Improving adherence to guidelines for spine pain care: what tools could support primary care clinicians in conforming to guidelines?

Background: Spine pain is one of the most common conditions seen in primary care and is often treated with ineffective, aggressive interventions, such as prescription pain medications, imagery and referrals to surgery. Aggressive treatments are associated with negative side effects and high costs while conservative care has lower risks and costs and equivalent or better outcomes. Despite multiple well-publicised treatment guidelines and educational efforts recommending conservative care, primary care clinicians (PCCs) widely continue to prescribe aggressive, low-value care for spine pain.

The combination of collaborative drug therapy management and E-prescribing.

Many discussions regarding electronic prescribing (E-prescribing) continue to focus on "who" should be responsible for building the communication platform: retail pharmacy or managed care. National pharmacy practice experts were interviewed to discuss a broader question: Given the potential for E-prescribing to reduce medication errors and improve communication between pharmacists and physicians, and given the increasing trend toward formal arrangements between pharmacists and physicians to establish collaborative drug therapy management (CDTM) practice settings, what are the implications for the practice of pharmacy? Specifically, how can technology for E-prescribing assist in the expansion of CDTM opportunities for the pharmacy profession?

Functional status and somatization as predictors of medical offset in anxious and depressed patients.

Objective: Certain anxious/depressed primary care patients decrease medical utilization after mental health treatment. Previous research has established demo-graphic and medical comorbidities as distinguishing these patients. We asked whether characteristics such as symptom severity, somatization, or health-related quality of life (HRQoL) could also distinguish patients who reduce or increase primary care utilization after mental health care.

A second and more promising round of E-health enterprises.

After several years of false starts and failed enterprises, E-medicine is starting to generate practical applications in health care. The new generation of E-businesses is benefiting from the dot-com bust, which has driven away expectations of high financial returns from enterprises based on overblown, ill-fitting models taken from non-health care industries. The more successful new models are adapted to hospital operations and practice patterns, and are backed by money and management indigenous to medicine.