PND44 Patient Characteristics and Comorbidities in Patients with Essential Tremor: A Retrospective Observational Study in a United States Commercially Insured and Medicare Advantage Population

ObjectivesIt is unclear why the use of email consultation is not more widespread in Dutch general practice, particularly because, since 2006, its costs can be reimbursed. To encourage further implementation, it is needed to understand the current use of email consultations. This study aims to understand the use of email consultation by different patient groups, compared with other general practice (GP) consultations.SettingFor this retrospective observational study, we used Dutch routine electronic health record data obtained from NIVEL Primary Care Database for the years 2010 and 2014.Participants200 general practices were included in 2010 (734 122 registered patients) and 434 in 2014 (1 630 386 registered patients).Primary outcome measuresThe number and percentage of email consultations and patient characteristics (age, gender, neighbourhood socioeconomic status and diagnoses) of email consultation users were investigated and compared with those who had a telephone or face-to-face consultation. General practice characteristics were also taken into account.Results32.0% of the Dutch general practices had at least one email consultation in 2010, rising to 52.8% in 2014. In 2014, only 0.7% of the GP consultations were by email (the others comprised home visits, telephone and face-to-face consultations). Its use highly varied among general practices. Most email consultations were done for psychological (14.7%); endocrine, metabolic and nutritional (10.9%); and circulatory (10.7%) problems. These diagnosis categories appeared less frequently in telephone and face-to-face consultations. Patients who had an email consultation were older than patients who had a telephone or face-to-face consultation. In contrast, patients with diabetes who had an email consultation were younger.ConclusionEven though email consultation was done in half the general practices in the Netherlands in 2014, the actual use of it is extremely low. Patients who had an email consultation differ from those who had a telephone or face-to-face consultation. In addition, the use of email consultation by patients is dependent on its provision by GPs.

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Opioid prescribing patterns among medical providers in the United States, 2003-17: retrospective, observational study

BMJ ◽

10.1136/bmj.l6968 ◽

2020 ◽

pp. l6968 ◽

Cited By ~ 10

Author(s):

Mathew V Kiang ◽

Keith Humphreys ◽

Mark R Cullen ◽

Sanjay Basu

Keyword(s):

United States ◽

Observational Study ◽

The United States ◽

Prescribing Patterns ◽

Retrospective Observational Study ◽

Washington Dc ◽

Medical Providers ◽

Opioid Prescribing ◽

One Year ◽

Improving Patient Care

AbstractObjectiveTo examine the distribution and patterns of opioid prescribing in the United States.DesignRetrospective, observational study.SettingNational private insurer covering all 50 US states and Washington DC.ParticipantsAn annual average of 669 495 providers prescribing 8.9 million opioid prescriptions to 3.9 million patients from 2003 through 2017.Main outcome measuresStandardized doses of opioids in morphine milligram equivalents (MMEs) and number of opioid prescriptions.ResultsIn 2017, the top 1% of providers accounted for 49% of all opioid doses and 27% of all opioid prescriptions. In absolute terms, the top 1% of providers prescribed an average of 748 000 MMEs—nearly 1000 times more than the middle 1%. At least half of all providers in the top 1% in one year were also in the top 1% in adjacent years. More than two fifths of all prescriptions written by the top 1% of providers were for more than 50 MMEs a day and over four fifths were for longer than seven days. In contrast, prescriptions written by the bottom 99% of providers were below these thresholds, with 86% of prescriptions for less than 50 MMEs a day and 71% for fewer than seven days. Providers prescribing high amounts of opioids and patients receiving high amounts of opioids persisted over time, with over half of both appearing in adjacent years.ConclusionsMost prescriptions written by the majority of providers are under the recommended thresholds, suggesting that most US providers are careful in their prescribing. Interventions focusing on this group of providers are unlikely to effect beneficial change and could induce unnecessary burden. A large proportion of providers have established relationships with their patients over multiple years. Interventions to reduce inappropriate opioid prescribing should be focused on improving patient care, management of patients with complex pain, and reducing comorbidities rather than seeking to enforce a threshold for prescribing.

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A Retrospective Observational Study of Rurioctocog Alfa Pegol in Clinical Practice in the United States

Journal of Managed Care & Specialty Pharmacy ◽

10.18553/jmcp.2020.26.4.492 ◽

2020 ◽

Vol 26 (4) ◽

pp. 492-503

Author(s):

Louis Aledort ◽

Scott Milligan ◽

Maureen Watt ◽

Jason Booth

Keyword(s):

United States ◽

Clinical Practice ◽

Observational Study ◽

The United States ◽

Retrospective Observational Study

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Prevalence of drug-drug interactions with pangenotypic direct-acting antivirals for hepatitis C and real-world care management in the United States: a retrospective observational study

Journal of Managed Care & Specialty Pharmacy ◽

10.18553/jmcp.2021.20550 ◽

2021 ◽

pp. 1-10

Author(s):

Michael P Curry ◽

Steven L Flamm ◽

Scott Milligan ◽

Naoky Tsai ◽

Nicole Wick ◽

...

