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Establishing a treatment relationship with a mental healthcare provider can be difficult for myriad reasons. This chapter discusses the different types of mental healthcare providers, including prescribing clinicians, psychotherapists, and behavior analysts. All bring a unique and useful perspective to treatment. When deciding on the right provider, it is important to consider the symptoms and behaviors to be addressed. Providers can be found through recommendations of primary care physicians, PWS associations, professional organizations, state licensing boards, and recommendations of friends or family members. Finally, while ending a relationship with a provider can be difficult, there are times when it may be necessary in order to provide continuity or improve the quality of care you or your loved one is receiving. A collaborative relationship with your loved one’s treating clinician is based on trust and strengthened overtime. With careful cultivation, your relationship with a provider can prove to be long-lasting support to your loved one with PWS.
Consultation and decision making form a central and critical part of non-medical prescribing practice. This chapter introduces the reader to key consultation and decision-making models which can be used to help practitioners guide their development in this area. The importance of communication and consideration of the patient’s health beliefs will be discussed. Some of the evidence related to consultation by different non-medical prescribing professions will be explored. Frameworks supporting good prescribing will be discussed as well as influences on prescribing.
Benzodiazepine (BZD) prescription rates have increased over the past decade in the United States. Available literature indicates that sociodemographic factors may influence diagnostic patterns and/or prescription behaviour. Herein, the aim of this study is to determine whether the gender of the prescriber and/or patient influences BZD prescription.
Methods
Cross-sectional study using data from the Florida Medicaid Managed Medical Assistance Program from January 1, 2018 to December 31, 2018. Eligible recipients ages 18 to 64, inclusive, enrolled in the Florida Medicaid plan for at least 1 day, and were dually eligible. Recipients either had a serious mental illness (SMI), or non-SMI and anxiety.
Results
Total 125 463 cases were identified (i.e., received BZD or non-BZD prescription). Main effect of patient and prescriber gender was significant F(1, 125 459) = 0.105, P = 0 .745, partial η2 < 0.001. Relative risk (RR) of male prescribers prescribing a BZD compared to female prescribers was 1.540, 95% confidence intervals (CI) [1.513, 1.567], whereas the RR of male patients being prescribed a BZD compared to female patients was 1.16, 95% CI [1.14, 1.18]. Main effects of patient and prescriber gender were statistically significant F(1, 125 459) = 188.232, P < 0.001, partial η2 = 0.001 and F(1, 125 459) = 349.704, P < 0.001, partial η2 = 0.013, respectively.
Conclusions
Male prescribers are more likely to prescribe BZDs, and male patients are more likely to receive BZDs. Further studies are required to characterize factors that influence this gender-by-gender interaction.
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