Catherine A Marco

American Osteopathic Board of Emergency Medicine, East Lansing, Michigan, United States

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Publications (82)210.6 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objectives The initial step in certification by the American Board of Emergency Medicine (ABEM) requires passing a multiple-choice-question qualifying examination. The qualifying examination is typically taken in the first year after residency training. This study was undertaken to determine if a delay in taking the qualifying examination is associated with poorer performance. The authors also examined the relationship between in-training examination scores and qualifying examination scores.Methods This was a pooled time-series cross-section study. Primary measurements were initial qualifying examination scores, the timing of the qualifying examination, and in-training examination scores. The three groups, based on qualifying examination timing, were immediate, 1-year delay, and ≥2-year delay. In-training examination scores were analyzed to determine the relationship between intrinsic ability, examination timing, and qualifying examination scores. For analysis, a generic pooled ordinary least-squares dummy variable model with robust standard errors was used. A pre hoc level of significance was determined to be α < 0.01.ResultsThere were 16,353 qualifying examination test administrations between 2000 and 2012. In-training examination scores were positively correlated with qualifying examination scores (p < 0.001). The group pass rates were 98.9% immediate, 95.6% 1-year delay, and 86.6% ≥2-year delay. After controlling for in-training examination scores, delay taking the qualifying examination of 1 year was associated with a decrease in score of –0.6 (p = 0.003). A delay in taking the qualifying examination ≥2 years was associated with a decrease in score of –2.5 points (p < 0.001).Conclusions After accounting for innate ability using in-training examination scores, delay taking the qualifying examination was associated with poorer performance. This effect was more pronounced if the delay was ≥2 years.ResumenObjetivosEl paso inicial en la certificación por la American Board of Emergency Medicine (ABEM) requiere aprobar un examen de cualificación (EC) de preguntas de elección múltiple. El EC se realiza habitualmente en el primer año tras la formación de la residencia. Este estudio se llevó a cabo para determinar si un retraso en la realización del EC está asociado con un peor rendimiento. También se examinó la relación entre las puntuaciones del examen durante la formación (EDF) y las puntuaciones del EC.MetodologíaEstudio transversal de series temporales sumatorias. Las mediciones principales fueron las puntuaciones iniciales del EC, el momento del EC y las puntuaciones del EDF. Los tres grupos, basados en el momento del EC fueron: inmediato, un año de retraso y 2 o más años de retraso. Se analizaron las puntuaciones del EDF para determinar la relación entre la capacidad intrínseca, el tiempo del examen y las puntuaciones del EC. Para el análisis, se utilizó un modelo variable de mínimos cuadrados ordinarios sumatorio genérico con errores estándar robustos. Se determinó un nivel de significación pre hoc de α < 0,01.ResultadosHubo 16.353 EC entre el 2000 y el 2012. Las puntuaciones del EDF se correlacionaron positivamente con las puntuaciones del EC (p < 0,001). La proporción de aprobados de cada grupo fue: 98,9% para el grupo inmediato, 95,6% para 1 año de retraso y 86,6% para 2 o más años de retraso. Tras ajustar por las puntuaciones de EDF, el retraso del EC un año se asoció con un descenso en la puntuación de -0,6 (p = 0,003). Un retraso de realización del EC de 2 o más años se asoció con descenso en la puntación de -2,5 puntos (p < 0,001).ConclusionesTras tener en cuenta las capacidades innatas mediante las puntuaciones del EDF, el retrasar la realización del EC se asoció con un peor rendimiento. Este efecto fue más pronunciado si el retraso fue ≥ a 2 años.
    Academic Emergency Medicine 06/2014; 21(6). · 2.20 Impact Factor
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    ABSTRACT: Night shift work is an integral component of the practice of emergency medicine (EM). Previous studies have demonstrated the challenges of night shift work to health and well being among health care providers.
