Identification of Strategies Used to Cope with Chronic Pain in Older Persons Receiving Primary Care from a Veterans Affairs Medical Center

2004 ◽  
Vol 52 (6) ◽  
pp. 950-956 ◽  
Author(s):  
Lisa C. Barry ◽  
Robert D. Kerns ◽  
Zhenchao Guo ◽  
Bao D. Duong ◽  
Lynne P. Iannone ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Older Persons ◽  
Medical Center ◽  
Veterans Affairs

scholarly journals Exploring the Relationship Between Serum Magnesium, Inflammation, and Chronic Pain in a Vermont Primary Care Population

2020 ◽  
Vol 4 (Supplement_2) ◽  
pp. 1821-1821
Author(s):  
Benjamin Littenberg ◽  
Thomas Ahern ◽  
Emily Tarleton
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Medical Center ◽  
Primary Care Patient ◽  
Serum Magnesium ◽  
Random Noise ◽  
Univariate Analysis ◽  
Care Patient ◽  
Cross Sectional ◽  
The Relationship

Abstract Objectives We sought to describe the relationship between serum magnesium, inflammation, and chronic pain in adult primary care patient. Methods We sought to describe this relationship utilizing a cross-sectional analysis of medical records from 5639 adults (mean age 59 years; 42% men) seen in The University of Vermont Medical Center primary care clinics between 2015 and 2018. Patients with at least one serum magnesium level, C-reactive protein (CRP, a measure of inflammation) level, and chronic pain score (self-reported visual analogue scale) were included. Results Univariate analysis confirmed the relationship between serum magnesium and chronic pain (−0.31 points/mg/dL; 95% CI −0.47, −0.14; P < 0.001). However, when serum magnesium and CRP were both included in the model, the relationship with pain is unclear (N = 1345; CI −0.003, 0.002; P = 0.69). Conclusions For adults seen in primary care, lower serum magnesium levels are associated with chronic pain. This inverse relationship is not explained by random noise, including age and gender. The complex relationship between serum magnesium, CRP, and pain is complex requires further exploration. Funding Sources None.

A preliminary comparison of primary care use by refugees before and after acupuncture

2014 ◽  
Vol 11 (4) ◽  
Author(s):  
Ellen Silver Highfield ◽  
Mckenna Longacre ◽  
Alan Sager ◽  
Michael A. Grodin
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Acupuncture Treatment ◽  
Medical Center ◽  
Preliminary Review ◽  
Care Services ◽  
Primary Care Services ◽  
Before And After ◽  
Total Utilization ◽  
Total Charges

Abstract: Limited research exits on utilization and cost-effectiveness of acupuncture among underserved communities, and virtually no evidence has been published with respect to refugee populations. In this study, we examined the relationship between acupuncture and the total utilization of primary care services in a cohort of refugee patients with chronic pain.: We retrospectively reviewed the medical records of 16 refugee patients with chronic pain at Boston Medical Center (BMC). The research was IRB-approved. Demographics and total charges associated with primary care over 18 months were collected.: Total charges associated with primary care services decreased by 50.2% in our refugee cohort in the 12 months following acupuncture treatment, equivalent to a savings of $691 per patient per month.: This preliminary review demonstrated a statistically significant decrease in total charges associated with primary care following acupuncture treatment (p=0.0308). This study suggests the need for further investigation of the relation between acupuncture and refugees with chronic pain, as well as the financial implications of this relationship. It is unclear why refugees may seek fewer primary care services after acupuncture treatment. Additional study is needed to further explore whether this relationship is generalizable to other hospital services and to other patient populations.

Suicide Screening in a Primary Care Setting at a Veterans Affairs Medical Center

1996 ◽  
Vol 37 (5) ◽  
pp. 413-424 ◽  
Author(s):  
Jennifer D. Lish ◽  
Mark Zimmerman ◽  
Neil J. Farber ◽  
David T. Lush ◽  
Mary Ann Kuzma ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Medical Center ◽  
Veterans Affairs ◽  
Suicide Screening

scholarly journals Agenda setting and visit openings in primary care visits involving patients taking opioids for chronic pain

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Eve Angeline Hood-Medland ◽  
Anne E. C. White ◽  
Richard L. Kravitz ◽  
Stephen G. Henry
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Patient Experience ◽  
Agenda Setting ◽  
Medical Center ◽  
Academic Medical Center ◽  
Internal Medicine Resident ◽  
Care Practice ◽  
Communication Tool ◽  
Resident Physicians

