Public sector low threshold office-based buprenorphine treatment: outcomes at year 7.

Background: Buprenorphine maintenance for opioid dependence remains of limited availability among underserved populations, despite increases in US opioid misuse and overdose deaths. Low threshold primary care treatment models including the use of unobserved, "home," buprenorphine induction may simplify initiation of care and improve access. Unobserved induction and long-term treatment outcomes have not been reported recently among large, naturalistic cohorts treated in low threshold safety net primary care settings.

Buprenorphine and methadone treatment for opioid dependence by income, ethnicity and race of neighborhoods in New York City.

Background: Geographic and demographic variation in buprenorphine and methadone treatment use in U.S. cities has not been assessed.

A better approach to opioid prescribing in primary care.

Purpose: Primary care physicians are at the center of a national prescription opioid epidemic, with little training or knowledge about the management of patients on opioids for chronic noncancer pain (CNCP). We developed an electronic medical record (EMR)-based protocol and educational intervention to standardize documentation and management of patients prescribed opioids by primary care providers. Our objective was to evaluate provider adherence to this protocol, attitudes toward the management of these patients, and knowledge of opioid prescribing.

Variation in use of buprenorphine and methadone treatment by racial, ethnic, and income characteristics of residential social areas in New York City.

National data indicate that patients treated with buprenorphine for opiate use disorders are more likely to be White, highly educated, and to have greater incomes than those receiving methadone, but patterns of buprenorphine dissemination across demographic areas have not been documented in major metropolitan areas where poverty, minority populations and injection heroin use are concentrated. Rates of buprenorphine and methadone treatment are compared among areas of New York City defined by their income and ethnic/racial composition. Residential social areas (hereinafter called social areas) were defined as aggregations of ZIP codes with similar race/ethnicity and income characteristics, and were formed based on clustering techniques.

Building a patient-centered medical home: obtaining the patient's voice.

Purpose: Many primary care practices are currently attempting to transform into patient-centered medical homes (PCMHs), but little is known about how patients view aspects of the PCMH or how they define patient-centeredness.

Methods: We conducted 3 focus groups with patients from urban academic internal medicine practices. We asked questions about patients' perceptions of what patient-centered care should be; care quality, teams and access; diabetes self-management; and community connections and services.

Obtaining patient feedback at point of service using electronic kiosks.

Background: Engaging patients in their healthcare is a goal of healthcare reform. Obtaining sufficient, reliable patient feedback about their experiences in an office encounter has been a challenge.

Objective: To determine the feasibility of collecting feedback from patients regarding their office encounter at the point of care using touch screen kiosk technology in an urban primary care clinic.

Extended-release naltrexone for treatment of alcohol dependence in primary care.

The feasibility of using extended-release injectable naltrexone (XR-NTX) to treat alcohol dependence in routine primary care settings is unknown. An open-label, observational cohort study evaluated 3-month treatment retention, patient satisfaction, and alcohol use among alcohol-dependent patients in two urban public hospital medical clinics. Adults seeking treatment were offered monthly medical management (MM) and three XR-NTX injections (380 mg, intramuscular).

Home buprenorphine/naloxone induction in primary care.

Background: Buprenorphine can be used for the treatment of opioid dependence in primary care settings. National guidelines recommend directly observed initial dosing followed by multiple in-clinic visits during the induction week. We offered buprenorphine treatment at a public hospital primary care clinic using a home, unobserved induction protocol.

Gender differences in adolescents' responses to themes of relaxation in cigarette advertising: Relationship to intentions to smoke.

Studies have shown that increased exposure to cigarette advertising increases adolescents' risk of smoking and moreover, that gender may play an important role in moderating how cigarette advertisements are viewed and processed. However, information about the particular features of cigarette advertising that interact with gender to promote smoking among adolescents is scarce. The purpose of this study was to examine if gender moderates the degree to which the relaxation valence (i.