Primary Care: Clinics in Office Practice This is an RSS file. You can use it to subscribe to this data in your favourite RSS reader or to display this data on your own website or blog.

Nonpharmacologic and Rehabilitative Strategies to Address Chronic Pain
With benefits on pain and pain-related outcomes and low-risk profile, there has been an emphasis on nonpharmacologic management of chronic pain. Physical therapy uses exercises, manual therapies, and electrotherapy. Exercises include aerobic, strengthening, and flexibility exercises. Aquatic exercises have similar efficacy to land-based exercises. Multidisciplinary care uses a biopsychosocial approach. All are effective for pain-related outcomes. Occupational therapy focuses on ergonomics, joint protection, orthoses, and assistive devices. Limited evidence exists for taping, orthoses, assistive devices, thermotherapy, and ...
Source: Primary Care: Clinics in Office Practice - August 27, 2022 Category: Primary Care Authors: Hiu Ying Joanna Choi Source Type: research

Guidelines and Policies
Rising rates of prescription opioids for chronic pain from the 1990s along with a concomitant worsening overdose crisis led to rapid evaluation and public health strategies to curb problems with prescription opioids. Guideline development, grounded in solid theory but based on limited evidence that translated into rigid and discordant policies, has contributed to controversies in pain management, worsening the treatment experience for people experiencing chronic pain and highlighting existing inequities from a system clouded with systemic racism. Newer public health approaches need to evaluate root causes and be more holis...
Source: Primary Care: Clinics in Office Practice - August 17, 2022 Category: Primary Care Authors: David T. O ’Gurek, Menachem J. Leasy Source Type: research

Chronic Pain: Opportunities Amid Adversity
Chronic pain, experienced by patients across the lifespan, is a common global health problem. The management of chronic noncancer pain remains a discomfort among clinicians, in part, due to limited scientific understanding of the pathophysiology as well as difficulty accessing the comprehensive, multidisciplinary programs and services that are cited as best practice. In addition, the experience of how best to provide care to a person and population that experiences significant morbidity and effects quality of life amid limited evidence, limited effective treatments, treatment guidelines codified into law that stipulates ho...
Source: Primary Care: Clinics in Office Practice - August 4, 2022 Category: Primary Care Authors: David T. O ’Gurek Tags: Preface Source Type: research

Diabetes: A Growing Problem
As our country grows older and more obese, the number of people living with diabetes is increasing dramatically. While this is occurring, the pool of available endocrinologists and diabetologists (specialists trained to manage diabetes) has remained stable. Currently, roughly 85% of people with diabetes are treated by primary care physicians in primary care settings. This issue was written with you, the primary care provider, in mind. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 18, 2022 Category: Primary Care Authors: Lenny Salzberg Tags: Preface Source Type: research

Comprehensive Diabetes Care
In the era of panel management, I was surprised to learn that of nearly 2200 patients I provide primary care for, over 800 of these patients have diabetes. Many of these patients have complications of diabetes, and while many are well controlled, it is common for patients to inquire about new treatment and glucose-monitoring options. Certainly, the management of diabetes has changed dramatically since I finished training in the late 1990s. There are more oral medications, more insulins and insulin combinations, more novel classes of drugs, and avant-garde technology that allows for beaming your glucose reading to your cell...
Source: Primary Care: Clinics in Office Practice - May 18, 2022 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Diabetes Management
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 18, 2022 Category: Primary Care Authors: Lenny Salzberg Source Type: research

Copyright
ELSEVIER (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 18, 2022 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 - May 18, 2022 Category: Primary Care Source Type: research

Contents
Joel J. Heidelbaugh (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 18, 2022 Category: Primary Care Source Type: research

Forthcoming Issues
Chronic Pain Management (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 18, 2022 Category: Primary Care Source Type: research

Pharmacology —Insulin
Insulin is an important treatment in diabetes, and understanding insulin pharmacokinetics is vital to clinical practice. The primary care physician should be knowledgeable about the decision for use, initiation of treatment and titration as well as common pitfalls such as hypoglycemia and cost. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - April 27, 2022 Category: Primary Care Authors: Jay H. Shubrook, Kim M. Pfotenhauer Source Type: research

Macrovascular Complications
Because macrovascular complications of diabetes are the leading cause of mortality and decreased quality of life for individuals with diabetes, prevention and risk reduction are paramount. Besides lifestyle management, contemporary therapies can significantly reduce risk for cardiovascular events in diabetes. For primary prevention, most individuals should be on statin therapy, whereas those at high atherosclerotic cardiovascular disease risk should also be on glucagon-like peptide 1 receptor agonists (GLP1RA) or sodium/glucose cotransporter-2 inhibitors (SGLT2i) at any hemoglobin A1c. For secondary prevention, addition of...
Source: Primary Care: Clinics in Office Practice - April 25, 2022 Category: Primary Care Authors: Michael McRae, Cecilia C. Low Wang Source Type: research

The State of Telehealth Before and After the COVID-19 Pandemic
Telemedicine has been under-utilized and not well studied until the COVID-19 pandemic. At the onset of the pandemic, in-person care quickly transitioned to remote consultation, facilitated by legislation that waived regulations and increased payment parity. A comprehensive look at our collective experience with telemedicine as published in literature suggests it has many advantages for patients and healthcare providers, it can often result in outcomes similar to in-person care, and it may have cost-saving implications. We must better define what conditions are best suited to telemedicine and how to dispense that care remot...
Source: Primary Care: Clinics in Office Practice - April 24, 2022 Category: Primary Care Authors: Julia Shaver Source Type: research

Risk Factors and Lifestyle Interventions
There are many nonmodifiable and modifiable risk factors for type 2 diabetes. Nonmodifiable risk factors include age, genetics, epigenetics, and social determinants of health (including education level, socioeconomic status, and noise and arsenic exposure). Modifiable risk factors include obesity, the microbiome, diet, cigarette smoking, sleep duration, sleep quality, and sedentary behavior. Major lifestyle interventions to prevent and treat diabetes relate to these risk factors. Weight loss is the lifestyle intervention with the largest benefit for both preventing and treating diabetes. Exercise, even without weight loss,...
Source: Primary Care: Clinics in Office Practice - April 22, 2022 Category: Primary Care Authors: Lenard (Lenny) Salzberg Source Type: research

Glycemic Targets and Glucose Monitoring
Assessing glycemia over time remains a standard recommendation in the care of all people with diabetes. Glycemic assessment methods range from laboratory- and office-based methods to patient-based methods. Assessing A1c has long been the most common method of assessing overall glycemia. Continuous glucose monitoring (CGM) can also be used, especially via glucose management indicator or time-in-range, which can be useful especially when A1c might be impractical, unreliable, or inaccurate, or for glycemia assessment over a shorter interval. Other measures of glycemia, including hypoglycemia and glycemic variability, are beco...
Source: Primary Care: Clinics in Office Practice - April 22, 2022 Category: Primary Care Authors: Tamara K. Oser, Sean M. Oser Source Type: research