Medical Issues in Adolescent Substance Use: Background and Role of the Primary Care Physician

2016 ◽  
pp. 574-592
Author(s):  
Miriam Schizer ◽  
Elissa R. Weitzman ◽  
Sharon Levy
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Specific Treatment ◽  
Primary Care Providers ◽  
Evidence Base ◽  
Care Physician ◽  
Care Providers ◽  
Adolescent Substance ◽  
Medical Issues

Use of psychoactive substances is both common during adolescence and highly associated with acute and chronic health risks. Routine health care provides an opportunity to provide a range of interventions—from primary prevention to assisting adolescents with substance use disorders in accessing treatment. In particular, primary care offers a unique opportunity to intervene with adolescents who have developed substance use problems but do not meet criteria or are unwilling to enter specific treatment for a substance use disorder, and thus provide a level of service for adolescents who would otherwise likely receive no intervention. This chapter reviews the evidence base for primary care interventions and explores the role for primary care providers.

scholarly journals Matching Inhaler Devices with Patients: The Role of the Primary Care Physician

2018 ◽  
Vol 2018 ◽  
pp. 1-9 ◽  
Author(s):  
Alan Kaplan ◽  
David Price
Keyword(s):  
Primary Care ◽  
Treatment Success ◽  
Primary Care Providers ◽  
Care Physician ◽  
Chronic Obstructive ◽  
Inhaler Technique ◽  
Care Providers ◽  
Obstructive Pulmonary Disease ◽  
Inhaler Devices

Poor inhaler technique and nonadherence impair the efficacy of medications for asthma and chronic obstructive pulmonary disease (COPD). A range of factors, including age, dexterity, inspiratory capacity, cognitive ability, health literacy, and ethnicity, can impact a patient’s ability and intention to use their device. Treatment success can also be influenced by patient preferences and perceptions. Therefore, it is important that healthcare professionals effectively match inhaler devices to individual patients’ needs and abilities and empower patients by including them in treatment decisions. Physicians must, therefore, fully understand the characteristics of each device, as well as their patients’ demographic characteristics and comorbidities. Following device selection, patient training and education, including a physical demonstration of the device, are key to eliminate any critical errors that may impact on health outcomes. Inhaler technique should be frequently rechecked. This review will examine the important role of primary care providers in the selection of appropriate inhaler devices and provision of training for patients with COPD and asthma to optimize correct inhaler use and adherence. An overview of the key features of available devices and of the factors to consider when selecting devices will be provided in the context of current asthma and COPD guidelines.

Pain and Addiction in Patients with Post-Traumatic Stress Disorder (DRAFT)

2018 ◽  
Author(s):  
Steven A. Eraker
Keyword(s):  
Substance Use ◽  
Substance Use Disorders ◽  
Psychiatric Symptoms ◽  
Primary Care Providers ◽  
Psychiatric Diagnoses ◽  
Care Providers ◽  
Post Traumatic Stress ◽  
Basic Principles ◽  
Post Traumatic

Addressed equally to psychiatrists and to primary care providers, this chapter is intended to explore non–substance use disorder psychiatric diagnoses as they impact the perception of pain and the treatment of substance use disorders. A screening checklist emphasizing basic principles of psychiatric history-taking is provided to help identify the patient’s requirements. The author reviews the classes of psychiatric diagnoses most likely to be present in the pain/addiction and other comorbidly-ill patients, and reviews suicide risks. Similarly, the classes of medications employed in psychiatry and their capacity for alleviation or aggravation of substance use disorders are reviewed, with notations of drug–drug interactions. A final section addresses the role of emotions and psychiatric symptoms in the perception and management of pain.

scholarly journals Primary Care Physician Experiences with Integrated Population-Scale Genetic Testing: A Mixed-Methods Assessment

