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Article ; Online: Development of 2nd generation aminomethyl spectinomycins that overcome native efflux in

Phelps, Gregory A / Cheramie, Martin N / Fernando, Dinesh M / Selchow, Petra / Meyer, Christopher J / Waidyarachchi, Samanthi L / Dharuman, Suresh / Liu, Jiuyu / Meuli, Michael / Molin, Michael Dal / Killam, Benjamin Y / Murphy, Patricia A / Reeve, Stephanie M / Wilt, Laura A / Anderson, Shelby M / Yang, Lei / Lee, Robin B / Temrikar, Zaid H / Lukka, Pradeep B /

Meibohm, Bernd / Polikanov, Yury S / Hobbie, Sven N / Böttger, Erik C / Sander, Peter / Lee, Richard E

Proceedings of the National Academy of Sciences of the United States of America

2024 Volume 121, Issue 2, Page(s) e2314101120

Abstract: Mycobacterium ... ...

Abstract	Mycobacterium abscessus
MeSH term(s)	Humans ; Animals ; Mice ; Mycobacterium abscessus ; Spectinomycin/pharmacology ; Mycobacterium Infections, Nontuberculous/drug therapy ; Mycobacterium Infections, Nontuberculous/microbiology ; Anti-Bacterial Agents/pharmacology ; Nontuberculous Mycobacteria ; Anti-Infective Agents/pharmacology ; Ethylenes/pharmacology ; Microbial Sensitivity Tests
Chemical Substances	Spectinomycin (93AKI1U6QF) ; Anti-Bacterial Agents ; Anti-Infective Agents ; Ethylenes
Language	English
Publishing date	2024-01-02
Publishing country	United States
Document type	Journal Article
ZDB-ID	209104-5
ISSN	1091-6490 ; 0027-8424
ISSN (online)	1091-6490
ISSN	0027-8424
DOI	10.1073/pnas.2314101120
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Zs.A 1148: Show issues

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Article ; Online: Ruthenium Promoted On-DNA Ring-Closing Metathesis and Cross-Metathesis.

Lu, Xiaojie / Fan, Lijun / Phelps, Christopher B / Davie, Christopher P / Donahue, Christine P

Bioconjugate chemistry

2017 Volume 28, Issue 6, Page(s) 1625–1629

Abstract: DNA-encoded library technology (ELT) is now widely used in pharmaceutical, biotechnological, and academic research for hit identification and target validation. New on-DNA reactions are keys to exploring greater chemical space and accessing challenging ... ...

Abstract	DNA-encoded library technology (ELT) is now widely used in pharmaceutical, biotechnological, and academic research for hit identification and target validation. New on-DNA reactions are keys to exploring greater chemical space and accessing challenging chemotypes such as configurationally constrained macrocycles. Herein, we describe the first on-DNA ring-closing metathesis (RCM) and cross-metathesis (CM) reactions promoted by fast initiating Grubbs Ru reagents. Under the optimized conditions, MgCl
MeSH term(s)	Cyclization ; DNA/chemistry ; Magnesium Chloride ; Ruthenium/chemistry
Chemical Substances	Magnesium Chloride (02F3473H9O) ; Ruthenium (7UI0TKC3U5) ; DNA (9007-49-2)
Language	English
Publishing date	2017-06-21
Publishing country	United States
Document type	Journal Article
ZDB-ID	1024041-x
ISSN	1520-4812 ; 1043-1802
ISSN (online)	1520-4812
ISSN	1043-1802
DOI	10.1021/acs.bioconjchem.7b00292
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Zs.A 3400: Show issues

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Article ; Online: Integration of Lead Discovery Tactics and the Evolution of the Lead Discovery Toolbox.

Leveridge, Melanie / Chung, Chun-Wa / Gross, Jeffrey W / Phelps, Christopher B / Green, Darren

SLAS discovery : advancing life sciences R & D

2018 Volume 23, Issue 9, Page(s) 881–897

Abstract: There has been much debate around the success rates of various screening strategies to identify starting points for drug discovery. Although high-throughput target-based and phenotypic screening has been the focus of this debate, techniques such as ... ...

