Conversations between doctors and their patients about firearms can save lives

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US firearm-related injuries. Credit: New England Journal of Medicine (2024). DOI: 10.1056/NEJMra2306867

Health care providers who counsel their patients about firearm safety and prevention can prevent future injuries or deaths, including suicides, violent injuries and unintentional injuries from firearms, according to a University of Michigan report.

In an article published in the New England Journal of MedicineResearchers at UM’s Institute for Firearm Injury Prevention are calling for firearm safety counseling to be included as a regular part of patient care and offering their report as a resource for physicians and health care systems.

Their article, “Clinical Approaches to the Prevention of Firearm-Related Injury,” provides an overview of evidence-based strategies that physicians and other clinicians can use with their patients, as well as data on firearm deaths and injuries and an overview of prevention approaches for various populations.

Strategies include screening for firearm availability and access, counseling on gun safety and locked storage, and tailored screening and intervention strategies for preventing firearm-related suicide, intimate partner violence, community violence, and firearm injuries in older adults.

“Physicians have a unique opportunity to engage with patients about firearm safety to prevent firearm suicide, unintentional injury and interpersonal violence by offering critical interventions shown to reduce injury risk,” says co-author Patrick Carter, co-director of the Institute. for Firearm Injury Prevention and a professor of emergency medicine at the medical school. He is also a professor of health behavior and health equity at the School of Public Health.

“Further, research shows that, when done correctly, patients are receptive to these discussions with their healthcare providers, and they can make a difference in the decisions patients make at home regarding firearm safety,” Carter said.

Rebecca Cunningham, former UM vice president for research and innovation and longtime firearms injury prevention researcher, co-authored the paper. She was named president of the University of Minnesota earlier this year.

The researchers’ guidelines come just months after the U.S. surgeon general declared gun violence an urgent public health crisis.

Firearms are one of the leading causes of death across all demographics, often leading to lifelong physical and mental health effects for survivors, as well as lasting consequences for families, friends and communities. Firearms are also the leading cause of death for children and adolescents ages 1 to 19.

In addition to approaches and strategies for physicians, the article also provides resources such as sample clinical screening questions you can use with patients to initiate discussions about gun safety, and step-by-step guidance on how to have evidence-based conversations with patients about firearm safety. , and an overview of firearms storage methods.

In addition, Carter and Cunningham emphasize the importance of nonjudgmental, patient-centered counseling that respects patients’ rights and motivations for firearm ownership, noting that counseling is most effective when physicians tailor safety recommendations to patients’ motivations, goals, and values.

They also outline steps healthcare leaders must take to advance prevention efforts in their healthcare systems, including by supporting the implementation of evidence-based counseling programs and providing additional training for physicians to improve the use of evidence-based counseling based programs to improve clinical practice. .

“Despite previous funding limitations, we now have a base of scientific evidence to support effective clinical practices to reduce firearm injuries,” Carter said. “It is critical for healthcare systems to provide physicians with the necessary time, training and resources to integrate evidence-based strategies for reducing firearm injuries and deaths into their clinical practice.

“We hope this article can be a resource for physicians and hospital systems looking to make an impact on reducing the risk of firearm injury in their patient populations and communities.”

More information:
Patrick M. Carter et al, Clinical Approaches to the Prevention of Firearm-Related Injury, New England Journal of Medicine (2024). DOI: 10.1056/NEJMra2306867

Provided by the University of Michigan


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