Medicine and Health Sciences Commons^™

Safe Storage: Prevention Of Drug Misuse And Overdose With Locked Medication Bags, Emily Claire Battle

Family Medicine Clerkship Student Projects

Safe storage of medications is critical to public health and safety in the state of Maine as well as across the country. Current public health efforts target education and prevention of accidental ingestion of medication by children and animals at home. This has become especially important in Maine with the increasing prevalence of substances used for treatment of opioid use disorder, as well as increasing prevalence of other non-prescription substances including fentanyl, cocaine, and methamphetamine. In Lewiston, Maine, interviews with public health leaders, patients, and providers at the Family Medicine Residency at Central Maine Medical Center reiterated concerns for the …

Improving Nutrition Education And Access To Healthy Food For Low-Income Mainers, Jessica Wyn

Family Medicine Clerkship Student Projects

Many people in Androscoggin county are not able to consistently achieve a diet with the recommended food variety for improving health. Adequate nutrition for improving health outcomes requires access to healthy food at affordable prices, health literacy regarding diet and nutrition concepts, and the skills and access to equipment required to prepare and store food. A lack of resources in any one of these areas can limit a person’s ability to engage in a healthy diet, which increases their risk of developing preventable non-communicable diseases later in life.

Prescription Stimulants: Preventing Misuse Among Adults With Adhd, Sadie M. Casale

Family Medicine Clerkship Student Projects

Stimulant drugs are a cornerstone in the treatment of Attention Deficit and Hyperactivity Disorder (ADHD) and are being prescribed at increasing rates. The safe prescription and use of these drugs by providers and patients alike is critically important to appropriately treating ADHD and preventing misuse. This presentation discusses how patients can be educated on the uses of stimulants and provides information on what to do in case of overdose. Additionally, resources for providers are provided to continue improving awareness of at-risk patients and community resources available to them.

Increasing Narcan Distribution In A Primary Care Setting, Charlotte Evans

Family Medicine Clerkship Student Projects

Opioid use and overdoses are an ongoing health issue in Maine, especially in the Lewiston/Auburn metropolitan area. While Maine has a robust Narcan distribution system, it is not frequently given out in primary care settings. Though interviews and an anonymous survey, it seems the reason behind this is multifaceted, so multiple interventions were created to target both patient awareness and education and provider screening and prescription, with the goal of increasing distribution in this setting.

Utilization Of Pocus In Family Medicine At Cmmc, Jacob P. Cappiello

Family Medicine Clerkship Student Projects

Maine has a significant portion of patients who live in a rural area far from doctor’s offices and medical centers. Combined with a low SES population where transportation issues are common, POCUS can be an invaluable tool in an FM practice to reduce the number of appointments, and travel needed, for patients in need of healthcare. Access to Care was the number two health priority in the Franklin County community health needs assessment. This project surveyed family medicine practitioners at CMMC about their experience with, clinical use of, and willingness to continue education in POCUS. This survey had few respondents …

Integrating Artificial Intelligence Into The Mental Health Landscape, Luke Giangregorio

Family Medicine Clerkship Student Projects

The capabilities of the mental healthcare system have been vastly outpaced by present mental health demands. Chatbots are an innovative, self-engaging, adjunctive solution that might help mitigate system-wide implementation failures in access and offer real-time support instead of just being stuck on a long provider waitlist.

Improving Access To Medication Assisted Treatment For Opioid Use Disorder In A Rural Emergency Department, Warren Grunvald

Family Medicine Clerkship Student Projects

Opioid Use Disorder (OUD) is a growing epidemic throughout the United States and Maine has not been sparred by this. As the Emergency Department is a frequent location for people with OUD to interact with physicians it has been targeted as an opportunity to initiate Medication-Assisted Treatment (MAT) with Suboxone. This project details an effort to streamline this process and improve outcomes for patients interested in MAT.

Improving access to medication assisted treatment for opioid use disorder in a rural Emergency Department

Improving Access To Medication Assisted Treatment For Opioid Use Disorder In A Rural Emergency Department, Warren Grunvald

Family Medicine Clerkship Student Projects

Opioid Use Disorder (OUD) is a growing epidemic throughout the United States and Maine has not been sparred by this. As the Emergency Department is a frequent location for people with OUD to interact with physicians it has been targeted as an opportunity to initiate Medication-Assisted Treatment (MAT) with Suboxone. This project details an effort to streamline this process and improve outcomes for patients interested in MAT.

Accessible And Affordable Medications: Mainecare Edition, Amanda Nattress

Family Medicine Clerkship Student Projects

Addressing gaps in prescriber tools for accessible and affordable medications regarding the most common diagnoses in primary care. MaineCare Edition.

Home Exercise For Patients With Limited Access And Resources, Justin L. Esteban

Family Medicine Clerkship Student Projects

Patients with limited resources and who are socioeconomically disadvantaged, don’t have the time or resources available to partake/pursue exercise. Having a home workout program may prove to be beneficial to patients who don't have access to a gym, equipment, or are otherwise constrained by time.

