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

Glucose Self-monitoring in Non –Insulin-Treated Patients With Type 2 Diabetes
This randomized trial compares 3 approaches of self-monitoring of blood glucose levels for effects on hemoglobin A1c levels and health-related quality of life among patients with non –insulin-treated type 2 diabetes in primary care practice. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - June 10, 2017 Category: Internal Medicine Source Type: research

How good is the evidence to support primary care practice?
In conclusion, approximately half of the recommendations for primary care practice are based on patient-oriented evidence, but only 18% are based on patient-oriented evidence from consistent, high-quality studies. (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - June 9, 2017 Category: Internal Medicine Authors: Ebell, M. H., Sokol, R., Lee, A., Simons, C., Early, J. Tags: Editor's choice Original EBM Research Source Type: research

Team-based primary care with integrated mental health is associated with higher quality of care, lower usage and lower payments received by the delivery system
This study compares measures of healthcare quality and usage as well as actual payments received and programme investment costs for patients receiving care in TBC/mental health integration practices versus those in usual care. Methods This was a retrospective, longitudinal, cohort study of adult patients (n=113 452) who received primary care at Intermountain Healthcare primary care practices. Patients ≥18 years old... (Source: Evidence-Based Medicine)
Source: Evidence-Based Medicine - June 9, 2017 Category: Internal Medicine Authors: English, A. F. Tags: Therapeutics/Prevention Source Type: research

Can Personalized Care Planning Improve Primary Care?
This Viewpoint proposes that integration of patient goals, optimization of chronic disease management, and central record-keeping are essential if personalized care planning is to improve primary care and patient outcomes rather than simply burden primary care practices. (Source: JAMA - Journal of the American Medical Association)
Source: JAMA - Journal of the American Medical Association - June 8, 2017 Category: General Medicine Source Type: research

An Overview of Home-Based Primary Care: Learning from the Field
In this issue brief, the authors report that successful home-based primary care practices optimize care by: fielding interdisciplinary teams, incorporating behavioral care and social supports into primary care, responding rapidly to urgent and acute care needs, offering palliative care, and supporting family members and caregivers.         (Source: The Commonwealth Fund: Publications)
Source: The Commonwealth Fund: Publications - June 7, 2017 Category: International Medicine & Public Health Source Type: research

Prevalence and characteristics of OSAFED syndrome in atrial fibrillation primary care patients.
CONCLUSIONS: Frequently coexisting OSAFED syndrome components in all AF patients from the primary care setting should encourage a more active search for OSA and ED in patients with any documented form of AF. Most of the studied patients did not have the diagnosis of OSA nor ED done prior to participation in the study. PMID: 28181212 [PubMed - indexed for MEDLINE] (Source: Kardiologia Polska)
Source: Kardiologia Polska - June 7, 2017 Category: Cardiology Authors: Wolf J, Dereziński T, Szyndler A, Narkiewicz K Tags: Kardiol Pol Source Type: research

A multi ‐state initiative to implement pediatric oral health in primary care practice and clinical education
ConclusionWe have created an enduring infrastructure and model for primary care practices and education programs for training in pediatric oral health. (Source: Journal of Public Health Dentistry)
Source: Journal of Public Health Dentistry - June 7, 2017 Category: Dentistry Authors: Hugh Silk, Ellen Sachs Leicher, Veronica Alvarado, Elizabeth Cote, Susan Cote Tags: Original Article Source Type: research

Financing of Vaccine Delivery in Primary Care Practices
Conclusions Practices report variable payment for vaccination services from different payer types. Practices may benefit from increased use of strategies to reduce vaccine purchase costs and increase payment for vaccine delivery. (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 7, 2017 Category: Pediatrics Source Type: research

A multi ‐state initiative to implement pediatric oral health in primary care practice and clinical education
Journal of Public Health Dentistry,Volume 78, Issue 1, Page 25-31, Winter 2018. (Source: Journal of Public Health Dentistry)
Source: Journal of Public Health Dentistry - June 7, 2017 Category: Dentistry Source Type: research