Abstract	There has been much debate around the success rates of various screening strategies to identify starting points for drug discovery. Although high-throughput target-based and phenotypic screening has been the focus of this debate, techniques such as fragment screening, virtual screening, and DNA-encoded library screening are also increasingly reported as a source of new chemical equity. Here, we provide examples in which integration of more than one screening approach has improved the campaign outcome and discuss how strengths and weaknesses of various methods can be used to build a complementary toolbox of approaches, giving researchers the greatest probability of successfully identifying leads. Among others, we highlight case studies for receptor-interacting serine/threonine-protein kinase 1 and the bromo- and extra-terminal domain family of bromodomains. In each example, the unique insight or chemistries individual approaches provided are described, emphasizing the synergy of information obtained from the various tactics employed and the particular question each tactic was employed to answer. We conclude with a short prospective discussing how screening strategies are evolving, what this screening toolbox might look like in the future, how to maximize success through integration of multiple tactics, and scenarios that drive selection of one combination of tactics over another.
MeSH term(s)	Animals ; Drug Design ; Drug Discovery/methods ; Drug Discovery/standards ; Drug Evaluation, Preclinical/methods ; Drug Evaluation, Preclinical/standards ; High-Throughput Screening Assays ; Humans ; Small Molecule Libraries ; Structure-Activity Relationship
Chemical Substances	Small Molecule Libraries
Language	English
Publishing date	2018-06-06
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2885123-7
ISSN	2472-5560 ; 2472-5552
ISSN (online)	2472-5560
ISSN	2472-5552
DOI	10.1177/2472555218778503
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Zs.A 4911: Show issues

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Article ; Online: Development of a Selection Method for Discovering Irreversible (Covalent) Binders from a DNA-Encoded Library.

Zhu, Zhengrong / Grady, LaShadric C / Ding, Yun / Lind, Kenneth E / Davie, Christopher P / Phelps, Christopher B / Evindar, Ghotas

SLAS discovery : advancing life sciences R & D

2018 Volume 24, Issue 2, Page(s) 169–174

Abstract: DNA-encoded libraries (DELs) have been broadly applied to identify chemical probes for target validation and lead discovery. To date, the main application of the DEL platform has been the identification of reversible ligands using multiple rounds of ... ...

Abstract	DNA-encoded libraries (DELs) have been broadly applied to identify chemical probes for target validation and lead discovery. To date, the main application of the DEL platform has been the identification of reversible ligands using multiple rounds of affinity selection. Irreversible (covalent) inhibition offers a unique mechanism of action for drug discovery research. In this study, we report a developing method of identifying irreversible (covalent) ligands from DELs. The new method was validated by using 3C protease (3CP) and on-DNA irreversible tool compounds (rupintrivir derivatives) spiked into a library at the same concentration as individual members of that library. After affinity selections against 3CP, the irreversible tool compounds were specifically enriched compared with the library members. In addition, we compared two immobilization methods and concluded that microscale columns packed with the appropriate affinity resin gave higher tool compound recovery than magnetic beads.
MeSH term(s)	3C Viral Proteases ; Chromatography, Affinity ; Cysteine Endopeptidases/metabolism ; Drug Discovery/methods ; Gene Library ; Humans ; Microspheres ; Viral Proteins/metabolism
Chemical Substances	Viral Proteins ; Cysteine Endopeptidases (EC 3.4.22.-) ; 3C Viral Proteases (EC 3.4.22.28)
Keywords	covid19
Language	English
Publishing date	2018-11-01
Publishing country	United States
Document type	Journal Article
ZDB-ID	2885123-7
ISSN	2472-5560 ; 2472-5552
ISSN (online)	2472-5560
ISSN	2472-5552
DOI	10.1177/2472555218808454
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Zs.A 4911: Show issues

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Article ; Online: Antibodies from primary humoral responses modulate the recruitment of naive B cells during secondary responses.

