Optical transfer diagnosis differentiating benign and malignant pigmented lesions in a simulated primary care practice
In this study, from the U.S.A., U.K. and Norway, the authors took images using OTD and then analysed 712 pigmented lesions (which could be moles or melanomas). Of them, 415 were harmless, or ‘benign’, and 297 were suspicious when examined by specialists using a magnifier called a dermatoscope. After image capture, all of the suspicious moles were biopsied and the tissue samples were examined under the miscroscope. Of the suspicious lesions, 80 proved to be cancer on biopsy (64 melanomas, and 16 other types of skin cancer). OTD misdiagnosed 1 of the 80 cancerous lesions as benign. If verified in further studies,...
Source: British Journal of Dermatology - February 14, 2018 Category: Dermatology Authors: D.L. Swanson, R.V. Venneugues, S.Q. Vicencio, J. Garioch, M. Biryulina, G. Ryzhikov, B. Hamre, L. Zhao, F.S. Castellana, K. Stamnes, J.J. Stamnes Tags: Plain Language Summary Source Type: research

Optical transfer diagnosis differentiating benign and malignant pigmented lesions in a simulated primary care practice
British Journal of Dermatology,Volume 178, Issue 2, Page e157-e157, February 2018. (Source: British Journal of Dermatology)
Source: British Journal of Dermatology - February 14, 2018 Category: Dermatology Source Type: research

Preventive care among primary care patients living with spinal cord injury.
CONCLUSION: There are many opportunities to improve the preventive care of patients living with SCI. PMID: 29424661 [PubMed - as supplied by publisher] (Source: Journal of Spinal Cord Medicine)
Source: Journal of Spinal Cord Medicine - February 11, 2018 Category: Orthopaedics Tags: J Spinal Cord Med Source Type: research

Educational Text Messages Decreased Emergency Department Utilization among Infant Caregivers: a Randomized Trial
Conclusions Sending educational text messages to caregivers is effective in reducing the number of visits to the ED. Given the accessibility and small expense of sending text messages, these findings have direct implications on the cost of healthcare, in addition to improving continuity and quality of care for pediatric patients. (Source: Academic Pediatrics)
Source: Academic Pediatrics - February 10, 2018 Category: Pediatrics Source Type: research

Impact of an Interprofessional Primary Care Training on Fear of Cancer Recurrence on Clinicians ’ Knowledge, Self-Efficacy, Anticipated Practice Behaviors, and Attitudes Toward Survivorship Care
AbstractThere are an estimated 15.5 million cancer survivors in the United States, with numbers projected to increase. Many cancer survivors are receiving survivorship care in primary care settings, yet primary care providers report a need for additional training on addressing medical and psychosocial concerns of cancer survivors. This paper presents findings from a pilot study on the effectiveness of a novel training for interprofessional primary care providers on the clinically significant issue of fear of cancer recurrence. The on-site training was provided to a total of 46 participants, including physicians (61%), phys...
Source: Journal of Cancer Education - February 10, 2018 Category: Cancer & Oncology Source Type: research

Embedding routine health checks for adults with intellectual disabilities in primary care: practice nurse perceptions
ConclusionWhile the trial found the intervention to be dominant over standard health care, the adjustments nurses made may not have maximised potential benefits to patients. Increasing training could further improve the benefits that health checks provide for people with IDs. (Source: Journal of Intellectual Disability Research)
Source: Journal of Intellectual Disability Research - February 9, 2018 Category: Disability Authors: S. Macdonald, J. Morrison, C. A. Melville, M. Baltzer, L. MacArthur, S. A. Cooper Tags: Original Manuscript Source Type: research

Embedding routine health checks for adults with intellectual disabilities in primary care: practice nurse perceptions
Journal of Intellectual Disability Research,Volume 62, Issue 4, Page 349-357, April 2018. (Source: Journal of Intellectual Disability Research)
Source: Journal of Intellectual Disability Research - February 9, 2018 Category: Disability Source Type: research