Is it time for comprehensive geriatric assessment to move beyond primary care? The case for targeting medical sub-specialty practice
AbstractComprehensive geriatric assessment (CGA) as a consultative service for older adults with complex medical and psychosocial challenges has existed for decades. However, studies have often showed inconsistent acceptance and implementation of geriatric recommendations by primary care providers (PCPs) raising doubts about the overall benefits of CGA in this setting. Press and colleagues investigated the patient- and provider-related factors that affect recommendation implementation, and like previous studies, they too found similarly low rates of implementation. In this commentary, we acknowledge the perennial challenge...
Source: Israel Journal of Health Policy Research - June 6, 2017 Category: International Medicine & Public Health Source Type: research

Colon Cancer Screening in Concierge Practice.
This study evaluated the effectiveness of the Center for Executive Medicine (CEM) concierge primary care practice on preventive colorectal cancer (CRC) screening rates relative to local and national comparator data. METHODS: We performed an electronic medical record search encompassing our entire patient population who are between the ages of 50 and 75 years to determine the rate of CRC screening. We compared this rate with the average rate of Medicare Advantage plans reported by our Independent Physician Association (IPA) in 2015 and national health plans reported by the National Committee for Quality Assurance in 201...
Source: Southern Medical Journal - June 3, 2017 Category: General Medicine Tags: South Med J Source Type: research

Evaluation of teledermatology implementation with insurance reimbursement in outpatient primary care practices
Background: Teledermatology has been shown to provide acceptably equivalent diagnosis and management compared to in person evaluation. Further, studies have shown excellent patient satisfaction with teledermatology care, and it shows great promise as a triage tool for both inpatient and outpatient dermatology consults from primary care providers. However, despite strong evidence supporting its use, implementation of teledermatology has been limited by liability concerns, licensing regulation, and especially nonreimbursement. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - May 31, 2017 Category: Dermatology Source Type: research

A Narrative Evaluation of a Community ‐based Nurse Navigation Role in an Urban At‐Risk Community
ConclusionsThe relational process of navigation as an antecedent to barrier reduction has direct implications for program development, continuing education of navigators and quality improvement of existing navigation services. Study findings have implications for development of navigation competencies for nurses working with priority populations to address health inequities.This article is protected by copyright. All rights reserved. (Source: Journal of Advanced Nursing)
Source: Journal of Advanced Nursing - May 30, 2017 Category: Nursing Authors: Janice Feather, Nancy Carter, Ruta Valaitis, Helen Kirkpatrick Tags: Original Research: Empirical research ‐ qualitative Source Type: research

Survival analysis using primary care electronic health record data.
CONCLUSION: Survival analysis applied to primary care electronic medical data is a research approach that has been frequently used in recent times. The utility of this approach was demonstrated by the ability to produce research with large numbers of subjects, across a wide range of conditions and with the potential of a high impact. Importantly, primary care data were thus available to inform primary care practice. PMID: 28537200 [PubMed - as supplied by publisher] (Source: Health Information Management Journal)
Source: Health Information Management Journal - May 26, 2017 Category: Health Management Tags: HIM J Source Type: research

Transition tools and access to adult primary care
This study rated existing health care transition tools to identify tools ready for use in primary care clinics and develop a set of transition principles. Design/methodology/approach Four pediatric and family medicine providers from community health centers reviewed 12 transition tools and provided ratings and in-depth responses about the usefulness and feasibility of each tool through online surveys and telephone interviews. A conference call was used to discuss the findings and develop a set of transition principles. Findings The top rated tools included three youth self-management tools, two tools focused on ASD informa...
Source: Advances in Autism - May 26, 2017 Category: Child Development Source Type: research

The Implications of Psychological Symptoms for Length of Sick Leave.
CONCLUSION: The impact of anxiety on burnout symptoms and sick leave days might have been underestimated so far. A holistic approach in patient centered communication should comprise the evaluation of psychosomatic comorbidity under consideration of the established concepts of depression and anxiety disorder to ensure adequate diagnostic and therapeutic management. PMID: 28530171 [PubMed - in process] (Source: Deutsches Arzteblatt International)
Source: Deutsches Arzteblatt International - May 24, 2017 Category: General Medicine Tags: Dtsch Arztebl Int Source Type: research

