Journal of general internal medicine
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Approximately 20% of the United States' population lives in a state or jurisdiction where medical aid in dying (MAiD) is legal. It is unknown how physicians' own barriers are associated with their provision of the spectrum of MAiD services. ⋯ Approximately one-quarter of physicians likely to care for MAiD-eligible patients in Colorado reported religious and/or ethical barriers to MAiD. Despite religious and/or ethical barriers, the vast majority of physicians were willing to discuss MAiD and/or refer patients seeking MAiD services. These data provide important empirical foundation for policy from hospitals and health systems as well as medical specialty groups with official positions on MAiD.
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Inpatients with impaired decision-making capacity may attempt to leave the hospital prematurely. When no surrogate decision-maker is available, clinical teams often lack a legal basis to keep these patients. ⋯ Clinicians need explicit legal authority to temporarily detain and treat incapacitated and unrepresented patients. Physician and hospital associations should lobby state legislatures to create new statutes for medical incapacity modeled after mental health laws.
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Randomized Controlled Trial Comparative Study
Academic Detailing Compared with Group Meetings to Change Drug Prescribing for Type 2 Diabetes-A Randomized Controlled Trial.
Academic detailing (AD) is a one-on-one educational outreach with the goal to improve prescribing. There is insufficient evidence on the difference in impact between AD and group visits to facilitate behavior change among general practitioners (GPs). ⋯ Short educational visits of 20-45 min impact the prescribing of drugs for T2D, either the education is given one-on-one as AD or in a group setting.
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Multicenter Study
The Association Between Chronic Pain, Substance use, and Primary Care Experience Among Veterans with Ongoing or Recent Homelessness.
Chronic pain and problematic substance use are prevalent among Veterans with homeless experience (VHE) and may contribute to a challenging primary care experience. ⋯ Chronic pain is associated with unfavorable primary care experiences among VHE, potentially contributing to poor care outcomes. Strategies are needed to enhance patient-provider trust and communication and increase VHE's access to effective pain treatments.
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Multicenter Study
Patient and Physician Perspectives on Discussing Addiction Recovery and Spirituality in the Primary Care Setting.
Spirituality is an important component of recovery for many individuals with substance use disorder (SUD). However, few studies have compared patient and physician attitudes on spirituality in SUD recovery. ⋯ Spirituality can have diverse effects on an individual's SUD recovery. Physicians endorsed the benefits of discussing spirituality in the context of their patients' recovery, while patients expressed reservations about engaging in these conversations with their physicians. This variation in perspectives highlights the need for additional research to understand the individual and structural factors that contribute to it, as well as best practices for engaging in effective, non-judgmental conversations about spirituality in recovery.