Physicians Asking Patients About Guns: Promoting Patient Safety, Respecting Patient Rights

Parent, Brendan

doi:10.1007/s11606-016-3694-2

Cited by 14 publications

(6 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…15 While firearm-related injuries and deaths are a public health problem, particularly in the US, 16 a minority of physicians report engaging in firearm counseling. 17 Despite several groups having recommended both targeted and universal screening for firearm access, [17][18][19][20][21][22][23][24] there are no current national guidelines for screening in primary care, urgent care or emergency care settings even though gun safety is associated with lower risk of injuries and death. 25,26 To understand how current practice may be adapted, more information on the frequency with which healthcare providers document firearm screening is needed.…”

Section: Introductionmentioning

confidence: 99%

Documentation of Screening for Firearm Access by Healthcare Providers in the Veterans Healthcare System: A Retrospective Study

Brandt¹,

Workman²,

Farmer³

et al. 2021

WJEM

View full text Add to dashboard Cite

Introduction Presence of a firearm is associated with increased risk of violence and suicide. United States military veterans are at disproportionate risk of suicide. Routine healthcare provider screening of firearm access may prompt counseling on safe storage and handling of firearms. The objective of this study was to determine the frequency with which Veterans Health Administration (VHA) healthcare providers document firearm access in electronic health record (EHR) clinical notes, and whether this varied by patient characteristics. Methods The study sample is a post-9–11 cohort of veterans in their first year of VHA care, with at least one outpatient care visit between 2012–2017 (N = 762,953). Demographic data, veteran military service characteristics, and clinical comorbidities were obtained from VHA EHR. We extracted clinical notes for outpatient visits to primary, urgent, or emergency clinics (total 105,316,004). Natural language processing and machine learning (ML) approaches were used to identify documentation of firearm access. A taxonomy of firearm terms was identified and manually annotated with text anchored by these terms, and then trained the ML algorithm. The random-forest algorithm achieved 81.9% accuracy in identifying documentation of firearm access. Results The proportion of patients with EHR-documented access to one or more firearms during their first year of care in the VHA was relatively low and varied by patient characteristics. Men had significantly higher documentation of firearms than women (9.8% vs 7.1%; P < .001) and veterans >50 years old had the lowest (6.5%). Among veterans with any firearm term present, only 24.4% were classified as positive for access to a firearm (24.7% of men and 20.9% of women). Conclusion Natural language processing can identify documentation of access to firearms in clinical notes with acceptable accuracy, but there is a need for investigation into facilitators and barriers for providers and veterans to improve a systemwide process of firearm access screening. Screening, regardless of race/ethnicity, gender, and age, provides additional opportunities to protect veterans from self-harm and violence.

show abstract

Section: Introductionmentioning

confidence: 99%

Documentation of Screening for Firearm Access by Healthcare Providers in the Veterans Healthcare System: A Retrospective Study

Brandt¹,

Workman²,

Farmer³

et al. 2021

WJEM

View full text Add to dashboard Cite

show abstract

“…It is increasingly clear that addressing firearm safety in clinical situations constitutes an ethical imperative that physicians should satisfy, particularly as physician skills in counseling patients about firearm violence prevention are increasingly considered key to helping prevent firearm deaths [12,31]. Fulfilling this imperative requires the cultural competence and nuance necessary to have dedicated and respectful conversations with patients [13].…”

Section: Discussionmentioning

confidence: 99%

Continuing Medical Education and Firearm Violence Counseling

2018

AMA Journal of Ethics

View full text Add to dashboard Cite

show abstract

“…Despite encouraging findings, social workers may encounter some resistance from their clients to discussing guns. As evidenced by the now-defunct Florida law that regulated patient conversations about guns, some proportion of the American public clearly feels that these conversations are an intrusion of their rights (Parent, 2016). Moreover, asking about some clients' access to guns may be equivalent to asking whether they are disobeying the law, as some individuals with criminal records may be prohibited from possessing weapons.…”

Section: Recommendations For Social Workers In Practicementioning

confidence: 99%

Social Work Practice and Gun Safety in the United States

Logan-Greene

Sperlich²,

Finucane³

2019

ASW

View full text Add to dashboard Cite

Public policy debate about guns continues in the United States, with many professional organizations taking strong stands in policy statements. Moreover, many clinical organizations have provided recommendations for practitioners to use with clients to encourage gun safety in the home, particularly for vulnerable populations such as families with young children and those at risk of suicide. Social workers are in an excellent position to encourage gun safety with some of the most at-risk populations; however, clinical guidelines and research on preventing gun violence has lagged in social work compared to other disciplines. In this article we examine the importance of gun safety for social work clients (with special attention to families with children, families experiencing violence, and individuals at risk of suicide), consider the recommendations made by other professional organizations, and provide some initial thoughts about how social workers might engage with the families they serve to reduce the incidence of gun violence.

show abstract

Physicians Asking Patients About Guns: Promoting Patient Safety, Respecting Patient Rights

Cited by 14 publications

References 19 publications

Documentation of Screening for Firearm Access by Healthcare Providers in the Veterans Healthcare System: A Retrospective Study

Documentation of Screening for Firearm Access by Healthcare Providers in the Veterans Healthcare System: A Retrospective Study

Continuing Medical Education and Firearm Violence Counseling

Social Work Practice and Gun Safety in the United States

Contact Info

Product

Resources

About