The Need for Practice Transformation in Children ’s Mental Health Care
With the movement toward population health and value-based payment since the passage of the Affordable Care Act, pediatric primary care practices have been preoccupied with the enterprise of practice transformation. Practice transformation involves using process improvement methodology to change the way that care is organized to achieve better clinical outcomes, improved experience of care, and decreased per-capita cost of care. The effort to integrate mental health into the primary care setting is an important aspect of practice transformation and has been supported by different Department of Health and Human Services dem...
Source: Journal of the American Academy of Child and Adolescent Psychiatry - May 24, 2017 Category: Psychiatry Authors: Barry Sarvet Tags: Editorial Source Type: research

Effectiveness of shared goal setting and decision making to achieve treatment targets in type 2 diabetes patients: A cluster ‐randomized trial (OPTIMAL)
Abstract ObjectiveAbout 20% of patients with type 2 diabetes achieve all their treatment targets. Shared decision making (SDM) using a support aid based on the 5‐years results of the ADDITION study on multifactorial treatment, could increase this proportion. Research design and methodsCluster‐randomized trial in 35 former ADDITION primary care practices. Practices were randomized to SDM or care as usual (1:1). Both ADDITION and non‐ADDITION type 2 diabetes patients, 60‐80 years, known with diabetes for 8‐12 years, were included. In the intervention group, patients were presented evidence about the relat...
Source: Health Expectations - May 24, 2017 Category: Health Management Authors: Henk Den Ouden, Rimke C. Vos, Guy E. H. M. Rutten Tags: ORIGINAL RESEARCH PAPER Source Type: research

The Active Implementation Frameworks: A roadmap for advancing implementation of Comprehensive Medication Management in Primary care
This article describes the novel application of the AIFs to facilitate the implementation and improvement of Comprehensive Medication Management (CMM) in primary care practices to optimize medication use and improve care for patients. (Source: Research in Social and Administrative Pharmacy)
Source: Research in Social and Administrative Pharmacy - May 21, 2017 Category: Pharmaceuticals Authors: Carrie Blanchard, Melanie Livet, Caryn Ward, Lindsay Sorge, Todd Sorensen, Mary Roth McClurg Source Type: research

Demographics, insulin use and clinical targets in type 2 diabetes insulin users: comparison of a local integrated diabetes service vs a UK ‐wide cohort
Abstract Insulin‐treated patients with type 2 diabetes require specialist multidisciplinary input to achieve treatment targets. We compared the demographics, achievement of combined NICE targets for HbA1c (≤7.5%), blood pressure (
Source: Practical Diabetes - May 19, 2017 Category: Endocrinology Authors: Uchenna Anyanwagu, Karissa Owen, Jil Mamza, Suma Sugunendran, Lisa Stone, Lin Langeland, Iskandar Idris Tags: Original article Source Type: research

An Electronic Health Record–based Intervention to Promote Hepatitis C Virus Testing Among Adults Born Between 1945 and 1965: A Cluster-randomized Trial
Background: The Centers for Disease Control and Prevention (CDC) recommends one-time hepatitis C virus (HCV) antibody testing for “Birth Cohort” adults born during 1945–1965. Objective: To examine the impact of an electronic health record (EHR)-embedded best practice alert (BPA) for HCV testing among Birth Cohort adults. Design: Cluster-randomized trial was conducted from April 29, 2013 to March 29, 2014. Subjects and Setting: Ten community and hospital-based primary care practices. Participants were attending physicians and medical residents during 25,620 study-eligible visits. Intervention: Physicia...
Source: Medical Care - May 16, 2017 Category: Health Management Tags: Original Articles Source Type: research

Patient Dismissal by Primary Care Practices
This survey study examines the prevalence of and reasons for patient dismissal among primary care practices participating in the Comprehensive Primary Care initiative and a matched sample of comparison practices. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - May 15, 2017 Category: Internal Medicine Source Type: research

Integrative Medicine and Primary Care
In primary care, we have become increasingly aware of our patients ’ interest in seeking alternatives to conventional approaches to treatment. This interest often arises from a patient’s desire to have their care aligned with their values, beliefs, and philosophies about wellness. Patients understand they are more than the sum of their illnesses. Integrative me dicine, the practice of medicine that focuses on caring for the whole person, using all available therapeutic choices from a variety of cultures, is a way to introduce additional healing tools into primary care practice. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - May 11, 2017 Category: Primary Care Authors: Deborah S. Clements, Melinda Ring Tags: Preface Source Type: research

