Primary care physician attitudes and perceptions of the impact of FDA-proposed REMS policy on prescription of extended-release and long-acting opioids.

With increasing numbers of patients experiencing chronic pain, opioid therapy is becoming more common, leading to increases in concern about issues of abuse, diversion, and misuse. Further, the US Food and Drug Administration recently released a statement notifying sponsors and manufacturers of extended-release and long-acting opioids of the need to develop Risk Evaluation and Mitigation Strategies (REMS) programs in order to ensure that the benefits of this therapy choice outweigh the potential risks. There is little research on physician opinions concerning opioid-prescribing and education policies.

Understanding the factors that influence the adoption and meaningful use of social media by physicians to share medical information.

Background: Within the medical community there is persistent debate as to whether the information available through social media is trustworthy and valid, and whether physicians are ready to adopt these technologies and ultimately embrace them as a format for professional development and lifelong learning.

Objective: To identify how physicians are using social media to share and exchange medical information with other physicians, and to identify the factors that influence physicians' use of social media as a component of their lifelong learning and continuing professional development.

Methods: We developed a survey instrument based on the Technology Acceptance Model, hypothesizing that technology usage is best predicted by a physician's attitudes toward the technology, perceptions about the technology's usefulness and ease of use, and individual factors such as personal innovativeness.

Communication gaps between physicians and patients with postherpetic neuralgia: results from a national study on practice patterns.

Background: The purpose of this study was to identify differences in perceptions of care regarding postherpetic neuralgia, including communication patterns between patients and physicians and levels of satisfaction with therapies and care.

Methods: A survey was developed for physicians (neurologists, internists, and family physicians) and patients with postherpetic neuralgia in order to determine their perspectives on its management.

Results: A total of 142 eligible patient respondents were included in the study, and responses were compared with those of 150 primary care physicians and 76 neurologist respondents.

Primary care physician attitudes and practice patterns in the management of obese adults: results from a national survey.

Purpose: Obesity remains a serious public health problem. The purpose of this study was to identify the current attitudes and practices of primary care physicians (PCPs) with respect to obesity.

Methods: A survey was systematically developed and administered electronically to PCPs, who received a small honorarium for their time.

Attitudes toward management of decreased sexual desire in premenopausal women: a national survey of nurse practitioners and physician assistants.

Recent studies have determined that low sexual desire affects between one quarter to one third of adult premenopausal women, leading to distress. The prevalence of distress from low desire may suggest management gaps in the clinicians managing these patients, as recent studies have shown a reluctance to discuss sexual concerns. A survey based on the Theory of Planned Behavior, a predictive model linking attitudes and behavior, was designed to determine what factors influenced behavioral intent and behavior of nurse practitioners and physician assistants when managing decreased sexual desire and sexual concerns in premenopausal women.

Barriers to adherence to chronic obstructive pulmonary disease guidelines by primary care physicians.

Purpose: Even with the dissemination of several clinical guidelines, chronic obstructive pulmonary disease (COPD) remains underdiagnosed and mismanaged by many primary care physicians (PCPs). The objective of this study was to elucidate barriers to consistent implementation of COPD guidelines.

Patients And Methods: A cross-sectional study implemented in July 2008 was designed to assess attitudes and barriers to COPD guideline usage.

Effectiveness of INROADS into pain management, a nursing educational intervention.

Nurses play a critical role in managing a patient's pain, from initial evaluation to ongoing patient education. However, little information exists on current gaps in nurses' knowledge and their pain-related decision making. To this end, an educational intervention-the INROADS initiative-was designed to improve the knowledge of nurses involved in patient management as well as to guide them toward practices that are consistent with currently available evidence.

Management of female sexual problems: perceived barriers, practice patterns, and confidence among primary care physicians and gynecologists.

Introduction: Although approximately 40% of women report female sexual problems--and particularly sexual desire disorders, there are numerous practical, professional, and personal barriers to their diagnosis and management by treating clinicians.

Aim: To identify practice patterns, perceptions, and barriers to the diagnosis and management of female sexual problems among U.S.

Practice patterns and guideline adherence of medical oncologists in managing patients with early breast cancer.

Background: Studies of adherence to breast cancer guidelines have often focused on primary therapies, but concordance with other guideline recommendations has not been examined as extensively. This study assesses the knowledge and practice patterns of medical oncologists in the United States to inform education and quality improvement initiatives that can improve breast cancer care.

Methods: A survey containing case vignettes and related questions was developed to examine oncologists' clinical decision-making in evaluating and treating women with early breast cancer.

Improving the physician-patient cardiovascular risk dialogue to improve statin adherence.

Background: The purpose of this study was to evaluate the effectiveness of a patient education program developed to facilitate statin adherence.

