Journal of general internal medicine
-
Hospitals are increasingly screening patients for social risk factors to help improve patient and population health. Intelligence gained from such screening can be used to inform social need interventions, the development of hospital-community collaborations, and community investment decisions. ⋯ Hospital patients' social needs differed between hospitals within a metropolitan area. Patients at different hospitals have different needs. Local considerations are essential in formulating social need interventions and in developing hospital-community partnerships to address these needs.
-
Editorial
Champions Among Us: Leading Primary Care to the Forefront of Opioid Use Disorder Treatment.
Despite more than a decade of investment in opioid use disorder (OUD) treatment infrastructure, the year 2020 saw the highest mortality related to opioid overdose in American history. Treatment access remains critically limited, with less than half of people living with OUD receiving any treatment. ⋯ The "clinical champions" framework is a tool that has shown promise in creating the type of mentorship and culture change necessary to expand uptake of medication-based OUD treatment among primary care providers. The early success of this model and the increased availability of tools for broad implementation warrant further investment as a means of leading primary care into a larger role in combatting the opioid addiction epidemic.
-
A study has shown that industry payments to physicians for drugs are associated not only with higher drug prescriptions but also with higher non-drug costs due to additional utilization of healthcare services. However, the association between industry payments to cardiologists for antiplatelet drugs and the costs and number of percutaneous coronary interventions they perform has not been investigated. ⋯ Industry payments to cardiologists for antiplatelet drugs were associated with both prescribing of antiplatelet drugs and the use of cardiac procedures and stents. Further research is warranted to understand whether the observed associations are causal or reflect a greater propensity for higher volume proceduralists to have relationships with industry.
-
Lifelong learning in medicine is an important skill and ethical obligation, but many residents do not feel prepared to be effective self-directed learners when training ends. The learning sciences offer evidence to guide self-directed learning, but these insights have not been integrated into a practical and actionable plan for residents to improve their clinical knowledge and reasoning. ⋯ We provide tips for residents to implement and refine their approach and discuss how residency programs can foster these routines and habits. By optimizing their scarce self-directed learning time with a training plan, residents may enhance patient care and their career satisfaction through their pursuit of clinical mastery.
-
Point-of-care antigen tests (AgTs) for the detection of severe acute respiratory syndrome coronavirus type 2 (SARS-CoV-2) enable the rapid testing of infected individuals and are easy-to-use. However, there are few studies evaluating their clinical use. ⋯ Antigen tests from NP swab samples show high sensitivity in patients with a Ct value < 20. The best clinical sensitivity can be obtained using AgTs within the first 6 days after symptom onset.