J Am Board Fam Med
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Despite evidence demonstrating that medications for opioid use disorder (OUD) reduce morbidity and mortality, the majority of patients do not receive treatment. The National Academies of Science call for more research exploring the patient's perspective of treatment modalities to increase access to individualized, patient-centered care. We aim to build on existing literature by describing patient experiences treated for OUD in a rural family medicine setting. ⋯ This research identifies ways providers can provide individualized and effective OUD treatment within the family medicine setting.
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In an age of value-based payment, primary care providers are increasingly scrutinized on performance metrics that assess quality of care, including the outcomes of their patient population in key areas such as diabetes control. Although such measures often adjust for patient clinical risk factors or clinical complexity, most do not account for the social complexity of patient populations, despite research demonstrating the strong association between social factors and health. ⋯ Providers caring for patients with greater social risk factors may benefit from having their performance metrics adjusted for the social complexity of their patient populations.
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Primary care practices are ideal sites for integrating medication-assisted treatment (MAT) for opioid use disorder, but little is known about how practices have achieved this. Our study aimed to describe the implementation experiences and treatment models of practices implementing MAT. ⋯ As the fight against the opioid epidemic continues, we need to identify feasible and effective MAT treatment models and integration approaches for primary care.
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A decade of practice transformation, consolidation, and payment experimentation have highlighted the need for team-based primary care, but little is known about how team composition is changing over time. Surveys of Family Physicians (FPs) from 2014-18 reveal they continue to work alongside inter-professional team members and suggest slow but steady growth in the proportion of FPs working with nurses, behaviorists, clinical pharmacists, and social workers.
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Widespread pain (WP) is emerging as a key comorbid condition in patients with chronic low back pain (CLBP). This study measured the prevalence of comorbid WP in adults with CLBP, WP predictors, and impact on patients. ⋯ Greater efforts are needed in primary care to help close these gaps in pain intensity, back-related disability, and quality-of-life outcomes associated with WP.