PREPARE PATIENTS ON NALTREXONE FOR EMERGENCIES
When you prescribe naltrexone (oral or intramuscular), it's important to educate patients about how the drug interacts with opioids so they know how to prepare for emergencies.
I tell patients that if they are in a situation where they require pain medicine, the health care professionals treating them need to know they are on naltrexone. Naltrexone is an opioid antagonist, so their pain may need to be treated more aggressively in these situations.
I also help my patients prepare for the possibility that they might not be able to verbally communicate with medical staff during an emergency. Therefore, I instruct patients to always have written information with them about naltrexone. We enter their prescription information into a medical ID in their smartphone. I also ask patients to download a wallet-sized medication information card (several templates are available online), and encourage them to order a medical alert bracelet. Some drug manufacturers offer these for physician offices to make available to patients.
Finally, I encourage patients to share information about naltrexone with their emergency contacts, who can be listed on the wallet cards.
EQUIP LOW-INCOME PATIENTS TO MONITOR BLOOD PRESSURE
Managing hypertension is a major focus for primary care, but low-income patients often face structural risk factors such as lack of access to healthy foods or safe exercise opportunities. Providing these patients a home blood pressure monitor may help them overcome some of these factors.
A study of patients with uncontrolled hypertension at a community clinic in an underserved area found that 82% of those who received a home blood pressure monitor achieved hypertension control; of those who did not receive a monitor, 54% achieved hypertension control. Patients in both groups completed the same number of clinic visits (four) in the six-month study period. The patients who received monitors self-reported higher levels of adherence to a treatment plan that included reducing sodium in their diet, keeping their medical appointments, and taking their medications.
Several clinicians who participated in the study said patients expressed that they were already motivated to check their blood pressure at home but did not have the financial wherewithal to purchase a home monitor. Insurance coverage of the monitors varies. The ones used in the study retail for $50–$60, but study participants received them free through community health grants.
Source:
- 1.Sarkar A, Nwokocha C, Nash SG, Grigoryan L. Empowering low-income patients with home blood pressure monitors to improve hypertension control. J Am Board Fam Med. 2024;37(2):187-195.
ASK FPM: STARTING A SIDE GIG
I'm thinking about starting a side gig. Do I need to notify my employer?
Yes. Depending on the type of work you will be doing, you may need to negotiate with your employer to start a second job, whether it's a self-employed gig or moonlighting for another company. Some physician employment contracts restrict other income opportunities, especially if they are closely related to your employer's business or might interfere with your primary job. Contracts may even require your employer's written consent before you start the second job. However, it may be possible to negotiate for restrictions to be removed or reduced. Depending on the type of work you will be doing, you should also ensure that you have the right malpractice or liability coverage. Consult with an attorney if you have questions. (For more on this topic, see “Find Your Side Gig: Extra Income Opportunities for Family Physicians,” FPM.)
