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Item Daily Situational Brief, January 27, 2015(MESH Coalition, 1/27/2015) MESH CoalitionItem AN INVESTIGATION OF PROVIDER SELF-INSIGHT INTO THEIR CHRON-IC PAIN MANAGEMENT(Office of the Vice Chancellor for Research, 2012-04-13) Neufer, Amanda M.; Hollingshead, Nicole A.; Hirsh, Adam T.; Hirsh, AdamResearch indicates pain management varies across patient sex, race, and mental health status; however, little is known about the ex-tent to which providers are aware of these influences on their clinical decisions. This preliminary study examines the correspondence be-tween providers’ actual and self-reported use of these variables when making pain-related treatment decisions. We also examined the rela-tionship between providers’ self-awareness and their attitudes about sex, race, and depression. Forty-four participants (24 providers, 20 trainees) made pain treatment decisions for sixteen computer-simulated patients presenting with chronic back pain. Patient sex, race, and depression status were manipulated across vignettes. At study conclusion, participants rated the extent to which nine factors influenced their treatment decisions and completed measures as-sessing their attitudes about sex, race, and depression. Approximately 68% and 91% of participants reported using patient demographic characteristics and mental health symptoms, respectively, to make pain treatment decisions. Participants demonstrated some self-awareness for the influence of patient sex, but not race or depression, on their treatment decisions. Participants’ attitudes about sex and race were not significantly associated with their self-reported or actual use of patient demographic information when making treatment decisions. Of the participants who reportedly used mental health symptoms, higher negative attitudes about depression were significantly associat-ed with greater self-reported influence of mental health symptoms on pain treatment decisions (r=-0.42, p<0.01). However, there was no significant association between depression attitudes and actual use of depression symptoms. These findings suggest that (1) providers’ have some awareness of the influence of patient sex, but not race or de-pression, on their treatment decisions, and (2) providers’ attitudes about sex, race, and depression do not sufficiently explain this general lack of awareness. These findings have important clinical implications and may inform interventions to improve pain management and re-duce pain disparities.Item Key Findings and Recommendations from the 2013 IPLA INSPECT Knowledge and Use Survey(Richard M. Fairbanks School of Public Health, 2014-06) Kooreman, Harold; Carnes, Neal; Wright, EricThe Center for Health Policy in collaboration with the Indiana Professional Licensing Agency and the State Prescription Drug Abuse Prevention Task Force Education Committee developed a web-based survey to gather information on prescribers and dispensers knowledge, use, and opinions of INSPECT as well as to assess prescribers and dispensers attitudes and beliefs about prescribing and dispensing opioids. Key findings suggest that both providers and dispensers are strongly supportive and frequent users of the INSPECT program; the majority of users believe INSPECT is generally effective and a valuable tool in state-wide efforts to reduce the misuse, abuse, and diversion of prescription drugs.Item Symptom Burden in Geriatric Hospitalized ESRD Patients: Quantifying symptoms to increase Nephrologist Awareness and use of Palliative Care Consultation(Office of the Vice Chancellor for Research, 2016-04-08) Moe, Jawed A.; Moorthi, R.N.; Moe, S.M.; Torke, Alexia M.; Eadon, M.T.Background: End Stage Renal Disease (ESRD) patients have significant symptom burden. Reduced provider awareness of symptoms contributes to underutilization of symptom management resources. Hypothesis: We hypothesize that improved nephrologist awareness of symptoms will lead to symptom improvement. Methods: In this prospective, multicenter intervention study, 27 geriatric ESRD inpatients underwent symptom assessment using the modified Edmonton Symptom Assessment System (ESAS) at admission and 1 week post-discharge. Enrollees were sequentially randomized into 2 groups. In group 1, the nephrologist of each individual was provided baseline symptom assessment and not in group 2. Severity ratings were compared between in-hospital and post discharge scores as well as between the 2 groups. Results: 26 patients completed the study; 1 died. There were no significant differences in baseline characteristics and scores, except increased diabetes in Group 2(P = 0.03). For 70% of the total cohort physicians reported not being surprised if the patient died within a year. Among the total cohort, total ESAS scores improved between initial and follow-up assessments except for depression, anxiety, lack of appetite and nausea. The absolute change in total ESAS scores was 10.9 in group1 and 6.8 in group2 (NS). Among individual symptoms significant improvement was found in pain and itching in group 1 only. Drowsiness and dyspnea improved in both groups. There was one palliative care consult. Conclusions: Our findings reinforce the high symptom burden in geriatric ESRD patients. Residual symptoms post hospitalization and low utilization of palliative care resources is suggestive of a missed opportunity by nephrologists to address the high symptom burden at the inpatient encounter which is selective for sicker patients and/or inadequacy of dialysis to control these symptoms. The trend in improvement in pain and itching in group 1 may indicate better achievable symptom control if physician awareness is increased and simple pharmacological interventions are available.