2225) for general payments, respectively. Receipt of research payments was associated with increased prescribing for mRCC but not CML. Similarly, when treating payments as a continuous variable, increasing amounts of general payments were associated with increased prescribing. Considering individual drugs, we found increased prescribing when receiving vs not receiving general payments for sunitinib (50.5% vs 34.4%, P = .01), dasatinib (13.8% vs 11.4%, P = .02), and nilotinib (15.4% vs 12.5%, P = .01) (Figure) but found decreased prescribing of imatinib (72.4% vs 75.5%, P = .02). Differences for sorafenib and pazopanib were not statistically significant. Research payments were not associated with statistically significant differences in prescribing for any individual drug. Results were similar when including payments specifically attributed to the drug of interest rather than all payments from the corresponding manufacturer and when changing the exposure to receipt of payments in both 2013 and 2014 (vs 2013 without respect to 2014). Our study had some limitations. These include the observational design precluding causal assessment, potential inaccuracies with Open Payments data, 5 lack of generalizability to other cancers, absence of information about the indications for the drugs, and small sample sizes for comparisons in the research payments analysis, notably for physicians receiving CML research payments. Conclusions | For 3 of the 6 cancer drugs studied, physicians who received general payments were more likely to prescribe the drug marketed by the company that made the payments. Imatinib was a notable exception; this may reflect a strategy by the manufacturer of imatinib (which also produces nilotinib) to promote switching to nilotinib before the patent expiration of imatinib in 2015.
In the pandemic of coronavirus disease 2019, virtual visits have become the primary means of delivering efficient, high-quality, and safe health care while Americans are instructed to stay at home until the rapid transmission of the virus abates. An important variable in the quality of any patient–clinician interaction, including virtual visits, is how adroit the clinician is at forming a relationship. This article offers a review of the research that exists on forming a relationship in a virtual visit and the outcomes of a quality improvement project which resulted in the refinement of a “Communication Tip Sheet” that can be used with virtual visits. It also offers several communication strategies predicated on the R.E.D.E. to Communicate model that can be used when providing care virtually.
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