J Am Board Fam Med
-
Opioid misuse in the United States has made it challenging for physicians to treat chronic noncancer pain (CNCP). We implemented an educational program aimed at promoting safe opioid prescribing practices in hopes of increasing the level of appropriateness associated with prescribing opioids for CNCP. ⋯ Clinician education on best practices while treating CNCP is associated with an increase in the level of opioid use appropriateness.
-
In primary care, clinical pharmacists often deliver a service called comprehensive medication management (CMM). While research has identified that CMM positively influences most aspects of the Quadruple Aim, it is unclear how CMM-both the service and the role of the pharmacist-may influence the primary care provider's (PCP) clinical work, professional satisfaction, and burnout (described here as PCP's work-life). We aimed to identify how PCPs perceive CMM impacts their work-life. ⋯ Our findings suggest PCPs believe CMM, in general, positively affects their work-life. CMM's impact on PCPs aligns with many previously identified drivers of burnout and engagement among providers. These results shed light on how CMM may foster achievement of the Quadruple Aim.
-
Accommodating walk-in psychiatry visits in primary care can improve access to psychiatric care for patients from historically underserved groups. We sought to determine whether a walk-in psychiatry model embedded within an integrated care practice could be sustained over time, and to characterize the patients who accessed care through it. ⋯ Providing psychiatric care on a walk-in basis in integrated care is sustainable. Patients from historically underserved groups may access psychiatric care disproportionately through a walk-in option when it is available.
-
Housing insecurity has been linked to high-risk behaviors and chronic disease, although less is known about the pathways leading to poor health. We sought to determine whether housing insecurity is associated with access to preventive and primary care. ⋯ Housing insecurity is associated with worse access to preventive and primary care. Interventions to enhance access for these patients should be developed and studied.
-
Using data from 2014 through 2016, we demonstrated a decline in the percentage of family physicians providing endoscopic services in both rural and urban areas. Our findings suggest that forces in the health care system may be influencing the reduction in scope, rather than specific geographic factors.