Annals of family medicine
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Annals of family medicine · May 2019
Comparative StudyComparing Buprenorphine-Prescribing Physicians Across Nonmetropolitan and Metropolitan Areas in the United States.
Although there is a tremendous need to increase the use of buprenorphine for the treatment of opioid use disorder in rural areas, little is known about current rural/urban differences in treatment practices. We aimed to examine physician characteristics, treatment practices, and concordance with treatment guidelines among buprenorphine prescribers across different locations of practice. ⋯ There are important differences in characteristics of buprenorphine prescribers in nonmetropolitan areas compared with more urban areas, including the fact that the majority of nonmetropolitan physicians are primary care physicians. Although treatment access in rural areas is an ongoing challenge, buprenorphine treatment practices are similar. Understanding buprenorphine prescribers and their treatment practices may help inform tailored strategies to address treatment needs in different locations.
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Annals of family medicine · May 2019
Meta AnalysisPotentially Inappropriate Prescribing Among Older Persons: A Meta-Analysis of Observational Studies.
Potentially inappropriate prescribing (PIP) is a common yet preventable medical error among older persons in primary care. It is uncertain whether PIP produces adverse outcomes in this population, however. We conducted a systematic review with meta-analysis to pool the adverse outcomes of PIP specific to primary care. ⋯ This meta-analysis provides consolidated evidence on the wide-ranging impact of PIP among older persons in primary care. It highlights the need to identify PIP in primary care, calls for further research on PIP interventions in primary care, and points to the need to consider potential implications when deciding on the operational criteria of PIP.
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Annals of family medicine · May 2019
A New Comprehensive Measure of High-Value Aspects of Primary Care.
To develop and evaluate a concise measure of primary care that is grounded in the experience of patients, clinicians, and health care payers. ⋯ The person-centered primary care measure reliably, comprehensively, and parsimoniously assesses the aspects of care thought to represent high-value primary care by patients, clinicians, and payers. The measure is ready for further validation and outcome analyses, and for use in focusing attention on what matters about primary care, while reducing measurement burden.
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Annals of family medicine · May 2019
Opioid and Substance Use Disorder and Receipt of Treatment Among Parents Living With Children in the United States, 2015-2017.
Little is known about the prevalence of opioid use disorder (OUD) among parents who are living with children and their receipt of treatment, which could reduce the harmful effects of OUD on families. ⋯ Many parents in both groups have concurrent mental health issues, including suicidal thoughts and behavior. Primary care practices can play a critical role in screening and facilitating treatment initiation.