初级保健提供者向成瘾医学专家询问的电子咨询问题:回顾性内容分析。

IF 2.4 4区 医学 Q1 MEDICINE, GENERAL & INTERNAL
Cynthia Chan, Grace Zhu, Clare Liddy, Daniel T Myran, Erin Keely, Arun Radhakrishnan
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引用次数: 0

摘要

目的:确定初级保健提供者(pcp)通过尚普兰大楼通过咨询(BASE™)电子咨询(eConsult)服务访问专家,向初级保健提供者(pcp)发送的成瘾医学专家提出的临床问题的主要主题,以及pcp感知到的该服务的好处。设计:对2020年1月1日至2021年12月31日期间提交给成瘾医学专家的eConsult病例进行描述性、回顾性研究。环境:安大略省东部尚普兰地区。参与者:向成瘾药物咨询的初级保健提供者。干预措施:使用BASE™咨询服务促进pcp与成瘾医学专家之间的沟通。主要观察指标:pcp发送给成瘾医学专家的eConsult病例中问题类型和临床主题的分类,以及pcp在eConsult结束后完成的闭门调查中的回答。结果:初级保健提供者就阿片类药物(38.0%)和酒精(34.9%)寻求建议。最常见的问题类型涉及药物使用患者的药理学(77.5%)和非药理学(65.1%)管理。电子咨询最常与慢性疼痛的临床主题相关(28.7%)。超过95%的咨询结果在7个日历天内由专家回答。供应商报告发现eConsult的回复很有帮助,近三分之一的pcp报告在专家eConsult后避免了潜在的转诊。结论:本研究表明,pcp在阿片类药物和酒精的管理方面寻求建议,反映了阿片类药物危机期间受控物质处方的挑战,酒精使用障碍是加拿大最普遍的物质使用障碍。咨询服务提供了一个方便、及时和有益的过程,让pcp获得成瘾医学专家的建议。鉴于与COVID-19大流行的重叠和研究时间框架,进一步研究大流行后的结果将使研究结果具有更好的普遍性。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Electronic consultation questions asked to addiction medicine specialists by primary care providers: Retrospective content analysis.

Objective: To determine the major themes among clinical questions asked to addiction medicine specialists sent by primary care providers (PCPs) via the Champlain Building Access to Specialists through the eConsultation (BASE™) electronic consultation (eConsult) service and the PCP-perceived benefits of this service.

Design: A descriptive, retrospective study of the eConsult cases submitted to addiction medicine specialists between January 1, 2020, and December 31, 2021.

Setting: Champlain region of eastern Ontario.

Participants: Primary care providers who sent an eConsult to addiction medicine.

Interventions: The BASE™ eConsult service was used to facilitate communication between PCPs and addiction medicine specialists.

Main outcome measures: The classification of question types and clinical topics asked in eConsult cases sent to addiction medicine specialists by PCPs, and the answers in the close-out surveys completed by PCPs after eConsult was completed.

Results: Primary care providers sought advice regarding opioids (38.0%) and alcohol (34.9%). The most common question types involved pharmacologic (77.5%) and nonpharmacologic (65.1%) management of patients with substance use. Electronic consultations were most frequently related to the clinical topic of chronic pain (28.7%). Over 95% of eConsults were answered by a specialist within 7 calendar days. Providers reported finding the eConsult responses helpful, with nearly one-third of PCPs reporting a potential referral was avoided following an eConsult from specialists.

Conclusion: This study demonstrates that PCPs sought advice on management regarding opioids and alcohol, reflecting the challenges in controlled substance prescribing during an opioid crisis, with alcohol use disorder being the most prevalent substance use disorder in Canada. The eConsult service provided an accessible, timely, and beneficial process for PCPs to obtain addiction medicine specialist advice. Given the overlap with the COVID-19 pandemic and the study timeframe, further studies to examine postpandemic eConsults will allow for better generalizability of the findings.

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来源期刊
Canadian Family Physician
Canadian Family Physician 医学-医学:内科
CiteScore
2.30
自引率
9.70%
发文量
262
审稿时长
4-8 weeks
期刊介绍: Mission: Canadian Family Physician (CFP), a peer-reviewed medical journal, is the official publication of the College of Family Physicians of Canada. Our mission is to ensure that practitioners, researchers, educators and policy makers are informed on current issues and in touch with the latest thinking in the discipline of family medicine; to serve family physicians in all types of practice in every part of Canada in both official languages; to advance the continuing development of family medicine as a discipline; and to contribute to the ongoing improvement of patient care.
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