Clinical and metabolic features of the randomised controlled Diabetes Remission Clinical Trial (DiRECT) cohort
AbstractAims/hypothesisSubstantial weight loss in type 2 diabetes can achieve a return to non-diabetic biochemical status, without the need for medication. The Diabetes Remission Clinical Trial (DiRECT), a cluster-randomised controlled trial, is testing a structured intervention designed to achieve and sustain this over 2  years in a primary care setting to determine practicability for routine clinical practice. This paper reports the characteristics of the baseline cohort.MethodsPeople with type 2 diabetes for
Source: Diabetologia - February 7, 2018 Category: Endocrinology Source Type: research

Characteristics of Patient-Centered Medical Home Initiatives that Generated Savings for Medicare: a Qualitative Multi-Case Analysis
ConclusionsDesigners of future PCMH initiatives may increase their likelihood of generating net savings by incorporating the demonstration features we identified. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - February 5, 2018 Category: Internal Medicine Source Type: research

Frequency of Thyroid-Stimulating Hormone Monitoring in Patients After Thyroidectomy: A Retrospective Study in Primary Care Practices in Germany
This study included all individuals ≥18 years who had undergone a thyroidectomy between 2000 and 2015 in 258 general practices in Germany. Another inclusion criterion was a minimum of three medical visits between 2015 and 2016, following thyroidectomy. The primary outcome was the annual frequency of TSH monitoring in thyroidectomy patients in 2015. Demographic data included age, sex, and type of health insurance coverage (private versus statutory). Clinical and therapeutic data included the amount of time since the first thyroidectomy, thyroidectomy-associated diagnosis (thyroid cancer, noncancerous enlargement of the t...
Source: Experimental and Clinical Endocrinology and Diabetes - February 2, 2018 Category: Endocrinology Authors: Kostev, Karel Winiarski, Margarethe Sch üller, Lisa Sesterhenn, Andreas M. Jacob, Louis Tags: Article Source Type: research

Cervical Cancer Screening: What's New? Updates for the Busy Clinician
In the United States, 12,000 women are diagnosed with cervical cancer each year, even though the screening for this disease is safe and effective. There are 3 types of screening options available: cervical cytology (Papanicolaou  or “Pap” test), Pap/HPV (human papillomavirus) co-test, and HPV-only test. With simplified options such as HPV-only screening, providers who have been reluctant to incorporate cervical cancer screening into their primary care practice may feel more comfortable with offering these services to w omen. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - February 2, 2018 Category: General Medicine Authors: Salina Zhang, Megan McNamara, Pelin Batur Tags: Review Source Type: research

Quality Improvement to Immunization Coverage in Primary Care Measured in Medical Record and Population-Based Registry Data
Conclusions Medical record review indicated that QI efforts led to increases in immunization coverage in pediatric primary care. Results were partially validated in the IMR particularly among early childhood and adolescent groups, with a population-level impact of the intervention among adolescents. (Source: Academic Pediatrics)
Source: Academic Pediatrics - February 1, 2018 Category: Pediatrics Source Type: research

Team-Based Health Information Exchange Use Increased Mammography Documentation and Referral in an Academic Primary Care Practice: An Interrupted Time Series
AbstractBackgroundFew studies have examined the impact of health information exchanges (HIE) on quality in ambulatory settings.MethodsFrom September 29, 2014, to September 4, 2015, we conducted an interrupted time series analysis of query-based use of the state HIE as part of team-based care to improve mammography screening in an academic primary care practice. Women aged 50 –74 years with a practice visit and who were eligible for mammography were included. We conducted non-parametric data analysis using LOESS, followed by ARIMA analysis.ResultsDuring the study period, there were 2020 visits among 904 eligible ...
Source: Journal of General Internal Medicine - February 1, 2018 Category: Internal Medicine Source Type: research

Open communication strategies between a triad of 'experts' facilitates death in usual place of residence: A realist evaluation.
CONCLUSION: An empirically supported theory of how, for whom and in which circumstances death in usual place of residence happens is provided, which has important implications for both policy and practice. PMID: 29400631 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - February 1, 2018 Category: Palliative Care Authors: Dalkin S, Lhussier M, Jones D, Phillipson P, Cunningham W Tags: Palliat Med Source Type: research

