J Am Board Fam Med
-
Given the absence of guidelines for use of virtual visits for primary care delivery, a framework is needed to inform the most appropriate use of virtual visits. ⋯ After further validation, we expect that this framework may guide future research and practice: it may be valuable for clinical practice redesign, for designing evaluations of the outcomes of virtual visits, for outcomes research, for patient education, for triage, and possibly for reimbursement considerations.
-
After years of slow progress, the COVID-19 pandemic forced a rapid adoption of telehealth and telemedicine. The transition was not uniform across demographic groups, reflecting social determinants of health. ⋯ The focus on research on the COVID-19 pandemic is turning increasingly toward the long-term impact of the pandemic. Reports on Medicare wellness visits, drug safety, medical abortion, and the differences in scope and location of practice by race and ethnicity of family physicians can also be found in this issue.
-
Beginning around 2011, innumerable policies have aimed to improve pain treatment while minimizing harms from excessive use of opioids. It is not known whether changing insurance coverage for specific conditions is an effective strategy. We describe and assess the effect of an innovative Oregon Medicaid back/neck pain coverage policy on opioid prescribing patterns. ⋯ Regardless of starting opioid dose, nearly half of patients affected by the 2016 Oregon Medicaid back/neck pain treatment policy no longer received opioid prescriptions by the end of the 18-month study period; another 30% decreased their dose. Gradual dose reduction was typical. These outcomes suggest that the policy impacted opioid prescribing. Understanding patient experiences resulting from such policies could help clinicians and policy makers navigate the complex balance between potential harms and benefits of LOT.