Harm Reduction In Family Medicine, Tess Hickey

Family Medicine Clerkship Student Projects

In Lewiston, Maine the opioid epidemic is a public health crisis resulting in overdose-related deaths, infectious disease transmission, and public health costs. Harm reduction through resources such as syringe service centers, peer counseling, and Narcan distribution can help negate the negative health impact of substance use disorder. This project focused on creating a list of local harm reduction resources for providers so they can educate patients on how to be as safe as possible when using substances.

Covid-19 Vaccination: Educating Patients On Vaccine Availability And Distribution Plans In Lewiston, Me, Erick Maclean

Family Medicine Clerkship Student Projects

In December 2020, the U.S. Food and Drug Administration issued emergency use authorizations for two COVID-19 vaccines. Many patients at the Central Maine Medical Center Family Medicine Residency clinic had questions related to the vaccines and the plans for vaccine distribution in Maine. With the prevalence of misinformation related to the COVID-19 vaccines on the internet, there existed a need for accurate, easily understandable information to assist with patient education about the vaccines.

Dental Basics For The Pcp, Tierra Lynch

Family Medicine Clerkship Student Projects

Oral health is a key component of overall systemic health. However, dental care remains a severely under met need in healthcare today, especially in rural settings. Thus, the primary care physician may find herself presented with a variety dental pathology and may feel underprepared for this challenge.

The purpose of this project is to develop concise, evidence based resources regarding the identification, stabilization, and management of common dental pathologies for the primary care physician. Additionally, a database of local resources for patients including basic oral care and local dental clinics for those without insurance will be compiled. This project will …

Hepatitis A Vaccination In Adults, Francesca Garofalo

Family Medicine Clerkship Student Projects

No abstract provided.

Accessing Healthcare In The Era Of Covid-19 For Youth Experiencing Homelessness, Ray Mak

Family Medicine Clerkship Student Projects

Youth experiencing homelessness face multifactorial challenges in obtaining adequate health literacy. The COVID-19 pandemic has increased the need for healthcare as well as heightened confusion with the spread of health misinformation. This project aims to provide a step-by-step guide for when youth should seek medical treatment for COVID-19 to avoid unnecessary medical costs.

Eat, Sleep, Console For Neonatal Abstinence Syndrome Babies, Kathryn Patton

Family Medicine Clerkship Student Projects

Neonatal Abstinence Syndrome (NAS) is a complex disorder that manifests with neurologic, gastrointestinal, and musculoskeletal disturbances and is most often associated with opioid withdrawal. In the US, 6 out of 1,000 babies are born to mothers who used opioids during their pregnancy. These babies go on to develop NAS. Androscoggin County, where Central Maine Medical Center is located, has an even higher rate of babies with NAS: 100 out of 1,000. Most institutions use the Finnegan Neonatal Abstinence Scoring System (FNASS) to guide pharmacologic treatment. This system assigns a score based on 21 clinical signs of withdrawal with a score …

Oral Health Tips, Myths And Resources: A Guide To Lewiston Dental Care, Bridget Moore

Family Medicine Clerkship Student Projects

In a 2016 study, only 61.5% of Androscoggin County, Maine residents had visited a dentist in the past year. Barriers such as access and education limit residents' ability to obtain proper dental care. Most dental problems can be prevented through education on how to properly take care of one's teeth such as using a toothbrush twice a day. In order to increase patient education, a pamphlet was designed to explain proper dental hygiene and misunderstandings about dental health as well as provide resources for obtaining dental health in Lewiston, ME.

Restoring Self-Sufficiency With Suboxone Group Therapy, Jacob Thomas Lehman

Family Medicine Clerkship Student Projects

No different than many other Northeastern states, Maine continues to face an opioid epidemic. Drug-induced deaths continue to rise each year and Lewiston, ME remains no exception. In 2017 Maine saw 418 deaths related to drugs, a number that is only increasing every year. There remains a rising need for effective treatments such as medically assisted therapy. Starting in 2018, the Family Medicine Residency at the Central Maine Medical Center created such a group and began treating patients. The scope of this research is to track improvements in self-sufficiency among patients and to aide in advertisement of the program. Programs …

Needs Assessment: Complementary Medicine (Cm) Services, Zara S. Bowden

Family Medicine Clerkship Student Projects

In 2012, 33.2% of U.S. adults used complementary health approaches, spending over $30 billion. Despite this substantial investment and a growing body of research supporting the use of these approaches, access to them is still limited in the Primary Care setting. While Central Maine Medical Center’s Family Medicine Residency (CMMC FMR) has historically acknowledged the importance of an holistic approach to care, many of the complementary health approaches previously offered are no longer available. To determine specific, patient-identified needs regarding these approaches, a Needs Assessment was performed by surveying established patients presenting for appointments at CMMC FMR. The data collected …

Window Of Opportunity For Opiate Dependence, Scott C. Mitchell Ii

Family Medicine Clerkship Student Projects

Opiate dependence is a prevalent problem and there is a need for current regional information for those seeking to break opiate dependence. There is a small window of opportunity for these patients to seek and find help before they give up and return to using. This project provides a pamphlet with current resources for opiate dependent individuals to get help in a rapid period of time for the Bangor, Maine area.

