Objective: Clinical review of a prescription drug monitoring program (PDMP) is considered a valuable tool for opioid prescribing risk mitigation; however, PDMP use is often low, even in states with mandatory registration and use policies. The objective was to evaluate the impact of an academic detailing (AD) outreach intervention on PDMP use among primary care prescribers.
Methods: AD intervention was delivered to primary care based controlled substance prescribers (N = 87) and their associated PDMP delegates (n = 42) by a clinical pharmacist as 1 component of a large-scale, statewide initiative to improve opioid prescribing safety. Prescriber PDMP use behavior was assessed by prescriber self-report and analysis of objective 2016-2018 PDMP data regarding the number of monthly report requests. We compared means between pre- and postintervention using a paired t test and plotted the monthly average reports over time to assess the trend of mean reports over time. Generalized linear mixed model with a negative binomial distribution was used to assess the difference in the trend and magnitude of the combined count of reports for the entire sample and prescriber subsets that were segmented on the basis of the adoption status of PDMP.
Results: The monthly mean of reports by combined prescribers and delegates significantly increased after the AD intervention (mean 28.1 pre vs. 53.0 post; P < 0.001), with the increase in delegate reports (mean 17.1 pre vs. 60.0 post; P < 0.001) driving the overall increase. Reports were requested 40.4 times more often than in the preintervention period (P < 0.001). Patterns of pre- to postchanges in mean monthly report requests differed by baseline PDMP adoption status.
Conclusion: The AD intervention was transformative in facilitating practice change to use delegates to run reports. Visits with both prescribers and delegates, including hands-on PDMP training and registration assistance, can be viewed as beneficial for practice facilitation.
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http://dx.doi.org/10.1016/j.japh.2021.02.019 | DOI Listing |
Am J Hosp Palliat Care
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Graduate School of Medicine, Mie University, Tsu, Japan.
Background: Delirium is a condition characterized by an acute and transient disturbance in attention, cognition, and consciousness. It is increasingly prevalent at the end of life in patients with cancer. While non-pharmacological nursing interventions are essential for delirium prevention, their effectiveness in terminally ill patients with cancer remains unclear.
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January 2025
Departments of1Neurosurgery.
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View Article and Find Full Text PDFJ Med Internet Res
January 2025
Cancer Rehabilitation and Survivorship, Department of Supportive Care, Princess Margaret Cancer Centre, Toronto, ON, Canada.
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PLoS One
January 2025
Department of Nursing, College of Medicine, Chosun University, Gwangju, Republic of Korea.
Background: Person-centered care focuses on individualized care that respects patients' values, preferences, and autonomy. To enhance the quality of critical care nursing, institutions need to identify the factors influencing ICU nurses' ability to provide person-centered care. This study explored the relationship between clinical judgment ability and person-centered care among intensive care unit (ICU) nurses, emphasizing how the ICU nursing work environment moderates this relation.
View Article and Find Full Text PDFPLoS One
January 2025
School of Primary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, United Kingdom.
The concept of 'resilience' is pervasive, permeating academic disciplines and political discourses. This paper considers (i) the construal of 'resilience' in the contexts of food insecurity and cost-of-living in governmental discourses in the United Kingdom (UK); (ii) to what extent the political representations are reflected in research funding calls of UK national funding bodies, thus showing possibility of shaping research agendas; and (iii) to what extent official uses of 'resilience' reflect lay understandings. We are combining a corpus-based discourse analysis of UK governmental discourses and research funding calls with a study of focus group discussions.
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