TY  - JOUR
PY  - 2016//
TI  - Impact of a state law on physician practice in sports-related concussions
JO  - Journal of pediatrics
A1  - Flaherty, Michael R.
A1  - Raybould, Toby
A1  - Jamal-Allial, Aziza
A1  - Kaafarani, Haytham M. A.
A1  - Lee, Jarone
A1  - Gervasini, Alice
A1  - Ginsburg, Richard
A1  - Mandell, Mark
A1  - Donelan, Karen
A1  - Masiakos, Peter T.
SP  - 268
EP  - 274
VL  - 178
IS  - 
N2  - OBJECTIVE: To determine physician-reported adherence to and support of the 2010 Massachusetts youth concussion law, as well as barriers to care and clinical practice in the context of legislation. STUDY DESIGN: Primary care physicians (n = 272) in a large pediatric network were eligible for a cross-sectional survey in 2014. Survey questions addressed key policy and practice provisions: concussion knowledge, state regulations and training, practice patterns, referrals, patient characteristics, and barriers to care. Analyses explored relationships between practice and policy, adjusting for physician demographic and practice characteristics. <br><br>RESULTS: The survey response rate was 64% among all responders (173 of 272). A total of 146 respondents who had evaluated, treated, or referred patients with a suspected sports-related concussion in the previous year were eligible for analysis. The vast majority (90%) of providers agreed that the current Massachusetts laws regarding sports concussions are necessary and support the major provisions. Three-quarters (74%) had taken a required clinician training course on concussions. Those who took training courses were significantly more likely to develop individualized treatment plans (OR, 3.6; 95% CI, 1.1-11.0). Physician training did not improve screening of youth with concussion for depression or substance use. Most physicians (77%) advised patients to refrain from computer, telephone, or television for various time periods. Physicians reported limited communication with schools. <br><br>CONCLUSIONS: Primary care physicians report being comfortable with the diagnosis and management of concussions, and support statewide regulations; however, adherence to mandated training and specific legal requirements varied. Broader and more frequent training may be necessary to align current best evidence with clinical care and state-mandated practice.<br><br>Copyright © 2016 Elsevier Inc. All rights reserved.<p />  <p>Language: en</p>
LA  - en
SN  - 0022-3476
UR  - http://dx.doi.org/10.1016/j.jpeds.2016.08.025
ID  - ref1
ER  -