(Press-News.org) Doctor and Pharmacist Revamp Standard Processes for Ordering and Documenting Mifepristone Use
Clinical researchers at the University of Minnesota Medical School partnered with the university health system’s compliance department to create standard processes for ordering and documenting mifepristone administration, which adhere to the Risk Evaluation and Mitigation Strategy (REMS) requirements. They established a single prescriber account to represent all system prescribers who met REMS requirements, allowing for centralized ordering and distribution by the pharmacy purchasing team. This process mirrors other standard operating procedures used by the health system to purchase other medications. Establishing processes for mifepristone for early pregnancy loss accelerated integration of its use for medical abortion. As the barriers to mifepristone use are similar, regardless of indication, the new process reduced barriers to providing abortion care at a time when access has become limited throughout the Midwest.
What We Know: Mifepristone and misoprostol taken together remain the standard for medical management of early pregnancy loss (EPL) and first-trimester abortion. While misoprostol is readily available, distribution of mifepristone has been restricted, regardless of reason for its use. Despite its documented safety, mifepristone is regulated by a Risk Evaluation and Mitigation Strategy (REMS) program—a barrier for both labeled and off-label use.
What This Study Adds: Study authors created standard processes for ordering and documenting mifepristone administration that were in compliance with the new regulations restricting use of this medication. This process reduced barriers to providing both management of early pregnancy loss and first-trimester abortion care.
Streamlining the Use of Mifepristone for Early Pregnancy Loss Across a Large Health Care System Sets the Stage for Rapid Expansion of Medication Abortion Access in a Post-Roe Environment
Nicole Chaisson, MD, MPH, University of Minnesota Medical Center Residency Program, Department of Family Medicine and Community Health, University of Minnesota Medical School, St. Paul, Minnesota, and Katherine Montag Schafer, PharmD, St. John’s Hospital Family Medicine Residency Program, Department of Family Medicine and Community Health, University of Minnesota Medical School, St. Paul, Minnesota
Pre-embargo article link (Link expires at 5 p.m. EDT Sept. 25, 2023)
Permanent link
END
Doctor and pharmacist revamp standard processes for ordering and documenting mifepristone use
Streamlining the use of mifepristone for early pregnancy loss across a large health care system sets the stage for rapid expansion of medication abortion access in a post-roe environment
2023-09-25
ELSE PRESS RELEASES FROM THIS DATE:
Screening for adverse childhood experience can improve trauma-informed care, though time constraints and limited referral resources present challenges
2023-09-25
Screening for Adverse Childhood Experience Can Improve Trauma-Informed Care, Though Time Constraints and Limited Referral Resources Present Challenges
Researchers conducted a qualitative evaluation in five clinics in Los Angeles County to understand physician and clinical staff perspectives on the implementation of routine Adverse Childhood Experience (ACE) screening in pediatric primary care. The researchers employed focus group discussions with 125 clinic staff involved in ACE screening, including frontline staff who administer ...
Understanding parents’ care expectations for a child with gastroenteritis could prevent after-hours care requests
2023-09-25
Understanding Parents’ Care Expectations for a Child With Gastroenteritis Could Prevent After-Hours Care Requests
Researchers from the Netherlands conducted a qualitative study to explore parental motivations, expectations, and experiences of off-hours primary care contacts for children with acute gastroenteritis. They conducted 14 semistructured interviews with parents who contacted primary care physicians outside of normal operating hours seeking medical attention for their children. Parents were more likely to contact their primary care physician after hours when their ...
Learning collaborative promotes mifepristone education and utilization training in federally qualified health centers
2023-09-25
Learning Collaborative Promotes Mifepristone Education and Utilization Training in Federally Qualified Health Centers
Researchers created a learning collaborative that included implementing an intervention titled, “Excellence in Providing Access to New Directions in Mifepristone Use (ExPAND Mifepristone)” in two Chicago-area Federally Qualified Health Centers with a focus on enhancing educational and training support services for primary care doctors and staff to use mifepristone for miscarriage management and abortion provision.
Prior to program implementation, clinicians and staff had little knowledge of mifepristone. After program ...
Men who trust their doctors, receive adequate time and general information about prostate cancer screening are more likely to have productive discussions
2023-09-25
Men Who Trust Their Doctors, Receive Adequate Time and General Information About Prostate Cancer Screening Are More Likely to Have Productive Discussions
Members of the University of Ottawa Department of Family Medicine conducted a scoping review to understand men’s communication preferences when they discuss prostate cancer screening with their doctors. Researchers analyzed a total of 29 studies and identified four main themes: men preferred that their doctors use everyday language; men wanted more information; men wanted the doctor to spend adequate time with them to explain prostate cancer; and desired a trusting and respectful relationship with their doctor. Three additional themes ...
Study identifies patient and clinician-level characteristics associated with sexual history screening administration
2023-09-25
Study Identifies Patient and Clinician-Level Characteristics Associated With Sexual History Screening Administration
Researchers conducted a mixed methods study that investigated patient- and clinician-level characteristics associated with a sexual history screening (SHS). Participants included 53,246 patients and 56 clinicians from 13 clinical sites. Less than half (42.41%) of patients had any SHS documentation. Gay and lesbian patients; patients who were cisgender women; and patients whose doctors were cisgender women had significantly higher odds of having any SHS documented in their medical chart. Conversely, older patients; patients whose doctors have more patients on their ...
