Frequency of Cannabis Use Among Primary Care Patients in Washington State

Lapham, Gwen T.; Lee, Amy K.; Caldeiro, Ryan M.; McCarty, Dennis; Browne, Kendall C.; Walker, Denise D.; Kivlahan, Daniel R.; Bradley, Katharine A.

doi:10.3122/jabfm.2017.06.170062

Cited by 38 publications

(50 citation statements)

References 43 publications

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“…Study details are described in a prior study of the prevalence of cannabis use in primary care. 6 Briefly, Kaiser Permanente Washington, a large health system in Washington State where medical and nonmedical cannabis use is legal, implemented annual behavioral health screening, including a single-item about the frequency of past-year cannabis use, in three primary care sites beginning March 2015. Data are from electronic health record (EHR) and claims.…”

Section: Methodsmentioning

confidence: 99%

“…Other behavioral health conditions identified by screening included depression symptoms (Patient Health Questionnaire-2 [PHQ-2]; ≥ 2 points on either item), unhealthy alcohol use (Alcohol Use Disorders Identification Test-Consumption [AUDIT-C]; ≥ 3 points women; ≥ 4 men), and any illicit drug use and/or medication misuse. 6 Other conditions assessed in the year prior to the screen included EHR-documented tobacco use and composite indicators for both mental health and substance use disorder diagnoses derived from EHRdocumented International Classification of Disease 9/10 codes. 6 Sample characteristics, including the unadjusted prevalence of behavioral health conditions, were calculated.…”

Section: Methodsmentioning

confidence: 99%

“…6 Other conditions assessed in the year prior to the screen included EHR-documented tobacco use and composite indicators for both mental health and substance use disorder diagnoses derived from EHRdocumented International Classification of Disease 9/10 codes. 6 Sample characteristics, including the unadjusted prevalence of behavioral health conditions, were calculated. The age-and gender-adjusted prevalence of behavioral health conditions across three levels of cannabis use frequency was estimated from logistic regression models.…”

Section: Methodsmentioning

confidence: 99%

“…1,2 Individuals who use cannabis have increased risk of behavioral health conditions, including depression, anxiety, and tobacco, alcohol, and other substance use disorders, [3][4][5] but little is known about the association between frequency of cannabis use and behavioral health conditions among primary care patients. This population-based study of primary care patients 6 reports on the prevalence of common behavioral health conditions across cannabis use frequency.…”

Section: Introductionmentioning

confidence: 99%

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Prevalence of Behavioral Health Conditions Across Frequency of Cannabis Use Among Adult Primary Care Patients in Washington State

et al. 2018

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Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Prevalence of Behavioral Health Conditions Across Frequency of Cannabis Use Among Adult Primary Care Patients in Washington State

et al. 2018

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“…Lapham et al 14 report on the frequency of admitted cannabis use in a primary care office and finds use was higher in younger men and associated with mental health disorders and smoking. Of note, this article is from Kaiser Permanente Washington, which is implementing routine questions on marijuana use as part of behavioral health screening for primary care patients.…”

Section: A New Type Of Pain Consult Service Opioids Used For Low Bacmentioning

confidence: 99%

Multiple Practical Facts and Ideas to Improve Family Medicine Care

Bowman¹,

Seehusen

Neale³

2017

J Am Board Fam Med

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Seconds count in a study on the best electronic health note format to reduce medical record charting time and increase accuracy. Directly observed family physician work is compared with Current Procedural Terminology (CPT) coding examples and notably under-recognized. This issue contains articles from single practices that that implemented new methods of care and other reports on practice innovations that can be more broadly implemented. We have articles on opioid medication use for acute low back pain in primary care, an electronic chronic pain consult service, a key question to identify potential opioid misuse risk, and newly implemented screening for other substances of abuse. Omissions (or gaps) in care are also highlighted: from the common types of omissions identified by primary care clinicians, self-reported low levels of substance use screening by family medicine prenatal care providers, and inadequate and inadequately available hospital discharge summaries. In addition, the most important alarm symptoms for a cancer diagnosis are reported. Seconds Count-How to Improve Electronic Health Records, and Thus Physicians' LivesIn the category of useful and practical, and some potential relief from the electronic health record (EHR) frustrations blamed for physician burnout, Belden et al 1 compared different EHR note formats (including some novel prototypes) by several excellent methods (audio, computer-screen activity, eye tracking, and field notes). The authors measured the actual time-on-task, as well as accuracy and effort. A reminder is that the few seconds' difference between the formats can add up quickly across many charts and visits. Some notes were collapsible in design. The proposed note prototypes performed better than the traditional Subjective, Objective, Assessment, Plan (SOAP) note format for speed, accuracy, and usability. It is worth looking at the appendices to see the actual note formats. Here's to having many individuals show this article to their EHR vendor! Care Innovation Reports from Single Family Medicine OfficesIn our lead article, Schwartz et al 2 discusses incorporating pharmacogenetics into a family practice for making medication decisions. A pharmacist completed medication reconciliation with patients taking a large number of medications and reviewed the completed pharmacogenetic testing, then made recommendations to the physician for medication changes. Drug-gene interactions were found a quarter of the time. In practice, I (MAB) have received pharmacogenetic reports ordered by psychiatrists for patients who have tried many different antidepressants without sufficient success. The reports seem to be useful for medication selection, but the full outcomes of pharmacogenetics on patient care are far from known. Axten et al 3 report on a novel wellness group visit model for obesity. A single family physician and collaborating dietician report on the success of this model, finding that much of the weight loss was sustained through 3 years of followup. See their excellent helpful hint...

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