Older people's experiences of nurse ‐patient telephone communication in the primary health care setting
ConclusionDecision making by older people around treatment seeking is complex. Increasing the awareness of the nurse role in the General Practice is integral to creating a health system which will meet the needs of a growing older population. Primary care practices can review their systems to better inform older people how the nurse telephone role as a specific health service works and what they can expect when using this service.This article is protected by copyright. All rights reserved. (Source: Journal of Advanced Nursing)
Source: Journal of Advanced Nursing - September 1, 2017 Category: Nursing Authors: Susan Waterworth, Deborah Raphael, John Parsons, Bruce Arroll, Merryn Gott Tags: Original Research: Empirical research ‐ qualitative Source Type: research

Risk Stratification Methods and Provision of Care Management Services in Comprehensive Primary Care Initiative Practices.
CONCLUSIONS: CPC practices used 4 primary methods to identify high-risk patients. Although practices that developed their own algorithm identified the greatest number of high-risk patients, practices that used clinical intuition connected the greatest proportion of patients to care management services. PMID: 28893815 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - September 1, 2017 Category: Primary Care Authors: Reddy A, Sessums L, Gupta R, Jin J, Day T, Finke B, Bitton A Tags: Ann Fam Med Source Type: research

Effectiveness of the Spirometry 360 Quality Improvement Program for Improving Asthma Care: A Cluster Randomized Trial
Conclusions In this study, the Spirometry 360 distance learning QI program was ineffective in improving spirometry test quality or parent- or patient-reported outcomes. QI programs like the one assessed here may need to focus on practices with lower baseline performance levels or may need to be tailored for those with higher baseline performance. (Source: Academic Pediatrics)
Source: Academic Pediatrics - August 31, 2017 Category: Pediatrics Source Type: research

Registered Nurses in Primary Care: Emerging New Roles and Contributions to Team-Based Care in High-Performing Practices
This study examined the roles of RNs in 30 exemplary primary care practices. We identified the emergence of new roles and activities for RNs characterized by greater involvement in face-to-face patient care and care management, their own daily schedule of patient visits and contacts, and considerable autonomy in the care of their patients. (Source: The Journal of Ambulatory Care Management)
Source: The Journal of Ambulatory Care Management - August 30, 2017 Category: Emergency Medicine Tags: Original Articles Source Type: research

Addressing the Social Needs of Hypertensive Patients: The Role of Patient-Provider Communication as a Predictor of Medication Adherence [Original Articles]
Conclusions— The odds of poor medication adherence are greater when patient–provider interactions are low in patient centeredness and do not address patients’ sociodemographic circumstances or their medication regimen. (Source: Circulation: Cardiovascular Quality and Outcomes)
Source: Circulation: Cardiovascular Quality and Outcomes - August 22, 2017 Category: Cardiology Authors: Schoenthaler, A., Knafl, G. J., Fiscella, K., Ogedegbe, G. Tags: Hypertension, Compliance/Adherence, Quality and Outcomes Original Articles Source Type: research

Implementation of point-of-care testing in a general internal medicine practice: A confirmation study
Conclusions Our data confirm the earlier published findings that POCT can improve metrics of practice efficiency in a primary care practice. (Source: Clinica Chimica Acta)
Source: Clinica Chimica Acta - August 19, 2017 Category: Laboratory Medicine Source Type: research

Implementation of point-of-care testing in a general internal medicine practice: A confirmation study.
Abstract BACKGROUND: In a previous study we reported on the impact of point-of-care testing (POCT) on practice efficiency in an academic primary care practice that was established to develop new models of care delivery. Here we report a follow-on confirmation study in a more typical primary care practice in the community. METHODS: In this observational study with a retrospective comparison analysis we measured metrics of practice efficiency on two patient cohorts: those that did not receive POCT and those that did. RESULTS: In the patient cohort that received POCT there was a 99% reduction in letters to patients (p
Source: International Journal of Clinical Chemistry - August 19, 2017 Category: Chemistry Authors: Lewandrowski EL, Yeh S, Baron J, Benjamin Crocker J, Lewandrowski K Tags: Clin Chim Acta Source Type: research

