Common Infectious Diseases
This article provides discussion of a series of common tropical and infectious diseases providing refugee and geographic contexts and links to international resources that have been developed to improve the care of newly arriving immigrants and refugees. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 18, 2020 Category: Primary Care Authors: Kevin Pottie, Vincent Girard Source Type: research

Caring for Refugees and Immigrants: Challenges and Opportunities
Refugees, immigrants, and asylum seekers are moving throughout the world in record numbers, bringing innovation, cultural enhancement, and diversity to their destinations. Refugees and asylum seekers flee their country of origin in hopes of a better, safer life in the country of resettlement. Immigrants travel to a new country for a variety of reasons, many reuniting with family or seeking employment or education. These diverse individuals contribute to society in meaningful ways through the arts, culture, science, and multiple other facets of life, as well as working arduous and lower-paid positions seen as less desirable...
Source: Primary Care: Clinics in Office Practice - December 14, 2020 Category: Primary Care Authors: Fern R. Hauck, Carina M. Brown Tags: Preface Source Type: research

The Time is NOW
As I write this foreword, the 2020 Presidential Election is only 3 short weeks away, and we are in the throes of the COVID-19 global pandemic. Similar to previous elections, health care provisions for Americans will be a top consideration for all voters. In the last decade, the United States has seen a dramatic influx of immigrants and refugees from around the world, as well as the inherent challenges in providing adequate health care for them. These challenges come with many barriers in policy, poor understanding of inherent cultural beliefs, and often insufficient training for health care providers across all disciplines...
Source: Primary Care: Clinics in Office Practice - December 9, 2020 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Preventive Care and Management of Chronic Diseases in Immigrant Adults
Immigrants may have variable access to chronic disease screening and treatment in their countries of origin and host country, often limited by their immigration status. Immigrants face barriers to chronic disease management and preventive care, including health insurance access, linguistic challenges, lack of culturally sensitive care, limited records, and acculturation. Health care providers should prioritize chronic disease screening and follow up regularly to encourage preventive care and self-management of chronic disease. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 7, 2020 Category: Primary Care Authors: Colleen Payton, Sarah Kimball, Nicole Chow Ahrenholz, Mark L. Wieland Source Type: research

Mental Health and Illness
Circumstances forcing individuals and families to flee set the stage for disruptions in mental health and forge resilience. Individual characteristics and conditions premigration, perimigration, and postmigration influence health, mental health, care-seeking behavior, and stages of well-being and successful resettlement. Primary care providers have strategies to promote mental well-being, including focusing on resilience and social determinants of health. Integrated or collaborative care models are ideal for delivering optimum care for refugee and immigrant communities. Connecting primary and behavioral care promotes a tea...
Source: Primary Care: Clinics in Office Practice - December 3, 2020 Category: Primary Care Authors: Kim S. Griswold, Dianne M. Loomis, Patricia A. Pastore Source Type: research

Preventive Care in Children and Adolescents
This article describes the current state of migration of immigrant children into the United Sates and the various categories of immigrant children, including refugees, asylum seekers, unaccompanied minors, adoptees, and Special Immigrant Visa holders, hereafter called immigrant children. It focuses on guidelines for medical screening and management of newcomer immigrant children and adolescents and their ongoing preventive care. This article also addresses challenges unique to immigrant children and adolescents and the importance of culturally sensitive anticipatory guidance. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - November 27, 2020 Category: Primary Care Authors: Shruti Simha, Amy C. Brown Source Type: research

Common Hematologic, Nutritional, Asthma/Allergic Conditions and Lead Screening/Management
This article describes hematologic, nutritional, allergic/asthmatic conditions, lead screening, and management of these among immigrants and refugees. Some of these conditions present more frequently or differently in the newcomer population. Early identification and treatment are key to improving health outcomes. Screening and treatment suggested in this article are based on current guidelines and are intended for primary care providers who are caring for refugee and immigrant patients, especially within a medical home. Special considerations include level of education, instruction, demonstration, and cultural humility. (...
Source: Primary Care: Clinics in Office Practice - November 27, 2020 Category: Primary Care Authors: Brittany DiVito, Rachel Talavlikar, Sarah Seifu Source Type: research