    The Journal of emergency medicine. 05/2014;
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    ABSTRACT: In 2001, “The Model of the Clinical Practice of Emergency Medicine” was first published. This document, the first of its kind, was the result of an extensive practice analysis of emergency department (ED) visits and several expert panels, overseen by representatives from six collaborating professional organizations (the American Board of Emergency Medicine, the American College of Emergency Physicians, the Society for Academic Emergency Medicine, the Residency Review Committee for Emergency Medicine, the Council of Emergency Medicine Residency Directors, and the Emergency Medicine Residents' Association). Every 2 years, the document is reviewed by these organizations to identify practice changes, incorporate new evidence, and identify perceived deficiencies. For this revision, a seventh organization was included, the American Academy of Emergency Medicine.ResumenEn 2001 se publicó por primera vez el “Modelo de Práctica Clínica de la Medicina de Urgencias y Emergencias.” Este documento, el primero de su tipo, fue el resultado de un extenso análisis práctico de las visitas al servicio de urgencias y varios grupos de expertos, supervisado por los representantes de seis organizaciones profesionales colaboradoras (la American Board of Emergency Medicine, el American College of Emergency Physicians, la Society for Academic Emergency Medicine, el Residency Review Committee for Emergency Medicine, el Council of Emergency Medicine Residency Directors y la Emergency Medicine Residents' Association). Cada dos años, se revisa el documento por estas organizaciones para identificar los cambios en la práctica clínica, incorporar nueva evidencia e identificar las deficiencias percibidas. En esta revisión, se incluye una séptima organización, la American Academy of Emergency Medicine.
    Academic Emergency Medicine 05/2014; 21(5). · 2.20 Impact Factor
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    ABSTRACT: Objectives The American Board of Emergency Medicine (ABEM) Maintenance of Certification (MOC) program is a four-step process that includes the Continuous Certification (ConCert) examination. The ConCert examination is a validated, summative examination that assesses medical knowledge and clinical reasoning. ABEM began administering the ConCert examination in 1989. The ConCert examination must be passed at least every 10 years to maintain certification. This study was undertaken to determine longitudinal physician performance on the ConCert examination.Methods In this longitudinal review, ConCert examination performance was compared among residency-trained emergency physicians (EPs) over multiple examination cycles. Longitudinal analysis was performed using a growth curve model for unbalanced data to determine the growth trajectories of EP performance over time to see if medical knowledge changed. Using initial certification qualifying examination scores, the longitudinal analysis corrected for intrinsic variances in physician ability.ResultsThere were 15,085 first-time testing episodes from 1989 to 2012 involving three examination cycles. The mean adjusted examination scores for all physicians taking the ConCert examination for a first cycle was 85.9 (95% confidence interval [CI] = 85.8 to 85.9), the second cycle mean score was 86.2 (95% CI = 86.0 to 86.3), and the third cycle was 85.4 (95% CI = 85.0 to 85.8). Using the first examination cycle as a reference score, the growth curve model analysis resulted in a coefficient of +0.3 for the second cycle (p < 0.001) and –0.5 for the third cycle (p = 0.02). Initial qualifying (written) examination scores were significant predictors for ConCert examination scores.Conclusions Over time, EP performance on the ConCert examination was maintained. These results suggest that EPs maintain medical knowledge over the course of their careers as measured by a validated, summative medical knowledge assessment.ResumenObjetivosEl programa de mantenimiento de certificación (MC) de la American Board of Emergency Medicine (ABEM) es un proceso de cuatro pasos que incluye el examen de certificación continuada (continuous certification, ConCert). El ConCert es un examen sumatorio y validado que valora el conocimiento