Abstract Background Agenda setting is associated with more efficient care and better patient experience. This study develops a taxonomy of visit opening styles to assess use of agenda and non-agenda setting visit openings and their effects on participant experience. Methods This observational study analyzed 83 video recorded US primary care visits at a single academic medical center in California involving family medicine and internal medicine resident physicians (n = 49) and patients (n = 83) with chronic pain on opioids. Using conversation analysis, we developed a coding scheme that assessed the presence of agenda setting, distinct visit opening styles, and the number of total topics, major topics, surprise patient topics, and returns to prior topics discussed. Exploratory quantitative analyses were conducted to assess the relationship of agenda setting and visit opening styles with post-visit measures of both patient experience and physician perception of visit difficulty. Results We identified 2 visit opening styles representing agenda setting (agenda eliciting, agenda reframing) and 3 non-agenda setting opening styles (open-ended question, patient launch, physician launch). Agenda setting was only performed in 11% of visits and was associated with fewer surprise patient topics than visits without agenda setting (mean (SD) 2.67 (1.66) versus 4.28 (3.23), p = 0.03). Conclusions In this study of patients with chronic pain, resident physicians rarely performed agenda setting, whether defined in terms of “agenda eliciting” or “agenda re-framing.” Agenda setting was associated with fewer surprise topics. Understanding the communication context and outcomes of agenda setting may inform better use of this communication tool in primary care  practice.

Workforce design in primary care-mental health integration: a case study at one veterans affairs medical center

2017 ◽  
Vol 6 (2) ◽  
pp. 148-160 ◽  
Author(s):  
Renata Konrad ◽  
Christine Tang ◽  
Brian Shiner ◽  
Bradley V Watts
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Medical Center ◽  
Veterans Affairs ◽  
Primary Care Mental Health ◽  
Mental Health Integration

Pharmacists on a primary care team at a Veterans Affairs medical center

1997 ◽  
Vol 54 (11) ◽  
pp. 1280-1287 ◽  
Author(s):  
Christine Chandler ◽  
Patricia Barriuso ◽  
Karine Rozenberg-Ben-Dror ◽  
Brian Schmitt
Keyword(s):  
Primary Care ◽  
Medical Center ◽  
Veterans Affairs ◽  
Care Team ◽  
Primary Care Team

Evaluation of clinical pharmacy interventions in a Veterans Affairs medical center primary care clinic

2013 ◽  
Vol 70 (13) ◽  
pp. 1168-1172 ◽  
Author(s):  
Augustus Hough ◽  
Christine M. Vartan ◽  
Julie A. Groppi ◽  
Sonia Reyes ◽  
Nick P. Beckey
Keyword(s):  
Primary Care ◽  
Clinical Pharmacy ◽  
Medical Center ◽  
Primary Care Clinic ◽  
Veterans Affairs ◽  
Care Clinic ◽  
Pharmacy Interventions

scholarly journals Evaluation of clinical pharmacy services within the primary care–mental health integration model at the Tuscaloosa Veterans Affairs Medical Center

2016 ◽  
Vol 6 (5) ◽  
pp. 260-265 ◽  
Author(s):  
Mamta Parikh ◽  
Ekaette E. Ebong ◽  
Erin Harris ◽  
Brittany Barnes
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Clinical Pharmacy ◽  
Medical Center ◽  
Veterans Affairs ◽  
Pharmacy Services ◽  
Specialty Mental Health ◽  
Primary Care Mental Health ◽  
Number Of Patients ◽  
Mental Health Integration

Abstract Introduction: The purpose of this review is to evaluate the direct delivery of health care to veterans before and after incorporating clinical pharmacy services within primary care mental health integration (PCMHI) at the Tuscaloosa Veterans Affairs Medical Center. Prior to establishing the role of the clinical pharmacy specialist (CPS) within PCMHI, the primary care providers deferred all mental health assessments to specialty mental health. As the demands of the service grew exponentially, assistance from clinical pharmacy was critical. Methods: A randomized, computer-generated list of 114 patients selected for the retrospective chart review was used to evaluate clinical outcomes in patients enrolled in the PCMHI clinic 1 year preincorporation and postincorporation of CPS. Outcome measures included the number of patients discharged from the PCMHI clinic upon achieving therapeutic goals or discharged to specialty mental health due to therapeutic failure or adverse drug events with first- and second-line psychotropic agents. Results: When contrasting the end points, there was a 60% increase in the number of patients who achieved therapeutic goal and a 32% decrease in the number of patients discharged to specialty mental health clinic postincorporation of CPS into PCMHI as compared to preincorporation of CPS (P = .024). Discussion: The results support the significance of CPS in the PCMHI in providing pharmacotherapy, patient education, and medication monitoring for managing psychiatric conditions, such as depression, anxiety, and insomnia. In addition, patients had greater accessibility to medication and frequent monitoring and follow-up, ultimately improving patient outcomes.

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