Models of Health Care: Interprofessional Approaches to Serving Immigrant Populations
This article provides an in-depth understanding of the components necessary to develop a model of care addressing the needs of immigrants and to share opportunities and challenges associated with these models. This includes highlighting population- and individual-level factors important to caring for immigrant populations, providing guidance on creating a model of care that addresses these factors, and describing established clinics that exemplify various models of care. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - November 27, 2020 Category: Primary Care Authors: Catherine E. Elmore, Rebekah Compton, Erica Uhlmann Source Type: research

Refugee Medical Screening
The domestic medical examination of newly arrived refugees is a comprehensive medical visit. It includes a review of the overseas medical examination and a thorough medical and immigration history. It should include laboratory testing for infectious diseases, pregnancy, and other conditions as recommended by the Centers for Disease Control and Prevention and resettlement state, as well as a comprehensive physical examination with attention paid to conditions known to specific refugee groups. It should also include vaccinations for age-appropriate vaccine-preventable diseases. The concept of preventive care should be introd...
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Kelly Reese, Brianna Moyer Source Type: research

Effective Communication with Refugees and Immigrants
Immigrant and refugee patients may have limited English proficiency. Effective use of professional interpreter services reduces clinically significant errors and increases the quality of care. A multitude of professional interpreter services are available, and clinicians should carefully select the preferred modality of interpretation based on the type of encounter. Ad hoc interpreters, such as family members, are least preferred because of concerns of privacy and evidence of poorer outcomes. Children less than 18 years of age should only be used as interpreters in emergency situations. Professional telephonic, video, or i...
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Carina M. Brown, Scott Bland, Nadia Saif Source Type: research

Cultural Considerations in Caring for Refugees and Immigrants
This article describes the different ways culture affects health care, in terms of patient-related factors, health care provider –related factors, and health care system–related factors. This article also reviews interventions and best practices that draw on the incorporation of culture into health care and that thus may be effective for building cross-cultural understanding between providers and their immigrant and refug ee patients. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Joseph S. Tan, Claudia W. Allen Source Type: research

Women ’s Health and Gender-Specific Considerations
Women ’s health is largely influenced by cultural beliefs, local traditions, and access to care across the world. Immigrant and refugee women experience health in varied ways; prior experiences with health care and beliefs about health should be explored with women on their arrival to the United States. Topics that should be discussed include menstrual practices, contraception and beliefs about family planning, prior screening for preventable diseases, pregnancies and experiences with childbirth, sexual assault and trauma, and history of traditional practices, including female genital mutilation ( dependent on area o...
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Alison N. Huffstetler, Sarah I. Ramirez, Sarah N. Dalrymple, Megan H. Mendez Miller Source Type: research

Special Issues in Immigrant Medicine
Immigrants enrich the United States through economic contributions and unique perspectives. Immigrants find themselves navigating a new culture, a complicated health care system, unfamiliar social programs, and an ever-changing policy environment. They may be discouraged by unmet expectations of life in the United States, changing family dynamics, and discrimination. Screening for the social determinants of health is crucial, as not all patients will proactively seek the advice of their health care provider for these issues. Health care providers can assist and empower immigrants to navigate these challenges, as well as se...
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Kristina Johnson, Elizabeth Carpenter, Taylor Walters Source Type: research

Caring for the Forcibly Displaced
Immigration, and health issues surrounding the immigration status of patients, remains much in the media forefront and will likely remain so in the future due to ongoing political challenges. Although precise definitions of immigrants, refugees, and asylum seekers remain vitally important when framing discussions around immigration, all newcomers face health challenges. By educating themselves about these issues, health care professionals can better care for their patients, no matter their specialty. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - November 26, 2020 Category: Primary Care Authors: Jeffrey Walden Source Type: research