Researchers identify important strategies for diabetes care and quality improvements in the primary care setting
2023-09-25
Researchers Identify Important Strategies for Diabetes Care and Quality Improvements in the Primary Care Setting
This qualitative study considers how the strategies used by high-performing primary care practices to improve diabetes care might play a role in successfully managing practice change. The research team conducted semistructured interviews at 10 Minnesota primary care practices (rural and urban) ranked in the top quartile of diabetes care improvement per their Optimal Diabetes Care (ODC) scores. (Minnesota’s ODC scores are calculated based on mandatory ...
Attentiveness to resting leg cramps may afford greater insight into advancing age and declining health
2023-09-25
Attentiveness to Resting Leg Cramps May Afford Greater Insight Into Advancing Age and Declining Health
Researchers developed and conducted a cross-sectional survey to examine the prevalence and characteristics of leg cramps in 294 primary care patients (with a mean age of 46.5 years), with 51.7% reporting leg cramps. Patients who experience resting or exercise-induced leg cramps were more likely to be older (mean age 49.1 years) and female (which comprised 69% of surveyed participants and 72% of the ...
Staffing challenges and general time constraints may harm primary care teams’ ability to implement quality improvement efforts
2023-09-25
Researchers aimed to identify factors leading primary care practice personnel to decline participation in quality improvement (QI) projects, and strategies to improve the feasibility and attractiveness of QI projects in the future. Representatives from 31 practices agreed to participate in the study. Overwhelmingly, respondents said that staff turnover, staffing shortages, and general time constraints, exacerbated by the COVID-19 pandemic, prevented participation in QI projects. Challenges with electronic health records (EHR); an expectation for greater financial compensation for participation; and confidence in the practices’ current care ...
Primary care investigators, clinicians, patients and community members reflect on NAPCRG’s 50 years of leadership and service
2023-09-25
Primary Care Investigators, Clinicians, Patients and Community Members Reflect on NAPCRG’s 50 Years of Leadership and Service
A team of primary care investigators, clinicians, learners, patients, and community members reflected on the North American Primary Care Research Group (NAPCRG) as it passed a 50-year milestone at its 2022 meeting. NAPCRG was started in 1972 by a small group of general practice researchers in the US, Canada, and the UK. It has evolved into an international, interprofessional, interdisciplinary, and intergenerational group devoted to improving health and health care through primary care research. The authors of the special report write that NAPCRG provides ...
September/October Annals of Family Medicine 2023 tip sheet
2023-09-25
Transgender Persons Face Challenges When Seeking Clinical Care, Including Decisions About What Information to Disclose and Risk of Substandard Care
Researchers conducted a qualitative study to investigate transgender people’s experiences with sharing health information in clinical encounters. They held seven qualitative focus groups with 30 transgender adults living in North America. Four themes emerged: 1) Transgender people often perceive clinicians’ questions as voyeuristic, stigmatizing, or self-protective; 2) Patients describe being pathologized, denied, given substandard care, or harmed when clinicians ...
LAST 30 PRESS RELEASES:
How does chemotherapy disrupt circadian rhythms?
A new bystander effect? Aggression can be contagious when observing it in peers.
Do you see what I see? People share brain responses for colors.
Blood test could streamline early Alzheimer's detection
New and simple detection method for nanoplastics.
Young children are not the main drivers of language change
Tarlatamab with anti-PD-L1 as first-line maintenance after chemo-immunotherapy for ES-SCLC demonstrates acceptable safety profile and unprecedented overall survival
GLP-1 RAs and cardiovascular and kidney outcomes by body mass index in type 2 diabetes
Ambient air pollution and the severity of Alzheimer disease neuropathology
Ocean warming puts vital marine microbe Prochlorococcus at risk
Nicotine pouches may offer path to reduced tobacco harm, Rutgers study finds
Duke-NUS study reveals how dengue rewires the immune system, reshaping vaccine response
Dr. Gianluca Ianiro wins a prestigious grant from the European Research Council (ERC)
‘Rogue’ DNA rings reveal earliest clues to deadly brain cancer’s growth
Clinical study deepens understanding of mesothelioma and opens the door to potential treatment options
New study and major data updates expand the Kids First data ecosystem
Seaweed snare: Sargassum stops sea turtle hatchlings in their tracks
Scientists uncover key to decoupling economic growth from pollution in developing countries
Frailty fuels gut imbalance and post-surgery gastrointestinal risks
BMS-986504 demonstrates durable responses in MTAP-deleted NSCLC, including EGFR and ALK-positive tumors
Phase III trial finds hypofractionated radiotherapy with chemotherapy offers comparable survival and lower toxicity to conventional schedule in LS-SCLC
Lung cancer screening benefits adults up to age 80 if surgical candidates, UK study finds
Video assisted thoracoscopy surgery reduces mortality by 21 percent compared to lobectomy
NADIM ADJUVANT trial suggests benefit of adjuvant chemo-immunotherapy in resected stage IB–IIIA NSCLC
EA5181 phase 3 trial finds no OS benefit for concurrent and consolidative durvalumab vs consolidation alone in unresectable stage 3 NSCLC
Training to improve memory
Are patients undergoing surgery for early-stage cancer at risk of persistent opioid use?
Black youth, especially Black girls, use mental health services less than their White peers
Canada must protect youth from sports betting advertising
First-in-human trial shows promising results for DLL3-targeted antibody-drug conjugate SHR-4849 in relapsed small cell lung cancer
[Press-News.org] Doctor and pharmacist revamp standard processes for ordering and documenting mifepristone useStreamlining the use of mifepristone for early pregnancy loss across a large health care system sets the stage for rapid expansion of medication abortion access in a post-roe environment