Facilitating early diagnosis of lung cancer amongst primary care patients: The views of GPs
Early diagnosis of lung cancer (LC) is a policy priority. However, symptoms are vague, associated with other morbidities, and frequently unrecognised by both patients and general practitioners (GPs). This qualitative study, part of a larger mixed methods study, explored GP views regarding the potential for early diagnosis of LC within primary care. Five focus group discussions (FGDs) were conducted with GPs (n = 16) at primary care practices (n = 5) across four counties in south England. FGDs were audio‐recorded, transcribed verbatim and analysed using a framework approach. Four broad themes emerged: ...
Source: European Journal of Cancer Care - May 11, 2017 Category: Cancer & Oncology Authors: R. Wagland, L. Brindle, E. James, M. Moore, A.I. Esqueda, J. Corner Tags: ORIGINAL ARTICLE Source Type: research

The Starfield model: Measuring comprehensive primary care for system benefit
This article describes “The Starfield Model”—an approach to measuring quality, capacity, and total cost of care at this scope of service—and the results achieved by a small family health team in implementing this model. This experience suggests that real benefits arise from meaningful feedback to providers. The model has the potential to work in any payment system of primary care, thereby providing insight into all types of comprehensive primary care practices. (Source: Healthcare Management Forum)
Source: Healthcare Management Forum - May 10, 2017 Category: Health Management Source Type: research

Factors Related to Implementation and Reach of a Pragmatic Multisite Trial: The My Own Health Report (MOHR) Study
Conclusions: Systematically assessing contextual factors prospectively throughout implementation of quality improvement initiatives helps translation to other health care settings. Knowledge of contextual factors is essential for scaling up of effective interventions. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 8, 2017 Category: Primary Care Authors: Balasubramanian, B. A., Heurtin-Roberts, S., Krasny, S., Rohweder, C. L., Fair, K., Olmos-Ochoa, T. T., Stange, K. C., Gorin, S. S., for the MOHR Study Group Tags: Original Research Source Type: research

Hospice-Appropriate Universal Precautions for Opioid Safety
Universal precautions for opioid safety, analogous to universal precautions for infection control, is one approach to managing the epidemic of prescription pain medication misuse that has been used in pain clinics, primary care practices, and in some hospices. In this project, a set of hospice-appropriate universal precautions was designed, drawing on hospice nursing strengths, and implemented in a midsize hospice agency. (Source: Journal of Hospice and Palliative Nursing)
Source: Journal of Hospice and Palliative Nursing - May 6, 2017 Category: Nursing Tags: Feature Articles Source Type: research

Higher Serum 25(OH)D Concentration is Associated with Lower Risk of Chronic Otitis Media with Effusion: A Case ‐Control Study
ConclusionThis finding supports further investigation into whether the risk of COME could be reduced by increasing serum 25(OH)D concentration through increased sun exposure, higher dietary intake, or vitamin D supplementation.This article is protected by copyright. All rights reserved. (Source: Acta Paediatrica)
Source: Acta Paediatrica - May 6, 2017 Category: Pediatrics Authors: Rebecca E. Walker, Jim Bartley, Carlos A. Camargo, David Flint, John M. D. Thompson, Edwin A. Mitchell Tags: Regular Article Source Type: research

Extended and standard duration weight-loss programme referrals for adults in primary care (WRAP): a randomised controlled trial
This study is registered with Current Controlled Trials, number ISRCTN82857232. Findings Between Oct 18, 2012, and Feb 10, 2014, we enrolled 1269 participants. 1267 eligible participants were randomly assigned to the brief intervention (n=211), the 12-week programme (n=528), and the 52-week programme (n=528). Two participants in the 12-week programme had been found to be ineligible shortly after randomisation and were excluded from the analysis. 823 (65%) of 1267 participants completed an assessment at 1 year and 856 (68%) participants at 2 years. All eligible participants were included in the analyses. At 1 year, mean wei...
Source: The Lancet - May 4, 2017 Category: Journals (General) Source Type: research

