Who sees you matters: a population study examining topical corticosteroid prescribing patterns between primary care providers and dermatologists for atopic dermatitis

2020 ◽  
pp. 1-4
Author(s):  
Indira Singh ◽  
Vipawee S. Chat ◽  
Angeline Uy ◽  
Andrea Borba ◽  
Alice Y. Chen ◽  
...  
Keyword(s):  
Primary Care ◽  
Atopic Dermatitis ◽  
Topical Corticosteroid ◽  
Population Study ◽  
Primary Care Providers ◽  
Prescribing Patterns ◽  
Care Providers

scholarly journals Diagnosis and Management of Atopic Dermatitis for Primary Care Providers

2020 ◽  
Vol 33 (4) ◽  
pp. 626-635
Author(s):  
Patrick Fleming ◽  
Yue Bo Yang ◽  
Charles Lynde ◽  
Braden O'Neill ◽  
Kyle O. Lee
Keyword(s):  
Primary Care ◽  
Atopic Dermatitis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Diagnosis And Management

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.

Management of pediatric atopic dermatitis by primary care providers: A systematic review

2021 ◽  
Author(s):  
Trevor K. Young ◽  
Alexander F. Glick ◽  
H. Shonna Yin ◽  
Avani M. Kolla ◽  
Jessica J. Velazquez ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Atopic Dermatitis ◽  
Primary Care Providers ◽  
Care Providers

An Atopic Dermatitis Management Algorithm for Primary Care Providers and Assessment of Its Usefulness as a Clinical Tool

2017 ◽  
Vol 34 (4) ◽  
pp. 402-407 ◽  
Author(s):  
Maria E. Miyar ◽  
Megan Brown ◽  
Karina L. Vivar ◽  
Kimberly Jablon ◽  
Christy Boscardin ◽  
...  
Keyword(s):  
Primary Care ◽  
Atopic Dermatitis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Clinical Tool ◽  
Management Algorithm

Translating Atopic Dermatitis Management Guidelines Into Practice for Primary Care Providers

PEDIATRICS ◽  
2015 ◽  
Vol 136 (3) ◽  
pp. 554-565 ◽  
Author(s):  
L. F. Eichenfield ◽  
M. Boguniewicz ◽  
E. L. Simpson ◽  
J. J. Russell ◽  
J. K. Block ◽  
...  
Keyword(s):  
Primary Care ◽  
Atopic Dermatitis ◽  
Primary Care Providers ◽  
Care Providers ◽  
Management Guidelines

Communication between nurse care managers and patients who take opioids for chronic pain: Strategies for exploring aberrant behavior

2018 ◽  
Vol 14 (3) ◽  
pp. 191-202 ◽  
Author(s):  
Jane M. Liebschutz, MD, MPH ◽  
Allison V. Lange, MD ◽  
Orlaith D. Heymann, MA ◽  
Karen E. Lasser, MD, MPH ◽  
Pamela Corey, MSN, EdD, RN, CHSE ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Management Strategies ◽  
Primary Care Providers ◽  
Prescribing Patterns ◽  
Care Providers ◽  
Nurse Care ◽  
Care Managers ◽  
Monitoring Strategies ◽  
Field Notes

Objective: One approach to potential misuse of prescription opioids by patients with chronic pain is team-based collaborative primary care, with primary care visits complemented by frequent visits with nurse care managers (NCMs) specializing in addiction care. However, little is known about the communication strategies NCMs employ in these visits. This study aimed to describe strategies NCMs used with patients when discussing aberrancies encountered during opioid monitoring.Design: Observational study of NCM-patient interactions. Patients' primary care providers had been randomized to the treatment arm of a study evaluating an intervention, of which NCM visits were part, to change opioid prescribing patterns. The overall intervention was found to be successful.Setting: Four primary care settings.Participants: Two NCMs and 41 patients.Main outcome measure: Forty one interactions between two NCMs and 41 unique patients were directly observed, and the detailed field notes coded for strategies using conventional content analysis.Results: Five themes describing strategies that NCMs use to navigate aberrant patient behavior emerged: (1) NCM develops therapeutic relationship with patient; (2) NCM encourages adherence to monitoring strategies by contextualizing intensive opioid management for patient; (3) NCM inquires into discrepancies between patient's narrative and objective data to further understand aberrancy; (4) NCM assesses patient's medication use and pain to obtain more information about aberrancy and determine risk for opioid misuse; and (5) NCM educates patient and makes recommendations to guide appropriate medication use.Conclusions: These findings provide a potential model for the replication of intensive care management strategies utilizing NCMs in primary care.

Challenge of food allergy testing and avoidance in children with atopic dermatitis

2021 ◽  
Vol 14 (6) ◽  
pp. e243141
Author(s):  
Stephanie Ann Kubala ◽  
Paula Mariam Mohyi ◽  
Kristin Sokol ◽  
Pamela Frischmeyer-Guerrerio
Keyword(s):  
Primary Care ◽  
Atopic Dermatitis ◽  
Food Allergy ◽  
Growth Failure ◽  
Clinical History ◽  
Primary Care Providers ◽  
Care Providers ◽  
Immediate Hypersensitivity ◽  
Allergy Testing ◽  
Food Avoidance

Atopic dermatitis (AD) is a common presenting complaint by children and their caretakers to their primary care providers. On testing, children with AD frequently exhibit positive food-specific IgE levels in the absence of immediate allergic reactions. Misinterpretation of these false positive tests can lead to unnecessary food avoidance, which can have tremendous psychosocial, economic and nutritional consequences and, in some cases, facilitate the development of an immediate hypersensitivity to the food. We present a child with persistent AD who underwent broad testing that led to unnecessary food avoidance resulting in Vitamin D deficiency, growth failure and the development of an IgE-mediated food allergy. This case underscores the need for caution by primary care clinicians in using food avoidance diets as a treatment for AD and the importance of limiting allergy testing to foods only when the clinical history indicates an immediate hypersensitivity reaction.

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