Family practice
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Medication for opioid use disorder (MOUD) is the management of opioid use disorder (OUD) on an outpatient basis with buprenorphine or buprenorphine/naloxone (or methadone, which is limited to federally certified opioid treatment programs). Primary care practices are well poised to provide comprehensive care for patients with OUD, including provision of MOUD. The aim of this study was to assess provider and staff OUD attitudes and role perceptions before and after implementation of a MOUD clinical service line. ⋯ There was no change in the role legitimacy domain. Implementation of a primary care-based MOUD service line positively affected provider and staff motivation, attitudes, satisfaction, sense of safety, role support, and adequacy when working with patients with OUD. This highlights the benefits of MOUD-specific clinical support to optimize care delivery within primary care.
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Self-care is crucial in the prevention and treatment of chronic diseases. It is important to identify patients who need support with self-care. ⋯ SCPI seems to identify individuals with different levels of preparedness in self-care. This provides means for health care providers to individualize the levels of support and counselling. SCPI seems to be a promising tool in primary health care but needs further validation before use in large scale trials or clinical practice.
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Little is known about how variation in the scheduled length of primary care visits can impact patients' patterns of health care utilization. ⋯ PCPs' choices about the scheduled length of in-person visits may impact their patients' specialty care use, and have varying impacts across different racial/ethnic groups.
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Pregnancy complications can impact the mother and child's health in the short and longterm resulting in an increased risk of chronic disease later in life. Telomere length is a biomarker of future cardiometabolic diseases and may offer a novel way of identifying offspring most at risk for future chronic diseases. ⋯ GPs were generally supportive of potential telomere screening in infants, particularly via a saliva test that could be embedded in current antenatal care. However, several challenges, such as lack of knowledge, ethical considerations, and time and financial constraints, need to be overcome before such a test could be implemented into practice.