Multiple Practical Facts and Ideas to Improve Family Medicine Care

Seconds count in a study on the best electronic health note format to reduce medical record charting time and increase accuracy. Directly observed family physician work is compared with Current Procedural Terminology (CPT) coding examples and notably under-recognized. This issue contains articles from single practices that that implemented new methods of care and other reports on practice innovations that can be more broadly implemented. We have articles on opioid medication use for acute low back pain in primary care, an electronic chronic pain consult service, a key question to identify potential opioid misuse risk, and newly implemented screening for other substances of abuse. Omissions (or gaps) in care are also highlighted: from the common types of omissions identified by primary care clinicians, self-reported low levels of substance use screening by family medicine prenatal care providers, and inadequate and inadequately available hospital discharge summaries. In addition, the most important alarm symptoms for a cancer diagnosis are reported.
Source: Journal of the American Board of Family Medicine - Category: Primary Care Authors: Tags: Editors ' Note Source Type: research

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Clinical reasoning is a cornerstone of evidence-based healthcare, in fact some would argue it’s the cornerstone of all healthcare. While there are many different processes, the ultimate purpose of clinical reasoning is to ensure the person seeking help has their needs identified then met, and the clinician has a basis upon which to decide which treatment they should offer. The approach we use in clinical reasoning, including the information we prioritise and search for, and the way we synthesise the information to make sense of it will depend on the model we have to explain our treatment approach. For example, if...
Source: HealthSkills Weblog - Category: Anesthesiology Authors: Tags: Chronic pain Clinical reasoning Occupational therapy Pain conditions Physiotherapy Professional topics Psychology Research Science in practice embodiment intersubjectivity making sense persistent pain Source Type: blogs
A Symphytum officinale Root Extract Exerts Anti-inflammatory Properties by Affecting Two Distinct Steps of NF-κB Signaling Jacqueline Seigner1, Marc Junker-Samek2, Alberto Plaza2, Gilda D‘Urso3, Milena Masullo3, Sonia Piacente3, Yvonne M. Holper-Schichl4*† and Rainer de Martin1*† 1Department of Vascular Biology, Medical University of Vienna, Vienna, Austria 2R&D, Procter &Gamble Health, Darmstadt, Germany 3Dipartimento di Farmacia, Università degli Studi di Salerno, Salerno, Italy 4Drehm Pharma GmbH, Vienna, Austria Symphytum officinale, commonly known as comfrey, constitute...
Source: Frontiers in Pharmacology - Category: Drugs & Pharmacology Source Type: research
Conclusion: Genetic associations of diseases considerably vary across populations which necessitates health-related genotyping efforts especially for so far understudied populations. SOM portrayal represents novel promising methods in population genetic research with special strength in visualization-based comparison of SNP data. Introduction Non-communicable polygenic diseases such as cancers, neurodegeneration, cardiovascular, and metabolic disorders have become the most prevalent type worldwide and account for the majority of death events in developed and transition economy countries (Habib and Saha, 2010; Benzi...
Source: Frontiers in Genetics - Category: Genetics & Stem Cells Source Type: research
Publication date: Available online 18 April 2019Source: Journal of Sport and Health ScienceAuthor(s): Xin Luan, Xiangyang Tian, Haixin Zhang, Rui Huang, Na Li, Peijie Chen, Ru WangAbstractA growing understanding of the benefits of exercise over the past few decades has prompted researchers to take an interest in the possibilities of exercise therapy. Because each sport has its own set of characteristics and physiological complications that tend to appear during exercise training, the effects and underlying mechanisms of exercise remain unclear. Thus, the first step in probing exercise effects on different diseases is the s...
Source: Journal of Sport and Health Science - Category: Sports Medicine Source Type: research
Million patients with chronic pain are treated with opioids and chronic low back pain (CLBP) is the top chronic non-cancer condition for which opioids are prescribed. There are very limited data on the psychosocial factors that can lead to opioid misuse. A multiple linear regression model was used to assess the association of opioid misuse (COMM) with pain severity (BPI), pain catastrophizing (PCS), mindfulness (MAAS) and disability (ODI) at baseline among subjects with low back pain (N  = 191) prescribed opioids. Controlling for opioid dose, the overall model was significant for perceived disability (F[4, 187] ...
Source: The Journal of Pain - Category: Materials Science Authors: Source Type: research
Abstract Among chronic low back pain (CLBP) patients, workers' compensation is associated with longer term prescription opioid analgesic use (OAU). The aim was to study the association between receiving Social Security Disability Insurance (SSDI) benefits and course of OAU. This prospective cohort study utilized data from primary care patients diagnosed with non-cancer CLBP. The outcomes were morphine equivalent dose (MED) - categorized as no OAU, 1-50mg MED, or>50mg MED - and change in MED over time using mixed multinomial logistic regression models. Covariates included sociodemographics, pain severity, pain m...
Source: Pain Physician - Category: Anesthesiology Authors: Tags: Popul Health Manag Source Type: research
These painkillers don ’t work against chronic pain. The UK must find alternatives to help sufferers in deprived areasPeople in Blackpool are twice as likely as the inhabitants of Wokingham to die before they are 70. Arecent paper which measured the distribution of opioids not by the number of prescriptions, but in equivalent units of morphine, found that NHS prescriptions of opioid painkillers have been generally rising in England and Wales, but have risen most in the north of England and more in poorer areas. Blackpool, again,tops the list. In part this is because poverty is correlated with chronic physical pain: bo...
Source: Guardian Unlimited Science - Category: Science Authors: Tags: Opioids Poverty Social exclusion Society Drugs Science Opioids crisis US news NHS Health GPs Doctors Conservatives Politics Austerity Economics Business Source Type: news
Chronic pain is a major source of suffering. It interferes with daily functioning and often is accompanied by distress. Yet, in the International Classification of Diseases, chronic pain diagnoses are not represented systematically. The lack of appropriate codes renders accurate epidemiological investigations difficult and impedes health policy decisions regarding chronic pain such as adequate financing of access to multimodal pain management. In cooperation with the WHO, an IASP Working Group has developed a classification system that is applicable in a wide range of contexts, including pain medicine, primary care, and lo...
Source: Pain - Category: Anesthesiology Tags: Narrative Review Source Type: research
Conclusion Evidence of clinical benefit of most available apps is very limited. Design features that enhance usability and maximise efficacy were identified. A provisional 'first-pass' evaluation framework is proposed that can help decide which apps should be endorsed by government agencies following more detailed technical assessments and which could then be recommended with confidence by clinicians to their patients.What is known about the topic? Smartphone health apps have attracted considerable interest from patients and health managers as a means of promoting more effective self-management of chronic diseases, which l...
Source: Australian Health Review - Category: Hospital Management Authors: Tags: Aust Health Rev Source Type: research
If self-care steps for back pain such as gentle activity, local heat, or massage don’t ease discomfort within a few weeks to a month, or if you struggle with chronic low back pain, a physiatrist can help you navigate the dizzying number of treatment options. These range from conservative therapies (such as medicines, physical therapy, and chiropractic care) to more invasive options (such as spine injections and spinal surgery). What is a physiatrist? Physiatrists are medical doctors who specialize in physical medicine and rehabilitation. We focus on holistic, nonsurgical care aimed at improving function for people wh...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Back Pain Bones and joints Health Pain Management Source Type: blogs
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