Specialized Pain Clinics in Primary Care: Common Diagnoses, Referral Patterns and Clinical Outcomes – Novel Pain Management Model

2017 ◽  
pp. 89-98 ◽  
Author(s):  
Yacov Fogelman ◽  
Eli Carmeli ◽  
Amir Minerbi ◽  
Baruch Harash ◽  
Simon Vulfsons
Keyword(s):  
Primary Care ◽  
Pain Management ◽  
Clinical Outcomes ◽  
Management Model ◽  
Referral Patterns ◽  
Pain Clinics

Presentation and Referral Patterns in Pediatric Closed Hand Fractures

Hand ◽  
2021 ◽  
pp. 155894472110085
Author(s):  
Landis R. Walsh ◽  
Laura C. Nuzzi ◽  
Amir H. Taghinia ◽  
Brian I. Labow
Keyword(s):  
Primary Care ◽  
Emergency Department ◽  
Pediatric Patients ◽  
Primary Care Providers ◽  
Care Providers ◽  
Referral Patterns ◽  
Old Patients ◽  
Hand Surgeon ◽  
Hand Fractures ◽  
The Mean

Background Although pediatric hand fractures are common and generally have good outcomes, they remain a considerable source of anxiety for non–hand surgeons, who are less familiar with these injuries. We hypothesized that this anxiety may manifest as inefficiency in referral patterns. Methods The records of pediatric patients with isolated, closed hand fractures without concurrent trauma seen at our institution by a hand surgeon between January 2017 and December 2018 were retrospectively reviewed. Results There were 454 patients included; 62.1% were men, and the mean age was 9.6 years at initial encounter. Most patients (89.6%) were treated nonoperatively and incurred few complications (0.5%). Roughly half of all cases (n = 262) initially presented to an outside provider. Of these, 24.0% (n = 64 of 262) were evaluated by 2+ providers before a hand surgeon. Most commonly, these patients were referred from an outside emergency department (ED) to our ED before hand surgeon evaluation (n = 45 of 64). Forty-seven patients required surgery; however, none were performed urgently. Although a greater proportion of 7- to 11-year-old patients saw 2+ providers prior to a hand surgeon ( P = .007), fewer required surgery ( P < .001). Conclusions Pediatric closed hand fractures are mainly treated nonoperatively and nonemergently with generally excellent outcomes. Our data suggest that many patients continue to be referred through the ED or multiple EDs/providers for treatment. These inefficient referral patterns demonstrate the need for better education for ED and primary care providers, as well as better communication between these providers and local pediatric hand surgeons. Advancements in these areas are likely to improve efficiency of care and decrease costs.

Chronic Low Back Pain Management in Primary Care

2003 ◽  
Vol 28 (8) ◽  
pp. 26-31 ◽  
Author(s):  
Kelly Phillips ◽  
Anne P.Y. Ch’ien ◽  
Barbara R. Norwood ◽  
Chris Smith
Keyword(s):  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Pain Management ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Back Pain Management

scholarly journals Assessing methods for measurement of clinical outcomes and quality of care in primary care practices

2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Michael E Green ◽  
William Hogg ◽  
Colleen Savage ◽  
Sharon Johnston ◽  
Grant Russell ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Clinical Outcomes ◽  
Care Practices ◽  
Primary Care Practices

A systems-based approach to implementing a pain management agreement system in primary care

2008 ◽  
Vol 7 (1) ◽  
pp. 27-39
Author(s):  
Catherine Florio Pipas ◽  
Rulon L Hardman ◽  
Kenton E Powell ◽  
Gillian C Jackson ◽  
Bjorn I Engstrom ◽  
...  
Keyword(s):  
Primary Care ◽  
Pain Management

scholarly journals Project ECHO and primary care buprenorphine treatment for opioid use disorder: Implementation and clinical outcomes

2021 ◽  
pp. 1-9
Author(s):  
James B. Anderson ◽  
Stephen A. Martin ◽  
Anne Gadomski ◽  
Nicole Krupa ◽  
Daniel Mullin ◽  
...  
Keyword(s):  
Primary Care ◽  
Clinical Outcomes ◽  
Opioid Use Disorder ◽  
Opioid Use ◽  
Project Echo ◽  
Buprenorphine Treatment

Impact of the New York State Prescription Drug Monitoring Program (IStop) on chronic pain management by primary care providers

2021 ◽  
Vol 17 (1) ◽  
pp. 39-54
Author(s):  
Josiah D. Strawser, MD ◽  
Lauren Block, MD, MPH
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Pain Management ◽  
Risk Reduction ◽  
New York State ◽  
Monitoring Program ◽  
Primary Care Providers ◽  
Care Providers ◽  
Reduction Strategies ◽  
Risk Reduction Strategies

Objective: To explore the impact of the New York State Prescription Drug Monitoring Program (IStop) on the self-reported management of patients with chronic pain by primary care providers.Design: Mixed-methods study with survey collection and semistructured interviews.Setting: Multiple academic hospitals in New York.Participants: One hundred and thirty-six primary care providers (residents, fellows, attendings, and nurse practitioners) for survey collection, and eight primary care clinicians (residents, attending, and pharmacist) for interviews. Interventions: Introduction of IStop.Main outcome measure(s): Change in usage of four risk reduction strategies (pain contracts, urine tests, monthly visits, and co-management) as reported by primary care providers for patients with chronic pain.Results: After the introduction of IStop, 25 percent (32/128) of providers increased usage of monthly visits, 28 percent (36/128) of providers increased usage of pain management co-management with other healthcare providers, and 46 percent (60/129) of providers increased usage of at least one of four risk reduction strategies. Residents indicated much higher rates of change in risk reduction strategies due to IStop usage; increasing in the use of monthly visits (32 vs. 13 percent, p = 0.02) and co-management (36 vs. 13 percent, p = 0.01) occurred at a much higher rate in residents than attending physicians. Interview themes revealed an emphasis on finding opioid alternatives when possible, the need for frequent patient visits in effective pain management, and the importance of communication between the patient and provider to protect the relationship in chronic pain management.Conclusions: After the introduction of IStop, primary care providers have increased usage of risk reduction strategies in the care of chronic pain patients.

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