Longitudinal Assessment: Where We Are and Why It Is Important
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Newton, W. P., Rode, K., O'Neill, T., Fain, R., Baxley, E. Tags: Board News Source Type: research

Initiation and Titration of Basal Insulin in Primary Care: Barriers and Practical Solutions
This article reviews strategies for the initiation of basal insulin therapy, with an emphasis on the characteristics and titration of second-generation basal insulins, introducing current guidelines and offering suggestions for recognizing and overcoming barriers to insulin therapy in the management of T2D. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Perreault, L., Vincent, L., Neumiller, J. J., Santos-Cavaiola, T. Tags: Clinical Review Source Type: research

Hepatitis C Update and Expanding the Role of Primary Care
Primary care physicians (PCPs) are increasing their role in the fight against the Hepatitis C Virus (HCV). Approximately 3.5 million Americans currently live with chronic HCV with rising incidence among young persons, especially those affected by the opioid epidemic. Online guidelines and drug interaction checkers streamline treatment and increase accessibility for both patients and providers. Although treatment with new Direct Acting Antiviral agents ensure cure rates that routinely exceed 95%, as well as cause fewer adverse effects than previously available interferon-based regimens, some states still restrict access to ...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Simoncini, G. M., Koren, D. E. Tags: Special Communications Source Type: research

Does My Patient with Multiple Comorbidities Have Heart Failure with Preserved Ejection Fraction, and Does It Matter?
Heart Failure with Preserved Ejection Fraction (HFpEF) is a common diagnosis and accounts for half or more of all cases of heart failure. Despite its high prevalence and significant morbidity, the pathophysiology of HFpEF remains incompletely understood. Patients diagnosed with HFpEF often have significant cardiac and extra-cardiac comorbidities. Given the availability of evidence-based treatments for common comorbidities, but not for HFpEF, the necessity of diagnosing HFpEF among symptomatic elderly patients with multiple comorbidities is unclear. This commentary raises the question of whether the search for the diagnosis...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Abramov, D. Tags: Special Communications Source Type: research

Opinions of Primary Care Clinicians and Psychiatrists on Monitoring the Metabolic Effects of Antipsychotics
This study aimed to compare primary care clinicians' and psychiatrists' attitudes toward metabolic monitoring and treatment of patients with SMI. Methods: Primary care clinicians and psychiatrists within 1 large urban integrated public health system were recruited to participate in this online survey study. Multivariate logistic regression analyses were used to examine if clinician characteristics were associated with attitudes or perceived barriers toward metabolic monitoring and treatment. Results: Response rates were 77% (164/214) of primary care providers and 69% (56/81) of psychiatrists completing the survey. There ...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Mangurian, C., Giwa, A., Brosey, E., Shumway, M., Dilley, J., Fuentes-Afflick, E., Perez-Stable, E. J., Schillinger, D. Tags: Research Letter Source Type: research

Patient Body Mass Index (BMI) Knowledge in a Rural Primary Care Population
Conclusion: In this cross-sectional cohort study, it was found that patients' knowledge about BMI and weight-related risk factors has increased modestly. However, despite the increase in patients' knowledge and discussions about BMI with their primary care physician, there was not a decrease in BMI. Future studies are needed to provide more detailed information about the discussion between patients and providers in relation to the patient's personal weight status. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Haggerty, T., Xiang, J., King, D. Tags: Brief Reports Source Type: research

Text Messages Can Encourage Patients to Discuss and Receive HIV Testing in Primary Care
Conclusion: Our proof-of-concept study suggests an HIV text message campaign may increase HIV testing by encouraging patients to initiate discussion with their physicians. This intervention may increase HIV testing among low-income populations. A larger study is needed to confirm these findings. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Wettermann, R., Marek, H., Giordano, T. P., Arya, M. Tags: Brief Reports Source Type: research

