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Both methadone and buprenorphine are effective agents, with improved safety compared with continued nonmedical opioid use during pregnancy. There is evidence to suggest that buprenorphine should be considered as an equivalent option to methadone for use in pregnancy; however, larger studies are still needed to fully evaluate buprenorphine safety and advantages over methadone in the obstetric population.

Being African American independently increased the likelihood of referral for diabetes education in patients with prediabetes and patients with diabetes. After adjusting for patient comorbidities and risk factors, this association remained significant for patients with prediabetes. Additional research is needed to determine if provider beliefs and attitudes regarding race and diabetes education account for this association.

Background: The medical home model has been gaining attention from the health care community as a strategy for improved outcomes for management of chronic disease, including diabetes. The purpose of this study was to compare referrals for diabetes education among patients receiving care from a medical home model versus a traditional practice.Methods: Data were obtained from a large, university-affiliated primary care patient data registry. All patients (age 18 -96 years) with a diagnosis of prediabetes or diabetes and seen by a physician at least twice during 2011 to 2013 were selected for inclusion. Multivariate regression models measuring the association between medical home status and referral to diabetes education were computed before and after adjusting for covariates.Results: A significantly (P < .001) higher percentage of patients in a medical home than without a medical home (23.9% vs 13.5%) received a referral for diabetes education. After adjusting for covariates, medical home patients were 2.7 times more likely to receive a referral for diabetes education (odds ratio, 2.70; 95% confidence interval, 1.69 -4.35).Conclusion: Patients in a medical home model were more likely to receive referrals for diabetes education than patients in a standard university-affiliated family medicine practice. Future longitudinal designs that match characteristics of patients with a medical home with those of patients without one will provide strong evidence to determine whether referral to diabetes education is a result of the medical home model of care independent of confounding factors. (J Am Board Fam Med 2016;29:377-384.)

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Purpose To highlight the prevalence and impact of obesity in the United States and provide nurse practitioners (NPs) with an overview of pharmacotherapy options for treatment of overweight and obese individuals. Data source A comprehensive review of the literature was conducted using multiple databases, including PubMed, MEDLINE, and Ovid. Keywords used to obtain relevant articles included obesity and drug, or orlistat, topiramate/phentermine, lorcaserin, bupropion/naltrexone, and liraglutide. Conclusions Obesity is a prevalent disease with more than two thirds of Americans being considered overweight and one third being obese. Obesity places patients at an increased risk for many comorbidities that impact patient health as well as public health. There are currently five approved medications for the chronic management of obesity, two of which were approved in 2014. These pharmacological therapies are options to aid weight loss in patients that are obese or those who are overweight with additional risk factors. Implications for practice NPs can assist patients struggling with their weight. With new pharmacotherapy options, there is an opportunity to add to diet and exercise in order to achieve increased weight loss. A decrease in obesity would potentially alleviate the burden on the healthcare system, both socially and economically, and improve patient quality of life.

Problem Smartphone applications are an increasingly useful part of patients' self‐management of chronic health conditions. Asthma is a common chronic health condition for which good self‐management by patients is very helpful in maintaining stability. User‐centered design and intelligent systems that learn are steps forward in building applications that are more effective in providing quality care that is scalable and tailored to each patient. Methods A literature and application store search to review historic and current asthma smart phone applications. User‐centered design is a methodology that involves all stakeholders of a proposed system from the beginning of the design phase to the end of installation. One aspect of this user‐centered approach involved conducting focus groups with patients and health care providers to determine what features they desire for use in applications and create a model to build smart infrastructure for a learning health care system. A simple prototype for an asthma smartphone application is designed and built with basic functionality. Outcomes Only one publication in the literature review of asthma smartphone applications describes both user‐centered design and intelligent learning systems. The authors have presented a set of user‐desired attributes for a smart health care application and a possible data flow diagram of information for a learning system. A prototype simple user‐centered designed asthma smartphone application that better assists patients in their care illustrates the value of the proposed architecture. Discussion Our user‐centered approach helped design and implement a learning prototype smart phone application to help patients better manage their asthma and provide information to clinical care providers. While popular in other industries, user‐centered design has had slow adoption in the health care area. However, the popularity of this approach is increasing and will hopefully result in mobile application that better meets the needs of both patients and their care providers.

Faculty development is a priority for colleges and schools of pharmacy for both corporate and individual success. Recommendations in the 2008 American College of Clinical Pharmacy (ACCP) position statement and white paper on faculty development remain relevant today. However, changes in educational standards, delivery of pharmacy education, and faculty and learners have prompted an update of the 2008 documents. This 2020 white paper focuses on three components: preceptor development, updates in pharmacy practice faculty development, and program formation and implementation. The paper provides evidence and recommendations for preceptor development and summarizes the literature updates related to pharmacy practice faculty development in several areas, including teaching, practice, and research. This update explores additional topics not emphasized in the previous paper, including faculty well-being, holistic career-long development, and challenges with implementing and assessing development programs. K E Y W O R D S faculty development, pharmacy education, preceptor development