The statements and opinions expressed in COVID-19 Curbside Consults are based on experience and the available literature as of the date posted. While we try to regularly update this content, any offered recommendations cannot be substituted for the clinical judgment of clinicians caring for individual patients. ABSTRACT Cleveland Clinic recognized the importance of mitigating community transmission of COVID-19 by keeping people at home. Patient-care activities quickly pivoted to remote touches, preserving continuity through a variety of digital and telephonic modalities. As the number of confi rmed cases grew, standardizing home-based care became critical to managing high-risk patients, moderating the risk of exposure for healthcare workers, and reducing the amount of community spread through appropriate education on home-based care for exposed or infected individuals. This novel, team-based approach to caring for patients with COVID-19 incorporates a self-monitoring app for patient engagement, monitors symptoms for early intervention, and promotes a holistic view of care.

Patients were largely satisfied with DTC telemedicine, yet satisfaction varied by coupon use and prescription receipt. The impact of telemedicine on primary care and emergency department use is likely to be small under present usage patterns.

2225) for general payments, respectively. Receipt of research payments was associated with increased prescribing for mRCC but not CML. Similarly, when treating payments as a continuous variable, increasing amounts of general payments were associated with increased prescribing. Considering individual drugs, we found increased prescribing when receiving vs not receiving general payments for sunitinib (50.5% vs 34.4%, P = .01), dasatinib (13.8% vs 11.4%, P = .02), and nilotinib (15.4% vs 12.5%, P = .01) (Figure) but found decreased prescribing of imatinib (72.4% vs 75.5%, P = .02). Differences for sorafenib and pazopanib were not statistically significant. Research payments were not associated with statistically significant differences in prescribing for any individual drug. Results were similar when including payments specifically attributed to the drug of interest rather than all payments from the corresponding manufacturer and when changing the exposure to receipt of payments in both 2013 and 2014 (vs 2013 without respect to 2014). Our study had some limitations. These include the observational design precluding causal assessment, potential inaccuracies with Open Payments data, 5 lack of generalizability to other cancers, absence of information about the indications for the drugs, and small sample sizes for comparisons in the research payments analysis, notably for physicians receiving CML research payments. Conclusions | For 3 of the 6 cancer drugs studied, physicians who received general payments were more likely to prescribe the drug marketed by the company that made the payments. Imatinib was a notable exception; this may reflect a strategy by the manufacturer of imatinib (which also produces nilotinib) to promote switching to nilotinib before the patent expiration of imatinib in 2015.

knee. The knee arthroplasty rate increased, but most of the increase preceded the decline in arthroscopy rates.Between 1999 and 2014, the prevalence of osteoarthritis in the US adult population more than doubled from 6.6% to 14.3%. 6 Trends in per capita knee surgical procedures, which are not adjusted for the increase in the prevalence of osteoarthritis, likely understate the degree to which use of arthroscopic surgery as a treatment for knee pain has declined.Some private insurers have started to require physicians to obtain authorization before an arthroscopic knee procedure. The fee-for-service Medicare program does not require prior authorization. Private insurers covered 72% of knee arthroscopies in patients younger than 65 years, and Medicare covered 83% of these procedures in patients aged 65 years or older. I could not observe the impact of prior authorization requirements directly, but trends in arthroscopy rates in these age groups were similar, indicating that the requirements may not be a major factor behind the decline in rates.The results suggest that the accumulating evidence on the lack of benefit associated with knee arthroscopy, compared with medical management, has altered treatment decisions. Despite the lower use rates, knee arthroscopy is still a common procedure. There may be additional opportunities to reduce the use of knee arthroscopy without adversely affecting patient outcomes.

This study provides preliminary data supporting the possible benefits of utilizing MMIT treatment early in the recovery of nonfluent aphasia patients.