Does Ownership Make a Difference in Primary Care Practice?
Purpose: We assessed differences in structural characteristics, quality improvement processes, and cardiovascular preventive care by ownership type among 989 small to medium primary care practices. Methods: This cross-sectional analysis used electronic health record and survey data collected between September 2015 and April 2017 as part of an evaluation of the EvidenceNOW: Advancing Heart Health in Primary Care Initiative by the Agency for Health Care Research and Quality. We compared physician-owned practices, health system or medical group practices, and Federally Qualified Health Centers (FQHC) by using 15 survey-based...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Lindner, S., Solberg, L. I., Miller, W. L., Balasubramanian, B. A., Marino, M., McConnell, K. J., Edwards, S. T., Stange, K. C., Springer, R. J., Cohen, D. J. Tags: Original Research Source Type: research

Provider Perspectives of Patient Experiences in Primary Care Imaging
This study aimed to explore the perceived impacts imaging tests have on patients from the perspective of the primary care providers (PCPs) and determine PCPs' understanding of patient-centered outcomes (PCOs) from imaging tests. Methods: Recruitment of PCPs occurred at 4 family medicine clinics in Washington and Idaho. Primary care physicians, nurse practitioners, or physician assistants who order imaging tests were eligible to participate. Semistructured interviews explored providers' perceptions of patient experiences during the process of ordering, performing and following up on imaging tests. Classic content analysis ...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Zigman Suchsland, M. L., Hardy, V., Zhang, Y., Vigil, P. D., Collins, K. L., Woodhouse, W. M., Chou, R., Findlay, S. D., Lavallee, D. C., Thompson, M. J. Tags: Original Research Source Type: research

Clinicians' Perspectives on Barriers and Enablers of Optimal Prescribing in Patients with Dementia and Coexisting Conditions
Conclusions: Clinicians identified numerous barriers to and some facilitators of optimizing prescribing in people with dementia. More data are needed on the benefits and harms of stopping medications in this population. Research should also test different approaches for supporting informed decision making about medications by people with dementia and caregivers. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Green, A. R., Lee, P., Reeve, E., Wolff, J. L., Chen, C. C. G., Kruzan, R., Boyd, C. M. Tags: Original Research Source Type: research

Sources and Impact of Time Pressure on Opioid Management in the Safety-Net
Conclusions: Time pressure was identified as a major barrier to safer opioid prescribing. Efforts, including changes to reimbursement structures, are needed to relieve time stress on primary care clinicians treating medically and socially complex patients with CNCP in safety-net settings. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Satterwhite, S., Knight, K. R., Miaskowski, C., Chang, J. S., Ceasar, R., Zamora, K., Kushel, M. Tags: Original Research Source Type: research

The Impact of Increased Hydrocodone Regulation on Opioid Prescribing in an Urban Safety-Net Health Care System
Background: Hydrocodone-combination analgesics were changed from Schedule III to Schedule II to discourage the prescribing of these analgesics. Our primary aim was to explore the effect of hydrocodone rescheduling on opioid prescribing within an urban safety-net health care system. Methods and Design: Data were extracted from electronic records of ambulatory patients (N = 82,432 patients) prescribed hydrocodone-combination, codeine-combination, or tramadol opioid analgesics (N = 200,675 prescriptions) between October 6, 2013 and October 6, 2015. Data analyses modeled predicted probabilities of hydrocodone-combination pres...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Northrup, T. F., Carroll, K., Suchting, R., Villarreal, Y. R., Zare, M., Stotts, A. L. Tags: Original Research Source Type: research

Timely Outpatient Follow-up Is Associated with Fewer Hospital Readmissions among Patients with Behavioral Health Conditions
Conclusion: The findings provide evidence that timely linking of behavioral health patients to outpatient care after hospitalization is an effective care transition strategy, as it is likely to reduce readmission rates. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Pourat, N., Chen, X., Wu, S.-H., Davis, A. C. Tags: Original Research Source Type: research

A Cluster Randomized Trial Comparing Strategies for Translating Self-Management Support into Primary Care Practices
Conclusion: An interactive behavior change technology tool such as CTH can increase primary care practice SMS activities and improve patient HbA1c levels. Even brief practice facilitation assists practices in implementing SMS. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Dickinson, W. P., Dickinson, L. M., Jortberg, B. T., Hessler, D. M., Fernald, D. H., Cuffney, M., Fisher, L. Tags: Original Research Source Type: research

