Knowledge gaps and practice patterns of clinicians treating patients with opioid use disorder.

OBJECTIVE: The goal of the study was to assess knowledge gaps and practice patterns of US-based addiction specialists, primary care physicians (PCPs), nurse practitioners (NPs), and physician assistants (PAs) who treat patients with opioid use disorder (OUD). DESIGN: As part of a prospective study, the authors developed a survey tool consisting of case-vignettes and questions designed to reveal practice patterns and highlight gaps in clinician knowledge. SETTING: The primary study setting included clinicians practicing in outpatient care. PARTICIPANTS: The surveys were distributed via email between August and September 2017 to a national sample of addiction specialists, PCPs, and NPs/PAs that see at least one patient per week and at least 1 percent of their patient population had to be diagnosed with OUD. RESULTS: The knowledge assessment results varied among the clinicians surveyed. Addiction specialists saw more patients with OUD than PCPs, NPs, or PAs. They also demonstrated a higher level of understanding and knowledge of the various domains assessed. CONCLUSIONS: There are multiple educational intervention strategies that can support the clinicians; including reducing restrictions to access treatment for OUD, care coordination programs for patients to improve early access to treatment and education, and frequent chart audit and feedback programs to support clinician decision making and education.

Perspectives on the Use of eHealth in the Management of Patients With Schizophrenia.

Mobile devices, digital technologies, and web-based applications-known collectively as eHealth (electronic health)-could improve health care delivery for costly, chronic diseases such as schizophrenia. Pharmacologic and psychosocial therapies represent the primary treatment for individuals with schizophrenia; however, extensive resources are required to support adherence, facilitate continuity of care, and prevent relapse and its sequelae. This paper addresses the use of eHealth in the management of schizophrenia based on a roundtable discussion with a panel of experts, which included psychiatrists, a medical technology innovator, a mental health advocate, a family caregiver, a health policy maker, and a third-party payor. The expert panel discussed the uses, benefits, and limitations of emerging eHealth with the capability to integrate care and extend service accessibility, monitor patient status in real time, enhance medication adherence, and empower patients to take a more active role in managing their disease. In summary, to support this technological future, eHealth requires significant research regarding implementation, patient barriers, policy, and funding.