What do academic primary care physicians want in an electronic journal?

Objective: Guidelines for appropriate management of chronic opioid therapy are underutilized by primary care physicians (PCPs). The authors hypothesized that developing a multicomponent, team-based opioid management system with electronic health record (EHR) support would allow our clinicians to improve adherence to chronic opioid prescribing and monitoring guidelines.Design: This was a retrospective pre-post study.Setting: The authors performed this intervention at our large, urban, academic primary care practice.Patients, participants: All patients with the diagnosis of “chronic pain, opioid requiring (ICD-10 F11.20)” on their primary care EHR problem lists were included in this study.Intervention: The authors implemented a five-pronged strategy to improve our system of opioid prescribing, including (1) a patient registry with regular dissemination of reports to PCPs; (2) standardization of policies regarding opioid prescribing and monitoring; (3) development of a risk-assessment algorithm and risk-stratified monitoring guidelines; (4) a team-based approach to care with physician assistant care managers; and (5) an EHR innovation to facilitate communication and guideline adherence.Main outcome measures: The authors measured percent adherence to opioid prescribing guidelines, including annual patient-provider agreements, biannual urine drug screens (UDSs), and prescription monitoring program (PMP) verification.Results: Between September 2015 and September 2016, the percentage of patients on chronic opioid therapy with a signed controlled substances agreement within the preceding year increased from 46 to 76 percent (p 0.0001), while the percentage of patients with a UDS done within the past 6 months rose from 23 to 79 percent (p 0.0001). The percentage of patients whose state PMPs profile had been checked by a primary care team member in the past year rose from 45 to 97 percent (p 0.0001).Conclusion: A comprehensive strategy to standardize chronic opioid prescribing in our primary care practice coincided with an increase in adherence to opioid management guidelines.

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Important Demographic Variables Impact the Musculoskeletal Knowledge and Confidence of Academic Primary Care Physicians

The Journal of Bone and Joint Surgery (American) ◽

10.2106/jbjs.e.01365 ◽

2006 ◽

Vol 88 (7) ◽

pp. 1589-1595 ◽

Cited By ~ 24

Author(s):

Joseph R. Lynch ◽

Gregory A. Schmale ◽

Douglas C. Schaad ◽

Seth S. Leopold

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Demographic Variables ◽

Academic Primary Care

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An intervention to improve advance emergency contraceptive prescribing practices among academic primary care physicians

Contraception ◽

10.1016/j.contraception.2008.03.014 ◽

2008 ◽

Vol 78 (2) ◽

pp. 131-135 ◽

Cited By ~ 6

Author(s):

Mindy Sobota ◽

Rebecca Warkol ◽

Marji Gold ◽

Felise Milan ◽

Eleanor B. Schwarz ◽

...

Keyword(s):

Primary Care ◽

Primary Care Physicians ◽

Prescribing Practices ◽

Emergency Contraceptive ◽

Academic Primary Care

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Faculty development: What academic primary care physicians need to know and what they want to know

Teaching and Learning in Medicine ◽

10.1080/10401339709539842 ◽

1997 ◽

Vol 9 (3) ◽

pp. 204-208

Author(s):

Rebecca Burke ◽

Dawn Bragg ◽

Jerome Van Ruiswyk

Keyword(s):

Primary Care ◽

Faculty Development ◽

Primary Care Physicians ◽

Academic Primary Care

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Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

American Journal of Law & Medicine ◽

10.1017/s0098858800002586 ◽

2003 ◽

Vol 29 (4) ◽

pp. 489-524

Author(s):

Brent Pollitt

Keyword(s):

Primary Care ◽

Mental Illness ◽

Nurse Practitioners ◽

Primary Care Physicians ◽

American Psychological Association ◽

The United States ◽

Psychotropic Medications ◽

American Psychological ◽

Training Requirements ◽

Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

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