doctor and patient can help to uncover additional risk factors, warning signs, and complications that could hinder an injured worker’s recovery or put them at risk for addiction or death. Engaging in open conversation with patients regarding their medical history and other current treating physicians (if more than one) opens the door to more informed treatment practices. For instance, this practice would be instrumental in identifying a patient whose clinical picture is more consistent with addiction. In which case, the treating physician would be prompted to utilize a non-opioid treatment plan that may also be far more cost effective. Further, it is through this relationship that patients can receive the necessary education on the risks and dangers of their prescribed opioid pain treatment plan thus promoting adherence to prescription guidelines.

ANS Pharmacotherapy Review

In our pharmacotherapy review program we take a highly comprehensive and multidisciplinary approach to the evaluation and treatment of injured workers. Through our advanced techniques our experts are able to uncover opportunities for modifications that can improve patient efficacy. Our proven results not only improve the quality of care and life for the patient but also reduce associated medical costs.

For more information on ANS drug utilization review through pharmacotherapy contact us today or visit www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/what-role-does-the-doctor-patient-relationship-play-in-the-opioid-epidemic/

High Risk Patient Profiles & Opioid Abuse

Predictive models in our industry show that specific risk factors correlate to the potential for long term opioid use -most notably, patients that smoke and/or have a history of substance abuse.   With increased opioid prescribing linked to trends of misuse and abuse and opioid related overdoses contributing to more deaths annually than vehicular crashes, it begs the question, are risk factors truly being taken into account with the treatment of chronic pain?

Improving Opioid Painkiller Practices

Physicians considering opioid therapy for an injured worker with chronic pain should use a structured approach. There should be a comprehensive evaluation for the cause of pain, assessment for risk of opioid abuse or addiction, detailed treatment history including a review of medical records and routine assessment for safety and effectiveness of the opioid therapy program once in place. A dedicated focus on the patient will allow treating physicians to:

• Get ahead of the warning signs of drug abuse and addiction.
• Modify a treatment program based on patient’s recovery.
• Modify treatment based on the availability of alternative treatments and therapies that may be more effective, and have fewer side effects.
• Avoid unnecessary or inappropriate pharmaceutical and medical treatments in the event there are multiple treating physicians in the picture.

Risks should be acknowledged openly and managed, whenever possible, before prescribing opioids. When continuous opioid therapy for as little as two weeks can produce drug tolerance in some patients, the bottom line is, we need to start thinking more about the injured worker.

ANS Drug Utilization Review

Interventions with prescribers can be instrumental in not only preventing long term opioid use but also improving the quality of life and treatment for patients while also driving down medical costs. At ANS, our approach to drug utilization review includes an extensive review of a patient’s medical history allowing our experts to pinpoint risk factors and other considerations that are all too often overlooked by other medical cost management programs in the industry.

For more information about our medical cost containment strategies contact us today or visit www.ans-solutions.com.

This content was originally posted at http://ans-solutions.com/high-risk-patient-profiles-opioid-abuse/

Ineffective Intervention Results in Less Than Optimal Outcomes

Workers’ compensation payers industry-wide have relied on pharmaceutical cost containment measures in one form or another as a means to manage escalating costs. But as everyone has learned, not all strategies are created equal. In fact, most are limited in scope and effectiveness.

A Holistic Approach to Medical Cost Management

At ANS, we take a holistic, collaborative approach to managing medical costs. When a comprehensive analysis is conducted on a pharmaceutical regimen, it reveals the bigger picture, thus uncovering points of concern that may impact the pharmacy plan. Quite often we uncover opportunities for modifications that improves patient efficacy while decreasing costs. Conducting an extensive review of a patient’s medical history can avoid missing crucial factors that are all too often overlooked by other programs.

Nurse Experts Apply Advanced Pharmaceutical and Jurisdictional Knowledge

ANS’ advanced program includes a national network of highly credentialed legal nurse consultants. Utilizing experts to employ a collaborative environment with the physician and integrating a holistic approach to medical cost containment results in successful, optimal outcomes for both the injured worker and the carrier:

ANS Solutions

We offer an industry-leading suite of Workers’ Compensation Medical Cost Containment Services designed to lower costs, improve loss ratios, and enhance the claimant’s quality of care. For more information contact us today or visit www.ans-solutions.com

This content was originally posted at http://ans-solutions.com/ineffective-intervention-results-in-less-than-optimal-outcomes-2/