Why are there discrepancies between depressed patients Global Rating of Change and scores on the Patient Health Questionnaire depression module? A qualitative study of primary care in England
Conclusions The combined used of the PHQ-9 and a more open question better captures the patient’s unique experiences of mental health. This approach ascertains the relevance of symptoms to the individual’s experience and influences treatment decisions. Study registration This study was an element of NIHR Programme Grant RP-PG 0610 10048. (Source: BMJ Open)
Source: BMJ Open - May 4, 2017 Category: Journals (General) Authors: Robinson, J., Khan, N., Fusco, L., Malpass, A., Lewis, G., Dowrick, C. Tags: Open access, General practice / Family practice Research Source Type: research

Preparing Physicians for Rural-Based Primary Care Practice: A Preliminary Evaluation of Rural Training Initiatives at OSU-COM.
Authors: Wheeler DL, Hackler JB Abstract The physician shortage in Oklahoma coupled with geographic maldistribution of primary care physicians limits access to care in rural and underserved areas. One of the most effective strategies to recruit and retain physicians in rural areas is to create undergraduate and graduate medical education training sites in these locations. Oklahoma State University Center for Health Sciences College of Osteopathic Medicine has implemented a rural training program that begins with early recruitment of rural high school students, introduces medical students to rural practice options t...
Source: Journal of the American Osteopathic Association - May 3, 2017 Category: Complementary Medicine Tags: J Am Osteopath Assoc Source Type: research

Preemptive Panel-Based Pharmacogenetic Testing: The Time is Now
AbstractWhile recent discoveries have paved the way for the use of genotype-guided prescribing in some clinical environments, significant debate persists among clinicians and researchers about the optimal approach to pharmacogenetic testing in clinical practice. One crucial factor in this debate surrounds the timing and methodology of genotyping, specifically whether genotyping should be performed reactively for targeted genes when a single drug is prescribed, or preemptively using a panel-based approach prior to drug prescribing. While early clinical models that employed a preemptive approach were largely developed in aca...
Source: Pharmaceutical Research - May 2, 2017 Category: Drugs & Pharmacology Source Type: research

Chronic obstructive pulmonary disease and comorbidities: a large cross-sectional study in primary care.
CONCLUSION: Patients with COPD have extensive associated comorbidities. There is a real need for guidelines and health care to reflect this complexity, including how to detect those common comorbidities that relate to both physical and mental health, and how best to manage them. Primary care, which is unique in terms of offering expert generalist care, is best placed to provide this integrated approach. PMID: 28450344 [PubMed - in process] (Source: The British Journal of General Practice)
Source: The British Journal of General Practice - May 1, 2017 Category: Primary Care Authors: Chetty U, McLean G, Morrison D, Agur K, Guthrie B, Mercer SW Tags: Br J Gen Pract Source Type: research

Alignment of Canadian Primary Care With the Patient Medical Home Model: A QUALICO-PC Study.
CONCLUSIONS: Provincial PMH scores indicate considerable room for improvement if the PMH goals are to be fully implemented in Canada. PMID: 28483888 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - May 1, 2017 Category: Primary Care Authors: Katz A, Herpai N, Smith G, Aubrey-Bassler K, Breton M, Boivin A, Hogg W, Miedema B, Pang J, Wodchis WP, Wong ST Tags: Ann Fam Med Source Type: research

Internet-Based Vestibular Rehabilitation for Older Adults With Chronic Dizziness: A Randomized Controlled Trial in Primary Care.
Abstract PURPOSE: Vestibular rehabilitation is an effective intervention for dizziness due to vestibular dysfunction, but is seldom provided. We aimed to determine the effectiveness of an Internet-based vestibular rehabilitation program for older adults experiencing dizziness in primary care. METHODS: We undertook a single-center, single-blind randomized controlled trial comparing an Internet-based vestibular rehabilitation intervention (Balance Retraining, freely available from with usual primary care in patients from 54 primary care practices in southern England. Patient...
Source: Annals of Family Medicine - May 1, 2017 Category: Primary Care Authors: Geraghty AWA, Essery R, Kirby S, Stuart B, Turner D, Little P, Bronstein A, Andersson G, Carlbring P, Yardley L Tags: Ann Fam Med Source Type: research