Optical Transfer Diagnosis Differentiating Benign and Malignant Pigmented Lesions in a Simulated Primary Care Practice.
CONCLUSIONS: High sensitivity and specificity, as provided by OTD in this preliminary study, would help PCPs reduce the number of referrals for dermatology consultation, excision, or biopsy. Further studies are planned for screening patients in a primary care setting, with comparisons of OTD results to biopsy or dermoscopy results. This article is protected by copyright. All rights reserved. PMID: 28832952 [PubMed - as supplied by publisher] (Source: The British Journal of Dermatology)
Source: The British Journal of Dermatology - August 18, 2017 Category: Dermatology Authors: Swanson DL, Venneugues RV, Vicencio SQ, Garioch J, Biryulina M, Ryzhikov G, Hamre B, Zhao L, Castellana FS, Stamnes K, Stamnes JJ Tags: Br J Dermatol 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 541-546, February 2018. (Source: British Journal of Dermatology)
Source: British Journal of Dermatology - August 18, 2017 Category: Dermatology Source Type: research

Result of a nurse-led community-based education and coaching intervention for coronary heart disease high-risk individuals in China: a randomized controlled trial
Conclusion A 6-month community-based intervention in a CHD high-risk population improved disease related risk factors, depression, and HRQoL. Results provide preliminary evidence for primary prevent of CVD-risk in a community high-risk population. (Source: Asian Nursing Research)
Source: Asian Nursing Research - August 17, 2017 Category: Nursing Source Type: research

Referral for Expert Physical Activity Counseling: A Pragmatic RCT
Conclusions Provision of expert physical activity counseling to insufficiently active primary care patients resulted in a significant increase in physical activity (approximately 70 minutes of walking per week) at 12 months. Face-to-face only and counseling conducted predominantly via telephone were both effective. This trial provides evidence to expand public funding for expert physical activity counseling and for delivery via telephone in addition to face-to-face consultations. Trial registration This trial is registered at www.anzctr.org.au/ ACTRN12611000884909. (Source: American Journal of Preventive Medicine)
Source: American Journal of Preventive Medicine - August 17, 2017 Category: International Medicine & Public Health Source Type: research

Mixed methods evaluation of a collaborative care implementation using RE-AIM.
Discussion: Evaluation of collaborative care using the RE-AIM framework may help others systematically evaluate programs, identify local improvement opportunities, and contribute to the broad literature on integrated care dissemination and implementation. (PsycINFO Database Record (c) 2017 APA, all rights reserved) (Source: Families, Systems, and Health)
Source: Families, Systems, and Health - August 14, 2017 Category: International Medicine & Public Health Source Type: research

Foreword −Foot disorders in the elderly: A mini-review
Chronic foot pain in older patients is a common complaint encountered in any primary care practice. Several studies suggest foot disorders currently affect between 71 and 87% of older patients and are a frequent cause of medical and foot care. Foot disorders are a leading risk factor in falls by impairing mobility, balance, and gait patterns as well as causing difficulty with putting on shoes, fractures, and performance of activities of daily living that in turn can produce serious physical, mental and social consequences in the elderly. (Source: Disease a Month)
Source: Disease a Month - August 14, 2017 Category: Infectious Diseases Authors: Jerrold B. Leikin Source Type: research

Foot disorders in the elderly: A mini-review
Chronic foot pain in older patients is a common complaint encountered in any primary care practice. Several studies suggest foot disorders currently affect between 71 and 87% of older patients and are a frequent cause of medical and foot care. Foot disorders are a leading risk factor in falls by impairing mobility, balance, and gait patterns as well as causing difficulty with putting on shoes, fractures, and performance of activities of daily living that in turn can produce serious physical, mental and social consequences in the elderly. (Source: Disease a Month)
Source: Disease a Month - August 14, 2017 Category: Infectious Diseases Authors: Jerrold B. Leikin Tags: Foreword Source Type: research