2020 ◽  
Vol 10 (4) ◽  
pp. 165
Author(s):  
Amy A. Lemke ◽  
Laura M. Amendola ◽  
Kristine Kuchta ◽  
Henry M. Dunnenberger ◽  
Jennifer Thompson ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Genetic Testing ◽  
Data Privacy ◽  
Qualitative Interviews ◽  
Genomic Medicine ◽  
Primary Care Providers ◽  
The United States ◽  
Care Physician ◽  
Care Providers

The scalable delivery of genomic medicine requires collaboration between genetics and non-genetics providers. Thus, it is essential to investigate and address the perceived value of and barriers to incorporating genetic testing into the clinical practice of primary care providers (PCPs). We used a mixed-methods approach of qualitative interviews and surveys to explore the experience of PCPs involved in the pilot DNA-10K population genetic testing program. Similar to previous research, PCPs reported low confidence with tasks related to ordering, interpreting and managing the results of genetic tests, and identified the need for additional education. PCPs endorsed high levels of utility for patients and their families but noted logistical challenges to incorporating genetic testing into their practice. Overall PCPs were not familiar with the United States’ Genetic Information Nondiscrimination Act and they expressed high levels of concern for patient data privacy and potential insurance discrimination. This PCP feedback led to the development and implementation of several processes to improve the PCP experience with the DNA-10K program. These results contribute to the knowledge base regarding genomic implementation using a mixed provider model and may be beneficial for institutions developing similar clinical programs.

Medical Home: Is there a place for recreational therapy?

2010 ◽  
Vol 9 (2) ◽  
pp. 13-20
Author(s):  
Mary Ann Keogh Hoss, PhD, CTRS, FACHE, FDRT ◽  
Kari Kensinger, PhD, CTRS
Keyword(s):  
Primary Care ◽  
Medical Home ◽  
Clinical Skills ◽  
Primary Care Providers ◽  
Care Physician ◽  
Recreational Therapy ◽  
Care Providers ◽  
Complex Needs ◽  
Community Skills ◽  
Medical Home Model

The purpose of this article is to explore the role of recreational therapy within a medical home model. Medical home is a movement to manage the care of individuals with complex and chronic health needs through their primary care physician and the physician’s team. The concepts of medical home are discussed. These concepts are the same as those on which recreational therapists have been trained. This article demonstrates the various ways in which recreational therapists can meet the challenges posed by serving individuals with chronic disease.The medical home model provides a rare opportunity for recreational therapists to combine clinical skills with community skills to meet the needs of those individuals in the community with chronic and complex needs. This article demonstrates that recreational therapists are already engaged and invested in this model. What is lacking is the promotion of skills and services of the recreational therapists to market and communicate this to primary care providers.

scholarly journals Use of Pharmacotherapies in the Treatment of Alcohol Use Disorders and Opioid Dependence in Primary Care

2015 ◽  
Vol 2015 ◽  
pp. 1-11 ◽  
Author(s):  
Jinhee Lee ◽  
Thomas F. Kresina ◽  
Melinda Campopiano ◽  
Robert Lubran ◽  
H. Westley Clark
Keyword(s):  
Public Health ◽  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Opioid Dependence ◽  
Alcohol Use Disorders ◽  
Primary Care Providers ◽  
Care Providers ◽  
Addictive Disorders ◽  
Care And Treatment

Substance-related and addictive disorders are chronic relapsing conditions that substantially impact public health. Effective treatments for these disorders require addressing substance use/dependence comprehensively as well as other associated comorbidities. Comprehensive addressing of substance use in a medical setting involves screening for substance use, addressing substance use directly with the patient, and formulating an appropriate intervention. For alcohol dependence and opioid dependence, pharmacotherapies are available that are safe and effective when utilized in a comprehensive treatment paradigm, such as medication assisted treatment. In primary care, substance use disorders involving alcohol, illicit opioids, and prescription opioid abuse are common among patients who seek primary care services. Primary care providers report low levels of preparedness and confidence in identifying substance-related and addictive disorders and providing appropriate care and treatment. However, new models of service delivery in primary care for individuals with substance-related and addictive disorders are being developed to promote screening, care and treatment, and relapse prevention. The education and training of primary care providers utilizing approved medications for the treatment of alcohol use disorders and opioid dependence in a primary care setting would have important public health impact and reduce the burden of alcohol abuse and opioid dependence.