Computer use in primary care practices in Canada.
Abstract OBJECTIVE: To examine the use of computers in primary care practices. DESIGN: The international Quality and Cost of Primary Care study was conducted in Canada in 2013 and 2014 using a descriptive cross-sectional survey method to collect data from practices across Canada. Participating practices filled out several surveys, one of them being the Family Physician Survey, from which this study collected its data. SETTING: All 10 Canadian provinces. PARTICIPANTS: A total of 788 family physicians. MAIN OUTCOME MEASURES: A computer use scale measured the extent to which family physicians inte...
Source: Canadian Family Physician Medecin de Famille Canadien - May 1, 2017 Category: Primary Care Authors: Anisimowicz Y, Bowes AE, Thompson AE, Miedema B, Hogg WE, Wong ST, Katz A, Burge F, Aubrey-Bassler K, Yelland GS, Wodchis WP Tags: Can Fam Physician Source Type: research

Abstract IA24: Developing and evaluating cancer risk assessment tools for primary care
Numerous risk assessment tools have been developed which predict either current or future risk of a cancer diagnosis yet very few are used in routine clinical practice. These tools could be used for tailored disease prevention, more efficient use of cancer screening tests and to promote behavioural change to reduce cancer risk. We have a growing number of cancer risk-prediction models which incorporate phenotypic, behavioural and, increasingly, genomic variables; these models require simple-to-use risk assessment tools for their implementation into clinical practice, and in particular ones which can be incorporated into pr...
Source: Cancer Epidemiology Biomarkers and Prevention - April 30, 2017 Category: Cancer & Oncology Authors: Emery, J. Tags: Improving Cancer Risk Prediction for Prevention and Early Detection: Oral Presentations - Invited Abstracts Source Type: research

The Addiction Recovery Clinic: A Novel, Primary-Care-Based Approach to Teaching Addiction Medicine
Problem: Substance use is highly prevalent in the United States, but little time in the curriculum is devoted to training internal medicine residents in addiction medicine. Approach: In 2014, the authors developed and launched the Addiction Recovery Clinic (ARC) to address this educational gap while also providing outpatient clinical services to patients with substance use disorders. The ARC is embedded within the residency primary care practice and is staffed by three to four internal medicine residents, two board-certified addiction medicine specialists, one chief resident, and one psychologist. Residents spend one half...
Source: Academic Medicine - April 27, 2017 Category: Universities & Medical Training Tags: Innovation Reports Source Type: research

Implementation and process evaluation of three interventions to promote screening mammograms delivered for 4  years in a large primary care population
AbstractThe optimal form of outreach to promote repeated, on time screening mammograms in primary care has not been established. The purpose of this study is to assess the implementation process and process outcomes for three interventions for promoting biannual screening mammography in a randomized trial. In a large urban primary care practice over a 4-year period, we randomized women aged 40 –85 and eligible for mammograms to three interventions: reminder letter only (LO), reminder letter + reminder call (RC), and reminder letter + counseling call (CC). We tracked information system development, staff training, pat...
Source: Translational Behavioral Medicine - April 27, 2017 Category: Global & Universal Source Type: research

Use of Rome criteria for the diagnosis of irritable bowel syndrome in primary care: a survey among European countries
Conclusion: Only about one-third of GPs regularly used the Rome criteria to diagnose IBS. In daily primary care practice, IBS largely remains a diagnosis of exclusion. This has implications in terms of GPs’ specialty training and questions the applicability of IBS guidelines in daily care, which advocate an early, positive, symptom-based diagnosis. (Source: European Journal of Gastroenterology and Hepatology)
Source: European Journal of Gastroenterology and Hepatology - April 26, 2017 Category: Gastroenterology Tags: Original Articles: Irritable Bowel Disease Source Type: research

Team-based versus traditional primary care models and short-term outcomes after hospital discharge.
Abstract BACKGROUND: Strategies to reduce hospital readmission have been studied mainly at the local level. We assessed associations between population-wide policies supporting team-based primary care delivery models and short-term outcomes after hospital discharge. METHODS: We extracted claims data on hospital admissions for any cause from 2002 to 2009 in the province of Quebec. We included older or chronically ill patients enrolled in team-based or traditional primary care practices. Outcomes were rates of readmission, emergency department visits and mortality in the 90 days following hospital discharge. We...
Source: cmaj - April 24, 2017 Category: Journals (General) Authors: Riverin BD, Li P, Naimi AI, Strumpf E Tags: CMAJ Source Type: research