Does hypoglycaemia affect the improvement in QoL after the transition to insulin in people with type 2 diabetes?
AbstractPurposeQuality of Life (QoL) of insulin-na ïve people with type 2 diabetes mellitus (T2DM) improves after transition to insulin. Little is known about the role of hypoglycaemia in this context. Secondary analyses of the Study of the Psychological Impact in Real care of Initiating insulin glargine Treatment (SPIRIT) aimed to investigate the relationship between hypoglycaemia and QoL when transitioning to insulin.MethodsInsulin-na ïve Dutch people with T2DM in suboptimal glycaemic control (HbA1c>53  mmol/mol; 7.0%) on maximum dose of oral glucose-lowering medications were included from 363 primary c...
Source: Journal of Endocrinological Investigation - August 12, 2017 Category: Endocrinology Source Type: research

Utilization of Standard and Target-Specific Oral Anticoagulants among Adults in the UK with Incident Atrial Fibrillation
New oral anticoagulants (OAC) and updated risk stratification have the potential to improve the quality of care for patients with atrial fibrillation (AF). To describe the time from AF diagnosis to initiation of OAC, characteristics associated with treatment and the incidence of switching OACs, we conducted this retrospective cohort study of 23,018 adults with incident AF receiving care between 2010 and 2014 in 647 primary care practices participating in the United Kingdom Clinical Practice Research Datalink. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 11, 2017 Category: Cardiology Authors: Todd A Durham, Kristen Hassmiller Lich, Anthony J Viera, Jason P Fine, Jayanti Mukherjee, Morris Weinberger, Stacie B Dusetzina Source Type: research

Utilization of Standard and Target-Specific Oral Anticoagulants Among Adults in the United Kingdom With Incident Atrial Fibrillation
New oral anticoagulants (OACs) and updated risk stratification have the potential to improve the quality of care for patients with atrial fibrillation (AF). To describe the time from AF diagnosis to the initiation of an OAC, characteristics associated with treatment, and the incidence of switching OACs, we conducted this retrospective cohort study of 23,018 adults with incident AF receiving care between 2010 and 2014 in 647 primary care practices participating in the United Kingdom Clinical Practice Research Datalink. (Source: The American Journal of Cardiology)
Source: The American Journal of Cardiology - August 11, 2017 Category: Cardiology Authors: Todd A. Durham, Kristen Hassmiller Lich, Anthony J. Viera, Jason P. Fine, Jayanti Mukherjee, Morris Weinberger, Stacie B. Dusetzina Source Type: research

Hypertension in the Older Adult
Hypertension is common among adults and is associated with significant morbidity and mortality and should be routinely addressed in primary care practice. Optimal blood pressure targets have evolved in the past decade with the release of large studies including older persons. However, controversy remains regarding the treatment of older and frail patients. The relationship between blood pressure treatment and falls or cognitive impairment is still an area of concern and debate. A strategy to address hypertension in older persons should consider an individual ’s fitness and the likelihood of adverse effects and worsen...
Source: Primary Care: Clinics in Office Practice - August 8, 2017 Category: Primary Care Authors: Belinda Setters, Holly M. Holmes Source Type: research

Federally Qualified Health Center Clinicians And Staff Increasingly Dissatisfied With Workplace Conditions [Workforce]
Better working conditions for clinicians and staff could help primary care practices implement delivery system innovations and help sustain the US primary care workforce. Using longitudinal surveys, we assessed the experience of clinicians and staff in 296 clinical sites that participated in the Centers for Medicare and Medicaid Services (CMS) Federally Qualified Health Center (FQHC) Advanced Primary Care Practice Demonstration. Participating FQHCs were expected to achieve, within three years, patient-centered medical home recognition at level 3—the highest level possible. During 2013–14, clinicians and staff i...
Source: Health Affairs - August 7, 2017 Category: International Medicine & Public Health Authors: Friedberg, M. W., Reid, R. O., Timbie, J. W., Setodji, C., Kofner, A., Weidmer, B., Kahn, K. Tags: Health Reform, Medicare, Workforce Issues Source Type: research

