‘Asking’ but Not ‘Screening’: Assessing Physicians’ and Nurses’ Substance-Related Clinical Behaviors

Background: Screening, brief intervention, and referral to treatment (SBIRT) is a promising public health approach for problematic substance use. A core component of SBIRT is the use of formal screening tools to categorize a patient's likely level of risk in order to provide an appropriately-matched service. Training in formal screening is included in many SBIRT training programs, but infrequently is emphasized. Objectives: To assess pre-training levels of SBIRT-related clinical behaviors, including screening, this study examined a secondary dataset collected from internal medicine residents and graduate nurse practitioner students. Methods: Learners (n = 117) completed 13 self-report items assessing use of SBIRT-related behaviors. Researchers used exploratory factor analysis to identify underlying concepts in the questionnaire, then used mixed ANOVA to compare mean frequency of utilization of each factor (asking, screening, and intervening) by academic program. Results: Learners reported asking about substance use frequently, intervening some of the time, and infrequently using formal screening tools. Interaction and between-academic-program effects were significant but small. Conclusions: Prior to SBIRT training, most clinical practitioners reported asking patients about substance use, but few reported regularly using formal substance use screening tools. This may have implications for the importance of SBIRT training as part of curricular work, and for the internal content foci of SBIRT curricula.     

‘围城’

今年以来,关于药店的话题最热的有两个:放开药店审批和平价药店。而这两个热点之间显而易见地存在着必然的因果关联。 自去年底,各地相继解冻了“封停”两、三年的零售药店开办申请,并进一步取消距离限制,药店急剧增长的势头让业外人都咋舌惊叹。有人统计,自去年放开药店经营审批以来,广东新开药店3077家;而江苏在半年内净增药店     

Physicians’ and pharmacies’ overview of patients’ medication. An analysis of fidelity coefficients

Background  

It is essential that pharmacies and prescribers have an overview of each patient’s medication in order to prevent drug interactions, unintentional co-prescribing, unnecessary polypharmacy and underprescribing. We have assessed this overview by measuring the ‘fidelity coefficient’, a measure of the extent to which a drug user has a preference for one prescriber or one pharmacy.     

It’s time

Statistical inference involves taking the results of models and knowledge about probability to make decisions about the relationship in question. This commentary explains the usefulness of statistical inference to the drug development process, as well as some common pitfalls. It also examines reasons why statistical inference does not seem to be fully integrated into pharmacometric modeling. An example is shown that demonstrates the inferential advantages of mechanistic models. Both statisticians and pharmacometricians ought to take note of these advantages and integrate their efforts in order to maximize the decision-making potential of clinical research.     

The association between family caregivers’ involvement in managing older adults’ medications and caregivers’ information-seeking behavior

Objectives

1) To explore the association between family caregivers’ involvement in managing care recipients’ medications and their information-seeking behavior related to caregiving; and 2) to examine the sources used by caregivers when seeking information.