Practice Characteristics Associated with Better Implementation of Patient Self-Management Support
This study aimed to promote the translation of SMS into primary care practices and reported on key baseline practice characteristics that may impact SMS implementation. Methods: Thirty-six practices in Colorado and California participated in the study from December 2013 to March 2017. Practice administrators completed a Practice Information Form describing practice characteristics. Clinicians and staff (n = 716) completed the Practice Culture Assessment and the Patient-Centered Medical Home (PCMH) Monitor. Descriptive statistics were computed to determine practice characteristics related to culture, quality improvement, l...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Jortberg, B. T., Fernald, D. H., Hessler, D. M., Dickinson, L. M., Wearner, R., Connelly, L., Holtrop, J. S., Fisher, L., Dickinson, W. P. Tags: Original Research Source Type: research

Patient-Refined Messaging for a Mailed Colorectal Cancer Screening Program: Findings from the PROMPT Study
Conclusions: Among unscreened individuals in this population, live phone call reminders either alone or in combination with automated prompts and reminders outperformed automated approaches alone. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Coronado, G. D., Thompson, J. H., Petrik, A. F., Nyongesa, D. B., Leo, M. C., Castillo, M., Younger, B., Escaron, A., Chen, A. Tags: Original Research Source Type: research

Developing Patient-Refined Messaging for a Mailed Colorectal Cancer Screening Program in a Latino-Based Community Health Center
Discussion: Using BCT, we successfully incorporated participant feedback to adapt culturally relevant health messages to promote FIT testing among Latino patients served by community clinics. Materials will be tested in the larger Participatory Research to Advance Colon Cancer Prevention (PROMPT) trial. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Thompson, J. H., Davis, M. M., Michaels, L., Rivelli, J. S., Castillo, M. L., Younger, B. M., Castro, M., Reich, S. L., Coronado, G. D. Tags: Original Research Source Type: research

Provider and Staff Feedback on Screening for Social and Behavioral Determinants of Health for Pediatric Patients
This study highlights the various SDOH screening methods currently used in Boston CHCs, and the need for workflow and process individualization of SDOH screening and referral. Providers and clinical staff should be part of the discussion when implementing SDOH screening and referral procedures to ensure appropriate work flow, staff buy-in, and to maximize resources available. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Byhoff, E., Garg, A., Pellicer, M., Diaz, Y., Yoon, G. H., Charns, M. P., Drainoni, M.-L. Tags: Original Research Source Type: research

Family Physicians' Contributions to Rural Emergency Care and Urban Urgent Care
Using 2017 data, we demonstrate a sharp increase in the proportion of family physicians (FPs) working primarily in rural emergency departments and increasing numbers of FPs working in urgent care centers. Despite growth in emergency medicine–trained physicians, FPs are likely to continue to be the backbone of emergency care in rural America. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Peterson, L. E., Puffer, J. C., Nasim, U., Petterson, S., Newton, W. P. Tags: Policy Brief Source Type: research

Pawn and King Play: A Stalemate on Rural Emergency Medicine Staffing
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Gerard, W. A. Tags: Commentary Source Type: research

Content Usage and the Most Frequently Read Articles of 2018
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Lupo, P., Neale, A. V., Bowman, M. A., Seehusen, D. Tags: Editorial Office News and Notes Source Type: research

Family Medicine: Data Driven Practice with Emphasis on Underserved Patients
Family physicians' role and interest in caring for underserved or undertreated patients is quite evident in this issue of JABFM. One in 5 family physicians provide urgent or emergency care, which is particularly important in rural areas. Methods and resources for obtaining information about social determinants of health are variable. A data-rich article considers how family medicine practice ownership might be associated with quality outcomes. We have articles on using text messages to increase HIV testing and colon cancer screening for Latino patients. For patients with significant behavioral health disorders, 1 article c...
Source: Journal of the American Board of Family Medicine - May 8, 2019 Category: Primary Care Authors: Bowman, M. A., Neale, A. V., Seehusen, D. A. Tags: Editors ' Note Source Type: research

The American Board of Family Medicine: What's Next?
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Newton, W. Tags: Board News Source Type: research

Response: Re: The Complex Interpretation and Management of Zika Virus Test Results
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Lin, K. W., Kraemer, J. D., Piltch-Loeb, R., Stoto, M. A. Tags: Correspondence Source Type: research