Opportunities in the integration of primary care and public health nursing: Two case exemplars on physical activity and nutrition
DiscussionIntegrating primary care and public health nursing could improve the tailoring of physical activity and nutrition programs to local populations by following core principles of community engagement, infrastructural sustainability, aligned leadership, and data sharing for population health improvement. (Source: Nursing Forum)
Source: Nursing Forum - August 4, 2017 Category: Nursing Authors: Robin A. Evans ‐Agnew, Kala A. Mayer, Lori L. L. Miller Tags: ORIGINAL ARTICLE Source Type: research

Long-Term Impact of an Electronic Health Record-Enabled, Team-Based, and Scalable Population Health Strategy Based on the Chronic Care Model.
Authors: Kawamoto K, Anstrom KJ, Anderson JB, Bosworth HB, Lobach DF, McAdam-Marx C, Ferranti JM, Shang H, Yarnall KS Abstract The Chronic Care Model (CCM) is a promising framework for improving population health, but little is known regarding the long-term impact of scalable, informatics-enabled interventions based on this model. To address this challenge, this study evaluated the long-term impact of implementing a scalable, electronic health record (EHR)- enabled, and CCM-based population health program to replace a labor-intensive legacy program in 18 primary care practices. Interventions included point-of-care ...
Source: AMIA Annual Symposium Proceedings - August 3, 2017 Category: Bioinformatics Tags: AMIA Annu Symp Proc Source Type: research

Pediatricians' Comfort Level in Caring for Children With Special Health Care Needs
Conclusions Most pediatricians endorse that the medical home for children with special health care needs be in the primary care setting. Improving access to subspecialty care and providing resources, such as case management, to address family social complexity might raise pediatrician comfort in providing primary care to children with medical and developmental conditions. (Source: Academic Pediatrics)
Source: Academic Pediatrics - August 2, 2017 Category: Pediatrics Source Type: research

Optical Transfer Diagnosis Differentiating Benign and Malignant Pigmented Lesions in a Simulated Primary Care Practice
ConclusionsHigh sensitivity and specificity, as provided by OTD in this preliminary study, would help PCPs reduce the number of referrals for dermatology consultation, excision, or biopsy. Further studies are planned for screening patients in a primary care setting, with comparisons of OTD results to biopsy or dermoscopy results.This article is protected by copyright. All rights reserved. (Source: British Journal of Dermatology)
Source: British Journal of Dermatology - August 1, 2017 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: Original Article Source Type: research

CE: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States
This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents preventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF recommendation's applicability to public health and primary care practice in the United States. (Source: AJN)
Source: AJN - July 28, 2017 Category: Nursing Tags: Feature Articles Source Type: research

Continued Statin Prescriptions After Adverse Reactions and Patient Outcomes: A Cohort Study.
Abstract Background: Many patients discontinue statin treatment, often after having a possible adverse reaction. The risks and benefits of continued statin therapy after an adverse reaction are not known. Objective: To examine the relationship between continuation of statin therapy (any prescription within 12 months after an adverse reaction) and clinical outcomes. Design: Retrospective cohort study. Setting: Primary care practices affiliated with 2 academic medical centers. Participants: Patients with a presumed adverse reaction to a statin between 2000 and 2011. Measurements: Information...
Source: Annals of Internal Medicine - July 25, 2017 Category: Internal Medicine Authors: Zhang H, Plutzky J, Shubina M, Turchin A Tags: Ann Intern Med Source Type: research

Use of dipeptidyl peptidase-4 inhibitors and risk of bone fracture in patients with type 2 diabetes in Germany —A retrospective analysis of real-world data
AbstractSummaryIn type 2 diabetes patients treated in German primary care practices, the use of dipeptidyl peptidase-4 inhibitor (DPP4i) in combination with metformin was associated with a significant decrease in the risk of developing bone fractures compared to metformin monotherapy.IntroductionThe goal of this study was to analyze the impact of dipeptidyl peptidase-4 inhibitor (DPP4i) use on the risk of bone fracture in patients diagnosed with type 2 diabetes mellitus (T2DM) in Germany.MethodsPatients with an initial prescription of metformin between 2008 and 2014 from 1262 German general practitioner practices were sele...
Source: Osteoporosis International - July 24, 2017 Category: Orthopaedics Source Type: research

