INTRODUCTION Palliative patients with metastatic bone pain endure long waiting times and multiple visits to radiation therapy departments for treatment. This can prolong suffering and may be a factor in patients consenting for treatment. Rapid Access Palliative Clinics (RAPC) have been established around the world to provide a multidisciplinary approach to consultation, simulation and treatment...

INTRODUCTION The U.S. opioid epidemic has highlighted the need to identify patients at risk of opioid abuse and overdose. We initiated a novel emergency department- (ED) based interventional protocol to transition our superuser patients from the ED to an outpatient chronic pain program. The objective was to evaluate the protocol's effect on superusers' annual ED visits. Secondary outcomes inclu...

BACKGROUND The purpose of this study was to document the prevalence of panic states in patients presenting with chest pain in primary care settings, to determine the recognition rate of panic states by family physicians, and to assess the impact of lack of recognition on interventions and costs. METHODS Patients from the South Texas Ambulatory Research Network (STARNET) presenting with a new ...

Background Many patients are admitted to hospital with non-visible or palpable veins, often resulting in multiple painful attempts at cannulation, anxiety and catheter failure. We developed a difficult intravenous pathway at our institution to reduce the burden of difficult access for patients by increasing first attempt success with ultrasound guidance. The emphasis was to provide a solution f...

“In 2003, we had 119 total new identifications,” Todd said, referring to the number of physicians identified as candidates for PHP assistance. “That number rose to 196 in 2004 and through the first six months of 2005, we have had 103 identifications. Our needs are continuing to grow, and one of the biggest changes – a real plus – is we’re getting more self-referrals because physicians are feeli...

In this study we evaluated the effectiveness of telephone crisis services/hotlines, examining proximal outcomes as measured by changes in callers' suicide state from the beginning to the end of their calls to eight centers in the U.S. and again within 3 weeks of their calls. Between March 2003 and July 2004, 1,085 suicide callers were assessed during their calls and 380 (35.0%) participated in ...

INTRODUCTION Patients with chronic conditions can improve their health through participation in self-care programs. However, awareness of and enrollment in these programs are generally low. OBJECTIVE We sought to identify factors influencing patients' receptiveness to a referral for programs and services supporting chronic disease management. METHODS We analyzed data from 541 high-risk diab...

INTRODUCTION One in four people registered with a GP will consult for a musculoskeletal problem over a 12-month period; this accounts for one in seven GP consultations.1 Musculoskeletal conditions significantly impact daily life through pain, disability, and psychological ill-health.2,3 A rheumatology rotation is therefore a relevant and practical rotation for GP trainees to undertake. The key ...

BACKGROUND Despite the availability of clinical guidelines for the management of low back pain (LBP), there continues to be wide variation in general practitioners' (GPs') referral rates for lumbar spine x-ray (LSX). This study aims to explain variation in GPs' referral rates for LSX from their accounts of the management of patients with low back pain. METHODS Qualitative, semi-structured int...