Notes

Data-driven inferences regarding agency-level threat and also reaction communication in COVID-19 by way of interpersonal media-based interactions.
In the United States, national guidelines recommend screening adults born between 1945 and 1965 for hepatitis C, but screening rates in this population continue to be low. We added a hepatitis C screening reminder to the Epic Electronic Health Record and educated physicians on the use of the Health Maintenance section in Epic. We assessed the effect of this intervention on the completion of screening hepatitis C antibody tests. We examined data from 2 years before and after the addition of the reminder. Completed hepatitis C antibody testing increased from 733 to 6502, and the rate of positive testing decreased from 5.9% to 2.0%. Implementing the electronic health record reminder and educating providers on the routine use of the Health Maintenance section increased hepatitis C screening for at risk adults.
Emergency Department (ED) overutilization and avoidable hospital admissions have been identified as areas of improvement. Studies have shown that ensuring adequate primary care follow-up after discharge from ED is an area that can be targeted to help decrease hospitalizations.

Between April 2017 and December 2018, any family medicine patient presented by the ED for admission who was determined to be a candidate for rapid primary care follow-up, was offered a "Golden Letter." This letter guaranteed that the patient would be evaluated within 48 hours of discharge at the patient's primary care clinic. We studied the impact on reducing hospital admissions, 30-day ED revisits, and 30-day hospitalizations. Our data analysis included gender, age, and insurance status.

A total of 191 ED encounters that may have been admitted to the hospital were instead given a golden letter after shared decision making. A total of 104 (54.5%) completed a follow-up appointment within 48 hours. The 30-day ED revisit rate was 34% (65 encounters) with 33 (31.7%) of these patients having completed a follow-up visit and 32 (36.8%) did not follow up. There were 35 (18.3%) hospital admissions within 30 days of the ED visit. Of the patients admitted, 12 (11.5%) completed a follow-up visit and 23 (26.4%) did not complete a follow-up visit.

This initiative effectively reduced the number of low-acuity admissions and 30-day hospitalizations. This concept can provide a significant reduction of health care resource utilization and cost by ensuring safe ED discharge and rapid outpatient follow-up for low-acuity patients.
This initiative effectively reduced the number of low-acuity admissions and 30-day hospitalizations. https://www.selleckchem.com/products/cobimetinib-gdc-0973-rg7420.html This concept can provide a significant reduction of health care resource utilization and cost by ensuring safe ED discharge and rapid outpatient follow-up for low-acuity patients.
There is a paucity of research on awareness, education, and interventions that address increased risk of developing periodontal disease, the sixth complication of diabetes. Examining the knowledge of patients with diabetes and understanding of the bidirectional relationship between periodontal disease and diabetes could inform future diabetes self-management care. We assessed the knowledge and understanding of the bidirectional relationship between diabetes and periodontal disease; examined gender, education, and income differences in this knowledge and understanding, as well as other differences in dental hygiene practices.

A Web-based survey was conducted using a convenience sample of patients with diabetes.

A total of 927 patients with diabetes participated in the study. Gender and education were significantly associated with knowledge and understanding of the bidirectional relationship between diabetes and periodontal disease in patients with diabetes. After controlling for diabetes duration, dentalto address the needs of their diabetic patients.
Family medicine residency programs vary in the extent of training offered on opioid use disorder (OUD) in their curricula. The purpose of this study was to determine the impact of OUD education and buprenorphine waiver provision on postresidency buprenorphine prescribing patterns.

Three North Carolina family medicine residency programs differed in the extent to which they taught OUD, including buprenorphine waiver provision. Program A required OUD education and assisted residents in obtaining a waiver; Program B offered OUD education and did not assist with obtaining a waiver; and Program C did not offer OUD education. In November 2019, graduates from these 3 programs were surveyed regarding the extent to which they engaged in treatment of OUD. Descriptive statistics were used to characterize the survey participants and their responses.

Of the 62 graduates invited to participate, 49 (79.0%) responded. Across the 3 programs, the percentage of graduates with a waiver varied significantly (
 < .0001) Program A (84.2%), Program B (33.3%), and Program C (0.0%). Of those who were not waivered, Program B had a larger percentage that desired to prescribe buprenorphine products (70.0%) as compared with Program C (9.1%) (
 = .009).

Family medicine residency graduates from programs with more integrated OUD education were more likely to obtain and use a waiver to prescribe buprenorphine-containing medications postgraduation.
Family medicine residency graduates from programs with more integrated OUD education were more likely to obtain and use a waiver to prescribe buprenorphine-containing medications postgraduation.
Opioid misuse has become a national crisis. In response to the need for improved standards of opioid prescribing within medical practices, a university-based academic family medicine practice developed, implemented, and evaluated a series of initiatives to ensure appropriate opioid prescribing and support clinicians in the practice in providing optimal care.

In 2015-2018, the University of North Carolina Family Medicine Center developed and implemented a practice-wide opioid prescribing policy, created a controlled medication advisory board (CMAB), provided regular feedback to clinicians on opioid prescribing, and trained selected providers in management of opioid use disorder. The impact of these opioid stewardship initiatives on prescribing patterns, utilization of the CMAB, and provision of medications for opioid use disorder was evaluated using electronic health record data from 2015 to 2018 and chart audits.

Between 2014 and 2018 the opioid prescribing rate per 100 patient visits decreased by 31% and the rate of concomitant use of benzodiazepines and opioids decreased by 56%.
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