y el razonamiento clínico médico. La ABEM comenzó a realizar el examen ConCert en 1989. El ConCert debe ser aprobado al menos cada diez años para mantener la certificación. Este estudio se llevó a cabo para determinar el rendimiento del médico en el examen ConCert a lo largo del tiempo.MetodologíaEn esta revisión longitudinal, el rendimiento del examen ConCert se comparó entre los médicos de urgencias y emergencias (MUE) formados en el programa de residencia a lo largo de múltiples periodos de examen. Se realizó un análisis longitudinal mediante un modelo de curva de crecimiento (MCC) para datos no balanceados para determinar las trayectorias de crecimiento del rendimiento del MUE a lo largo del tiempo para ver si el conocimiento médico había cambiado. Con las puntuaciones iniciales del examen ConCert, el análisis longitudinal se ajustó por las varianzas intrínsecas en la habilidad del médico.ResultadosHubo 15.085 episodios de exámenes por primera vez desde 1989 a 2012, que incluían tres ciclos de examen. La media ajustada de las puntuaciones del examen para todos los médicos que realizaron el examen ConCert para un primer ciclo fue 85,9 (IC 95% = 85,8 a 85,9); la media de puntuación del segundo ciclo fue de 86,2 (IC 95% = 86,0 a 86,3); y la del tercer ciclo fue de 85,4 (IC 95% = 85,0 a 85,8). Usando el primer ciclo de examen como referencia de puntuación, el análisis de los MCC resultó en un coeficiente de +0.3 para el segundo ciclo (p<0,001), y de -0,5 para el tercer ciclo (p = 0,02). Las puntuaciones del examen (escrito) de cualificación inicial fueron predictivas de forma significativa para las puntuaciones del examen ConCert.ConclusionesA lo largo del tiempo, el rendimiento de los MUE en el examen ConCert se mantuvo. Estos resultados indican que los MUE mantienen el conocimiento médico durante el curso de sus carreras profesionales cuando se mide mediante una evaluación del conocimiento médico acumulado.
    Academic Emergency Medicine 05/2014; 21(5). · 2.20 Impact Factor
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    ABSTRACT: The American Board of Emergency Medicine gathers extensive background information on emergency medicine residency programs and the residents in them. We present the 2014 annual report on the status of US emergency medicine training programs.
    Annals of Emergency Medicine 05/2014; 63(5):637-645. · 4.33 Impact Factor
  • The American journal of emergency medicine 10/2013; · 1.54 Impact Factor
  • Hemangini C Bhakta, Catherine A Marco
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    ABSTRACT: Patient satisfaction with emergency care is associated with timeliness of care, empathy, technical competence, and information delivery. Previous studies have demonstrated inconsistent findings regarding the association between pain management and patient satisfaction. This study was undertaken to determine the association between pain management and patient satisfaction among Emergency Department (ED) patients presenting with acute painful conditions. In this survey study, a standardized interview was conducted at the Emergency Department at the University of Toledo Medical Center in May-July 2011. Participants were asked to answer 18 questions pertaining to patient satisfaction. Additional data collected included demographic information, pain scores, and clinical management. Among 328 eligible participants, 289 (88%) participated. The mean triage pain score on the verbal numeric rating scale was 8.2 and the mean discharge score was 6.0. The majority of patients (52%) experienced a reduction in pain of 2 or more points. Participants received one pain medication dose (44%), two medication doses (14%), three medication doses (5%), or four medication doses (2%). Reduction in pain scores of 2 or more points was associated with a higher number of medications administered. Reduction in pain scores was associated with higher satisfaction as scored on questions of patient perceptions of adequate assessment and response to pain, and treatment of pain. There was a significant association between patient satisfaction and a reduction in pain of 2 or more points and number of medications administered. Effective pain management is associated with improved patient satisfaction among ED patients with painful conditions.
