The West Virginia medical journal最新文献_第2页

Editor's Letter - One Common and Two Uncommon Medical Conditions in West Virginia 编者信-西弗吉尼亚州的一种常见和两种不常见的疾病

The West Virginia medical journal Pub Date : 2022-09-01 DOI: 10.21885/wvmj.2022.13

Linda S. Nield, MD

引用次数: 0

Prescriber Attitudes and Medication Assisted Treatment 处方态度和药物辅助治疗

The West Virginia medical journal Pub Date : 2022-09-01 DOI: 10.21885/wvmj.2022.16

Courtney A. Hereford, MSPH, MSW, Jacob Lyon, MD, Norman Montalto, DO, James Becker, MD, Todd H. Davies, PhD

{"title":"Prescriber Attitudes and Medication Assisted Treatment","authors":"Courtney A. Hereford, MSPH, MSW, Jacob Lyon, MD, Norman Montalto, DO, James Becker, MD, Todd H. Davies, PhD","doi":"10.21885/wvmj.2022.16","DOIUrl":"https://doi.org/10.21885/wvmj.2022.16","url":null,"abstract":"INTRODUCTION Increases in opioid use disorder (OUD) and the consequences to communities across the United States have resulted in a call for an increase in buprenorphine-based medication-assisted treatment (MAT) options. As legislative efforts continue to expand, it is important to understand the provider viewpoint of any such expansion. METHODS An anonymous survey was conducted in 2019 among primary care physicians, specialists, and mid-level practitioners, as well as dentists, op-tometrists, veterinarians, and providers currently practicing in West Virginia (WV) and eligible to prescribe opioids and scheduled substances. The survey included both quantitative and qualitative items measuring provider self-reported practices, training, support, experiences, and perceptions on treatment of patients using MAT. RESULTS A significant (p<0.001) majority of providers reported the need for MAT expansion and the belief that patients with OUD benefit from MAT (2.7% response rate). Despite this acknowledged need and established efficacy of MAT, survey findings suggest that fewer providers in WV seem interested or willing to expand their practice by providing MAT without additional resources and support. DISCUSSION Despite a small response rate, the participants responses provide useful information. While recent legislation efforts to encourage expansion of treatment waivers and access have been successful, providers reported significant barriers to expanding or incorporating MAT into their practices. Current MAT practitioners report institutional and staff support as major factors in their willingness to provide MAT. The critical question remains on how best to incentivize and sustain MAT practice and remove barriers for providers to meet the growing need and improve care.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83362638","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tuberculosis Presenting as Intestinal Granulomas in a Patient from West Virginia 一例西弗吉尼亚州肺结核患者表现为肠道肉芽肿

The West Virginia medical journal Pub Date : 2022-09-01 DOI: 10.21885/wvmj.2022.18

Kristen Catherman, MD, Vishal Deepak, MD, Bathmapriya Balakrishnan, MD, Hatim Al-Jaroushi,MD

引用次数: 0

Intentional Structured Opioid Monitoring Protocol: Responsible and Viable Opioid Deprescribing 有意结构化阿片类药物监测方案:负责任和可行的阿片类药物处方

The West Virginia medical journal Pub Date : 2022-09-01 DOI: 10.21885/wvmj.2022.15

Adam M. Franks, MD, Kevin S. McCann, MD, Kimberly Velthouse, MD, MPH, MBA, Rich Sutphin, MPH, Stephen M. Petrany, MD

{"title":"Intentional Structured Opioid Monitoring Protocol: Responsible and Viable Opioid Deprescribing","authors":"Adam M. Franks, MD, Kevin S. McCann, MD, Kimberly Velthouse, MD, MPH, MBA, Rich Sutphin, MPH, Stephen M. Petrany, MD","doi":"10.21885/wvmj.2022.15","DOIUrl":"https://doi.org/10.21885/wvmj.2022.15","url":null,"abstract":"INTRODUCTION Primary care providers are increasingly called to address the problem of treatment of non-malignant chronic pain with opioids, particularly in low resource areas. An Intentional Structured Opioid Management Protocol (ISOMP) is a primary care-based program shown to significantly decrease opioid burden. The development of sustainable programs that improve opioid-related outcomes is especially important in these low resource areas. METHODS A retrospective electronic health record review was conducted for financial data and billing practices for a cohort engaged in the ISOMP between 2011 and 2014. Data was analyzed for sustainability within macroscopic practice-wide and microscopic daily scopes. Further analysis was conducted on the implications of patients maintained on (Group A) and weaned from (Group B) opioids. Data was analyzed with STATA software. RESULTS ISOMP demonstrated decreased patient encounters numbers (-7.38%), increased total work relative value unit (RVU) (+7.73%), reduced no-show visits (-12.14%), and increased total reimbursement (+13.06%). Group A had fewer encounters (-6.41%) and increased work RVU (+42.95%). Group B had fewer encounters (-24.04%) but decreased work RVU (-17.56%). Significant decreases in encounters (-44.99%) and work RVUs (-47.39%) were seen after discontinuation of opioids. CONCLUSIONS Besides its previously documented opioid discontinuation rate, the ISOMP model was associated with fewer visits and better visit compli-ance. Sustainability was proven as neither global practice nor daily productivity was negatively impacted. Time-based coding for Group A offset losses seen in Group B productivity with savings directly related to speed of opioid wean","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"41 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82013893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Delayed Complete Chorioamniotic Membrane Separation in the Third Trimester Following a Motor Vehicle Collision 机动车碰撞后妊娠晚期绒毛膜-羊膜完全分离的延迟