Implementation of a scalable, web-based, automated clinical decision support risk-prediction tool for chronic kidney disease using C-CDA and application programming interfaces
Conclusions: We validated the use of interoperable documents and open-source components to develop a low-cost tool for automated clinical decision support. Since Consolidated Clinical Document Architecture –based data extraction extends to any certified EHR, this demonstrates a successful modular approach to clinical decision support. (Source: Journal of the American Medical Informatics Association)
Source: Journal of the American Medical Informatics Association - July 20, 2017 Category: Information Technology Source Type: research

Costs of Transforming Established Primary Care Practices to Patient-Centered Medical Homes (PCMHs)
Conclusion: Centralized PCMH support reduces the burden on practices; however, overall time and cost remains substantial, and should be weighed against the mixed evidence regarding PCMH's impact on quality and costs of care. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 18, 2017 Category: Primary Care Authors: Fleming, N. S., da Graca, B., Ogola, G. O., Culler, S. D., Austin, J., McConnell, P., McCorkle, R., Aponte, P., Massey, M., Fullerton, C. Tags: Original Research Source Type: research

Empathy, burnout, and antibiotic prescribing for acute respiratory infections: a cross-sectional primary care study in the US.
CONCLUSION: The authors found no significant association between empathy or burnout measures and antibiotic prescribing for ARIs in primary care. Other physician characteristics should be investigated to explain individual variation in antibiotic prescribing. PMID: 28717000 [PubMed - as supplied by publisher] (Source: The British Journal of General Practice)
Source: The British Journal of General Practice - July 17, 2017 Category: Primary Care Authors: Sun BZ, Chaitoff A, Hu B, Neuendorf K, Manne M, Rothberg MB Tags: Br J Gen Pract Source Type: research

Recruiting primary care practices for practice-based research: a case study of a group-randomized study (TRANSLATE CKD) recruitment process
ConclusionsDespite the general belief that the research topic, invitation method, and interest in research may facilitate practice recruitment, our results suggest that most of the recruitment challenges represent managerial challenges. Future research projects may need to consider relevant methodologies from businesses administration and marketing fields. (Source: Family Practice)
Source: Family Practice - July 15, 2017 Category: Primary Care Source Type: research

Randomized Trial of Reducing Ambulatory Malpractice and Safety Risk: Results of the Massachusetts PROMISES Project
Objective: Evaluate application of quality improvement approaches to key ambulatory malpractice risk and safety areas. Study Setting: In total, 25 small-to-medium-sized primary care practices (16 intervention; 9 control) in Massachusetts. Study Design: Controlled trial of a 15-month intervention including exposure to a learning network, webinars, face-to-face meetings, and coaching by improvement advisors targeting “3+1” high-risk domains: test result, referral, and medication management plus culture/communication issues evaluated by survey and chart review tools. Data Collection Methods: Chart reviews condu...
Source: Medical Care - July 14, 2017 Category: Health Management Tags: Original Articles Source Type: research

Knowledge and Preferences of Primary Care Providers in Delivering Head and Neck Cancer Survivorship Care
AbstractLong-term care for head and neck cancer (HNC) survivors is complex and requires coordination among multiple providers. Clinical practice guidelines highlight the role of primary care providers (PCPs) in screening for secondary cancer/recurrence, assessment of late/long-term side effects, and referrals for appropriate specialty management of toxicity. However, these responsibilities may be difficult to meet within the scope of primary care practice. We conducted this study to explore preferences, comfort, and knowledge of PCPs in the care of HNC survivors. We piloted a 40-item web-based survey developed with oncolog...
Source: Journal of Cancer Education - July 14, 2017 Category: Cancer & Oncology Source Type: research

CE: Tuberculosis: A New Screening Recommendation and an Expanded Approach to Elimination in the United States.
This article provides a general overview of tuberculosis transmission, pathogenesis, and epidemiology; presents preventive care recommendations for targeted testing among high-risk groups; and discusses the USPSTF recommendation's applicability to public health and primary care practice in the United States. PMID: 28704234 [PubMed - as supplied by publisher] (Source: The American Journal of Nursing)
Source: The American Journal of Nursing - July 12, 2017 Category: Nursing Authors: Parmer J, Allen L, Walton W Tags: Am J Nurs Source Type: research

