ObjectiveThe objective of this project was to develop core competencies in pain assessment and management for prelicensure health professional education. Such core pain competencies common to all prelicensure health professionals have not been previously reported.MethodsAn interprofessional executive committee led a consensus-building process to develop the core competencies. An in-depth literature review was conducted followed by engagement of an interprofessional Competency Advisory Committee to critique competencies through an iterative process. A 2-day summit was held so that consensus could be reached.ResultsThe consensus-derived competencies were categorized within four domains: multidimensional nature of pain, pain assessment and measurement, management of pain, and context of pain management. These domains address the fundamental concepts and complexity of pain; how pain is observed and assessed; collaborative approaches to treatment options; and application of competencies across the life span in the context of various settings, populations, and care team models. A set of values and guiding principles are embedded within each domain.ConclusionsThese competencies can serve as a foundation for developing, defining, and revising curricula and as a resource for the creation of learning activities across health professions designed to advance care that effectively responds to pain.
Objective. To examine whether reimbursement for Provider Counseling, Pharmacotherapies, and a telephone Quitline increase smoking cessation relative to Usual Care.
Study Design. Randomized comparison trial testing the effectiveness of four smoking cessation benefits.
Setting. Seven states that best represented the national population in terms of the proportion of those ≥65 years of age and smoking rate.
Participants. There were 7,354 seniors voluntarily enrolled in the Medicare Stop Smoking Program and they were followed‐up for 12 months.
Intervention(s). (1) Usual Care, (2) reimbursement for Provider Counseling, (3) reimbursement for Provider Counseling with Pharmacotherapy, and (4) telephone counseling Quitline with nicotine patch.
Main Outcome Measure. Seven‐day self‐reported cessation at 6‐ and 12‐month follow‐ups.
Principal Findings. Unadjusted quit rates assuming missing data=smoking were 10.2 percent (9.0–11.5), 14.1 percent (11.7–16.5), 15.8 percent (14.4–17.2), and 19.3 percent (17.4–21.2) at 12 months for the Usual Care, Provider Counseling, Provider Counseling + Pharmacotherapy, and Quitline arms, respectively. Results were robust to sociodemographics, smoking history, motivation, health status, and survey nonresponse. The additional cost per quitter (relative to Usual Care) ranged from several hundred dollars to $6,450.
Conclusions. A telephone Quitline in conjunction with low‐cost Pharmacotherapy was the most effective means of reducing smoking in the elderly.
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