Implementing the Addendum Guidelines for the Prevention of Peanut Allergy in a Primary Care Practice: A Quality Improvement Project
The “Addendum guidelines for the prevention of peanut allergy in the United States” was developed for use by both general practitioners and subspecialists. These were the first guidelines to provide the tools to help prevent development of peanut allergies. The aim of this quality improvement projec t was to assist a general pediatrics practice guideline implementation. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - February 1, 2018 Category: Allergy & Immunology Authors: Chloe L. Russo, Jennifer A. Shih Source Type: research

The acceptability and feasibility of lay ‐health led interventions for the prevention and early detection of cancer
ConclusionsLHW interventions to promote early diagnosis or screening were generally considered acceptable in a UK context. LHW interventions focussing on reducing cancer risk may be less feasible. (Source: Psycho-Oncology)
Source: Psycho-Oncology - February 1, 2018 Category: Cancer & Oncology Authors: Lorna McWilliams, Sarah Bellhouse, Janelle Yorke, Richard Cowan, Cathy Heaven, David P. French Tags: PAPER Source Type: research

Importance of comorbidities in the treatment of primary care patients with heart failure —Baseline results of the observational RECODE-HF Study
ConclusionFive somatic comorbidity groups as well as patient-reported psychosocial distress were significantly associated with a higher risk of GP-reported treatment difficulties. Further efforts to address comorbidities in clinical guidelines could be built on these results. (Source: Family Practice)
Source: Family Practice - January 29, 2018 Category: Primary Care Source Type: research

Estimating Associations Between Medical Home Adoption, Utilization, and Quality
Estimated " effects " of adopting medical home models can vary widely across different analytic strategies, even within the same primary care practices, performance measures, and timeframe. (Source: RAND Research Health and Health Care)
Source: RAND Research Health and Health Care - January 25, 2018 Category: Health Management Authors: Grant Martsolf; Ryan Kandrack; Matthew D. Baird; Mark W. Friedberg Source Type: research

The association between sex, age and health literacy and the uptake of cardiovascular prevention: a cross-sectional analysis in a primary care setting
ConclusionSex, age and health literacy affect engagement in healthy lifestyle choices and expectations towards preventative measure design. Consideration of these differences will allow better tailoring of preventative offers to the users ’ needs to increase their uptake. (Source: Journal of Public Health)
Source: Journal of Public Health - January 23, 2018 Category: Health Management Source Type: research

Capsule Commentary on Levine et al., Characteristics and Disparities of Primary Care Practices in the United States
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - January 23, 2018 Category: Internal Medicine Source Type: research

A Comparison of Health Risks among Adolescents from School-Based Health Centers and Primary Care Settings
Purpose: Most youth receive screening, education, and treatment of health risks through attending either a school-based health center (SBHC) or a primary care practice (PC). Little is known about the difference in health risk profiles of adolescents presenting across the two settings. We compared levels of health risk behaviors and psychosocial factors of adolescents across settings to better understand the needs of the youth they serve. (Source: Journal of Adolescent Health)
Source: Journal of Adolescent Health - January 17, 2018 Category: Child Development Authors: Adriana C. Arghira, Elon Gersh, Laura Paul Richardson, Cari A. McCarty Source Type: research

Primary Care Physician Perspectives about Antipsychotics and Other Medications for Symptoms of Dementia
Conclusions: PCPs continue to prescribe medications because they meet patient-oriented goals and because PCPs perceive drugs, including antipsychotics and their alternatives, to be more effective and less dangerous than evidence suggests. To optimally treat BPSD, PCPs need supportive verified prescribing guidelines and access to nonpharmacologic modalities that are as affordable, available, and efficacious as drugs; these require and deserve significant additional research and payer support. Community PCPs should be included in BPSD policy and guideline development. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 12, 2018 Category: Primary Care Authors: Kerns, J. W., Winter, J. D., Winter, K. M., Boyd, T., Etz, R. S. Tags: Original Research Source Type: research

Using Social Network Analysis to Examine the Effect of Care Management Structure on Chronic Disease Management Communication Within Primary Care
In this study, we examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. We sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager ’s connectivity within the practice’s communication network vary by the type of care management structure implemented?MethodsIndividual written surveys were given to all practice members in the participating practices. Survey questions assessed demographics as well as practice culture, quality improvement, care manag...
Source: Journal of General Internal Medicine - January 8, 2018 Category: Internal Medicine Source Type: research