Autosomal Dominant Polycystic Kidney Disease
is an inherited multisystemic disorder of the renal tubules with subsequent formation of multiple cysts and enlargement of the kidney, affecting various organs. Diagnosis is initially suspected in those with family history and/or individuals who develop hypertension early on (secondary hypertension) or certain symptoms. Renal function is initially preserved for years secondary to compensatory mechanisms. Associated conditions include: liver cysts, berry aneurysms, kidney stones, etc. The disease course is variable, but patients often progress to end-stage renal failure by age 60. There is no known cure, however, risk fact...
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Authors: Parvathi Perumareddi, Darin P. Trelka Source Type: research

Nephrology
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Authors: Parvathi Perumareddi Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Source Type: research

Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Source Type: research

Forthcoming Issues
Immigrant Health (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - October 27, 2020 Category: Primary Care Source Type: research

Impact of COVID-19 on Resettled Refugees
Refugees are among the world ’s most vulnerable people, and COVID-19 presents novel threats to their well-being. Suspension of resettlement prolongs persecution for those accepted but not yet relocated to a host country and delays family reunification. For new arrivals, pandemic-related modifications to resettlement services impair smooth transitions. Refugees are additionally more vulnerable to economic hardship, COVID-19 infection, and mental illness exacerbations. Communication barriers make telehealth access uniquely difficult, and children lose the school environment that is essential for their adaptation in a n...
Source: Primary Care: Clinics in Office Practice - October 5, 2020 Category: Primary Care Authors: Micah Brickhill-Atkinson, Fern R. Hauck Source Type: research

Acute Kidney Injury
Acute kidney injury (AKI) is defined as an increase in serum creatinine or a decrease in urine output over hours to days. A thorough history and physical examination can help categorize the underlying cause as prerenal, intrinsic renal, or postrenal. Initial evaluation and management of AKI in the community setting includes laboratory work-up, medication adjustment, identification and reversal of underlying cause, and referral to appropriate specialty care. Even one episode of AKI increases the risk of cardiovascular disease, chronic kidney disease, and death. Therefore, early determination of etiology, management, and lon...
Source: Primary Care: Clinics in Office Practice - September 30, 2020 Category: Primary Care Authors: Jackcy Jacob, Joanne Dannenhoffer, Annie Rutter Source Type: research

Renovascular Hypertension
This article discusses various definitions of hypertension, approach to diagnosis of RVH, and management. Data from clinical trials are discussed with evidence-based medicine practice recommendations. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 30, 2020 Category: Primary Care Authors: Sai Sudha Mannemuddhu, Jason C. Ojeda, Anju Yadav Source Type: research

Nephrotic Syndrome
Nephrotic syndrome is one cause of end-stage kidney disease. Because edema is a common presenting feature and hypertension and dyslipidemia are often present in nephrotic syndrome, it is important for the primary care physician to suspect this entity. Common causes in adults include diabetic nephropathy, focal segmental glomerulosclerosis, and membranous nephropathy. In adults, many primary causes are due to an underlying disease. A cause of the nephrotic syndrome should be established with serologic workup and renal consultation. Renal biopsy is necessary in those with an unknown cause to or classify disease. Treatment fo...
Source: Primary Care: Clinics in Office Practice - September 24, 2020 Category: Primary Care Authors: Seth Anthony Politano, Gates B. Colbert, Nida Hamiduzzaman Source Type: research

Chronic Kidney Disease
Chronic kidney disease is encountered by the primary care physician, in no small part owing to the high rates of hypertension and diabetes, the 2 most common etiologies of chronic kidney disease in the United States. As a primary care physician, it is important to understand the epidemiology, pathophysiology, and evaluation methods of chronic kidney disease even before a referral to nephrology. Additionally, the primary care physician plays a vital role in mitigating the risks of chronic kidney disease as well as the complications and comorbidities. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 23, 2020 Category: Primary Care Authors: Cornelia Charles, Allison H. Ferris Source Type: research