Keyword(s):

United States ◽

Hepatitis C ◽

Observational Study ◽

Drug Interactions ◽

Real World ◽

Care Management ◽

The United States ◽

Retrospective Observational Study ◽

Direct Acting Antivirals ◽

Direct Acting

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Electroencephalography: Experience at Abakaliki Nigeria

Global Journal of Health Science ◽

10.5539/gjhs.v13n9p71 ◽

2021 ◽

Vol 13 (9) ◽

pp. 71

Author(s):

Chukwuemeka O Eze ◽

Olaronke F Afolabi ◽

Emeka O Onwe ◽

Richard L Ewah ◽

Ugochukwu U Nnadozie ◽

...

Keyword(s):

Observational Study ◽

Neurological Disorders ◽

Clinical Characteristics ◽

Patient Characteristics ◽

Tertiary Hospital ◽

Seizure Disorder ◽

Retrospective Observational Study ◽

Eeg Pattern ◽

Extract Information

BACKGROUND: Electroencephalography (EEG) remains the most important investigative modality in the evaluation of individuals with epilepsy and other neurological disorders. The pattern of EEG done in a tertiary hospital at Abakaliki Nigeria is not known. It is against this background that we embarked on this retrospective observational study on the EEG pattern and patient characteristics in Neurophysiology laboratory at Abakaliki Nigeria. METHOD: This is a retrospective observational hospital based study where the attendance register of the Neurophysiology laboratory was used to extract information on the demography, clinical characteristics and EEG reports of patients seen at the Laboratory from November 2018 to April 2021. RESULTS: A total of 125 (Male- 69, Female- 56) persons did EEG over the study period, and 75.2% had epileptiform waves (generalized- 16.8%, focal- 57.6%).  CONCLUSION: EEG services are been utilized at Abakaliki in evaluation of seizure disorder and other paroxysmal neurological events with more prevalent focal epileptiform waves.

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Efficiency of primary spine care as compared to conventional primary care: a retrospective observational study at an Academic Medical Center

Chiropractic & Manual Therapies ◽

10.1186/s12998-022-00411-x ◽

2022 ◽

Vol 30 (1) ◽

Author(s):

Serena Bezdjian ◽

James M. Whedon ◽

Robb Russell ◽

Justin M. Goehl ◽

Louis A. Kazal

Keyword(s):

Primary Care ◽

Observational Study ◽

Opioid Analgesic ◽

Primary Care Clinic ◽

Patient Characteristics ◽

Retrospective Observational Study ◽

Initial Visit ◽

Care Clinic ◽

Spine Care ◽

Primary Spine

Abstract Background Primary Spine Care (PSC) is an innovative model for the primary management of patients with spine-related disorders (SRDs), with a focus on the use of non-pharmacological therapies which now constitute the recommended first-line approach to back pain. PSC clinicians serve as the initial or early point of contact for spine patients and utilize evidence-based spine care pathways to improve outcomes and reduce escalation of care (EoC; e.g., spinal injections, diagnostic imaging, hospitalizations, referrals to a specialist). The present study examined 6-month outcomes to evaluate the efficiency of care for patients who received PSC as compared to conventional primary care. We hypothesized that patients seen by a PSC clinician would have lower rates of EoC compared to patients who received usual care by a primary care (PC) clinician. Methods This was a retrospective observational study. We evaluated 6-month outcomes for two groups seen and treated for an SRD between February 01, 2017 and January 31, 2020. Patient groups were comprised of N = 1363 PSC patients (Group A) and N = 1329 PC patients (Group B). We conducted Pearson chi-square and logistic regression (adjusting for patient characteristics that were unbalanced between the two groups) to determine associations between the two groups and 6-month outcomes. Results Within six months of an initial visit for an SRD, a statistically significantly smaller proportion of PSC patients utilized healthcare resources for spine care as compared to the PC patients. When adjusting for patient characteristics, those who received care from the PSC clinician were less likely within 6 months of an initial visit to be hospitalized (OR = .47, 95% CI .23–.97), fill a prescription for an opioid analgesic (OR = .43; 95% CI .29–.65), receive a spinal injection (OR = .56, 95% CI .33–.95), or have a visit with a specialist (OR = .48, 95% CI .35–.67) as compared to those who received usual primary care. Conclusions Patients who received PSC in an academic primary care clinic experienced significantly less escalation of their spine care within 6 months of their initial visit. The PSC model may offer a more efficient approach to the primary care of spine problems for patients with SRDs, as compared to usual primary care.

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