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Am Fam Physician. 2018;97(9):558

Residency Leaders Encourage Training in Opioid Prescribing

The American Academy of Family Physicians' (AAFP's) recent Residency Program Solutions conference included a session focused on an issue that many family physicians struggle with in their efforts to treat patients with chronic pain or who have become dependent on pain medication. The session's three-physician panel examined the roots of the opioid crisis and provided insight into what residents need to know. Predictors that indicate which patients are prone to misuse prescription opioids include a patient or family history of drug or alcohol abuse, a previous drug-related criminal conviction, or a psychiatric disorder. The panel identified universal precautions for opioid prescribing: evaluate the need; assess the risk; select the specific opioid; discuss with the patient and obtain written agreement and informed consent; monitor the patient closely; and document thoroughly. The panel also identified red flags in state prescription drug monitoring programs, including early refills, dosages greater than 100 mg per day, multiple concurrent prescribers or pharmacies, certain drug combinations, and escalating dosages. For more information, go to

EveryONE Project Unveils Team-Based Tools

To help family physicians modify their practices to better address patients' social determinants of health, the EveryONE Project from the AAFP has released a toolkit and implementation guide that focus on a team-based approach. Social determinants of health—the conditions under which a person is born, grows, lives, works, ages, and dies—account for a substantial proportion of health outcomes and are the primary driver of health inequalities. The AAFP created the EveryONE Project with the goal of advancing health equity by promoting evidence-based strategies that support community and policy changes, creating tools to help family physicians and their teams advocate for health equity, and collaborating with others who share these values. The EveryONE Project's implementation guide offers a practice assessment with a series of questions to help practices determine what changes they could make to the practice environment and workflow. The guide concludes with an implementation plan worksheet that family physicians can use to begin to address their patients' social determinants of health. For more information, go to

AAFP Approves Functional Medicine CME

The AAFP is now approving functional medicine topics for continuing medical education (CME) in accordance with the AAFP Credit System's eligibility requirements and topic-specific guidance issued by its Commission on Continuing Professional Development (COCPD). The Cleveland Clinic defines functional medicine as a personalized, systems-oriented model that empowers patients and practitioners to achieve the highest expression of health by working in collaboration to address the underlying causes of disease. The COCPD's topic-specific guidance on functional medicine specifies that activities and sessions eligible for CME credit are limited to those that provide clinicians with an overview of functional medicine and the techniques that functional medicine practitioners use. Activities that are ineligible for credit include those that teach clinicians how to perform techniques or applications of functional medicine in clinical practice. AAFP members may claim CME credit for functional medicine activities and sessions that are certified for credit by the AAFP Credit System. For more information, go to

New Immunization App Customizes Vaccine Recommendations

The AAFP and the Society of Teachers of Family Medicine (STFM) recently announced that the new Shots by AAFP/STFM applet has been added to the AAFP mobile app and is available in a stand-alone version. Shots by AAFP/STFM includes the latest guidance from the Advisory Committee on Immunization Practices' 2018 adult and childhood immunization schedules, including children's catch-up schedules. It also offers schedules for combination vaccines and can tailor vaccine recommendations according to specific medical conditions or other circumstances. Individual dosing schedules, potential adverse reactions, contraindications, brand names and Current Procedural Terminology codes, and resident education are listed for each specific vaccine. Physicians can enter a patient's information, medical conditions, and special circumstances (e.g., employment as a health care professional) to determine which vaccines are indicated. For more information, go to


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