Nephritic Syndrome
This article describes the pathophysiology, incidence, clinical presentation, treatment, and di sease progression of these nephritic syndrome entities, and provides guidance for when to refer to a nephrologist. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 23, 2020 Category: Primary Care Authors: Perola Lamba, Ki Heon Nam, Jigar Contractor, Aram Kim Source Type: research

Diabetic Kidney Disease
Diabetic kidney disease (DKD) is the most common cause of chronic kidney disease in the United States. Approximately 30% to 40% of individuals with diabetes mellitus develop DKD, and the presence of DKD significantly elevates the risk for morbidity and mortality. Understanding of DKD has grown in recent years. This review describes the pathogenesis of DKD and expands on evidence-based strategies for DKD management, integrating traditional approaches for hyperglycemia, hypertension, and albuminuria management with emerging therapeutic options. Given the public health burden of DKD, it is essential to prioritize prevention, ...
Source: Primary Care: Clinics in Office Practice - September 22, 2020 Category: Primary Care Authors: Ryan Bonner, Oltjon Albajrami, James Hudspeth, Ashish Upadhyay Source Type: research

Nephrolithiasis
This article highlights the pathogenesis of kidney stones, the risk factors for their formation, and common complications. The article concludes with management guidelines for nephrolithiasis and when primary care physicians should refer patients to nephrology or urology. In light of the current opioid epidemic, salient points for nonopioid treatment as initial treatment of nephrolithiasis likewise are discussed. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 22, 2020 Category: Primary Care Authors: Kelley Bishop, Tobe Momah, Janet Ricks Source Type: research

Renal Repercussions of Medications
Medications are a common cause of acute kidney injury and chronic kidney disease. Older patients with multiple comorbidities and polypharmacy are at increased risk and require extra diligence. Antimicrobials, antihypertensives, and nonsteroidal anti-inflammatory drugs are common offenders of drug-induced kidney injury. Other drug classes that can cause kidney damage include immunosuppressive medications, statins, proton pump inhibitors, and herbal supplements. Awareness of such medications and their mechanisms of nephrotoxicity helps decrease morbidity and mortality. If nephrotoxic agents cannot be avoided, hydration, avoi...
Source: Primary Care: Clinics in Office Practice - September 22, 2020 Category: Primary Care Authors: Rachel Shaddock, Katherine Vogel Anderson, Rebecca Beyth Source Type: research

Care of the Renal Transplant Patient
This article provides an overview of the renal transplant process from initial evaluation through surgery and then focuses on long-term issues that renal transplant patients face in the primary care setting. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 22, 2020 Category: Primary Care Authors: Jennifer G. Foster, Keith J. Foster Source Type: research

Preface
An estimated 40 million individuals in the United States have kidney disease according to the National Institute of Diabetes and Digestive Kidney Diseases, with an estimated 1 in 3 individuals at risk. Recent statistics reveal that there are close to 100,000 people on a list for kidney transplant per United Network of Organ Sharing with an average wait time of 3.6 years. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 22, 2020 Category: Primary Care Authors: Parvathi Perumareddi Source Type: research

Approach to Electrolyte Abnormalities, Prerenal Azotemia, and Fluid Balance
Volume and electrolyte evaluation and management is seen frequently in primary care practices. Some of the most common abnormalities encountered in outpatient practices are prerenal azotemia, dysnatremias, and altered potassium levels. Perturbations in volume or electrolyte concentrations can lead to serious organ dysfunction as well as hemodynamic collapse. This review focuses on the maintenance and regulation of intravascular volume and electrolytes, specifically sodium and potassium. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 18, 2020 Category: Primary Care Authors: Lisa C. Martinez, Sana F. Khan, Brendan T. Bowman Source Type: research