    Journal of Emergency Medicine 07/2013; · 1.33 Impact Factor
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    ABSTRACT: BACKGROUND: The Model of the Clinical Practice of Emergency Medicine is the basis for the content specifications of all American Board of Emergency Medicine (ABEM) examinations. This study describes the frequency with which ABEM diplomates diagnose and manage the conditions and components listed in the Model of the Clinical Practice of Emergency Medicine. OBJECTIVES: The objectives of this study were to determine the frequency with which ABEM diplomates diagnose and manage the conditions and components described in the Model of the Clinical Practice of Emergency Medicine. METHODS: The listing of conditions and components of the Model of the Clinical Practice of Emergency Medicine were sent to 16,230 randomly selected ABEM diplomates. One of five surveys was sent to each diplomate. Each condition and component was assessed by participants for the frequency that emergency physicians diagnose (D) and manage (M) that condition, as seen in their practice of Emergency Medicine. RESULTS: Of the 16,230 surveys sent, 5006 were returned (30.8% response rate). The genders of the respondents were 75% male and 24% female. The ages of the respondents were primarily in the age 40-49 years, and 30-39 years age groups. All categories of the listing of conditions and components of the Model of the Clinical Practice of Emergency Medicine were encountered frequently in the practice of Emergency Medicine, as indicated by study participants. CONCLUSIONS: A survey of practicing ABEM diplomates was useful in defining the frequency with which specific conditions and components are diagnosed and managed in the practice of Emergency Medicine.
    Journal of Emergency Medicine 03/2013; 44(6):1153-1166. · 1.33 Impact Factor
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    ABSTRACT: The 2012 Academic Emergency Medicine consensus conference on education research in emergency medicine (EM) addressed various issues, including that of ethics in medical education research for EM. Education research in EM is essential to patient care and safety, and with recent advances in simulation and the advent of the Milestones project, it will become even more vital. Education research in EM is guided by the same principles that guide the ethical conduct of all human subjects' research: respect for persons, beneficence, and justice. Regulatory provisions and widely accepted ethical standards provide a framework for research in EM education; however, special considerations exist for education research. To ensure patient and trainee safety and to maintain the integrity of new knowledge, ethical considerations should remain at the forefront of EM education research. For EM education researchers, recognition of the vulnerability of residents, medical students, and others as research subjects is paramount. This article fills an important gap by outlining the principles guiding education research in EM, exploring the ethical challenges and approaches to education research, and offering a framework and future directions for the ethical conduct of education research in EM.
    Academic Emergency Medicine 12/2012; · 2.20 Impact Factor
  • Catherine A Marco, Terry Kowalenko
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    ABSTRACT: BACKGROUND: The American Board of Emergency Medicine conducts an annual survey of residents in Emergency Medicine, the Longitudinal Study of Residents in Emergency Medicine survey. Objective: This study was undertaken to describe self-reported competence and challenges facing Emergency Medicine (EM) residents. METHODS: In this descriptive, observational analysis of the Longitudinal Study of Residents in Emergency Medicine survey, survey data from 1996-2008 were compared for 70 survey items. Responses were analyzed with means and 95% confidence intervals by post-graduate year (PGY) and over time. RESULTS: A total of 496 residents were included in this study. Most participated for 3 years, for a total of 1320 total responses. The most serious day-to-day challenges reported by residents (overall median scores of 3 or more) included knowing enough, keeping up with the medical literature, having enough time for personal life, ancillary support, and having enough time for family. Current level of competence in areas deemed weakest by residents included grant writing, contract negotiation, academic writing, disaster planning, research, and financial management. Residents reported improved competence in most (15 out of 16) areas from PGY-1 to PGY-3 year of training. Resident reports of competence did not change significantly over time from 1998-2008 (15 out of 16 items). CONCLUSIONS: Emergency Medicine residents identified several important day-to-day problems, including knowing enough, keeping up with the medical literature, and having enough time for a personal life. PGY-3 residents reported improved competence in almost all aspects of EM work and clinical EM as compared to PGY-1 residents. Knowledge of perceived competence and problems among EM residents is crucial to the development of improved educational approaches to address these issues.