Methods: A controlled trial was designed to test the effectiveness of a multifaceted patient education program to facilitate statin adherence. The program included a brief, in-office physician counseling kit followed by patient mailings.

Men's sexual health: evaluating the effectiveness of print- and PDA-based CME.

Introduction: Personal digital assistant (PDA)-based continuing medical education (CME) activities have become widely available.

Aims: To evaluate the effectiveness of print- and PDA-based CME materials in erectile dysfunction (ED).

Methods: CME materials describing links between ED and comorbid medical conditions, effects of certain lifestyle modifications on ED, and treatment of ED with phosphodiesterase 5 (PDE5) inhibitors were distributed as a print supplement and as electronic modules, viewed with PDAs.

Hospital strategic preparedness planning: the new imperative.

Strategic preparedness planning is an important new imperative for many hospitals. Strategic preparedness planning goes beyond traditional product/market strategic planning by focusing on disaster prevention, containment, and response roles. Hospitals, because of their unique mission, size, complexity, the types of materials they handle, and the types of patients they encounter, are especially vulnerable to natural and human-initiated disasters.

Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events.

Background: Adherence to clinical practice guidelines for management of cardiovascular disease (CVD) is suboptimal. The purposes of this study were to identify practice patterns and barriers among U.S.

Market effects on electronic health record adoption by physicians.

Background: Despite the advantages of electronic health record (EHR) systems, the adoption of these systems has been slow among community-based physicians. Current studies have examined organizational and personal barriers to adoption; however, the influence of market characteristics has not been studied.

Purpose: The purpose of this study was to measure the effects of market characteristics on EHR adoption by physicians.

Enhancing COPD management in primary care settings.

Context: Primary care physicians provide care for the majority of patients with mild-to-moderate chronic obstructive pulmonary disease (COPD). Although clinical practice guidelines have been developed for COPD, their influence on primary care practice is unclear.

Objective: To examine primary care decision making, perceptions, and educational needs relating to COPD.

A standardized approach to assessing physician expectations and perceptions of continuing medical education.

Introduction: Rapidly expanding science and mandates for maintaining credentials place increasing demands on continuing medical education (CME) activities to provide information that is current and relevant to patient care. Quality may be seen as the perceived level of service measured against consumer expectations. Standard tools have not been developed to determine how well CME activities meet consumer expectations.

Effective media communication of disasters: pressing problems and recommendations.

Background: Public health officials and journalists play a crucial role in disseminating information regarding natural disasters, terrorism and other human-initiated disasters. However, research suggests that journalists are unprepared to cover terrorism and many types of natural disasters, in part because of lack sufficient expertise in science and medicine and training. The objective of this research was to identify solutions to problems facing journalists and public health public information officer (PIOs) of communicating with the public during natural and human-initiated disasters.

Evaluation of an online bioterrorism continuing medical education course.

Introduction: Much of the international community has an increased awareness of potential biologic, chemical, and nuclear threats and the need for physicians to rapidly acquire new knowledge and skills in order to protect the public's health. The present study evaluated the educational effectiveness of an online bioterrorism continuing medical education (CME) activity designed to address clinical issues involving suspected bioterrorism and reporting procedures in the United States.

Methods: This was a retrospective survey of physicians who had completed an online CME activity on bioterrorism compared with a nonparticipant group who had completed at least 1 unrelated online CME course from the same medical school Web site and were matched on similar characteristics.

Chlamydia screening of at-risk young women in managed health care: characteristics of top-performing primary care offices.

Objectives: Despite effective approaches for managing chlamydial infection, asymptomatic disease remains highly prevalent. We linked administrative data with physician data from the American Medical Association physician survey to identify characteristics of primary care offices associated with best chlamydia screening practices.

Study: Criteria from the National Committee for Quality Assurance provided chlamydia screening rates.

Using email reminders to engage physicians in an Internet-based CME intervention.

Background: Engaging practicing physicians in educational strategies that reinforce guideline adoption and improve the quality of healthcare may be difficult. Push technologies such as email offer new opportunities to engage physicians in online educational reinforcing strategies. The objectives are to investigate 1) the effectiveness of email announcements in engaging recruited community-based primary care physicians in an online guideline reinforcement strategy designed to promote Chlamydia screening, 2) the characteristics of physicians who respond to email announcements, as well as 3) how quickly and when they respond to email announcements.

Developmental defects observed in hypomorphic anaphase-promoting complex mutants are linked to cell cycle abnormalities.

In C. elegans, mutants in the anaphase-promoting complex or cyclosome (APC/C) exhibit defects in germline proliferation, the formation of the vulva and male tail, and the metaphase to anaphase transition of meiosis I. Oocytes lacking APC/C activity can be fertilized but arrest in metaphase of meiosis I and are blocked from further development.