“So Am I Leaking Pasta?”
Like many organs, the science of the kidney has always fascinated me and has provided a constant challenge in solving the enigmatic mystery of its many functions. As my wife is a pharmacist, I am constantly challenged to consider the renal excretion of drugs and how declining function impacts metabolism and excretion. Of course, this challenge is never mastered, which keeps me motivated to keep learning. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - September 18, 2020 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Immunizing in a Global Society
The risk of travel-related illnesses that require vaccines varies depending on destination and traveler characteristics. Travelers who are not immune and going to countries and regions with endemic diseases are at risk of contracting vaccine-preventable diseases; they can serve as conduits of the disease on return to their home country. Individual travelers can work with a health care professional to assess travel risk based on diseases endemic to the region, time of year of travel, and presence of acute outbreaks. Travelers should discuss personal medical history, immunization status, purpose of trip, and other individual...
Source: Primary Care: Clinics in Office Practice - July 25, 2020 Category: Primary Care Authors: Oritsetsemaye Otubu, Ranit Mishori Source Type: research

Immunizations
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 25, 2020 Category: Primary Care Authors: Margot Savoy Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 25, 2020 Category: Primary Care Source Type: research

Contributors
JOEL J. HEIDELBAUGH, MD, FAAFP, FACG (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 25, 2020 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 25, 2020 Category: Primary Care Source Type: research

Forthcoming Issues
Nephrology (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 25, 2020 Category: Primary Care Source Type: research

Addressing Immunization Health Disparities
Vaccines can prevent illness but are effective only if they reach a majority of the population at risk. Disparities based on many factors, such as race and ethnicity, economic status, and rural versus urban locations of residents, are ongoing issues in the United States. Reasons for disparities include cost, access, coverage, attitudes/beliefs, and systems issues. At the government level, programs like Vaccines for Children, Medicaid reform, Medicare, and state efforts funded in part by 317 grants have helped reduce but not eliminate disparities. At a practice level, vaccine disparities can be addressed by community outrea...
Source: Primary Care: Clinics in Office Practice - July 6, 2020 Category: Primary Care Authors: Melissa L. Martinez, Sarah Coles Source Type: research

Improving Immunization Coverage in Special Populations
This highlights the key recommendations for immunization in the setting of chronic disease, children and adults with special needs, and health care providers. Immunization is an effective strategy to reduce the burden of suffering and cost of care from chronic disease. Standard child and adolescent and adult immunization schedules identify categories of high-risk conditions and chronic diseases. Clinicians need to develop systems to evaluate patients ’ risk factors and tailor immunization recommendations to their individual needs. Patients with intellectual disabilities, neurologic and neurodevelopmental disorders, a...
Source: Primary Care: Clinics in Office Practice - July 3, 2020 Category: Primary Care Authors: Mary M. Stephens, Erin Kavanaugh Source Type: research

Recognizing Vaccine-Preventable Diseases and Managing Outbreaks
This article describes the populations most at risk from illnesses associated with sporadic outbreaks, with information on diagnosis, treatment, and ways to limit the spread of infection. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 3, 2020 Category: Primary Care Authors: Jennifer L. Hamilton Source Type: research

What ’s New in Vaccine Science
Today vaccines can provide immunity against and treatment of a growing number of diseases including noninfectious conditions. Vaccine science continues to evolve newer and safer ways to deliver prevention and treatment of infectious and noninfectious diseases. This includes new adjuvants to enhance immunogenicity; delivery systems to reduce pain and improve acceptability; a wider range of uses including preventing emerging infectious diseases, such as Zika virus and Ebola, treatment of chronic diseases, such as cancer, and autoimmune disorders; and repurposing of existing vaccines, such as bacillus Calmette-Gu érin ...
Source: Primary Care: Clinics in Office Practice - July 3, 2020 Category: Primary Care Authors: Margot Savoy Source Type: research

Establishing and Maintaining a Vaccine-Positive Practice Culture
A vaccine-positive practice culture encourages immunization against vaccine-preventable diseases by supporting policies and practices that reduce barriers and improve efficacy for vaccine delivery. Key components of a vaccine-positive practice include a well-trained, knowledgeable, collaborative health care practice team; access to immunizations in the practice; and a vaccine practice champion. Leveraging these encourages a provaccine environment and fosters productive dialogue, even among vaccine-hesitant patients/parents. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 3, 2020 Category: Primary Care Authors: Amra A. Resic Source Type: research