    Journal of Emergency Medicine 08/2012; · 1.33 Impact Factor
  • Catherine A Marco, William Kanitz, Matthew Jolly
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    ABSTRACT: BACKGROUND: Treatment for pain and pain-related conditions has been identified as the most common reason for Emergency Department (ED) visits. OBJECTIVE: This study was undertaken to characterize the distribution of self-reported pain scores for common ED diagnoses. METHODS: In this retrospective exploratory chart review, eligible participants included all adult ED patients age 18 years and over, with a self-reported triage pain score of 1 or higher during January-June 2011. Data were collected from ED electronic medical records. RESULTS: Among 1229 patients, the mean age was 44 years; 56% of patients were female, and 59% were white. The mean triage pain score for all patients was 7.1 (interquartile range 6-9). The most common reported diagnoses included: minor injuries (10%), abdominal pain (8%), and respiratory infections (8%). The diagnoses with the highest mean pain scores were: sickle cell crisis (mean pain score 8.7), back/neck/shoulder pain (8.5), and headache/migraine (8.3). Higher pain scores were significantly correlated with younger age (p<0.001) and number of ED visits (p<0.001). Demographic factors including female gender, African American race, and Medicaid insurance reported significantly higher pain scores (p<0.001). Patients with multiple ED visits in the recent 12 months reported significantly higher pain scores (p<0.001). CONCLUSION: ED patients report a wide variety of pain scores. Factors associated with higher pain scores included younger age, female gender, African American race, Medicaid insurance status, multiple ED visits in the past year, and ED diagnoses of sickle cell crisis, back/neck/shoulder pain, and headache.
    Journal of Emergency Medicine 07/2012; · 1.33 Impact Factor
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    ABSTRACT: The American Board of Emergency Medicine (ABEM) gathers extensive background information on emergency medicine residency training programs and the residents in those programs. We present the 2012 annual report on the status of US emergency medicine training programs.
    Annals of emergency medicine 05/2012; 59(5):416-24. · 4.33 Impact Factor
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    ABSTRACT: The recent enactment of the Patient Protection and Affordable Care Act (ACA) of 2010, and the ongoing debate over reform of the U.S. health care system, raise numerous important ethical issues. This article reviews basic provisions of the ACA; examines underlying moral and policy issues in the U.S. health care reform debate; and addresses health care reform's likely effects on access to care, emergency department (ED) crowding, and end-of-life care. The article concludes with several suggested actions that emergency physicians (EPs) should take to contribute to the success of health care reform in America.
    Academic Emergency Medicine 04/2012; 19(4):461-8. · 2.20 Impact Factor
  • Catherine A Marco, Lindsay R Wetzel
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    ABSTRACT: Communication with survivors of severe motor vehicle crashes is challenging for emergency physicians. The appropriate timing of death notification to survivors of severe motor vehicle crashes is unknown. To determine communication preferences among survivors of motor vehicle crashes. In this cross-sectional survey study, eligible participants included adult survivors of motor vehicle crashes in which there was a death, between 2005 and 2009. Participants were interviewed and responses to 30 questions about communication were recorded verbatim. Responses were coded and grouped for statistical analysis. Among 26 eligible participants, 21 consented to participate (81% participation rate). Survivors' relationship to the deceased included spouse/significant other (33%), friend (24%), child (5%) and no relationship (38%). Survivors had been notified of the death in the prehospital setting (14%), in the emergency department (43%), or later in the inpatient setting (43%). Survivors were notified of the death by family members (43%), indirect communication (14%), police (10%), prehospital provider (10%), or friend (10%). Most participants (88%) had to ask directly to obtain information about the status of others in the crash. Participants demonstrated variable opinions about the ideal time of death notification: some recommended immediately (24%), in the emergency department (24%), in the inpatient setting (29%), or it depends on the circumstances (24%). Survivors of motor vehicles crashes are notified of fatalities most commonly by family members, most commonly in the hospital setting. Recommendations from survivors about the appropriate timing and setting for death notification varied significantly.