Diagnostic Evaluation of Patients Presenting to Primary Care with Rectal Bleeding
ConclusionsDiagnostic evaluation of patients presenting to primary care with rectal bleeding may be suboptimal because of inadequate risk factor assessment and prioritization of patients ’ other concurrent medical problems. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - January 4, 2018 Category: Internal Medicine Source Type: research

Impact of Collaborative Care on Absenteeism for Depressed Employees Seen in Primary Care Practices: A Retrospective Cohort Study
Conclusions: Collaborative care led to faster improvement in depression symptoms but did not translate to less time away from work. (Source: Journal of Occupational and Environmental Medicine)
Source: Journal of Occupational and Environmental Medicine - January 1, 2018 Category: Occupational Health Tags: Original Articles Source Type: research

Rural Patients' and Primary Care Clinic Staffs' Perceptions of EHR Implementation: An Ethnographic Exploration
This focused ethnographic research study explores patients' and clinic staffs' experience of electronic health record (EHR) implementation in a small, independent, rural primary care practice. On the basis of participant observation of clinic staff, staff focus group, and patient interviews, results demonstrate that both patients and clinic staff have distrust and disconnect from technology. Yet, patients and clinic staff embrace patient-centered approaches and value team-based care. Understanding patients' and staffs' experience can facilitate the EHR implementation in the rural primary care setting and facilitate online ...
Source: The Journal of Ambulatory Care Management - January 1, 2018 Category: Emergency Medicine Tags: Original Articles Source Type: research

Impact of Collaborative Care on Absenteeism for Depressed Employees Seen in Primary Care Practices: A Retrospective Cohort Study
Conclusions: Collaborative care led to faster improvement in depression symptoms but did not translate to less time away from work. (Source: Journal of Occupational and Environmental Medicine)
Source: Journal of Occupational and Environmental Medicine - January 1, 2018 Category: Occupational Health Tags: Original Articles Source Type: research

Primary Care Physician Perspectives about Antipsychotics and Other Medications for Symptoms of Dementia.
CONCLUSIONS: PCPs continue to prescribe medications because they meet patient-oriented goals and because PCPs perceive drugs, including antipsychotics and their alternatives, to be more effective and less dangerous than evidence suggests. To optimally treat BPSD, PCPs need supportive verified prescribing guidelines and access to nonpharmacologic modalities that are as affordable, available, and efficacious as drugs; these require and deserve significant additional research and payer support. Community PCPs should be included in BPSD policy and guideline development. PMID: 29330235 [PubMed - in process] (Source: American Family Physician)
Source: American Family Physician - January 1, 2018 Category: Primary Care Authors: Kerns JW, Winter JD, Winter KM, Boyd T, Etz RS Tags: J Am Board Fam Med Source Type: research

Experiences of practice facilitators working on the Improved Delivery of Cardiovascular Care project: Retrospective case study.
CONCLUSION: Both practices encountered various barriers and facilitators throughout the IDOCC's 3 phases. The case studies reveal the complex interactions of these factors over time, and provide insight into the implementation of practice facilitation programs. PMID: 29358265 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - January 1, 2018 Category: Primary Care Authors: Liddy C, Rowan M, Valiquette-Tessier SC, Drosinis P, Crowe L, Hogg W Tags: Can Fam Physician Source Type: research

Translating aetiological insight into sustainable management of type 2 diabetes
AbstractUsing a low-energy diet as a tool, it has been possible to elucidate the sequence of pathophysiological changes that lead to the onset of type 2 diabetes. Negative energy balance in type 2 diabetes causes a profound fall in liver fat content resulting in normalisation of hepatic insulin sensitivity within 7  days. As the period of negative energy balance extends and liver fat levels fall to low normal, the rate of export of triacylglycerol from the liver falls. Consequent to this, the raised pancreas fat content falls and in early type 2 diabetes, normal first-phase insulin secretion becomes re-establ ished wi...
Source: Diabetologia - December 30, 2017 Category: Endocrinology Source Type: research