Incontinence And Pelvic Floor Pt In The Primary Care Setting, Nikolas A. Moring

Family Medicine Clerkship Student Projects

Stress incontinence and overactive bladder are two causes of decreased quality of life in the general population. Many patients report a long latency between the onset of symptoms of incontinence and identification and treatment. This project aimed to provide educational materials to both providers and patients about incontinence to help better identify patients who may benefit from pelvic floor physical therapy. Pelvic floor physical therapy has been demonstrated as a safe, non-pharmacological intervention for stress incontinence which may be overlooked in the primary care setting.

Psa Screening In Lewiston Maine, Francis G. Gause Iv

Family Medicine Clerkship Student Projects

PSA Screening Patient Information for 2017 guidelines

Sad Management In Lewiston, Me, Ashley L. Deeb

Family Medicine Clerkship Student Projects

Seasonal affective disorder may be a significant issue in Lewiston, ME due to it's latitude. In addition, lack of transportation and poverty are also issues in this community. This project attempts to address treatment and increase awareness of SAD in Lewiston.

Counseling Pregnant Women On Marijuana Use, Theresa B. Flanagan

Family Medicine Clerkship Student Projects

Marijuana is the most commonly used illicit substance for pregnant women nationwide, with rates of use trending upward. Marijuana use in Penobscot County is elevated well above the national average, and is likely to continue to rise with the legalization of recreational marijuana in the state of Maine. Though the American Congress of Obstetricians and Gynecologists (ACOG) discourages marijuana use during pregnancy and breastfeeding, studies have shown that providers do not emphasize counseling pregnant patients on marijuana use. This project looked at provider practices and perceptions regarding marijuana use during pregnancy at the Center for Family Medicine at Eastern Maine …

Concussion, Kasra Sarabakhsh

Family Medicine Clerkship Student Projects

Concussions are very common, especially among young athletes and students. Most patients are encouraged to rest and avoid activities that are physically and cognitively demanding. However, there is not much education regarding alcohol use after a concussion and its detrimental effects on brain recovery.

Familial Hypercholesterolemia In Lewiston/Auburn, Me: Directed Education Towards Improving Community Awareness, Omkar Betageri, Dervilla Mccann, Bethany Picker

Family Medicine Clerkship Student Projects

There is a need for an improved awareness about Familial Hypercholesterolemia to promote prompt treatment and long-term management amongst a population disproportionately affected by the disease, namely Franco-Americans in Lewiston-Auburn, Maine

Marijuana Use Counseling During Pregnancy, Adam Petchers

Family Medicine Clerkship Student Projects

Penobscot County, Maine has among the highest rates of marijuana use in the country, and Maine has recently voted to legalize recreational use of marijuana. Research has shown that pregnant women frequently seek out and are dissatisfied with information regarding the safety of marijuana use during pregnancy. We surveyed Family Medicine providers at the Center for Family Medicine at Eastern Maine Medical Center in Bangor Maine regarding their counseling of pregnant patients on the topic of marijuana use. From the results, we created an information sheet to aid providers in marijuana use counseling with pregnant women.

Educating Providers On The Value Of Community Health Outreach Workers In The New Mainer Population, Julia Lane Cowenhoven

Family Medicine Clerkship Student Projects

Lewiston, Maine has seen a recent surge of asylum seekers, refugees, and migrants, mainly from African Countries, termed New Mainers. Community health outreach workers (CHOWs) are front line public health workers who are trusted members of the community being served, which enables them to serve as a liaison between providers and their patients. Educating providers on the role of CHOWs may increase their utilization in the clinical setting and improve the quality of care for the New Mainer population in Lewiston.

Mat For Opioid Use Disorder In Maine, Eliot S. Jia

Family Medicine Clerkship Student Projects

Opioid Use Disorder (OUD) is a major problem in the state of Maine with one person dying from overdose every day. Medication Assisted Treatment (MAT) using Suboxone has been shown to be helpful in the treatment of OUD, but there is currently a great need for providers to prescribe Suboxone in this region. We looked at barriers that providers saw for obtaining a waiver to prescribe Suboxone and created a handout to educate providers on MAT and the process for getting the waiver.

Confronting Barriers To Exercise In Patients With Chronic Health: Community Health Improvement Project In The Lewiston/Auburn Area Concerns, Marie R. Lemay

Family Medicine Clerkship Student Projects

The CDC recommends at least 150 minutes of moderate-intensity aerobic activity every week, but most individuals with chronic disease do not reach this goal despite its numerous health benefits. Research has shown that scheduled exercise programs and exercise partners help individuals to sustain their exercise goals. Using this premise of group mentality individuals affected from cancer at the Dempsey center and patients attending CMMC’s diabetes group in Lewiston ME were polled about exercise self –efficacy and barriers to exercise. Subsequently, a one-time walking event was offered to the diabetes group and a phone-tree was introduced to one yoga class at …