Re: The Complex Interpretation and Management of Zika Virus Test Results
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Yasri, S., Wiwanitkit, V. Tags: Correspondence Source Type: research

Response: Re: Family Medicine and Obstetrics: Let's Stop Pretending
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Young, R. A., Sundermeyer, R. L. Tags: Correspondence Source Type: research

Re: Family Medicine and Obstetrics: Let's Stop Pretending
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Avery, D. M., Reed, M. D., Skinner, C. A. Tags: Correspondence Source Type: research

Screening for Psychotherapeutic Medication Misuse in Primary Care Patients: Comparing Two Instruments
Conclusions: Rates of prescription medication misuse were substantial with both RxCAGE and POMI-e showing promise as screening instruments. Future studies are needed to test prescription medication misuse screening tools in broader populations and pilot interventions for those screening positive. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Tong, S. T., Polak, K. M., Weaver, M. F., Villalobos, G. C., Smith, W. R., Svikis, D. S. Tags: Brief Reports Source Type: research

Reports of Two Broken Nexplanon(R) Rods
This report describes 2 cases of Nexplanon® rod breakage in an 18-year-old female and a 25-year-old female. The literature regarding damaged progestin implants is reviewed. These reports often involve an alteration in menstrual bleeding pattern and patients frequently request removal of bent or broken implants. The overall incidence of rod breakage and impact of damaged implants on contraceptive efficacy is not clear. Evidence based guidelines to inform management of suspected damage to contraceptive implants would be helpful. In the meantime, a shared decision-making process offering removal and replacement of damaged...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Campodonico, J., Wolfrey, J., Buchanan, J. Tags: Brief Reports Source Type: research

Emergency Department High Utilizers among Family Medicine Patients
Background: Increases in emergency department (ED) use are contributing to inefficient health care spending and becoming a public health concern. Previous studies have identified characteristics of ED high utilizers aimed at designing interventions to improve efficiency. We aim to expand on these findings in a family medicine outpatient population. Methods: We conducted a retrospective analysis on a population of ED high utilizers, defined as those who had been to the ED 6 or more times in 1 year, including medical and demographic characteristics from 2015 to 2017. Results: Compared with our source population, ED high ut...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Kirkpatrick, S., Agana, D. F. G., Lynch, K., Carek, P. J. Tags: Brief Reports Source Type: research

Relationship of Training in Acupuncture to Physician Burnout
Background: Physician burnout is an ongoing problem that affects both physician wellbeing and patient care. Burnout is characterized by emotional exhaustion and depersonalization. Studies have explored ways to prevent and alleviate burnout. Receiving training in acupuncture may reduce physician burnout. Objective: The purpose of this study is to determine if acupuncture training is associated with less patient depersonalization and less emotional exhaustion among physicians. Methods: These self-reported data were collected from a cross-sectional survey of family physicians at the Uniformed Services Academy of Family Phys...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Crawford, P. F., Rupert, J., Jackson, J. T., Walkowski, S., Ledford, C. J. W. Tags: Brief Reports Source Type: research

A Randomized Trial to Train Vulnerable Primary Care Patients to Use a Patient Portal
Background: Patient portals are becoming ubiquitous. Previous research has documented substantial barriers, especially among vulnerable patient subgroups such as those with lower socioeconomic status or limited health literacy (LHL). We tested the effectiveness of delivering online, video-based portal training to patients in a safety net setting. Methods: We created an online video curriculum about accessing the San Francisco Health Network portal, and then randomized 93 English-speaking patients with 1+ chronic diseases to receive 1) an in-person tutorial with a research assistant, or 2) a link to view the videos on thei...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Lyles, C. R., Tieu, L., Sarkar, U., Kiyoi, S., Sadasivaiah, S., Hoskote, M., Ratanawongsa, N., Schillinger, D. Tags: Original Research Source Type: research

Signs and Symptoms That Rule out Community-Acquired Pneumonia in Outpatient Adults: A Systematic Review and Meta-Analysis
Conclusions: Adults with an acute respiratory infection who have normal vital signs and a normal pulmonary examination are very unlikely to have CAP. Given a baseline CAP risk of 4%, these patients have only a 0.4% likelihood of CAP. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Marchello, C. S., Ebell, M. H., Dale, A. P., Harvill, E. T., Shen, Y., Whalen, C. C. Tags: Original Research Source Type: research

