To Juul or Not To Juul: What We Know About The Health Effects of Vaping

E-cigarette use, also known as Vaping, has garnered national attention over recent years due to its rapidly rising popularity. While some claim it is the healthier alternative to cigarette smoking we need to reduce the 480,000 deaths in the US from smoking-related diseases each year, others warn that its popularity among teens has the potential to undo years of progress combating nicotine addiction and is just another attempt by the tobacco industry to lure a new generation of customers. Given this ongoing public conversation, it is up to health care providers to stay informed on the health effects of vaping and to educate their patients appropriately. This project aimed to synthesize what we currently know about the effects of e-cigarette use for health care providers and to equip them with ways to minimize the harms, while maximizing any potential benefits, of vaping. This presentation demonstrates the effectiveness of that intervention.https://scholarworks.uvm.edu/fmclerk/1558/thumbnail.jp

The 2017 Vermont Opioid Prescribing Rules: Prescriber Attitudes

Introduction. In July of 2017, Vermont enacted new rules on acute opioid pre- scribing to reduce misuse, addiction, and overdose associated with prescription opioids. The new rules include requirements of non-opioid therapy use when possible, querying VPMS, patient education and informed consent, and co-prescription of naloxone. Our study objective was to gain insight into the perspectives of opioid prescribers on the new rules. Methods. The 17-item survey included closed and open-ended questions addressing prescriber perceptions about the new rules as well as demographic information about respondents. The survey was sent to Vermont-based opioid prescribers via email, to multiple healthcare organizations and professional societies, and through personal contacts. Open-ended responses were categorized using paired reviewers and group consensus, using a grounded theory approach. Results. A total of 431 responses were obtained, with MD/DOs accounting for 65%, APRNs- 14%, DDS/DMD- 7%, PAs-13%, and NDs- 1%. Of the respondents, 75% thought that more restrictive opioid prescribing rules were necessary, 74% felt the new rules would have some positive effect on the opioid crisis, but only 48% were in favor of the new rules. Barriers to implementation included co-prescribing naloxone (50% were unsuccessful), justifying exceptions to rules in medical record (46% unsuc- cessful), considering non-pharmacologic therapies (39% unsuccessful), and adhering to prescription limits (31% unsuccessful). Conclusions. Roll-out of the new rules has been criticized for implementation issues, overall reducing favorability among prescribers. Feedback obtained may be utilized by the Vermont Health Department and by other states to improve current models of opioid prescribing.https://scholarworks.uvm.edu/comphp_gallery/1264/thumbnail.jp