scholarly journals Opioid Prescribing by Primary Care Providers: a Cross-Sectional Analysis of Nurse Practitioner, Physician Assistant, and Physician Prescribing Patterns

2020 ◽  
Vol 35 (9) ◽  
pp. 2584-2592
Author(s):  
M. James Lozada ◽  
Mukaila A. Raji ◽  
James S. Goodwin ◽  
Yong-Fang Kuo
Keyword(s):  
Primary Care ◽  
Nurse Practitioner ◽  
Primary Care Providers ◽  
Prescribing Patterns ◽  
Care Providers ◽  
Cross Sectional ◽  
Opioid Prescribing ◽  
Cross Sectional Analysis ◽  
Physician Prescribing ◽  
Sectional Analysis

Patient satisfaction and provider use of electronic communication: A cross-sectional analysis

2017 ◽  
Vol 5 (4) ◽  
pp. 441 ◽  
Author(s):  
Joy L Lee ◽  
Sydney M. Dy ◽  
Steven J. Kravet ◽  
Bimal H. Ashar ◽  
Todd Nesson ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Text Messaging ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Communication Behaviors ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
The Relationship

Background: The way patients and providers communicate with one another outside of the clinic is changing. However, little is known about primary care provider perspectives and experiences of these changes and whether these provider behaviors correlate with patient satisfaction. This study examines provider patterns of communication with patients outside of the clinic setting via cellphone, email and text messaging and the relationship between communication behaviors and patient satisfaction. Method: Cross-sectional analysis of the association between patient satisfaction scores and a 16-question community survey of 149 Mid-Atlantic primary care providers in community practice was conducted in the year prior to clinic implementation of a new electronic health record system with secure patient-messaging capabilities.Results: Providers who gave patients their email addresses were more likely to communicate with their patients electronically than those who did not. Providers who made their email addresses available to patients also had significantly higher overall satisfaction scores than those who did not, although there were no statistically significant differences in individual satisfaction domains. The use of these cellphone, email and text-messaging were also not found to be associated with patient satisfaction domains.    Conclusions: Provider provision of their email addresses may be an indicator of a stronger relationship with certain patients. This study elucidates the relationship between provider communication behaviors and patient satisfaction. A better understanding of the role of the patient-provider relationship and its role in patient satisfaction may help practices and providers improve their patients’ experience of primary care.  

scholarly journals Opioid Use Among Rural Medicare Beneficiaries

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 335-335
Author(s):  
Yvonne Jonk ◽  
Heidi O'Connor ◽  
Karen Pearson ◽  
Zachariah Croll ◽  
John Gale
Keyword(s):  
Primary Care ◽  
Rural Areas ◽  
Urban Areas ◽  
Primary Care Providers ◽  
Community Dwelling ◽  
Prescribing Patterns ◽  
Medicare Beneficiaries ◽  
Care Providers ◽  
Opioid Prescription ◽  
Opioid Prescribing

Abstract This study examines differences in opioid prescribing rates among a nationally representative sample of Medicare beneficiaries across rural and urban areas, as well as among beneficiaries with chronic overlapping pain conditions (COPCs). We assess whether prescribing patterns exceed the Centers for Disease Control and Prevention guidelines for dose and duration, and identify socioeconomic and health risk factors associated with opioid prescribing using logistic regression analyses. Data were from the 2010-2017 Medicare Current Beneficiary Survey files. Rural-Urban Commuting Area codes were used to identify patients’ residential location. The Area Health Resource Files were used to identify market characteristics such as primary care and mental health shortage areas. With the exception of 2010, over years 2011-2017, higher percentages of community-dwelling rural beneficiaries received opioid prescriptions (21.8-25.4%) compared to their urban counterparts (19.1-23.7%). During the same time period, facility-dwelling rural beneficiaries were more likely to receive opioid prescriptions (39.8-47.2%) compared to their urban counterparts (28.8-35.0%). Higher percentages (18.8%) of the community dwelling population in rural had COPCs compared to urban (15.2%), and a higher percentage of rural beneficiaries with COPCs (31.4%) received an opioid prescription than their urban counterparts (22.2%). Previous research points to other factors contributing to a lack of alternatives to opioids for pain management in rural areas, including greater reliance on primary care providers, lack of access to chronic pain specialists and alternative therapies, and travel barriers. Improving the capacity of rural primary care to deal with COPCs and expanding access to specialists via telehealth warrants further attention from policymakers.

scholarly journals Preoperative prevalence of deep vein thrombosis in patients scheduled to have surgery for degenerative musculoskeletal disorders

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Keigo Sato ◽  
Hideki Date ◽  
Takehiro Michikawa ◽  
Mitsuhiro Morita ◽  
Kazue Hayakawa ◽  
...  
Keyword(s):  
Lower Extremity ◽  
Musculoskeletal Disorders ◽  
Pulmonary Thromboembolism ◽  
Elective Surgery ◽  
Knee Surgery ◽  
Care Providers ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
D Dimer

