scholarly journals Primary Care Providers Believe That Comprehensive Medication Management Improves Their Work-Life

2019 ◽  
Vol 32 (4) ◽  
pp. 462-473 ◽  
Author(s):  
Kylee A. Funk ◽  
Deborah L. Pestka ◽  
Mary T. Roth McClurg ◽  
Jennifer K. Carroll ◽  
Todd D. Sorensen
Keyword(s):  
Primary Care ◽  
Medication Management ◽  
Primary Care Providers ◽  
Work Life ◽  
Care Providers

Patient Digital Technologies to Support Primary Care across Disorders: Perspectives from Primary Care Providers, Behavioral Health Consultants, and Nurses (Preprint)

2021 ◽  
Author(s):  
Oleg Zaslavsky ◽  
Frances Chu ◽  
Brenna Renn
Keyword(s):  
Primary Care ◽  
Mobile Apps ◽  
Medication Management ◽  
Primary Care Providers ◽  
Health Conditions ◽  
Care Providers ◽  
Health Promoting Behaviors ◽  
Live Video ◽  
Health Promoting ◽  
Clinical Conditions

BACKGROUND Acceptance of digital health technologies among primary care providers and staff for various clinical conditions has not been explored. OBJECTIVE The purpose of this nationwide study was to determine differences between behavioral health consultants (BHCs), primary care providers (PCPs), and nurses in acceptance of mobile apps, wearables, live video, phone, email, instant chats, text messages, social media, and patient portals to support patient care across clinical conditions. METHODS We surveyed 51 BHCs, 52 PCPs, and 48 nurses embedded in primary care clinics across the United States. We asked respondents to mark technologies they consider appropriate to support patients in: acute and chronic disease, medication management, health-promoting behaviors, sleep, substance use, and common and serious mental health conditions. RESULTS Respondents were geographically dispersed across the nation, although most (82.9%) practiced in urban and suburban settings. Compared to other personnel, a higher proportion of BHCs endorsed live video. Similarly, a higher proportion of nurses endorsed all other technologies. PCPs had the lowest rates of endorsement across technologies. Within clinical contexts, the highest acceptance rates were 81% and 70% for BHCs and PCPs respectively in live video for common mental health conditions, and 75% for nurses in mobile apps for health-promoting behaviors. The lowest (9%) endorsement rate across providers was in social media for medication management. CONCLUSIONS The survey suggests subtle differences in the way clinicians envision using technologies to support patient care. Future work must attend to provider perceptions to ensure the sustainment of services across conditions and patient populations.

scholarly journals Primary Care Providers’ Acceptance of Pharmacists’ Recommendations to Support Optimal Medication Management for Patients with Diabetic Kidney Disease

2019 ◽  
Vol 35 (1) ◽  
pp. 63-69 ◽  
Author(s):  
Leah L. Zullig ◽  
Shelley A. Jazowski ◽  
Clemontina A. Davenport ◽  
Clarissa J. Diamantidis ◽  
Megan M. Oakes ◽  
...  
Keyword(s):  
Primary Care ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Medication Management ◽  
Primary Care Providers ◽  
Care Providers ◽  
Diabetic Kidney

scholarly journals Opportunities and Barriers to Medication Safety in Community-Dwelling Older Adults

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 611-612
Author(s):  
Fatoumata Jallow ◽  
Elisa Stehling ◽  
Zara Sajwani ◽  
Kathryn Daniel ◽  
Yan Xiao
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Medication Safety ◽  
Medication Management ◽  
Primary Care Providers ◽  
Vulnerable Population ◽  
Community Dwelling ◽  
Care Providers ◽  
Essential Information ◽  
Barriers And Enablers

Abstract Community-dwelling multi-morbid older adults are a vulnerable population for medication safety-related threats. We interviewed a sample of these older adults recruited from local retirement communities and from primary care practices to learn their perceptions of barriers and enablers for their medication safety. The present study is part of the Partnership in Resilience for Medication Safety (PROMIS) study. One of the aims of this project is to identify barriers and opportunities to improve older adults' medication safety. These interviews were conducted during COVID-19 pandemic conditions. Results from this qualitative study suggest that trust between these older adults and their healthcare providers is an essential component of medication safety. Overarching themes include disruptions in medication management, caregivers caring for each other, patient safety practices or habits, and medication management literacy. Participants also shared strain due to lack of skills to navigate telemedicine visits, trust in Primary Care Providers (PCPs) and pharmacists to prescribe and dispense safely for them, reliance on PCPs and pharmacists to give essential information about medications without having to be asked. Our interviews illustrated large variations in older adults’ perceived role in medication safety, with some developing expertise in understanding how medications work for them and how long-term medications should be periodically reviewed. The types of information needs and supports from PCPs were likely different. Understanding these barriers and enablers for safe medication management can help us develop medication safety improvements for this vulnerable population.

scholarly journals Development of a Telehealth-Coordinated Intervention to Improve Access to Community-Based Mental Health

2018 ◽  
Vol 28 (Supp) ◽  
pp. 457-466 ◽  
Author(s):  
Sandra Contreras ◽  
Lorena Porras-Javier ◽  
Bonnie T. Zima ◽  
Neelkamal Soares ◽  
Christine Park ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Los Angeles ◽  
Qualitative Interviews ◽  
Medication Management ◽  
Primary Care Providers ◽  
Care Process ◽  
Care Providers ◽  
Community Mental Health Clinics ◽  
Transition Points

