@BenjaminLinas Like that time a world class institution dropped coverage for elderly folks who live in the same community? baltimoresun.com/health/bs-hs-m…
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Jarratt Pytell
355 posts
Jarratt Pytell
@JarrattPytell
Addiction medicine MD and researcher at @CUAnschutz. Improving primary care for people using drugs. By way of @LSUHealthNO | @BayviewMedicine | @Hopkins_GIM
Baltimore, MD Katılım Nisan 2009
1.3K Takip Edilen379 Takipçiler
Jarratt Pytell retweetledi
1/Here is DEA’s complete safety plan for legacy pain patients left stranded when they just shut down a California doc who saw “opioid refugees”
It’s a list of ERs!😨
DEA closed down a doc.
Within days, one I previously interviewed is dead by suicide and another is scrambling
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@DrCindyCooper @BrownHospMed Fresh water exposure including municipal water! Tragic story from 2015 in Louisiana when a child died from Naegleria. It was found in the water supply. ldh.la.gov/news/2862
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A young girl presented with lethargy & confusion after swimming in a freshwater pond. During her hospital stay, she developed seizures & died few days later. What is the likely diagnosis? (image: Seattle times) #Medtwitter
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@PaulNWilliamz Great thread! Dosing NRT by nicotine levels is also in your toolbox. Checking prior to quit date and then while on NRT to adjust.
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@TamiMark2 @pewtrusts @RTI_Intl Long list of recommended PROMs to consider to monitor recovery. Implementing PROMs alone is a Herculean effort. When, how often, what mode? Any update on the APA/CMS collab referenced?
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RTI and Pew released a toolkit for states to use to implement standard metrics to track their progress in expanding effective treatment for opioid use disorders @pewtrusts @RTI_Intl #addictionrecovery
rti.org/sites/default/…
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Jarratt Pytell retweetledi
Feeling powerless to harness the reachable moment when patients using stimulants are hospitalized with infection? Worried about patient-directed discharge?
Us too.
Check out my poster (virtually!!) describing our pilot of a novel adaptation of contingency management... 1/10
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Jarratt Pytell retweetledi
Fantastic work by @AyeshaAppaMD! CM is low hanging fruit - it’s cheap, effective, easily adaptable to so many settings, and yet still widely unavailable. We can do better!
Ayesha Appa@AyeshaAppaMD
Feeling powerless to harness the reachable moment when patients using stimulants are hospitalized with infection? Worried about patient-directed discharge? Us too. Check out my poster (virtually!!) describing our pilot of a novel adaptation of contingency management... 1/10
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@NIAAAnews Hot off the press! @MarinaGaeta1 et al show patients prefer person-first descriptors. Decrease stigma & be patient-centered is a win for all. #citeas" target="_blank" rel="nofollow noopener">link.springer.com/article/10.100…
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Many of the words commonly used to describe alcohol-related problems are stigmatizing. Instead of addict, use person w/ alcohol use disorder. Instead of recovering alcoholic, use person in recovery from alcohol use disorder. fal.cn/3sSwf
#TreatmentWeek #EndStigma
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@DrMoPPC Great talk. If I remember, you took some heat for it.
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@CchristmColleen @meggerber @FriedbergEric @CancerGeek @GIMaPreceptor @EricLast3 @InduPartha @dhpomerantz @gabrieldane @myheroistrane @DrKJobbins @AlgaseLeslie @ashapandu22 @ORourkeJr @StevenMurphyQD Option 2: replace time spent on ROS with the following structured questions at the end of visit, 1) anything else? 2) are you sure nothing else? 3) seriously, my hand is on the doorknob, is there anything else?
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@meggerber @FriedbergEric @CancerGeek @GIMaPreceptor @EricLast3 @InduPartha @dhpomerantz @gabrieldane @myheroistrane @DrKJobbins @AlgaseLeslie @ashapandu22 @ORourkeJr @StevenMurphyQD “Free time” was an odd word selection. I think they meant, stuff that is more valuable than spending time on ROS. I can’t remember the last time I felt I had sufficient time to cover all we needed in a visit. Always there are choices abt what to trim.
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Moving to More Evidence-Based Primary Care Encounters
F-2-F time b/w primary care clinicians &patients is precious &deserves 2B spent effectively 2improve patients health-including building relationships that facilitate care &improve outcomes
@CancerGeek
ja.ma/3MnSMCH
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Jarratt Pytell retweetledi
An isolation period of 5 days after Covid is totally inadequate for most people. New report from >63,000 people. Negative rapid tests are an essential guide
jamanetwork.com/journals/jaman… @JAMANetworkOpen
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@steveaschmd @JournalGIM @StanfordHP Well @ekhbrown, lots of work at multiple levels. Add this to your to-do list.
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As I’ve said before, no one should be in jail just for using or possessing marijuana.
Today, I’m taking steps to end our failed approach. Allow me to lay them out.
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new paper out in @JAMANetworkOpen (my first first-author)! hoping it's useful to clinicians, methodologists, and analysts alike.
🔑 finding: modern methods for causal inference from observational data can recover RCT estimates
jamanetwork.com/journals/jaman…
🧵⬇️
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Jarratt Pytell retweetledi
1/I want to highlight a new way selling out one’s academic profile- here a @JohnsHopkinsDOM doc has made his Twitter channel a “sincere” advertisement for an inhaler, “sponsored” by AstraZeneca
The false statement by the faculty member is concerning
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Jarratt Pytell retweetledi
Our @FreeMethadone coalition created a sign on letter asking @samhsagov, the DEA, @ONDCP44 , and congress to reform methadone treatment for opioid use disorder
PLEASE ADD YOUR VOICE AND SHARE #methadone
Link to sign on letter -👇👇👇👇
chng.it/CFNtghTknW
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@JessicaBmoreMD @SusanMirabalMD @MedEdChat @MedEdPGH @DraOrozco14 @MCW_Kern @CchristmColleen @jesscolburn @NMaruthur @kavitachapla @meggerber Fellow @BayviewMedicine alumni @LarochelleMarc could drop some knowledge
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@SusanMirabalMD @MedEdChat @MedEdPGH @DraOrozco14 @MCW_Kern @CchristmColleen @jesscolburn @NMaruthur @kavitachapla @meggerber I think it is important to decide your own comfort level with narcotics and how/when you will manage them, and to always have a pain contract no matter who your patient is. Being consistent will make you feel more confident and can reduce stigma! @JarrattPytell tell me more.
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What do you wish your learners knew about managing chronic pain in the outpatient setting? #MedTwitter @MedEdChat @MedEdPGH #MedEd #medicaleducation @DraOrozco14 @MCW_Kern @CchristmColleen @jesscolburn @JessicaBmoreMD @NMaruthur @kavitachapla @meggerber #whatistherebesidesNSAIDS
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@JessicaBmoreMD @SusanMirabalMD @MedEdChat @MedEdPGH @DraOrozco14 @MCW_Kern @CchristmColleen @jesscolburn @NMaruthur @kavitachapla @meggerber Many thoughts! Patients with chronic pain are treated like pariahs in healthcare systems. Keep an open mind and recognize that the are often traumatized when interacting with clinicians. Forced tapers can be harmful and should be the last intervention you consider.
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