Behavioral and mental health risk factor profiles among diverse primary care patients
Publication date: Available online 22 December 2017 Source:Preventive Medicine Author(s): Beth A. Glenn, Catherine M. Crespi, Hector P. Rodriguez, Narissa J. Nonzee, Siobhan M. Phillips, Sherri N. Sheinfeld Gorin, Sallie Beth Johnson, Maria E. Fernandez, Paul Estabrooks, Rodger Kessler, Dylan H. Roby, Suzanne Heurtin-Roberts, Catherine L. Rohweder, Marcia G. Ory, Alex H. Krist Behavioral and mental health risk factors are prevalent among primary care patients and contribute substantially to premature morbidity and mortality and increased health care utilization and costs. Although prior studies have found most adults scre...
Source: Preventive Medicine - December 23, 2017 Category: International Medicine & Public Health Source Type: research

Frequent attenders in late life in primary care: a systematic review of European studies
High utilization of health care services is a costly phenomenon commonly observed in primary care practices. However, while frequent attendance in primary care has been broadly studied across age groups, aspec... (Source: BMC Family Practice)
Source: BMC Family Practice - December 20, 2017 Category: Primary Care Authors: Franziska D. Welzel, Janine Stein, Andr é Hajek, Hans-Helmut König and Steffi G. Riedel-Heller Tags: Research article Source Type: research

Identification of physicians providing comprehensive primary care in Ontario: a retrospective analysis using linked administrative data.
Abstract BACKGROUND: Given the changing landscape of primary care, there may be fewer primary care physicians available to provide a broad range of services to patients of all age groups and health conditions. We sought to identify physicians with comprehensive primary care practices in Ontario using administrative data, investigating how many and what proportion of primary care physicians provided comprehensive primary care and how this changed over time. METHODS: We identified the pool of active primary care physicians in linked population-based databases for Ontario from 1992/93 to 2014/15. After excluding...
Source: cmaj - December 19, 2017 Category: General Medicine Authors: Schultz SE, Glazier RH Tags: CMAJ Open Source Type: research

Practicing safety: a quality improvement intervention to test tools to enhance pediatric psychosocial care for children 0-3 years.
CONCLUSION: Lessons learned included that practices appreciate and can adopt brief interventions that have meaningful and useful tools and process to enhance psychosocial care for children 0-3 and that do not place a burden on pediatric practice. An innovative, quality improvement strategy, intuitive to pediatricians, with a brief intervention may help prevent child maltreatment. PMID: 29248033 [PubMed - as supplied by publisher] (Source: Primary Care)
Source: Primary Care - December 18, 2017 Category: Primary Care Authors: Abatemarco DJ, Gubernick RS, LaNoue MD, Pohlig RT, Slovin SR, Healy JA, Kairys S Tags: Prim Health Care Res Dev Source Type: research

Pathways to Medical Home Recognition: A Qualitative Comparative Analysis of the PCMH Transformation Process
ConclusionsFuture efforts at primary care transformation should take into account multiple pathways sites may pursue. Sites should be assessed on key cultural and implementation factors, in addition to structural components, in order to differentiate interventions and technical assistance. (Source: Health Services Research)
Source: Health Services Research - December 15, 2017 Category: Health Management Authors: Peter Mendel, Emily K. Chen, Harold D. Green, Courtney Armstrong, Justin W. Timbie, Amii M. Kress, Mark W. Friedberg, Katherine L. Kahn Tags: Research Article Source Type: research

Validity of Self-Rated Memory Among Middle-Aged and Older Chinese Adults
A self-rated memory survey item on the China Health and Retirement Longitudinal Study (CHARLS) performed poorly in comparison to objective measures of memory, signaling the need for caution in its use in survey research or primary care practice. (Source: RAND Research Health and Health Care)
Source: RAND Research Health and Health Care - December 15, 2017 Category: Health Management Authors: Zhiyong Huang; J ü rgen Maurer Source Type: research

Engaging Patients in Decisions About Cancer Screening: Exploring the Decision Journey Through the Use of a Patient Portal
Conclusions Although this sample was predisposed to screening, most patients wanted help in finalizing their decision. Many wanted to weigh the pros and cons and expressed fears of potential harms from screening. Understanding how patients approach decisions may help design more effective engagement strategies. (Source: American Journal of Preventive Medicine)
Source: American Journal of Preventive Medicine - December 12, 2017 Category: International Medicine & Public Health Source Type: research

