Chan Cynthia, Zhu Grace, Liddy Clare, Myran Daniel T, Keely Erin, Radhakrishnan Arun
Family physician practising in Ontario.
Family physician practising in British Columbia.
Can Fam Physician. 2025 May;71(5):e82-e89. doi: 10.46747/cfp.7105e82.
To determine the major themes among clinical questions asked to addiction medicine specialists sent by primary care providers (PCPs) via the Champlain Building Access to Specialists through the eConsultation (BASE™) electronic consultation (eConsult) service and the PCP-perceived benefits of this service.
A descriptive, retrospective study of the eConsult cases submitted to addiction medicine specialists between January 1, 2020, and December 31, 2021.
Champlain region of eastern Ontario.
Primary care providers who sent an eConsult to addiction medicine.
The BASE™ eConsult service was used to facilitate communication between PCPs and addiction medicine specialists.
The classification of question types and clinical topics asked in eConsult cases sent to addiction medicine specialists by PCPs, and the answers in the close-out surveys completed by PCPs after eConsult was completed.
Primary care providers sought advice regarding opioids (38.0%) and alcohol (34.9%). The most common question types involved pharmacologic (77.5%) and nonpharmacologic (65.1%) management of patients with substance use. Electronic consultations were most frequently related to the clinical topic of chronic pain (28.7%). Over 95% of eConsults were answered by a specialist within 7 calendar days. Providers reported finding the eConsult responses helpful, with nearly one-third of PCPs reporting a potential referral was avoided following an eConsult from specialists.
This study demonstrates that PCPs sought advice on management regarding opioids and alcohol, reflecting the challenges in controlled substance prescribing during an opioid crisis, with alcohol use disorder being the most prevalent substance use disorder in Canada. The eConsult service provided an accessible, timely, and beneficial process for PCPs to obtain addiction medicine specialist advice. Given the overlap with the COVID-19 pandemic and the study timeframe, further studies to examine postpandemic eConsults will allow for better generalizability of the findings.
确定基层医疗服务提供者（PCP）通过尚普兰地区通过电子会诊获取专家服务（BASE™）电子会诊（eConsult）服务发送给成瘾医学专家的临床问题中的主要主题，以及PCP对该服务的感知益处。
对2020年1月1日至2021年12月31日期间提交给成瘾医学专家的eConsult病例进行描述性回顾性研究。
安大略省东部的尚普兰地区。
向成瘾医学发送eConsult的基层医疗服务提供者。
使用BASE™ eConsult服务促进PCP与成瘾医学专家之间的沟通。
PCP发送给成瘾医学专家的eConsult病例中所询问问题的类型和临床主题分类，以及PCP在eConsult完成后在结案调查中给出的答案。
基层医疗服务提供者寻求有关阿片类药物（38.0%）和酒精（34.9%）的建议。最常见的问题类型涉及物质使用患者的药物治疗（77.5%）和非药物治疗（65.1%）。电子会诊最常与慢性疼痛的临床主题相关（28.7%）。超过95%的eConsult在7个日历日内得到专家回复。提供者报告称发现eConsult回复很有帮助，近三分之一的PCP报告称在收到专家的eConsult后避免了潜在的转诊。
本研究表明，PCP寻求有关阿片类药物和酒精管理的建议，这反映了阿片类药物危机期间受管制物质处方方面的挑战，酒精使用障碍是加拿大最普遍的物质使用障碍。eConsult服务为PCP获取成瘾医学专家建议提供了一个便捷、及时且有益的过程。鉴于与COVID-19大流行和研究时间框架的重叠，进一步研究以检查大流行后电子会诊将使研究结果具有更好的普遍性。