Tas, Jeroen M J / Koo, Ja-Hyun / Lin, Ying-Cing / Xie, Zhenfei / Steichen, Jon M / Jackson, Abigail M / Hauser, Blake M / Wang, Xuesong / Cottrell, Christopher A / Torres, Jonathan L / Warner, John E / Kirsch, Kathrin H / Weldon, Stephanie R / Groschel, Bettina / Nogal, Bartek / Ozorowski, Gabriel / Bangaru, Sandhya / Phelps, Nicole / Adachi, Yumiko /

Eskandarzadeh, Saman / Kubitz, Michael / Burton, Dennis R / Lingwood, Daniel / Schmidt, Aaron G / Nair, Usha / Ward, Andrew B / Schief, William R / Batista, Facundo D

Immunity

2022 Volume 55, Issue 10, Page(s) 1856–1871.e6

Abstract: Vaccines generate high-affinity antibodies by recruiting antigen-specific B cells to germinal ... during primary humoral responses shaped the naive B cell recruitment to GCs during secondary exposures ... B cells: broad-binding, low-affinity, and low-titer antibodies enhanced recruitment, whereas, by contrast ...

Abstract	Vaccines generate high-affinity antibodies by recruiting antigen-specific B cells to germinal centers (GCs), but the mechanisms governing the recruitment to GCs on secondary challenges remain unclear. Here, using preclinical SARS-CoV and HIV mouse models, we demonstrated that the antibodies elicited during primary humoral responses shaped the naive B cell recruitment to GCs during secondary exposures. The antibodies from primary responses could either enhance or, conversely, restrict the GC participation of naive B cells: broad-binding, low-affinity, and low-titer antibodies enhanced recruitment, whereas, by contrast, the high titers of high-affinity, mono-epitope-specific antibodies attenuated cognate naive B cell recruitment. Thus, the directionality and intensity of that effect was determined by antibody concentration, affinity, and epitope specificity. Circulating antibodies can, therefore, be important determinants of antigen immunogenicity. Future vaccines may need to overcome-or could, alternatively, leverage-the effects of circulating primary antibodies on subsequent naive B cell recruitment.
MeSH term(s)	Animals ; Antibodies, Neutralizing ; Antibodies, Viral ; Antigens ; B-Lymphocytes ; Epitopes ; Germinal Center ; Immunity, Humoral ; Mice
Chemical Substances	Antibodies, Neutralizing ; Antibodies, Viral ; Antigens ; Epitopes
Language	English
Publishing date	2022-08-04
Publishing country	United States
Document type	Journal Article ; Research Support, N.I.H., Extramural ; Research Support, Non-U.S. Gov't
ZDB-ID	1217235-2
ISSN	1097-4180 ; 1074-7613
ISSN (online)	1097-4180
ISSN	1074-7613
DOI	10.1016/j.immuni.2022.07.020
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Zs.A 4227: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MG 69: Show issues

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Article: The role of the N terminus and transmembrane domain of TRPM8 in channel localization and tetramerization.

Phelps, Christopher B / Gaudet, Rachelle

The Journal of biological chemistry

2007 Volume 282, Issue 50, Page(s) 36474–36480

Abstract: Transient receptor potential (TRP) channels are a family of cation channels involved in diverse cellular functions. They are composed of a transmembrane domain of six putative transmembrane segments flanked by large N- and C-terminal cytoplasmic domains. ...

