March 2, 2018 | Today’s News

FDA issues safety alert regarding drug products manufactured by Cantrell Drug Company

The U.S. Food and Drug Administration (FDA) is alerting healthcare professionals and patients not to use drug products produced by Cantrell Drug Company of Little Rock, Ark., including opioids and other drugs intended for sterile injection. FDA investigators observed unsanitary conditions and violations of current Good Manufacturing Practice that could cause the company’s drugs to become contaminated or made injurious to health. The agency states that healthcare professionals should immediately check their medical supplies, quarantine any drug products from Cantrell Drug Company, and not administer them to patients.

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Study: Use of multimodal analgesia may reduce opioid use and complications after joint arthroplasty

Findings from a study published online in the journal Anesthesiology suggest that, compared to opioids alone, a multimodal analgesia regimen may help reduce opioid prescribing and complications for joint arthroplasty patients. The researchers reviewed data on 512,393 total hip arthroplasties (THAs) and 1,028,069 total knee arthroplasties (TKAs) and found that 85.6 percent of patients (n = 1,318,165) received multimodal analgesia. Compared to patients who received opioids-only, they found that patients who received multimodal analgesia experienced 19 percent fewer respiratory complications and 26 percent fewer gastrointestinal complications. They also found that there was up to 18.5 percent decrease in opioid prescriptions and a 12.1 percent decrease in length of stay. The researchers state that TKA analyses displayed similar patterns. They write that NSAIDs and cyclooxygenase-2 inhibitors appeared to be the most effective modalities used, but further study will be required to determine an optimized multimodal regimen.

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A study conducted in Sweden and published online in the journal Clinical Orthopaedics and Related Research suggests that elective THA may be associated with a slight increase in life expectancy for approximately 10 years after surgery, especially among patients whose diagnosis was primary osteoarthritis (OA). The authors reviewed data on 131,808 patients from the Swedish Hip Arthroplasty Register, of whom 21,755 had died at final follow-up. They found that at one year after surgery, survival in patients undergoing THA was 1 percent better than expected survival of a matched cohort from the general population. At five years, improved survival increased to 3 percent; at 10 years, the difference was 2 percent; and at 12 years, there was no difference. The authors write that patients who underwent surgery for osteonecrosis of the femoral head, inflammatory arthritis, or secondary osteoarthritis all had poorer relative survival compared to the general population. Comorbidities and the Elixhauser comorbidity index also displayed a negative association with relative survival.

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According to a study conducted in Taiwan and published in The Journal of the American Medical Association, varicose veins may be associated with a significantly increased risk of incident deep venous thrombosis (DVT). Members of the research team conducted a retrospective, cohort study of 212,984 patients with varicose veins and 212,984 matched controls. Over 7.3-year to 7.8-year follow-up, they found that patients diagnosed with varicose veins were at increased risk for DVT, pulmonary embolism (PE), and peripheral artery disease (PAD) compared to controls. However, they state that the findings for PE and PAD are less clear due to the potential for confounding. “Whether the association between varicose veins and DVT is causal or represents a common set of risk factors requires further research,” the researchers write.

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A survey conducted by consulting firm Accenture PLC suggests that many healthcare employees would be willing to sell confidential data. The company surveyed 912 qualified employees of health providers (n = 601) and payer organizations (n = 311) from the United States and Canada. All respondents had access to digital health data, including personally identifiable information, payment card information, and protected health data. They found that 18 percent of respondents would be willing to sell confidential data to unauthorized parties; many for as little as between $500 and $1,000. The researchers state that respondents from provider organizations were significantly more likely than those in payer organizations to say they would sell confidential data, including login credentials, installing tracking software, and downloading data to a portable drive, among other actions. Further, 24 percent of respondents said they actually know of someone in their organization who has sold their credentials or access to an unauthorized outsider.

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March 12, 2018 is the deadline for providers to submit an application to participate in the U.S. Centers for Medicare & Medicaid Services (CMS) Bundled Payments for Care Improvement (BPCI) Advanced program. BPCI Advanced is an Advanced Alternative Payment Model, under which participants will be expected to redesign care delivery to keep Medicare expenditures within a defined budget, while maintaining or improving performance on specific quality measures. Participants bear financial risk, have payments under the model tied to quality performance, and are required to use Certified Electronic Health Record Technology.

Learn more about BPCI Advanced…

Read the BPCI Advanced FAQ (PDF)…

Visit the BPCI Advanced Application Portal…

Given the proximity to the application submission deadline, CMS is prioritizing questions that are time sensitive and relevant to the application process. To submit application questions, please make “Application” the email subject line. Other examples of email subject lines may include: General Model Questions, Data, Pricing, and Model Overlap. Email CMS BPCI Advanced support at:

BPCIAdvanced@cms.hhs.gov

Call for volunteers: Instructional Course Committees

March 30, 2018, is the last day to submit an application for a position on an Instructional Course Committee. Committee members grade Instructional Course Lecture applications in May and evaluate courses at the AAOS Annual Meeting in March. The following openings are available:

• Hand and Wrist (chair)
• Practice Management (chair)

Applicants for these positions must be active fellows with a practice emphasis in the relevant topic.

Learn more and submit your application…  (member login required)