Glycaemic, blood pressure and lipid goal attainment and chronic kidney disease stage of type 2 diabetic patients treated in primary care practices.
Abstract INTRODUCTION: The prevalence of chronic kidney disease and diabetes is rising in Europe. These patients are at high cardiovascular and renal risk and need a challenging multifactorial therapeutic approach. METHOD: The goal of this cross-sectional study was to examine the treatment and attainments of goals related to cardiovascular risk factors within chronic kidney disease stages in type 2 diabetic patients followed up by primary care physicians in Switzerland. Each participating physician entered into a web database the anonymised data of up to 15 consecutive diabetic patients attending her/his offi...
Source: Swiss Medical Weekly - July 11, 2017 Category: General Medicine Authors: Corcillo A, Pivin E, Lalubin F, Pitteloud N, Burnier M, Zanchi A Tags: Swiss Med Wkly Source Type: research

Effectiveness of the Spirometry 360 ™ Quality Improvement Program for Improving Asthma Care: A Cluster Randomized Trial
Conclusion In this study, the Spirometry 360™ distance learning QI program was ineffective in improving spirometry test quality or parent/patient-reported outcomes. QI programs like the one assessed here may need to focus on practices with lower baseline performance levels or be tailored for those with higher baseline performance. (Source: Academic Pediatrics)
Source: Academic Pediatrics - July 9, 2017 Category: Pediatrics Source Type: research

Using CollaboRATE, a brief patient ‐reported measure of shared decision making: Results from three clinical settings in the United States
This study demonstrates that CollaboRATE can be used in diverse primary care settings. A clinic's workflow plays a crucial role in implementation. Patient experience measurement risks becoming a burden to both patients and administrators. Episodic use of short measurement tools could reduce this burden. (Source: Health Expectations)
Source: Health Expectations - July 5, 2017 Category: Health Management Authors: Rachel C. Forcino, Paul J. Barr, A. James O'Malley, Roger Arend, Molly G. Castaldo, Elissa M. Ozanne, Sanja Percac ‐Lima, Cheryl D. Stults, Ming Tai‐Seale, Rachel Thompson, Glyn Elwyn Tags: ORIGINAL RESEARCH PAPER Source Type: research

Antibiotic stewardship in the retail clinic setting: Implementation in 1100 clinics nationwide
Publication date: Available online 5 July 2017 Source:Healthcare Author(s): Jennifer M. Polinski, Sandra L. Harmon, Kimberly J. Henderson, Tobias Barker, Andrew Sussman, Nancy J. Gagliano In light of increasing antibiotic resistance and a slowed antibiotic development pipeline, stewardship is more urgent than ever. To date, most stewardship guidelines and best practice recommendations for implementation focus on local or regional health care organizations. CVS MinuteClinic has implemented a consistent, evidence-based stewardship approach in its >1100 clinics in 33 states. The approach is associated with higher qual...
Source: Healthcare - July 5, 2017 Category: Middle East Health Source Type: research

Implementation of Practice Transformation: Patient Experience According to Practice Leaders
Conclusions: PCMH practice transformation can improve patient experience. Most patient experience domains reported as improved during PCMH efforts are measured by CAHPS items. Practices would benefit from collecting specific information on staff behaviors related to teamwork, team-based communication, scheduling, emergency and inpatient follow-up, and referrals. All 3 types of practice leaders reported 4 main mechanisms of PCMH change that improved patient experience. Our findings provide guidance for practice leaders on which strategies of PCMH practice transformation lead to specific improvements in patient experience me...
Source: Quality Management in Healthcare - July 1, 2017 Category: Health Management Tags: Original Articles Source Type: research

Perceptions of Ambulatory Workflow Changes in an Academic Primary Care Setting
This article presents the results of a survey that evaluated various components of a CMA workflow in adult primary care practices within an academic medical center. Although the survey identified improved engagement and satisfaction with standardized changes overall, it also showed time constraints and provider discretion forcing unplanned modifications. Reviewing and reconciling medications seemed to be the most challenging for CMA staff, leading us to reconsider their involvement in this aspect of each visit. It will be important to continue innovating and testing team-based care models to keep up with the demands of a q...
Source: The Health Care Manager - July 1, 2017 Category: Health Management Tags: Article Source Type: research