Abstract	Transient receptor potential (TRP) channels are a family of cation channels involved in diverse cellular functions. They are composed of a transmembrane domain of six putative transmembrane segments flanked by large N- and C-terminal cytoplasmic domains. The melastatin subfamily (TRPM) channels have N-terminal domains of approximately 700 amino acids with four regions of shared homology and C-terminal domains containing the conserved TRP domain followed by a coiled-coil region. Here we investigated the effects of N- and C-terminal deletions on the cold and menthol receptor, TRPM8, expressed heterologously in Sf21 insect cells. Patch-clamp electrophysiology was used to study channel activity and revealed that only deletion of the first 39 amino acids was tolerated by the channel. Further N-terminal truncation or any C-terminal deletions prevented proper TRPM8 function. Confocal microscopy with immunofluorescence revealed that amino acids 40-86 are required for localization to the plasma membrane. Furthermore, analysis of deletion mutant oligomerization shows that the transmembrane domain is sufficient for TPRM8 assembly into tetramers. TRPM8 channels with C-terminal deletions tetramerize and localize properly but are inactive, indicating that although not essential for tetramerization and localization, the C terminus is critical for proper function of the channel sensor and/or gate.
MeSH term(s)	Amino Acid Sequence/genetics ; Animals ; Cell Line ; Cell Membrane/genetics ; Cell Membrane/metabolism ; Microscopy, Confocal ; Patch-Clamp Techniques ; Protein Structure, Quaternary/genetics ; Protein Structure, Secondary/genetics ; Protein Structure, Tertiary/genetics ; Rats ; Sequence Deletion ; TRPM Cation Channels/genetics ; TRPM Cation Channels/metabolism
Chemical Substances	TRPM Cation Channels ; Trpm8 protein, rat
Language	English
Publishing date	2007-10-01
Publishing country	United States
Document type	Journal Article ; Research Support, Non-U.S. Gov't
ZDB-ID	2997-x
ISSN	1083-351X ; 0021-9258
ISSN (online)	1083-351X
ISSN	0021-9258
DOI	10.1074/jbc.M707205200
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Article ; Online: Skin Antisepsis before Surgical Fixation of Extremity Fractures.

Sprague, Sheila / Slobogean, Gerard / Wells, Jeffrey L / O'Hara, Nathan N / Thabane, Lehana / Mullins, C Daniel / Harris, Anthony D / Wood, Amber / Viskontas, Darius / Apostle, Kelly L / O'Toole, Robert V / Joshi, Manjari / Johal, Herman / Al-Asiri, Jamal / Hymes, Robert A / Gaski, Greg E / Pilson, Holly T / Carroll, Eben A / Babcock, Sharon /

Halvorson, Jason J / Romeo, Nicholas M / Matson, Christopher A / Higgins, Thomas F / Marchand, Lucas S / Bergin, Patrick F / Morellato, John / Van Demark, Robert E / Potter, G David / Gitajn, I Leah / Chang, Gerard / Phelps, Kevin D / Kempton, Laurence B / Karunakar, Madhav / Jaeblon, Todd / Demyanovich, Haley K / Domes, Christopher M / Kuhn, Gabrielle R / Reilly, Rachel M / Gage, Mark J / Weaver, Michael J / von Keudell, Arvind G / Heng, Marilyn / McTague, Michael F / Alnasser, Ahmad / Mehta, Samir / Donegan, Derek J / Natoli, Roman M / Szatkowski, Jan / Scott, Alesha N / Shannon, Steven F / Jeray, Kyle J / Tanner, Stephanie L / Marmor, Meir T / Matityahu, Amir / Fowler, Justin T / Pierrie, Sarah N / Beltran, Michael J / Thomson, Cameron G / Lin, Carol A / Moon, Charles N / Scolaro, John A / Amirhekmat, Arya / Leonard, Jordan / Pogorzelski, David / Bzovsky, Sofia / Heels-Ansdell, Diane / Szasz, Olivia P / Gallant, Jodi L / Della Rocca, Gregory J / Zura, Robert D / Hebden, Joan N / Patterson, Joseph T / Lee, Christopher / O'Hara, Lyndsay M / Marvel, Debra / Palmer, Jana E / Friedrich, Jeff / D'Alleyrand, Jean-Claude G / Rivera, Jessica C / Mossuto, Franca / Schrank, Gregory M / Guyatt, Gordon / Devereaux, P J / Bhandari, Mohit

The New England journal of medicine

2024 Volume 390, Issue 5, Page(s) 409–420

Abstract: Background: Studies evaluating surgical-site infection have had conflicting results with respect to the use of alcohol solutions containing iodine povacrylex or chlorhexidine gluconate as skin antisepsis before surgery to repair a fractured limb (i.e., ... ...

