Electronic Health Record-Based Screening for Bipolar Disorder
Finding new ways to incorporate national guidelines into daily practice using an electronic health record (EHR) may impact the care of primary care patients. The integration of screening tools for bipolar disorder into an EHR is a new development in the care of primary care patients. Gill et al1 integrated a bipolar screening tool into the EHR to evaluate all persons with a prior diagnosis of depression. They compared similar practices and found that the intervention practice used the HER-integrated tool 47% of the time. Of the intervention patients, 2.5% scored at high or very high risk for bipolar disorder. Intervention group patients were more likely to be newly diagnosed with bipolar disorder and to receive new medications for bipolar disorder. It is notable that the rate of a new diagnosis of bipolar was less than the rate of positive screens.
This study gives insight in to the use of integrated EHR clinical decision support and management tools that were used almost 50% of the time in the intervention arm. The impact of integrated EHR screening tools for people with bipolar disorder will need to be elucidated, along with its utility for supporting primary care providers in efforts to meet national guidelines efficiently, impact patient care, and improve medication management.
Acupuncture for Hot Flashes
Breast cancer survivors compose the largest group of cancer survivors in the United States, and up to 66% of them experience hot flashes. Common therapies for hot flashes are either contraindicated or only moderately effective. Many breast cancer survivors use complementary and alternative therapies, including acupuncture, in an effort to reduce hot flashes.
To better understand the attitudes and beliefs regarding acupuncture for hot flashes, Mao et al,2 conducted a qualitative survey of 12 black and 13 white breast cancer survivors with stages I to III breast cancer who had completed primary cancer treatment. Most often, women turn to their family member or physician for treatment advice, and they value owning the decision themselves. Some women view acupuncture as a more natural approach and an alternative to medications.
Notes
Funding: none.
Conflict of interest: none declared.
- Received for publication March 6, 2012.
- Revision received March 6, 2012.
- Accepted for publication March 6, 2012.
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