Developmental Delay: When and How to Screen.
Abstract An estimated 15% of children in the United States have at least one developmental delay, yet less than one-fifth of those children receive early intervention services before three years of age. Many barriers exist to implementing initial screening and referral, but screening tools can be easily incorporated into the workflow of the primary care practice with preparation. The use of a validated screening tool at regular, repeated intervals, in addition to physician surveillance at well-child visits, may improve early detection. Early intervention is effective in high-risk children and associated with impro...
Source: American Family Physician - July 1, 2017 Category: Primary Care Authors: Vitrikas K, Savard D, Bucaj M Tags: Am Fam Physician Source Type: research

Costs of Transforming Established Primary Care Practices to Patient-Centered Medical Homes (PCMHs).
CONCLUSION: Centralized PCMH support reduces the burden on practices; however, overall time and cost remains substantial, and should be weighed against the mixed evidence regarding PCMH's impact on quality and costs of care. PMID: 28720627 [PubMed - in process] (Source: American Family Physician)
Source: American Family Physician - July 1, 2017 Category: Primary Care Authors: Fleming NS, da Graca B, Ogola GO, Culler SD, Austin J, McConnell P, McCorkle R, Aponte P, Massey M, Fullerton C Tags: J Am Board Fam Med Source Type: research

Pain-related fear of (re-)injury in patients with low back pain: Estimation or measurement in manual therapy primary care practice? A pilot study.
Authors: Oostendorp RAB, Elvers H, Mikolajewska E, Laekeman M, Roussel N, van der Zanden O, Nijs J, Samwel H Abstract BACKGROUND: Manual physical therapists (MPTs) working in primary care get limited information about patient's courses of (chronic) low back pain (LBP). Identification of kinesiophobia is mostly based on clinical perception. OBJECTIVE: The aim of this study was to evaluate the association between the scores with which manual physical therapists in a primary care setting identify kinesiophobia in patients with low back pain, and the patients' self-reported measures of kinesiophobia. METHODS: T...
Source: Journal of Back and Musculoskeletal Rehabilitation - June 30, 2017 Category: Orthopaedics Tags: J Back Musculoskelet Rehabil Source Type: research

Unwarranted claims of drug efficacy in pharmaceutical sales visits: Are drugs approved on the basis of surrogate outcomes promoted appropriately?
This study compares physicians’ recall of the claims of benefits on cardiovascular disease and diabetes made by pharmaceutical sales representatives for drugs approved on the basis of a surrogate outcome, i.e., an off‐label claim, versus those approved on the basis of a serious morbidity or mortality (clinical) outcome. MethodsPhysicians in primary care practices in Montreal, Vancouver, Sacramento and Toulouse who saw sales representatives as part of their usual practice and served a non‐referral population were contacted in blocks of 25 from a randomized list of all physicians practicing in the relevant metropol...
Source: British Journal of Clinical Pharmacology - June 30, 2017 Category: Drugs & Pharmacology Authors: Roojin Habibi, Joel Lexchin, Barbara Mintzes, Anne Holbrook Tags: PHARMACOEPIDEMIOLOGY Source Type: research

Implementation of Instrument-Based Vision Screening for Preschool-Age Children in Primary Care
CONCLUSIONS: Instrument-based vision screening for preschool-aged children can be effectively implemented into primary care practice, results in substantially improved rates of completed vision screening at well-child visits, and may result in a reduction in unnecessary referrals to eye care specialists. Additional research is needed regarding how best to overcome barriers to the widespread use of this technology in pediatric primary care settings, as well as its longer-term effect on referrals and the prevalence of amblyopia. (Source: PEDIATRICS)
Source: PEDIATRICS - June 30, 2017 Category: Pediatrics Authors: Modest, J. R., Majzoub, K. M., Moore, B., Bhambhani, V., McLaughlin, S. R., Vernacchio, L. Tags: Community Pediatrics, Bright Futures, Ophthalmology Quality Report Source Type: research