Abstract Background Although the incidence of symptomatic pulmonary thromboembolism after elective surgery for degenerative musculoskeletal disorders is comparatively low, it is extremely detrimental to both patients and health-care providers. Therefore, its prevention is mandatory. We aimed to perform a cross-sectional analysis of deep venous thrombosis (DVT) before elective surgery for degenerative musculoskeletal disorders, including total knee arthroplasty (TKA), total hip arthroplasty (THA), and spinal surgery, and identify the factors associated with the incidence of preoperative DVT. Methods The clinical data of patients aged ≥ 30 years who underwent TKA or THA, and spine surgery for lumbar or cervical degenerative disorders at our institution were retrospectively collected. D-dimer levels were measured preoperatively in all the patients scheduled for surgery. For the patients with D-dimer levels ≥ 1 µg/mL or who were determined by their physicians to be at high risk of DVT, the lower extremity vein was preoperatively examined for DVT on ultrasonography. Results Overall, we retrospectively evaluated 1236 consecutive patients, including 701 men and 535 women. Of the patients, 431 and 805 had D-dimer levels ≥ 1 and < 1 µg/mL, respectively. Of 683 patients who underwent lower extremity ultrasonography, 92 had proximal (n = 7) and distal types (n = 85) of DVT. The preoperative prevalence of DVT was 7.4 %. No patient had the incidence of postoperative symptomatic venous thromboembolism. A multivariate analysis revealed that age ≥ 80 years (odds ratio [OR], 95 % confidence interval [CI]: 2.8, 1.1–7.3), knee surgery (2.1, 1.1–4.0), American Society of Anesthesiologists (ASA) grade 2 (2.8, 1.2–6.8), ASA grades 3 or 4 (3.1, 1.0–9.4), and malignancy (1.9, 1.1–3.2) were significantly associated with DVT incidence. Conclusions This is the first study to conduct a cross-sectional analysis of preoperative DVT data of patients scheduled for elective surgery for degenerative musculoskeletal disorders. Although whether screening for preoperative DVT is needed to prevent postoperative symptomatic pulmonary thromboembolism remains to be clarified, our data suggested that DVT should be noted before surgery in the patients with advanced age, knee surgery, high ASA physical status, and malignancy.

Primary Care of Opioid use Disorder: The End of “the French Model”?

2020 ◽  
Vol 26 (6) ◽  
pp. 346-354 ◽  
Author(s):  
Julie Dupouy ◽  
Sandy Maumus-Robert ◽  
Yohann Mansiaux ◽  
Antoine Pariente ◽  
Maryse Lapeyre-Mestre
Keyword(s):  
Primary Care ◽  
Private Practice ◽  
Primary Care Providers ◽  
Opioid Use Disorder ◽  
Care Providers ◽  
Opioid Use ◽  
Access To Treatment ◽  
Cross Sectional ◽  
Number Of Patients ◽  
French Model

<b><i>Background:</i></b> In France, most patients with opioid use disorder (OUD) have been treated by buprenorphine, prescribed by general practitioners (GP) in private practice since 1996. This has contributed to building a ‘French model’ facilitating access to treatment based on the involvement of GPs in buprenorphine prescription. <b><i>Objectives:</i></b> Our study aimed to assess whether the involvement of primary care in OUD management has changed lately. <b><i>Materials and Methods:</i></b> Using data from the French National Health Insurance database, we conducted a yearly repeated cross-sectional study (2009–2015) and described proportion of opioid maintenance treatment (OMT)-prescribing GPs and OMT-dispensing community pharmacies (CP); and number of patients by GP or CP. <b><i>Results:</i></b> Whereas the number of buprenorphine-prescribing GPs in private practice remained quite stable (decrease of 3%), a substantial decrease in buprenorphine initial prescribers among private GPs was observed. In 2009, 10.3% of private GPs (6,297 from 61,301 French private GPs) prescribed buprenorphine for the initiation of a treatment, whereas they were 5.7% (<i>n</i> = 3,539 from 62,071 private GPs) in 2015 (43.8% decrease). GPs issuing initial prescriptions of buprenorphine tended to care for a higher number of patients treated by buprenorphine (14.6 ± 27.1 patients in 2009 to 16.0 ± 35.4 patients in 2015). The number of CPs dispensing buprenorphine remained quite stable (decrease of 2%), while there was a 7.5% decrease in the total number of French CPs across the study period. <b><i>Conclusions:</i></b> Our results suggest that primary care providers seem less engaged in buprenorphine initiation in OUD patients, while CPs have not modified their involvement towards these patients.

scholarly journals Acne in primary care: A cross-sectional analysis

2019 ◽  
Vol 48 (11) ◽  
pp. 781-788
Author(s):  
Hilary Brown ◽  
Amanda Tapley ◽  
Mieke L van Driel ◽  
Andrew R Davey ◽  
Elizabeth Holliday ◽  
...  
Keyword(s):  
Primary Care ◽  
Cross Sectional ◽  
Cross Sectional Analysis ◽  
Sectional Analysis
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