scholarly journals Reducing Alcohol and Opioid Use Among Youth in Rural Counties: An Innovative Training Protocol for Primary Health Care Providers and School Personnel

10.2196/21015 ◽  
2020 ◽  
Vol 9 (11) ◽  
pp. e21015
Author(s):  
Erica Francis ◽  
Kara Shifler Bowers ◽  
Glenn Buchberger ◽  
Sheryl Ryan ◽  
William Milchak ◽  
...  
Keyword(s):  
Primary Care ◽  
Substance Use ◽  
Alcohol Use ◽  
Substance Use Disorders ◽  
Health Care Providers ◽  
School Personnel ◽  
Primary Care Providers ◽  
School Nurses ◽  
Care Providers ◽  
Opioid Use

Background Given that youth alcohol use is more common in rural communities, such communities can play a key role in preventing alcohol use among adolescents. Guidelines recommend primary care providers incorporate screening, brief intervention, and referral to treatment (SBIRT) into routine care. Objective The aim is to train primary care providers and school nurses within a rural 10-county catchment area in Pennsylvania to use SBIRT and facilitate collaboration with community organizations to better coordinate substance use prevention efforts. Methods To build capacity to address underage drinking and opioid use among youth aged 9-20 years, this project uses telehealth, specifically Project ECHO (Extension for Community Healthcare Outcomes), to train primary care providers and school nurses to address substance use with SBIRT. Our project will provide 120 primary care providers and allied health professionals as well as 20 school nurses with SBIRT training. Community-based providers will participate in weekly virtual ECHO sessions with a multidisciplinary team from Penn State College of Medicine that will provide SBIRT training and facilitate case discussions among participants. Results To date, we have launched one SBIRT ECHO project with school personnel, enrolling 34 participants. ECHO participants are from both rural (n=17) and urban (n=17) counties and include school nurses (n=15), school counselors (n=8), teachers (n=5), administrators (n=3), and social workers (n=3). Before the study began, only 2/13 (15.5%) of schools were screening for alcohol use. Conclusions This project teaches primary care clinics and schools to use SBIRT to prevent the onset and reduce the progression of substance use disorders, reduce problems associated with substance use disorders, and strengthen communities’ prevention capacity. Ours is an innovative model to improve rural adolescent health by reducing alcohol and opioid use. International Registered Report Identifier (IRRID) DERR1-10.2196/21015

scholarly journals A Primary Care Perspective on Gout

2016 ◽  
Vol 9 (1) ◽  
pp. 27-34
Author(s):  
Eva Rimler ◽  
Jennifer Lom ◽  
Jason Higdon ◽  
Dominique Cosco ◽  
Danielle Jones
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Hospital Admissions ◽  
Primary Care Providers ◽  
Treat To Target ◽  
Care Providers ◽  
Work Related ◽  
Treat All ◽  
Care Costs

Gout causes patients’ significant morbidity, work-related disability, loss of productivity, increased health care costs, and even all-cause hospital admissions. As a result, primary care providers must be armed with the knowledge to properly diagnose and manage gout. While many aspects of care remain the same, some key updates that primary care providers must consider when treating their patients with gout will be discussed. In this perspective we will highlight and discuss acceptable circumstances for empiric treatment, renewed emphasis on treat to target, access to commonly used medications, recommended first line agents, and the role of primary care physicians in gout flare prevention among other topics. These strategies will aid primary care physicians treat all but the most complex cases of gout.

When should a PCP refer a patient with pustular psoriasis to a dermatologist?

2021 ◽  
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Pustular Psoriasis ◽  
Care Providers

This video guide for primary care providers describes the reasons for referring patients with pustular psoriasis to the dermatologist and the role of the dermatologist in managing patients with pustular psoriasis.

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