Background Prescription drug monitoring programs (PDMPs) are a key component of the president's Prescription Drug Abuse Prevention Plan to prevent opioid overdoses in the United States. Purpose To examine whether PDMP implementation is associated with changes in nonfatal and fatal overdoses; identify features of programs differentially associated with those outcomes; and investigate any potential unintended consequences of the programs. Data Sources Eligible publications from MEDLINE, Current Contents Connect (Clarivate Analytics), Science Citation Index (Clarivate Analytics), Social Sciences Citation Index (Clarivate Analytics), and ProQuest Dissertations indexed through 27 December 2017 and additional studies from reference lists. Study Selection Observational studies (published in English) from U.S. states that examined an association between PDMP implementation and nonfatal or fatal overdoses. Data Extraction 2 investigators independently extracted data from and rated the risk of bias (ROB) of studies by using established criteria. Consensus determinations involving all investigators were used to grade strength of evidence for each intervention. Data Synthesis Of 2661 records, 17 articles met the inclusion criteria. These articles examined PDMP implementation only (n = 8), program features only (n = 2), PDMP implementation and program features (n = 5), PDMP implementation with mandated provider review combined with pain clinic laws (n = 1), and PDMP robustness (n = 1). Evidence from 3 studies was insufficient to draw conclusions regarding an association between PDMP implementation and nonfatal overdoses. Low-strength evidence from 10 studies suggested a reduction in fatal overdoses with PDMP implementation. Program features associated with a decrease in overdose deaths included mandatory provider review, provider authorization to access PDMP data, frequency of reports, and monitoring of nonscheduled drugs. Three of 6 studies found an increase in heroin overdoses after PDMP implementation. Limitation Few studies, high ROB, and heterogeneous analytic methods and outcome measurement. Conclusion Evidence that PDMP implementation either increases or decreases nonfatal or fatal overdoses is largely insufficient, as is evidence regarding positive associations between specific administrative features and successful programs. Some evidence showed unintended consequences. Research is needed to identify a set of “best practices” and complementary initiatives to address these consequences. Primary Funding Source National Institute on Drug Abuse and Bureau of Justice Assistance.

We describe the concept and method of video elicitation interviews and provide practical guidance for primary care researchers who want to use this qualitative method to investigate physician-patient interactions. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool. Video elicitation is useful because it allows researchers to integrate data about the content of physician-patient interactions gained from video recordings with data about participants' associated thoughts, beliefs, and emotions gained from elicitation interviews. This method also facilitates investigation of specifi c events or moments during interactions. Video elicitation interviews are logistically demanding and time consuming, and they should be reserved for research questions that cannot be fully addressed using either standard interviews or video recordings in isolation. As many components of primary care fall into this category, highquality video elicitation interviews can be an important method for understanding and improving physician-patient interactions in primary care. INTRODUCTIONF ace-to-face interactions between physicians and patients are central to primary care and an important focus of primary care research. Video elicitation interviews are one qualitative method for evaluating these interactions. Elicitation interviews use a stimulus, such as photographs 1,2 or written records, 3 to prompt participants to discuss subjects in greater detail than they would during standard interviews. During video elicitation interviews, researchers interview patients or physicians about a recent clinical interaction using a video recording of that interaction as an elicitation tool.This article provides practical guidance for primary care researchers conducting video elicitation interviews. First, we briefl y review existing social science and health care literature on this method. Next, we discuss the key steps for designing and conducting video elicitation interviews and make recommendations to researchers based on our experience conducting a video elicitation study of preventive services in primary care. 4 Finally, we discuss the limitations of this method.We focus on video elicitation interviews as a qualitative method for investigating physician-patient interactions. Researchers also conduct video elicitation interviews as interventions 5,6 and for teaching purposes. [7][8][9] These important applications have many similarities with video elicitation interviews used as research tools, but they have different primary goals and are not the focus of this article. We also focus on interactions involving real physicians and patients rather than studies of students interviewing actors, 10,11 because the content and purpose of real and contrived interactions differ in important ways. 12,13Stephen G. 25 They discovered that physicians and patients typically paused videos at the exact same moments when asked to ...

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Communicating with patients is arguably the most common and important activity in medical practice, but this activity receives relatively little emphasis in graduate medical education. We propose 12 evidence-based communication competencies that program directors can adopt as a framework for teaching and evaluating residents' communication skills. We review supporting evidence for these competencies and argue that communication should be treated like a procedural skill that must be taught and evaluated by observing real resident-patient interactions. We make practical suggestions for implementing these competencies by addressing three critical components of a competency-based approach to communication skills: patient safety, faculty development, and direct observation of residents. This approach to teaching and assessing communication skills provides a rationale for incorporating routine direct observation into graduate medical education programs and also for designing communication skills training that ensures graduating residents develop the skills needed to provide safe, effective patient care.