Differences in prescribing patterns for anxiety and depression between General Internal Medicine and Family Medicine

Brieler, Jay; Scherrer, Jeffrey F.; Salas, Joanne

doi:10.1016/j.jad.2014.09.056

Cited by 14 publications

(8 citation statements)

References 18 publications

(19 reference statements)

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“…The protocol for creating this database and its use in numerous clinical epidemiologic and health services research studies has been previously described. [27][28][29][30][31][32][33][34] The study procedures were reviewed and approved by the university Institutional Review Board (IRB).…”

Section: Subjectsmentioning

confidence: 99%

Neighborhood Socioeconomic Status and Receipt of Opioid Medication for New Back Pain Diagnosis

2017

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Background: Although treatment for new back pain is heavily guideline driven, deviations occur frequently. Neighborhood socioeconomic status (nSES) may contribute to these deviations.Objective: Determine whether nSES is associated with type of treatment provided for patients seeking treatment for new back pain in primary care clinics.Methods: This retrospective cohort was conducted in academic internal and family medicine practices. Data were examined from the Primary Care Patient Data Registry. Eligibility criteria included age >18 years, free of HIV and cancer, and presenting to primary care with a new diagnosis of back pain, resulting in1646 patients included. Patients' nSES was determined using ZIP code and calculating a validated index of 7 census-tract variables. Multinomial logistic regression was used to measure the association between nSES and 3 treatment outcomes compared with no pharmacologic management. Outcomes included opioid prescription, nonsteroidal anti-inflammatory (NSAID)/muscle relaxant prescription, or combined opioid/nonopioid treatment within 90 days of initial presentation. Covariates included age, sex, race, high clinic utilization (HCU), depression, anxiety, substance use, obesity, comorbidities, smoking, number of pain conditions, and physical therapy (PT) referral. Results: The cohort was 67.9% female with an average age of 55.72 years (Standard Error [SE] ‫؍‬ 0.387). Compared with no pharmacologic treatment, individuals in the low nSES group had 63% higher odds of receiving an opioid only compared with the high nSES group (odds ratio [OR

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Section: Subjectsmentioning

confidence: 99%

Neighborhood Socioeconomic Status and Receipt of Opioid Medication for New Back Pain Diagnosis

2017

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“…The PCPD Registry has been used in several clinical epidemiology and health services research studies, where additional details regarding the PCPD Registry are available. [13][14][15][16][17] The institutional review board approved the creation of this retrospective cohort and its use for primary care research.…”

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confidence: 99%

Higher Referrals for Diabetes Education in a Medical Home Model of Care

Manard

Syberg

Behera

et al. 2016

The Journal of the American Board of Family Medicine

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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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“…This study was limited by the sample size and self-report design. Objective assessment of BHI within FMR clinics would add validity to 2 Means with different subscripts are significantly different using Tukey's post hoc comparisons (adjusted P<0.05) 3 Chi-square test 4 Fisher exact test 5 One-way ANOVA…”

Section: Discussionmentioning

confidence: 99%

“…The Accreditation Council on Graduate Medical Education requires significant behavioral training during family medicine residency (FMR), 2 and FMR graduates deliver more BH care than other primary care specialties. 3 Despite this, BH care in primary care clinics has been limited in quality and reach. 4,5 Integration of behavioral health professionals into primary care settings is a major organizational strategy that addresses gaps in mental health care.…”

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confidence: 99%

Integrated Behavioral Health Care in Family Medicine Residencies

Jacobs

Brieler

Salas

et al. 2018

Fam Med

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Almost half of FMR programs have colocated BH care or fully integrated BH as defined by SAMHSA. Highly integrated FMRs use a diversity of behavioral professionals and activities. Residencies currently at the collaboration stage could increase BH provider types and BHI practices to better prepare residents for practice. Residencies with full BHI may consider focusing on supporting BHI-trained residents transitioning into practice, or disseminating the model in the general primary care community.

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Differences in prescribing patterns for anxiety and depression between General Internal Medicine and Family Medicine

Cited by 14 publications

References 18 publications

Neighborhood Socioeconomic Status and Receipt of Opioid Medication for New Back Pain Diagnosis

Neighborhood Socioeconomic Status and Receipt of Opioid Medication for New Back Pain Diagnosis

Higher Referrals for Diabetes Education in a Medical Home Model of Care

Integrated Behavioral Health Care in Family Medicine Residencies

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