Abstract	Background: Studies evaluating surgical-site infection have had conflicting results with respect to the use of alcohol solutions containing iodine povacrylex or chlorhexidine gluconate as skin antisepsis before surgery to repair a fractured limb (i.e., an extremity fracture). Methods: In a cluster-randomized, crossover trial at 25 hospitals in the United States and Canada, we randomly assigned hospitals to use a solution of 0.7% iodine povacrylex in 74% isopropyl alcohol (iodine group) or 2% chlorhexidine gluconate in 70% isopropyl alcohol (chlorhexidine group) as preoperative antisepsis for surgical procedures to repair extremity fractures. Every 2 months, the hospitals alternated interventions. Separate populations of patients with either open or closed fractures were enrolled and included in the analysis. The primary outcome was surgical-site infection, which included superficial incisional infection within 30 days or deep incisional or organ-space infection within 90 days. The secondary outcome was unplanned reoperation for fracture-healing complications. Results: A total of 6785 patients with a closed fracture and 1700 patients with an open fracture were included in the trial. In the closed-fracture population, surgical-site infection occurred in 77 patients (2.4%) in the iodine group and in 108 patients (3.3%) in the chlorhexidine group (odds ratio, 0.74; 95% confidence interval [CI], 0.55 to 1.00; P = 0.049). In the open-fracture population, surgical-site infection occurred in 54 patients (6.5%) in the iodine group and in 60 patients (7.3%) in the chlorhexidine group (odd ratio, 0.86; 95% CI, 0.58 to 1.27; P = 0.45). The frequencies of unplanned reoperation, 1-year outcomes, and serious adverse events were similar in the two groups. Conclusions: Among patients with closed extremity fractures, skin antisepsis with iodine povacrylex in alcohol resulted in fewer surgical-site infections than antisepsis with chlorhexidine gluconate in alcohol. In patients with open fractures, the results were similar in the two groups. (Funded by the Patient-Centered Outcomes Research Institute and the Canadian Institutes of Health Research; PREPARE ClinicalTrials.gov number, NCT03523962.).
MeSH term(s)	Humans ; 2-Propanol/administration & dosage ; 2-Propanol/adverse effects ; 2-Propanol/therapeutic use ; Anti-Infective Agents, Local/administration & dosage ; Anti-Infective Agents, Local/adverse effects ; Anti-Infective Agents, Local/therapeutic use ; Antisepsis/methods ; Canada ; Chlorhexidine/administration & dosage ; Chlorhexidine/adverse effects ; Chlorhexidine/therapeutic use ; Ethanol ; Extremities/injuries ; Extremities/microbiology ; Extremities/surgery ; Iodine/administration & dosage ; Iodine/adverse effects ; Iodine/therapeutic use ; Preoperative Care/adverse effects ; Preoperative Care/methods ; Skin/microbiology ; Surgical Wound Infection/etiology ; Surgical Wound Infection/prevention & control ; Fractures, Bone/surgery ; Fracture Fixation ; Cross-Over Studies ; United States
Chemical Substances	2-Propanol (ND2M416302) ; Anti-Infective Agents, Local ; Chlorhexidine (R4KO0DY52L) ; chlorhexidine gluconate (MOR84MUD8E) ; Ethanol (3K9958V90M) ; Iodine (9679TC07X4)
Language	English
Publishing date	2024-01-05
Publishing country	United States
Document type	Journal Article ; Multicenter Study ; Randomized Controlled Trial
ZDB-ID	207154-x
ISSN	1533-4406 ; 0028-4793
ISSN (online)	1533-4406
ISSN	0028-4793
DOI	10.1056/NEJMoa2307679
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Article: Patients with glenohumeral arthritis are more likely to be prescribed opioids in the emergency department or urgent care setting.