Informing antimicrobial stewardship: factors associated with inappropriate antimicrobial prescribing in primary care
ConclusionsHigh frequency of potentially inappropriate antimicrobial prescribing, especially in certain patient populations, suggests the need for coordinated community-based AS programs to optimize prescribing and improve patient care. (Source: Family Practice)
Source: Family Practice - December 10, 2017 Category: Primary Care Source Type: research

Utility of a Precision Medicine Test in Elderly Adults with Symptoms Suggestive of Coronary Artery Disease
BackgroundDiagnosing obstructive coronary artery disease (CAD) is challenging in elderly adults, and current diagnostic approaches for CAD expose these individuals to risks from contrast dye and invasive procedures. DesignA Registry to Evaluate Patterns of Care Associated with the Use of Corus CAD in Real World Clinical Care Settings (PRESET; NCT01677156), pragmatic clinical trial. SettingCommunity, 21 primary care practices. ParticipantsOf 566 stable, nonacute outpatients presenting with symptoms suggestive of obstructive CAD, the 176 who were aged 65 and older (median age 70, 61% female) were the current study participan...
Source: Journal of the American Geriatrics Society - December 6, 2017 Category: Geriatrics Authors: Joseph A. Ladapo, Matthew J. Budoff, David Sharp, Jane Z. Kuo, Lin Huang, Bruce Maniet, Lee Herman, Mark Monane Tags: Clinical Investigation Source Type: research

Perception of smoking cessation resources and practices- a cross-sectional study in Portugal
Aim: To explore the perception of smoking cessation resources and clinical practices at a population level.Methods: Cross-sectional study based on CATI telephone interviews. Adults were surveyed in households selected randomly by telephone and stratified by region in mainland Portugal.Results: 1002 participants, mean age 46 ± 18 years, 52% females. Most (95%) reported the primary care practice as the setting to quit, followed by a private clinic or hospital, the community pharmacy (77%), and the public hospital (74%), p
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Belo Ravara, S., Braganca, F., Aguiar, P. Tags: Tobacco, Smoking Control and Health Education Source Type: research

Insight into frequent asthma exacerbations from a primary care perspective and the implications of UK National Review of Asthma Deaths (NRAD) recommendations
Conclusions: Understanding factors related to frequent exacerbations may allow initial modification of these in primary care, before referral to specialist asthma services.Reference: 1.Levy ML. The national review of asthma deaths: what did we learn and what needs to change? Breathe 2015;11:14.Funder:Novartis Pharmaceuticals [MEGS Grant] (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Chaudhuri, R., Thomson, N. C., McCallum, C., O'Pray, H., MacBride Stewart, S., Sharma, V., McSharry, C., Murray, D., Shepherd, M., Lee, W.-T. N., Barclay, S. T. Tags: General Practice and Primary Care Source Type: research

High prevalence of abnormal lung function is seen in children managed for asthma in primary care
Conclusion: Overall, 28% of our cohort had abnormal lung function. Obstructed spirometry was seen in both diagnosed and undiagnosed children in similar proportions. Spirometry altered clinical management in over one fifth of cases. This study supports the usefulness of paediatric spirometry in primary care. (Source: European Respiratory Journal)
Source: European Respiratory Journal - December 6, 2017 Category: Respiratory Medicine Authors: Lo, D., Danvers, L., Harcombe, N., Roland, D., Richardson, M., Yang, Y., Beardsmore, C., Wilson, A., Gaillard, E. Tags: Paediatric Asthma and Allergy Source Type: research

Primary care-led weight management for remission of type 2 diabetes (DiRECT): an open-label, cluster-randomised trial
Publication date: Available online 5 December 2017 Source:The Lancet Author(s): Michael EJ Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Renae Stefanetti, Michael Trenell, Paul Welsh, Sharon Kean, Ian Ford, Alex McConnachie, Naveed Sattar, Roy Taylor Background Type 2 diabetes is a chronic disorder that requires lifelong treatment. We aimed to assess whether intensive weight management...
Source: The Lancet - December 6, 2017 Category: General Medicine Source Type: research

Characteristics and Disparities among Primary Care Practices in the United States
ConclusionsParticipants ’ primary care practices were mostly independently owned, nearly always used EHRs (albeit of varying capability), and frequently participated in innovative payment arrangements for a portion of their patients. Patient practices in the South had fewer capabilities than the rest of the country. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - December 4, 2017 Category: Internal Medicine Source Type: research