Objective: To develop an intervention to improve the mental health referral and care process for children referred by primary care providers (PCPs) to community mental health clinics (MHCs) using a community partnered approach.Design: A Project Working Group (PWG) with representatives from each partner orga­nization met monthly for 6 months.Setting: Multi-site federally qualified health center (FQHC) and two community MHCs in Los Angeles county.Participants: 26 stakeholders (14 FQHC clinic providers/staff, 8 MHC providers/staff, 4 parents) comprised the PWG.Data Sources: Qualitative interviews, PWG meeting notes, intervention processes and workflow reports.Intervention: The PWG reviewed qualita­tive data from stakeholders (interviews of 7 parents and 13 providers/staff). The PWG met monthly to identify key transition points where access to and coordination of care were likely compromised and to develop solutions.Results: Three critical transition points and system solutions were identified: 1) Parents refuse initial referral to the MHC due to stigma regarding mental health services. Solution: During initial referral, parents watch a video introducing them to the MHC. 2) Parents don’t complete the MHC’s screening after referral. Solution: A live videoconference session connecting parents at the FQHC with MHC staff ensures completion of the screening and eligibility process. 3) PCPs reject transfer of patients back to primary care for ongoing psycho­tropic medication management. Solution: Regularly scheduled live videoconferences connect PCPs and MHC providers.Conclusions: A community partnered ap­proach to care design utilizing telehealth for care coordination between clinics can potentially be used to address key chal­lenges in MHC access for children.Ethn Dis. 2018;28(Suppl 2):457-466; doi:10.18865/ed.28.S2.457.

The assessment and treatment of back and neck pain: an initial investigation in a primary care practice-based research network

2014 ◽  
Vol 16 (05) ◽  
pp. 461-469 ◽  
Author(s):  
Rebecca Fischbein ◽  
Kenelm McCormick ◽  
Brian A. Selius ◽  
Susan Labuda Schrop ◽  
Michael Hewit ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Neck Pain ◽  
Medication Management ◽  
Primary Care Providers ◽  
Research Network ◽  
Care Providers ◽  
Primary Care Settings ◽  
Current Medication ◽  
Practice Based Research

AimThe purpose of this study was to conduct an exploratory examination of the current state of non-malignant acute and chronic back and neck pain assessment and management among primary care providers in a multi-site, practice-based research network.BackgroundAcute and chronic pain are distinct conditions that often require different assessment and management approaches, however, little research has examined assessment and management of acute and chronic pain as separate conditions. The large majority of patients with acute and chronic back and neck pain are managed in primary care settings. Given the differences between acute and chronic pain, it is necessary to identify differences in patient characteristics, practitioner evaluation, treatment and management in primary care settings.MethodsOver a two-week period, 24 practitioners in a multi-site practice-based research network completed 196 data cards about 39 patients experiencing acute back and neck pain and 157 patients suffering from chronic back and neck pain.FindingsThere were significant differences between the patients experiencing acute and chronic pain in regards to practitioner evaluation, current medication management and current treatment for depression. In addition, diagnostics differed between patients experiencing acute versus chronic back and neck pain. Further, primary care providers’ review of online drug monitoring program reports during the current visit was associated with current medication management using short term opioids, long-term opioids or tramadol. Most research examining acute and chronic pain focuses on the low back. Additional research needs to be conducted to explore and compare acute and chronic pain across the whole spine.

Primary Care Provider Perceptions of Pharmacist Services in an Urban, Safety Net Health System

2019 ◽  
Vol 33 (6) ◽  
pp. 790-798
Author(s):  
Anusha McNamara ◽  
Lenny L. S. Chan ◽  
Shirley L. Wong
Keyword(s):  
Primary Care ◽  
Patient Care ◽  
Medication Management ◽  
Primary Care Providers ◽  
Safety Net ◽  
Direct Patient Care ◽  
Case Conference ◽  
Pharmacy Services ◽  
Care Providers ◽  
Pharmacist Services

While pharmacists have provided services in a multidisciplinary, primary care setting for decades, few publications have yet to evaluate providers’ impressions of- these services. An anonymous 14-item survey distributed to nonresident primary care providers aimed to identify clinical pharmacist services that are most and least helpful to primary care providers, identify barriers to pharmacy services, and develop recommendations to improve pharmacy services in primary care. The most important pharmacist contribution identified by providers is medication management, whereas the least important contributions are case conference, panel management, quality improvement, and transition of care. The primary reasons for referrals to pharmacists included inadequately controlled chronic diseases, poor or questionable adherence, longer visits for more in-depth discussion, and complex regimen requiring frequent monitoring or titration. Providers favored pharmacists working in direct patient care versus indirect patient care activities. Although many providers perceived no barriers to pharmacist service access, pharmacists’ presence and visibility were 2 barriers identified. Most providers preferred comprehensive to disease-specific medication management.

Primary Care Pharmacist Practice Models Shape the Comprehensive Medication Management Process

2021 ◽  
pp. 106002802110420
Author(s):  
Mary Mulrooney ◽  
Marie Smith
Keyword(s):  
Primary Care ◽  
Medication Management ◽  
Primary Care Providers ◽  
Care Providers ◽  
Practice Model ◽  
Team Members ◽  
Primary Care Settings ◽  
Practice Models ◽  
Organizational Needs ◽  
Common Understanding

Pharmacists are well positioned to collaborate with primary care providers (PCPs) to conduct comprehensive medication management (CMM). However, depending on organizational needs and pharmacist staffing resources, different pharmacist practice models have been implemented. In this commentary, we (1) describe 2 common pharmacist practice models in primary care settings, (2) explain variations in the CMM process based on 2 practice models, and (3) outline outcomes and implications of this expanded CMM process. By tailoring the CMM process to their practice model, pharmacists can follow consistent delivery of CMM services to create a common understanding among patients, PCPs, and other care team members.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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