Journal of general internal medicine
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Drug prices affect government budgets directly through spending on public programs like Medicare and Medicaid, and indirectly via private coverage for public employees and tax subsidies for private insurance. Yet, the Senate parliamentarian ruled that the Senate could not use streamlined Budget Reconciliation to extend the Inflation Reduction Act's controls on insulin co-payment or drug prices to private insurers on the grounds that their expenditures do not affect the federal budget. ⋯ Governments directly or indirectly fund most drug purchases, including substantial expenditures that flow through private insurers. Hence, prices paid by private insurers impact government budgets, supporting the view that government should be allowed to regulate drug prices.
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Harm reduction, when applied to drug use, prioritizes improving patient-centered health outcomes and reducing drug-related harm. In order for harm reduction strategies to be adopted by people who inject drugs (PWID), they need to be promoted, accessible, and accepted in that population and the community-at-large. While PWID face stigma at multiple levels, less is known about how stigma influences uptake and acceptance of harm reduction services and strategies among PWID. ⋯ To expand the reach of harm reduction services, it is critical to develop interventions that can reduce the stigma against PWID and harm reduction.
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Valid, single-item cannabis screens for the frequency of past-year use (SIS-C) can identify patients at risk for cannabis use disorder (CUD); however, the prevalence of CUD for patients who report varying frequencies of use in the clinical setting remains unexplored. ⋯ Among patients who reported past-year cannabis use as part of routine screening, the prevalence of CUD and other cannabis exposure measures increased with greater frequency of cannabis use, underscoring the utility of brief cannabis screens for identifying patients at risk for CUD.
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Synchronous virtual visits aid in longitudinal primary care and fulfill unmet needs for patients and clinicians. Virtual visits are widely accepted for specialty consultation and follow-up; however, novel systems-based programs and processes may support earlier engagement. ⋯ Participants reported satisfaction and acceptability of team-based virtual visits, noting high satisfaction with information exchange and actionability of notes. Participants reported ongoing opportunities to enhance medication reconciliation. Virtual visits continue to evolve and may serve varying roles in primary care.