Vaccine Policy in the United States
This article discusses the federal agencies involved in vaccine development and recommendation, other organizations involved in vaccine policy, and the role of vaccine-related public health law in promoting universal vaccination. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - July 3, 2020 Category: Primary Care Authors: John W. Epling Source Type: research

Impact of Human Papillomavirus Vaccination in Reducing Cancer
Human papillomavirus (HPV) is a significant cause of global morbidity and mortality. A nonavalent HPV vaccine is widely available and recommended for routine use at 11 to 12  years old. Older teens and adults though age 45 years also could be offered vaccination. Widespread use of the HPV vaccine appears to impact the rate of infections and cancers. Some parents/teens may hesitate to be vaccinated. The strongest predictor to receiving the vaccine remains a trusted hea lth care professional making a strong recommendation to receive the vaccine. New HPV vaccines are in the pipeline, including therapeutic vaccines t...
Source: Primary Care: Clinics in Office Practice - July 2, 2020 Category: Primary Care Authors: Mina S. Khan, Margot Savoy Source Type: research

The Immunization Conundrum
It is an intriguing time to be a vaccine science expert. At our fingertips is a wealth of safe, effective vaccines to prevent disease. We have expanding knowledge of how to identify those in greatest need and tailor the schedules to maximize their benefit in special populations. We leverage growing understanding of maternal immunity to boost immunity in our vulnerable infants, protecting them from deadly infectious diseases. We have access to rapidly advancing technology poised to transform immunization from a mechanism primarily to prevent infectious contagious disease to one that could treat and prevent chronic diseases....
Source: Primary Care: Clinics in Office Practice - July 2, 2020 Category: Primary Care Authors: Margot Savoy Tags: Preface Source Type: research

Vaccinating in Pregnancy: Opportunities and Challenges
The continuum of preconception, antenatal period, fourth trimester, and interconception period are a critical time for comprehensive care to advance maternal-child health and deliver family-centered care. Immunizations are a key component of this care delivery; however, there are intricacies around indications of vaccinations during this key period. Both active immunity to the individual receiving the vaccine as well as passive immunity passed to the fetus during pregnancy highlight the benefits of this care. Understanding the indications and benefits of vaccine administration during this continuum is critical for provider...
Source: Primary Care: Clinics in Office Practice - July 1, 2020 Category: Primary Care Authors: Alexandra Schieber, David O ’Gurek Source Type: research

Creating a Sustainable Vaccine Delivery Practice
Providing vaccines places a significant logistical and financial burden on an office but is important in providing care to patients. Start the process by finding a vaccine champion, choosing a primary and backup vaccine coordinator, and creating a team in the office to promote and administer vaccines. Follow best practices when storing and monitoring vaccines. Create office policies for ordering vaccines in a fiscally sound manner, accepting deliveries, and managing inventory. Have backup processes in place to avoid preventable errors when administering vaccines. In addition, bill vaccine administration codes appropriately...
Source: Primary Care: Clinics in Office Practice - July 1, 2020 Category: Primary Care Authors: Jamie Loehr Source Type: research

Communicating About Immunizations
A significant minority of patients and parents are vaccine hesitant, defined as having the desire to delay or defer immunizations despite easy access to vaccines. Vaccine hesitancy exists along a spectrum, from patients who are concerned but willing to accept the recommended vaccine schedule to those who wish to use a delayed schedule to those who refuse vaccines altogether. A strong recommendation in favor of a vaccine is the most important reason a patient or parent accepts the immunization. Structural changes, such as removing personal and religious exemptions for vaccines required for attending school, are effective to...
Source: Primary Care: Clinics in Office Practice - July 1, 2020 Category: Primary Care Authors: Jamie Loehr Source Type: research