    Emergency Medicine Journal 08/2011; 29(8):626-9. · 1.65 Impact Factor
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    ABSTRACT: Pain is a common presenting complaint among emergency department (ED) patients. The verbal numeric pain scale is commonly used in the ED to assess self-reported pain. This study was undertaken to describe and compare pain scores in a variety of painful conditions and identify factors associated with self-reported pain scores. The study was a prospective, observational, descriptive survey study conducted at an urban university hospital ED. Eligible participants included consenting adults 18 years and older, with an acute painful condition, who spoke English, and were not in severe distress. Through a structured interview, collected data included pain score; diagnosis; medical history; previous painful experiences; and demographic information including age, insurance status, and highest level of education completed. Among 268 eligible participants, 263 (98%) consented and completed the study protocol. Seventy-one percent of participants were 50 years old or younger; 55%, women; and 68%, white. Fifty-four percent had private insurance, and 81%, high school education or higher. The most common chief complaints were soft tissue injury (33%), abdominal pain (18%), and chest pain (13%). The median self-reported pain score was 7/10 (mean, 6.7; interquartile range, 6-9; range, 0-10). The most common previous painful experiences were childbirth (21%), major trauma (18%), and surgery (14%). Participants cited reasons for self-reported pain scores, including current feeling of pain (62%), comparison to previous pain (31%), and comparison to hypothetical pain (12%). The number of previous ED visits was positively correlated with current pain score (Spearman correlation R = 0.28; P < .001). The chief complaints associated with the highest pain scores included dental pain (mean pain score, 8.5) and back pain (mean pain score, 7.6). Chief complaints associated with the lowest pain scores included chest pain (mean pain score, 5.2) and other medical conditions (mean pain score, 5.3). Factors associated with higher pain scores included younger age (P < .001, Kruskal-Wallis), Medicaid insurance (P = .02), and lower educational status (P = .01). There was not a statistically significant association between current pain score and sex, race, previous painful experiences, or number of hospital admissions. Emergency department patients with acute painful conditions report a wide range of self-reported pain scores. Participants rated pain based on current feeling of pain or comparison to previous or hypothetical pain. Chief complaints with highest pain scores included dental pain and back pain. Factors associated with higher pain scores included younger age, Medicaid insurance, lower educational status, and higher number of previous ED visits.
    The American journal of emergency medicine 02/2011; 30(2):331-7. · 1.54 Impact Factor
  • Annals of Emergency Medicine - ANN EMERG MED. 01/2011; 58(4).
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    ABSTRACT: The number of annual patient visits to US emergency departments (ED) has been increasing since 1995, whereas the number of ED is decreasing. Previous studies have identified many reasons why patients seek care in ED, including lack of access to care elsewhere, lack of insurance, inability to see their doctor in a timely manner and lower levels of social support. This study identifies factors that influence patients' decisions to seek care in ED and assesses their access to primary care. A prospective study, conducted by standardised verbal interview with adult ED patients, was performed in the XXX ED during June-July 2009. Non-English speaking patients, the mentally incapacitated and those under severe distress were excluded. Consenting patients were asked a series of questions on access to primary care, factors that influenced their decision to attend the ED, health insurance status and demographic information. Among 292 study participants (89% response rate), the majority were over 40 years (52%), Caucasian (69%) and unemployed (58%). Among employed participants, 66% (N=88/133) of employers offered health insurance. Most participants had a primary care physician (PCP; 73%; N=214), but a minority had called their PCP about the current problem (31%; N=78/253). Most participants came to the ED because of convenience/location (41%) or preference for this institution (23%). Participants came to the ED, rather than their regular doctor, because they had no PCP (27%), an emergency condition (19%), or communication challenges (17%). Convenience, location, institutional preference and access to other physicians are common factors that influence patients' decisions to seek care in ED.