Clinicians Perceptions of Screening for Food Insecurity in Suburban Pediatric Practice
CONCLUSIONS: We found it is feasible and acceptable for clinicians to screen for FI in suburban practices, but the referral method used in this study was ineffective in assisting families in obtaining benefits. Better approaches to connect families to local resources may be needed to maximize the effectiveness of screening in suburban settings. (Source: PEDIATRICS)
Source: PEDIATRICS - June 30, 2017 Category: Pediatrics Authors: Palakshappa, D., Vasan, A., Khan, S., Seifu, L., Feudtner, C., Fiks, A. G. Tags: Community Pediatrics, Nutrition Article Source Type: research

Suburban Families Experience With Food Insecurity Screening in Primary Care Practices
BACKGROUND: Food insecurity (FI) remains a major public health problem. With the rise in suburban poverty, a greater understanding of parents’ experiences of FI in suburban settings is needed to effectively screen and address FI in suburban practices. METHODS: We conducted 23 semistructured interviews with parents of children
Source: PEDIATRICS - June 30, 2017 Category: Pediatrics Authors: Palakshappa, D., Doupnik, S., Vasan, A., Khan, S., Seifu, L., Feudtner, C., Fiks, A. G. Tags: Community Pediatrics, Nutrition Article Source Type: research

The Impact of Whole-Genome Sequencing on the Primary Care and Outcomes of Healthy Adult Patients: A Pilot Randomized Trial.
Conclusion: Adding WGS to primary care reveals new molecular findings of uncertain clinical utility. Nongeneticist providers may be able to manage WGS results appropriately, but WGS may prompt additional clinical actions of unclear value. Primary Funding Source: National Institutes of Health. PMID: 28654958 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - June 27, 2017 Category: Internal Medicine Authors: Vassy JL, Christensen KD, Schonman EF, Blout CL, Robinson JO, Krier JB, Diamond PM, Lebo M, Machini K, Azzariti DR, Dukhovny D, Bates DW, MacRae CA, Murray MF, Rehm HL, McGuire AL, Green RC, MedSeq Project Tags: Ann Intern Med Source Type: research

Ethical Challenges Unique to the Primary Care Behavioral Health (PCBH) Model
This article reviews the extant literature in this realm, and proposes a more unifying set of ethical guidance for interprofessional, integrated primary care practice. We discuss common ethical dilemmas unique to the PCBH model through case examples, and then apply the newly proposed ethical guideline model to these cases to illustrate how the newly proposed model can be efficient and effective navigating these dilemmas. (Source: Journal of Clinical Psychology in Medical Settings)
Source: Journal of Clinical Psychology in Medical Settings - June 23, 2017 Category: Psychiatry & Psychology Source Type: research

The Impact of Whole-Genome Sequencing on the Primary Care and Outcomes of Healthy Adult Patients: A Pilot Randomized Trial.
Conclusion: Adding WGS to primary care reveals new molecular findings of uncertain clinical utility. Nongeneticist providers may be able to manage WGS results appropriately, but WGS may prompt additional clinical actions of unclear value. Primary Funding Source: National Institutes of Health. PMID: 28632283 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - June 22, 2017 Category: Internal Medicine Authors: Vassy JL, Christensen KD, Schonman EF, Blout CL, Robinson JO, Krier JB, Diamond PM, Lebo M, Machini K, Azzariti DR, Dukhovny D, Bates DW, MacRae CA, Murray MF, Rehm HL, McGuire AL, Green RC, MedSeq Project Tags: Ann Intern Med Source Type: research

Cognitive screening tools for primary care settings: examining the 'Test Your Memory' and 'General Practitioner assessment of Cognition' tools in a rural aging population in Greece.
CONCLUSION: The TYM and GPCog instruments appear to be suitable for routine use in the primary care setting as tools for cognitive impairment risk detection in elderly rural populations. PMID: 28604128 [PubMed - in process] (Source: European Journal of General Practice)
Source: European Journal of General Practice - June 14, 2017 Category: Primary Care Tags: Eur J Gen Pract Source Type: research