Cancer Survivorship Care in Advanced Primary Care Practices
This case study of 12 advanced primary care practices investigates why primary care has not begun to integrate comprehensive cancer survivorship services. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - December 1, 2017 Category: Internal Medicine Source Type: research

Integration of Cancer Survivorship Care and Primary Care Practice
More than 10 years ago, the Institute of Medicine (IOM) released a seminal report,From Cancer Patient to Cancer Survivor: Lost in Transition. In this publication, the IOM highlighted the now more than 15 million US adults with a history of cancer and outlined necessary components of high-quality survivorship care. Not unexpectedly, implementation of the IOM recommendations relied on the availability of well-informed and responsive primary care survivorship clinicians. Yet, in the time since that report, the primary care and oncology workforce has shrunk (and will continue to do so), while clinician uncertainty and survivor...
Source: JAMA Internal Medicine - December 1, 2017 Category: Internal Medicine Source Type: research

Chronic disease outcomes from primary care population health program implementation.
Abstract OBJECTIVES: We implemented a health information technology-enabled population health management program for chronic disease management in academic hospital-affiliated primary care practices, then compared quality-of-care outcome measures among practices assigned a central population health coordinator (PHC) and those not assigned a PHC. STUDY DESIGN: Quasi-experimental. METHODS: Central PHCs were nonrandomly assigned to 8 of 18 practices. They met with physicians, managed lists of patients not at goal in chronic disease registries, and performed administrative tasks. In non-PHC practices, existi...
Source: The American Journal of Managed Care - December 1, 2017 Category: Health Management Authors: Ashburner JM, Horn DM, O'Keefe SM, Zai AH, Chang Y, Wagle NW, Atlas SJ Tags: Am J Manag Care Source Type: research

Clinical features of gastroesophageal reflux disease in patients with obstructive sleep apnea syndrome
Introduction: Literature data suggest that at least 50% of patients with sleep disturbance examined at primary care practices have comorbid conditions. Due to these comorbidities and complications, obstructive sleep apnea (OSA) is often associated with increased medical expenses, although costs can be reduced with early diagnostics and appropriate treatment. Gastroesophageal reflux disease (GERD) seems to be one of such conditions. Nowadays the prevalence of gastroesophageal disturbances and the relationships between OSA and GERD are not researched. (Source: Sleep Medicine)
Source: Sleep Medicine - December 1, 2017 Category: Sleep Medicine Authors: Y. Shaukovich Tags: Other Source Type: research

Rural Patients' and Primary Care Clinic Staffs' Perceptions of EHR Implementation: An Ethnographic Exploration
This focused ethnographic research study explores patients' and clinic staffs' experience of electronic health record (EHR) implementation in a small, independent, rural primary care practice. On the basis of participant observation of clinic staff, staff focus group, and patient interviews, results demonstrate that both patients and clinic staff have distrust and disconnect from technology. Yet, patients and clinic staff embrace patient-centered approaches and value team-based care. Understanding patients' and staffs' experience can facilitate the EHR implementation in the rural primary care setting and facilitate online ...
Source: The Journal of Ambulatory Care Management - November 29, 2017 Category: Emergency Medicine Tags: Original Articles Source Type: research

Implementation of a Standardized Medication Therapy Management Plus Approach within Primary Care
Conclusion: Implementing a clinical pharmacist-led MTM Plus service in the primary care setting is feasible. This study highlights that DGIs are common in older adults in family practice and indicates that PGx testing identifies additional MRPs that may otherwise go unnoticed in these patients. The experiences we shared can aid other clinicians in establishing successful MTM Plus services. Future studies should also measure the impact of such personalized medicine services on economic, clinical, and humanistic outcomes. This study has been registered with ClinicalTrials.gov (study No. NCT02748148). (Source: Journal of the ...
Source: Journal of the American Board of Family Medicine - November 27, 2017 Category: Primary Care Authors: Schwartz, E. J., Turgeon, J., Patel, J., Patel, P., Shah, H., Issa, A. M., Knowlton, O. V., Knowlton, C. H., Bain, K. T. Tags: Original Research Source Type: research