Impact of a Rapid Point of Care Test for Influenza on Guideline Consistent Care and Antibiotic Use
Conclusions: The use of a rapid PCR test did not significantly improve the likelihood of guideline consistent care. However, independent of test outcome, patients who received the test were more likely to receive an antiviral and less likely to receive an antibiotic or have a return visit within 2 weeks. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Dale, A. P., Ebell, M., McKay, B., Handel, A., Forehand, R., Dobbin, K. Tags: Original Research Source Type: research

Primary Care Physician Characteristics Associated with Low Value Care Spending
Conclusion: Our analysis suggests that LVC services are associated with specific PCP characteristics. Further research should assess the strength of these associations, and future policy efforts should focus on systemic interventions to reduce LVC spending. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Barreto, T. W., Chung, Y., Wingrove, P., Young, R. A., Petterson, S., Bazemore, A., Liaw, W. Tags: Original Research Source Type: research

Patterns of Diabetes Screening and Prediabetes Treatment during Office Visits in the US
This study was designed to review the prevalence of screening and treatment of prediabetes in the United States by using the National Ambulatory Medical Care Survey, as well as identify any factors associated with screenings and treatment. Methods: The National Ambulatory Medical Care Survey was used to examine a study sample of office visits between 2012 and 2015, reviewing the prevalence of screenings and lab services ordered or provided at each patient visit. Inclusion criteria consisted of the recommendations given by the American Diabetes Association including any patient ≥45 years or adult patient
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Shealy, K. M., Wu, J., Waites, J., Taylor, N. A., Blair Sarbacker, G. Tags: Original Research Source Type: research

Patient Characteristics Associated with Making Requests during Primary Care Visits
Conclusions: Primary care physicians should expect a greater frequency of requests from older patients, patients with greater symptoms bother or worry, more extroverted patients, patients with greater global life satisfaction, and patients with whom they have had prior visits. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Fenton, J. J., Magnan, E. M., Jerant, A., Kravitz, R. L., Franks, P. Tags: Original Research Source Type: research

The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium
Background: Little is known about the burden of atopic dermatitis (AD) encountered in US primary care practices and the frequency and type of skin care practices routinely used in children. Objective: To estimate the prevalence of AD in children 0 to 5 years attending primary care practices in the United States and to describe routine skin care practices used in this population. Design: A cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason. Setting: Ten primary care practices in 5 US states. Results: Among 652 children attending primary car...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Al-naqeeb, J., Danner, S., Fagnan, L. J., Ramsey, K., Michaels, L., Mitchell, J., Branca, K., Morris, C., Nease, D. E., Zittleman, L., Levy, B., Daly, J., Hahn, D., Dolor, R. J., Williams, H. C., Chalmers, J. R., Hanifin, J., Tofte, S., Zuckerman, K. E., Tags: Original Research Source Type: research

Barriers and Facilitators of Colorectal Cancer Screening in a Federally Qualified Health Center (FQHC)
Conclusion: In this study, the most common perceived barriers to return of screening fecal test kits were forgetfulness and lack of motivation. The most common perceived facilitators were live call reminders and postage-paid return envelopes. Understanding barriers and facilitators to FITs may be necessary to enhance cancer screening rates in underserved patient populations. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Ylitalo, K. R., Camp, B. G., Umstattd Meyer, M. R., Barron, L. A., Benavidez, G., Hess, B., Laschober, R., Griggs, J. O. Tags: Original Research Source Type: research

Improving the Adoption of Advance Directives in Primary Care Practices
Background: Oklahoma's Advance Directive completion rate is less than 10%. We compared the implementation performance of 2 advance directive forms to determine which form could be more successfully disseminated. Methods: The implementation of the Oklahoma Advance Directive (OKAD) and the Five Wishes form were compared in an 8-month pair-matched cluster randomized study in 6 primary care practices. The outcomes measured during the 22-week implementation included form offering rate, acceptance/completion rate by patients, and documentation in the chart. Twenty semistructured interviews with patients and clinicians were cond...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Wickersham, E., Gowin, M., Deen, M. H., Nagykaldi, Z. Tags: Original Research Source Type: research

