2023
Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing
Manhapra A, MacLean R, Rosenheck R, Becker W. Are opioids effective analgesics and is physiological opioid dependence benign? Revising current assumptions to effectively manage long‐term opioid therapy and its deprescribing. British Journal Of Clinical Pharmacology 2023, 90: 2962-2976. PMID: 37990580, PMCID: PMC11563311, DOI: 10.1111/bcp.15972.Peer-Reviewed Original ResearchLong-term opioid therapyOpioid therapyFunctional gainsChronic pain syndromeMaximum functional recoveryOngoing opioid crisisParadoxical worseningAnalgesic benefitAnalgesic therapyPain reliefPain syndromeEffective analgesicMost patientsAntinociceptive effectAntinociceptive systemChronic painFunctional recoveryOpioid actionOpioid dependenceMedical instabilityFunctional improvementPlacebo effectClinical principlesOpioid crisisTherapeutic induction
2022
Complex Persistent Opioid Dependence—an Opioid-induced Chronic Pain Syndrome
Manhapra A. Complex Persistent Opioid Dependence—an Opioid-induced Chronic Pain Syndrome. Current Treatment Options In Oncology 2022, 23: 921-935. PMID: 35435616, DOI: 10.1007/s11864-022-00985-x.Peer-Reviewed Original ResearchConceptsChronic pain syndromeOpioid dependenceOpioid taperingPain syndromeClinical conundrumLong-term opioid useWorse pain controlNon-cancer painOpioid use disorderPoor patient acceptanceSeparate clinical entityAnti-reward systemsOpioid doseOpioid therapyPain providersPain controlOpioid usePain mechanismsClinical entityMore painIatrogenic problemsPatient acceptanceTreatment choiceChronic cancerPain experience
2021
Assessment of Common Comorbidity Phenotypes Among Older Adults With Knee Osteoarthritis to Inform Integrated Care Models
Lentz T, Hellkamp A, Bhavsar N, Goode A, Manhapra A, George S. Assessment of Common Comorbidity Phenotypes Among Older Adults With Knee Osteoarthritis to Inform Integrated Care Models. Mayo Clinic Proceedings Innovations Quality & Outcomes 2021, 5: 253-264. PMID: 33997625, PMCID: PMC8105527, DOI: 10.1016/j.mayocpiqo.2020.09.011.Peer-Reviewed Original ResearchKnee osteoarthritisMedicare beneficiariesDiagnosis of KOAConcordant conditionsOlder adultsNon-OA controlsChronic pain syndromeIntegrated care modelValue-based health careComorbidity phenotypesPain syndromeLow comorbidityComorbid conditionsKnee OARheumatic diseasesMusculoskeletal conditionsPsychological comorbiditiesCare pathwayVascular diseaseClinical pathwayCare modelCondition subgroupsControl groupComorbiditiesOsteoarthritis diagnosis