Background: During the COVID-19 pandemic telemedicine was rapidly expanded and incorporated into day-to-day practice by primary care providers to allow continued access to care for patients during this time. The quick adoption of telemedicine occurred out of necessity for social distancing, and evidence-based approaches are needed to determine the future utility of this approach to delivering care. The objective of this study was to identify factors associated with both provider and patient satisfaction with telemedicine visits in a primary care setting during the COVID-19 pandemic. Method: This survey-based study was conducted in 2020. Surveys were distributed electronically by e-mail to providers and patients. Participants: Surveys related to satisfaction levels with telemedicine were distributed to 73 primary care providers and 6,626 patients. Main Outcomes and Measures: The primary measures of this study were satisfaction level with telemedicine in primary care. Results: Studies were completed by 23 primary care providers and 1,692 patients. Most patient participants were female (70.8%), white (89.7%), non-Hispanic or non-Latino (96.6%), and Massachusetts residents (96.9%). Variables that were found to be significantly associated with higher levels of satisfaction with telemedicine visits included: travel time saved >30 min (odds ratio [OR] 1.8), having an easy visit connection (OR = 3.2), use of Zoomª video visit over telephone only (OR = 2.8), and identifying as female (OR 1.8). Conclusions and Relevance: Patients and providers reported high levels of satisfaction with telemedicine visits in a primary care setting. Providers felt that telemedicine visits usually take the same amount or less time than in-person visits. Both providers and patients reported a desire to see telemedicine visits continued after the pandemic. Patients who saved more than 30 min of travel time found it easy to connect or those who were female were more likely to be satisfied with telemedicine visits, while those that had telephone visits were less likely to be satisfied than those that had Zoomª visits.
Objective: We compare consensus recommendations for 5 surgical procedures to prospectively collected patient consumption data. To address local variation, we combined data from multiple hospitals across the country. Summary of Background Data: One approach to address the opioid epidemic has been to create prescribing consensus reports for common surgical procedures. However, it is unclear how these guidelines compare to patientreported data from multiple hospital systems. Methods: Prospective observational studies of surgery patients were completed between 3/2017 and 12/2018. Data were collected utilizing postdischarge surveys and chart reviews from 5 hospitals (representing 3 hospital systems) in 5 states across the USA. Prescribing recommendations for 5 common surgical procedures identified in 2 recent consensus reports were compared to the prospectively collected aggregated data. Surgeries included: laparoscopic cholecystectomy, open inguinal hernia repair, laparoscopic inguinal hernia repair, partial mastectomy without sentinel lymph node biopsy, and partial mastectomy with sentinel lymph node biopsy. Results: Eight hundred forty-seven opioid-naı ¨ve patients who underwent 1 of the 5 studied procedures reported counts of unused opioid pills after discharge. Forty-one percent did not take any opioid medications, and across all surgeries, the median consumption was 3 5 mg oxycodone pills or less. Generally, consensus reports recommended opioid quantities that were greater than the 75th percentile of consumption, and for 2 procedures, recommendations exceeded the 90th percentile of consumption. Conclusions: Although consensus recommendations were an important first step to address opioid prescribing, our data suggests that following these recommendations would result in 47%-56% of pills prescribed remaining unused. Future multi-institutional efforts should be directed toward refining and personalizing prescribing recommendations.
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