Canadian HIV Care Settings as Patient-Centered Medical Homes (PCMHs)
Conclusions: HIV care in Canada is reasonably well aligned with the PCMH, irrespective of structure of settings. We propose the need for improvements in the use of electronic medical records, quality improvement strategies, and integration of mental health services to achieve better care delivery and health outcomes among PLWH in Canada. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Kendall, C. E., Shoemaker, E. S., Porter, J. E., Boucher, L. M., Crowe, L., Rosenes, R., Bibeau, C., Lundrigan, P., Becker, M. L., Asghari, S., Rourke, S. B., Liddy, C. Tags: Original Research Source Type: research

Assessment of the Generalizability of an eConsult Service through Implementation in a New Health Region
Conclusions: Adoption of the eConsult service in the South East Local Health Integration Network was successful. The service exceeded all adoption targets, and the number of completed cases demonstrated a consistently upward trend, suggesting continued growth beyond the study's duration. The service's rate of adoption, high levels of satisfaction, and use data similar to other regions all demonstrate eConsult's generalizability. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Liddy, C., Moroz, I., Mihan, A., Keely, E. Tags: Original Research Source Type: research

Implementation and Evaluation of a Laboratory Safety Process Improvement Toolkit
Conclusion: The usability and usefulness of the toolkit were related to the characteristics of the toolkit itself (adaptability, simplicity, and design quality and packaging, and guidance in planning) and practice processes (presence of practice champions and implementation teams). In a set of 2 practices in which laboratory testing process improvement was a high priority and where well-established QI infrastructure exists, the toolkit was easy to use with little technical assistance. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Kwan, B. M., Fernald, D., Ferrarone, P., Loskutova, N., Summers Holtrop, J., Staton, E. W., Westfall, J. M. Tags: Original Research Source Type: research

Practice Intentions of Family Physicians Trained in Teaching Health Centers: The Value of Community-Based Training
Family medicine residents who graduate from Federally Qualified Health Center–aligned Teaching Health Center (THC) training residencies are nearly twice as likely to pursue employment in safety-net settings compared with non-THC graduates. This trend has been consistent over the past few years, suggesting that the program is fulfilling its mission to strengthen primary care in underserved settings. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Levin, Z., Meyers, P., Peterson, L., Habib, A., Bazemore, A. Tags: Policy Brief Source Type: research

Stuck in Graduate Medical Education Traffic? Teaching Health Centers Are Family Medicine's High-Occupancy-Vehicle Lane
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Gravel, J. W. Tags: Commentary Source Type: research

Peer Reviewers for the Journal of the American Board of Family Medicine in 2018
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Bowman, M. A., Neale, A. V., Seehusen, D., Lupo, P. Tags: Editorial Office News and Notes Source Type: research

Multiple Research Methodologies Can Advance the Science of Family Medicine
This issue of the Journal evidences the wide variety of research methods that can effectively answer questions important to the practice of family medicine. For example, this issue includes 4 highly informative reports from qualitative or mix-methods research, plus surveys, a meta-analysis, a case report, and more. Mixed-methods were used to look at practice changes and to compare advance directive tools. Surveys were used to identify practical, but addressable, issues for mailed colon cancer screening tests, and the prevalence of atopic dermatitis, and emollient use in young children. Secondary analyses of national survey...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Seehusen, D. A., Bowman, M. A., Neale, A. V. Tags: Editors ' Note Source Type: research

American Board of Family Medicine Rolls Out Family Medicine Certification Longitudinal Assessment (FMCLA) as 2019 Pilot
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 4, 2019 Category: Primary Care Authors: Ireland, J. Tags: Board News Source Type: research

Re: Impact of Medical Scribes in Primary Care on Productivity, Face-to-Face Time, and Patient Comfort
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 4, 2019 Category: Primary Care Authors: Thom, D. H. Tags: Correspondence Source Type: research

Response: Re: If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 4, 2019 Category: Primary Care Authors: Guan, W., Schmuhl, N. B., Brown, H. W. Tags: Correspondence Source Type: research