    Emergency Medicine Journal 12/2010; 29(1):28-31. · 1.65 Impact Factor
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    ABSTRACT: Ethics education is an essential component of graduate medical education in emergency medicine. A sound understanding of principles of bioethics and a rational approach to ethical decision-making are imperative. This article addresses ethics curriculum content, educational approaches, educational resources, and resident feedback and evaluation. Ethics curriculum content should include elements suggested by the Liaison Committee on Medical Education, Accreditation Council for Graduate Medical Education, and the Model of the Clinical Practice of Emergency Medicine. Essential ethics content includes ethical principles, the physician-patient relationship, patient autonomy, clinical issues, end-of-life decisions, justice, education in emergency medicine, research ethics, and professionalism. The appropriate curriculum in ethics education in emergency medicine should include some of the content and educational approaches outlined in this article, although the optimal methods for meeting these educational goals may vary by institution.
    Journal of Emergency Medicine 09/2010; 40(5):550-6. · 1.33 Impact Factor
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    ABSTRACT: Ohio recently instituted an online prescription monitoring program, the Ohio Automated Rx Reporting System (OARRS), to monitor controlled substance prescriptions within Ohio. This study is undertaken to identify the influence of OARRS data on clinical management of emergency department (ED) patients with painful conditions. This prospective quasiexperimental study was conducted at the University of Toledo Medical Center Emergency Department during June to July 2008. Eligible participants included ED patients with painful conditions. Patients with acute injuries were excluded. After clinical evaluation, and again after presentation of OARRS data, providers answered a set of questions about anticipated pain prescription for the patient. Outcome measures included changes in opioid prescription and other potential factors that influenced opioid prescription. Among 179 participants, OARRS data revealed high numbers of narcotics prescriptions filled in the most recent 12 months (median 7; range 0 to 128). Numerous providers prescribed narcotics for patients (median 3 per patient; range 0 to 40). Patients had filled narcotics prescriptions at different pharmacies (mean [SD] 3.5 [4.4]). Eighteen providers are represented in the study. Four providers treated 63% (N=114) of the patients in the study. After review of the OARRS data, providers changed the clinical management in 41% (N=74) of cases. In cases of altered management, the majority (61%; N=45) resulted in fewer or no opioid medications prescribed than originally planned, whereas 39% (N=29) resulted in more opioid medication than previously planned. The use of data from a statewide narcotic registry frequently altered prescribing behavior for management of ED patients with complaints of nontraumatic pain.
    Annals of emergency medicine 07/2010; 56(1):19-23.e1-3. · 4.33 Impact Factor
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    Catherine A Marco, Constance Shriner
    Medical Education 05/2010; 44(5):502. · 3.55 Impact Factor

Publication Stats

674 Citations
210.60 Total Impact Points

Institutions

  • 2014
    • American Osteopathic Board of Emergency Medicine
      East Lansing, Michigan, United States
  • 2008–2014
    • University of Toledo
      • Department of Surgery
      Toledo, Ohio, United States
  • 2000–2014
    • Medical University of Ohio at Toledo
      Toledo, Ohio, United States
  • 2011
    • Northside Hospital
      St. Petersburg, Florida, United States
  • 2010
    • Christian Medical College & Hospital
      Ludhiana, Punjab, India
  • 2003–2009
    • Emory University
      • Department of Emergency Medicine
      Atlanta, Georgia, United States
    • Wright State University
      Dayton, Ohio, United States
  • 1995–2009
    • Johns Hopkins Medicine
      • Department of Emergency Medicine
      Baltimore, Maryland, United States
  • 1999–2008
    • Mercy St. Vincent Medical Center
      Toledo, Ohio, United States
  • 2005
    • East Carolina University
      • The Bioethics Center
      Greenville, NC, United States
  • 2001
    • University of Pittsburgh
      • School of Medicine
      Pittsburgh, PA, United States
  • 1994–1999
    • Johns Hopkins University
      • Department of Emergency Medicine
      Baltimore, MD, United States