Journal of opioid management

2024 Volume 19, Issue 6, Page(s) 495–505

Abstract: Objective: The objective is to quantify the rate of opioid and benzodiazepine prescribing for the diagnosis of shoulder osteoarthritis across a large healthcare system and to describe the impact of a clinical decision support intervention on prescribing ...

Abstract	Objective: The objective is to quantify the rate of opioid and benzodiazepine prescribing for the diagnosis of shoulder osteoarthritis across a large healthcare system and to describe the impact of a clinical decision support intervention on prescribing patterns. Design: A prospective observational study. Setting: One large healthcare system. Patients and participants: Adult patients presenting with shoulder osteoarthritis. Interventions: A clinical decision support intervention that presents an alert to prescribers when patients meet criteria for increased risk of opioid use disorder. Main outcome measure: The percentage of patients receiving an opioid or benzodiazepine, the percentage who had at least one risk factor for misuse, and the percent of encounters in which the prescribing decision was influenced by the alert were the main outcome measures. Results: A total of 5,380 outpatient encounters with a diagnosis of shoulder osteoarthritis were included. Twenty-nine percent (n = 1,548) of these encounters resulted in an opioid or benzodiazepine prescription. One-third of those who received a prescription had at least one risk factor for prescription misuse. Patients were more likely to receive opioids from the emergency department or urgent care facilities (40 percent of encounters) compared to outpatient facilities (28 percent) (p < .0001). Forty-four percent of the opioid prescriptions were for "potent opioids" (morphine milliequivalent conversion factor > 1). Of the 612 encounters triggering an alert, the prescribing decision was influenced (modified or not prescribed) in 53 encounters (8.7 percent). All but four (0.65 percent) of these encounters resulted in an opioid prescription. Conclusion: Despite evidence against routine opioid use for osteoarthritis, one-third of patients with a primary diagnosis of glenohumeral osteoarthritis received an opioid prescription. Of those who received a prescription, over one-third had a risk factor for opioid misuse. An electronic clinic decision support tool influenced the prescription in less than 10 percent of encounters.
MeSH term(s)	Adult ; Humans ; Ambulatory Care ; Analgesics, Opioid/administration & dosage ; Benzodiazepines ; Emergency Service, Hospital ; Opioid-Related Disorders/prevention & control ; Osteoarthritis/diagnosis ; Osteoarthritis/drug therapy ; Osteoarthritis/epidemiology
Chemical Substances	Analgesics, Opioid ; Benzodiazepines (12794-10-4)
Language	English
Publishing date	2024-01-08
Publishing country	United States
Document type	Observational Study ; Journal Article
ZDB-ID	2397614-7
ISSN	1551-7489
ISSN	1551-7489
DOI	10.5055/jom.0834
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Zs.A 6563: Show issues

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Article ; Online: Removing systemic barriers to equity, diversity, and inclusion: Report of the 2019 Plant Science Research Network workshop "Inclusivity in the Plant Sciences".

Henkhaus, Natalie A / Busch, Wolfgang / Chen, Angela / Colón-Carmona, Adán / Cothran, Maya / Diaz, Nicolas / Dundore-Arias, Jose Pablo / Gonzales, Michael / Hadziabdic, Denita / Hayes, Rebecca A / MacIntosh, Gustavo C / Na, Ali / Nyamasoka-Magonziwa, Blessing / Pater, Dianne / Peritore-Galve, F Christopher / Phelps-Durr, Tara / Rouhier, Kerry / Sickler, Delanie B / Starnes, John H /

Tyler, Quentin R / Valdez-Ward, Evelyn / Vega-Sánchez, Miguel E / Walcott, Ron R / Ward, Joy K / Wyatt, Sarah E / Zapata, Felipe / Zemenick, Ash T / Stern, David B

Plant direct

2022 Volume 6, Issue 8, Page(s) e432

Abstract: A future in which scientific discoveries are valued and trusted by the general public cannot be achieved without greater inclusion and participation of diverse communities. To envision a path towards this future, in January 2019 a diverse group of ... ...

