As technology advances in all areas, pharmacy compounding is not excluded. Compounding pharmacists have a multitude of equipment available today that was not available 2 to 3 decades ago, and is still not available in many practice settings. Today, pharmacists have ointment mills, electronic balances, and capsule machines to help augment the skill of spatulation, replace the prescription torsion balance, and provide an alternative to the hand packing of capsules. Practice settings that regularly prepare capsules often purchase capsule-filling machines. These machines typically make anywhere from 100 to 300 capsules at a time. While this is an important skill, there are instances, such as those requiring only a small number of capsules, when the machine is impractical and the pharmacist needs to hand pack the capsules. Therefore, it was important that students learn the skills for hand packing capsules, as well as using a capsule machine, and how to ensure content uniformity and weight in both.
In addition to updating recommendations on the basis of new evidence regarding management of chronic pain, this clinical practice guideline is intended to assist clinicians in weighing benefits and risks of prescribing opioid pain medication for painful acute conditions (e.g., low back pain, neck pain, other musculoskeletal pain, neuropathic pain, dental pain, kidney stone pain, and acute episodic migraine) and pain related to procedures (e.g., postoperative pain and pain from oral surgery). In 2020, several of these indications were prioritized by an ad hoc committee of the National Academies of Sciences, Engineering, and Medicine (86) as those for which evidence-based clinical practice guidelines would help inform prescribing practices, with the greatest potential effect on public health. This update includes content on management of subacute painful conditions, when duration falls between that typically considered acute (defined as lasting 3 months). The durations used to define acute, subacute, and chronic pain might imply more specificity than is found in real-life patient experience, when pain often gradually transitions from acute to chronic. These time-bound definitions are not meant to be absolute but rather to be approximate guides to facilitate the consideration and practical use of the recommendations by clinicians and patients.
CDC identified peer reviewers on the basis of multiple factors, including scientific and subject matter expertise, racial and ethnic diversity, gender diversity, diversity of experiences and perspectives, independence from the clinical practice guideline development process, and consideration of conflicts of interest. Specific effort was made to identify subject matter experts with knowledge and experience in topics such as chronic and acute pain management, clinical practice, health equity, mental health and well-being, opioids and opioid therapies, opioid tapering, opioid use disorder treatment, pharmacologic and nonpharmacologic pain management, and surgical pain management. CDC assessed potential conflicts of interest before finalizing selection of peer reviewers. The NCIPC Associate Director for Science reviewed conflict of interest disclosure forms and determined no conflicts of interest were present. After the peer reviews were completed, CDC posted the names of peer reviewers on the NCIPC and CDC/ATSDR Peer Review Agenda websites, which provide information about the peer review of influential government scientific documents (114,115). Peer reviewers independently reviewed the draft clinical practice guideline and evaluated its scientific merit and practical implementation considerations, with the goal of maintaining high-quality science and providing evidence-based recommendations to guide clinical practice and decision-making to help prevent opioid-related harms. CDC reviewed and considered peer review comments when revising the clinical practice guideline. 2b1af7f3a8