The West Virginia medical journal Pub Date : 2022-09-01 DOI: 10.21885/wvmj.2022.17

Katherine R. Addicott, MD, Jesse N. Cottrell, MD

引用次数: 0

Impact of a Ryan White Clinic on Statewide New HIV Infections 瑞安·怀特诊所对全州新艾滋病毒感染的影响

The West Virginia medical journal Pub Date : 2022-06-01 DOI: 10.21885/wvmj.2022.11

Armaghan-e-Rehman Mansoor, MD, Arif Sarwari, MD

{"title":"Impact of a Ryan White Clinic on Statewide New HIV Infections","authors":"Armaghan-e-Rehman Mansoor, MD, Arif Sarwari, MD","doi":"10.21885/wvmj.2022.11","DOIUrl":"https://doi.org/10.21885/wvmj.2022.11","url":null,"abstract":"Introduction The Ryan White (RW) program is a cohort of services for underinsured, uninsured, and low-income patients with human immunodeficiency virus (HIV) infection. Although the RW program is known to enhance patient engagement and continuity of care, there are no studies that have investigated the direct impact of a RW clinic on statewide HIV transmission. Methods A retrospective review of 372 patients was undertaken at an HIV clinical site receiving RW funds in West Virginia (WV) in 2009-2019. Demographics, comorbid conditions, and details regarding disease acquisition were noted. In-state transmission was measured as the proportion of patients with newly diagnosed HIV who self-reported HIV acquisition within WV. With high rates of viral suppression and patient retention in our clinic, our hypothesis was that this proportion should decrease over time. Results Despite maintaining a greater than 90% retention of care and viral suppression rate over the study period, our data did not show a significant decline in the ratio of patients newly infected with HIV within WV over time (54.2% at the beginning of the study period vs 58.6% at the end, p-value 0.199). Conclusion Our results show that maintenance of high retention of care and viral suppression rates in one RW clinical site did not significantly reduce in-state transmission of HIV. Additional studies are needed to determine if maintaining high engagement in clinical services and sustained viral suppression across all HIV providers can reduce spread of in-state HIV infection.","PeriodicalId":23032,"journal":{"name":"The West Virginia medical journal","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80126043","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cervical Ganglioneuroma Presenting as a Neck Mass with Horner's Syndrome 颈神经节神经瘤表现为颈部肿块伴霍纳综合征

The West Virginia medical journal Pub Date : 2022-06-01 DOI: 10.21885/wvmj.2022.10

Erica Haught, BS, Tyler Harper, BS, Pamela Phillips, MD, Marcus Shaffer, MD

引用次数: 0

Message from the President: 2021-2022 Presidency in Review: Physician Unity Moves Medicine Through Diversity and Inclusivity 主席致辞:2021-2022年轮值主席回顾:医生团结通过多样性和包容性推动医学发展

The West Virginia medical journal Pub Date : 2022-06-01 DOI: 10.21885/wvmj.2022.8

Shafic Sraj, MD, MBA-c

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Editor's Letter: The Common Cold in the Time of COVID-19 编者按:COVID-19时期的普通感冒

The West Virginia medical journal Pub Date : 2022-06-01 DOI: 10.21885/wvmj.2022.7

Linda Nield, MD

引用次数: 0

Acute Otitis Media and Mastoiditis with Post-Auricular Abscess in a Five-Week-Old 五周大的急性中耳炎和乳突炎合并耳后脓肿

The West Virginia medical journal Pub Date : 2022-06-01 DOI: 10.21885/wvmj.2022.12

Tyler Wanstreet, BS, Marcus Shaffer, MD

引用次数: 0