Abstract	A future in which scientific discoveries are valued and trusted by the general public cannot be achieved without greater inclusion and participation of diverse communities. To envision a path towards this future, in January 2019 a diverse group of researchers, educators, students, and administrators gathered to hear and share personal perspectives on equity, diversity, and inclusion (EDI) in the plant sciences. From these broad perspectives, the group developed strategies and identified tactics to facilitate and support EDI within and beyond the plant science community. The workshop leveraged scenario planning and the richness of its participants to develop recommendations aimed at promoting systemic change at the institutional level through the actions of scientific societies, universities, and individuals and through new funding models to support research and training. While these initiatives were formulated specifically for the plant science community, they can also serve as a model to advance EDI in other disciplines. The proposed actions are thematically broad, integrating into discovery, applied and translational science, requiring and embracing multidisciplinarity, and giving voice to previously unheard perspectives. We offer a vision of barrier-free access to participation in science, and a plant science community that reflects the diversity of our rapidly changing nation, and supports and invests in the training and well-being of all its members. The relevance and robustness of our recommendations has been tested by dramatic and global events since the workshop. The time to act upon them is now.
Language	English
Publishing date	2022-08-24
Publishing country	England
Document type	Journal Article
ISSN	2475-4455
ISSN (online)	2475-4455
DOI	10.1002/pld3.432
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Article ; Online: Opioid Prescribing Risk Factors in Nonoperative Ankle Fractures: The Impact of a Prospective Clinical Decision Support Intervention.

The Journal of foot and ankle surgery : official publication of the American College of Foot and Ankle Surgeons

2021 Volume 61, Issue 3, Page(s) 557–561

Abstract: Opioids are frequently used for acute pain management of musculoskeletal injuries, which can lead to misuse and abuse. This study aimed to identify the opioid prescribing rate for ankle fractures treated nonoperatively in the ambulatory and emergency ... ...

Abstract	Opioids are frequently used for acute pain management of musculoskeletal injuries, which can lead to misuse and abuse. This study aimed to identify the opioid prescribing rate for ankle fractures treated nonoperatively in the ambulatory and emergency department setting across a single healthcare system and to identify patients considered at high risk for abuse, misuse, or diversion of prescription opioids that received an opioid. A retrospective cohort study was performed at a large healthcare system. The case list included nonoperatively treated emergency department, urgent care and outpatient clinic visits for ankle fracture and was merged with the Prescription Reporting With Immediate Medication Mapping (PRIMUM) database to identify encounters with prescription for opioids. Descriptive statistics characterize patient demographics, treatment location and prescriber type. Rates of prescribing among subgroups were calculated. There were 1,324 patient encounters identified, of which, 630 (47.6%) received a prescription opioid. The majority of patients were 18-64 years old (60.3%). Patients within this age range were more likely to receive an opioid prescription compared to other age groups (p < .0001). Patients treated in the emergency department were significantly more likely to receive an opioid medication (68.3%) compared to patients treated at urgent care (33.7%) or in the ambulatory setting (16.4%) (p < .0001). Utilizing the PRIMUM tool, 14.2% of prescriptions were provided to patients with at least one risk factor. Despite the recent emphasis on opioid stewardship, 14.2% of patients with risk factors for misuse, abuse, or diversion received opioid analgesics in this study, identifying an area of improvement for prescribers.
MeSH term(s)	Adolescent ; Adult ; Analgesics, Opioid/therapeutic use ; Ankle Fractures/therapy ; Decision Support Systems, Clinical ; Humans ; Middle Aged ; Practice Patterns, Physicians' ; Prospective Studies ; Retrospective Studies ; Risk Factors ; Young Adult
Chemical Substances	Analgesics, Opioid
Language	English
Publishing date	2021-10-20
Publishing country	United States
Document type	Journal Article
ZDB-ID	1146972-9
ISSN	1542-2224 ; 1067-2516
ISSN (online)	1542-2224
ISSN	1067-2516
DOI	10.1053/j.jfas.2021.09.030
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Zs.A 1468: Show issues

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