The value of European exchange programs for early career family doctors.
Authors: Bridgwood B, Willoughby H, Attridge M, Tang E Abstract The Hippokrates Exchange programme (HEP) is designed to give early career General Practitioners (Associates in Training (AITs)/First5s) first-hand experience into concepts of a primary healthcare system outside of their host country. The aim is to improve GP knowledge and skills, inspire professional development and promote a global approach to primary care. Although an increasing number are taking up this opportunity, their views and experiences of international exchanges are not well described. The aim of the study was to explore the experiences of A...
Source: Education for Primary Care - April 21, 2017 Category: Primary Care Tags: Educ Prim Care Source Type: research

The degree of integration of non-dispensing pharmacists in primary care practice and the impact on health outcomes: A systematic review
A non-dispensing pharmacist conducts clinical pharmacy services aimed at optimizing patients individual pharmacotherapy. Embedding a non-dispensing pharmacist in primary care practice enables collaboration, probably enhancing patient care. The degree of integration of non-dispensing pharmacists into multidisciplinary health care teams varies strongly between settings. The degree of integration may be a determinant for its success. (Source: Research in Social and Administrative Pharmacy)
Source: Research in Social and Administrative Pharmacy - April 21, 2017 Category: Pharmaceuticals Authors: Ankie C.M. Hazen, Antoinette A. de Bont, Lia Boelman, Dorien L.M. Zwart, Johan J. de Gier, Niek J. de Wit, Marcel L. Bouvy Source Type: research

The Development and Performance of After-Hours Primary Care in the Netherlands: A Narrative Review.
This article provides an overview of the organization, performance, and development of PCP cooperatives in the Netherlands. The Dutch after-hours primary care system might offer opportunities for other countries facing problems with after-hours care and inappropriate emergency department visits. During the past several years, the number of contacts with Dutch PCP cooperatives has increased to 245 contacts per 1000 citizens per year. Many contacts (45%) are nonurgent, and about half occur as part of a series of primary care contacts. Low accessibility and availability of daytime primary care are related to greater use of af...
Source: Annals of Internal Medicine - April 18, 2017 Category: Internal Medicine Authors: Smits M, Rutten M, Keizer E, Wensing M, Westert G, Giesen P Tags: Ann Intern Med Source Type: research

A systematic review of lifestyle counseling for diverse patients in primary care
Publication date: July 2017 Source:Preventive Medicine, Volume 100 Author(s): Cathy L. Melvin, Melanie S. Jefferson, LaShanta J. Rice, Lynne S. Nemeth, Andrea M. Wessell, Paul J. Nietert, Chanita Hughes-Halbert Prior research and systematic reviews have examined strategies related to weight management, less is known about lifestyle and behavioral counseling interventions optimally suited for implementation in primary care practices generally, and among racial and ethnic patient populations. Primary care practitioners may find it difficult to access and use available research findings on effective behavioral and lifestyle ...
Source: Preventive Medicine - April 14, 2017 Category: Global & Universal Source Type: research

195 The burden of childhood atopic dermatitis in U.S. primary care settings
Little is known about the atopic dermatitis (AD) burden encountered in primary care practices and the frequency and type of skin care practices used on children in U.S. communities. We measured the prevalence of parent-reported childhood AD in 10 primary care practices located in Oregon, Iowa, Wisconsin, Colorado and North Carolina using a convenience sample of children 0-5 years old. To better understand current skin care practices among the general pediatric population, we surveyed parents regarding current skin care used on their children. (Source: Journal of Investigative Dermatology)
Source: Journal of Investigative Dermatology - April 12, 2017 Category: Dermatology Authors: J. Al-naqeeb, S. Danner, L. Fagnan, K. Ramsey, L. Michaels, J. Mitchell, K. Branca, C. Morris, D. Nease, L. Zittleman, B. Levy, J. Daly, D. Hahn, R. Dolor, J. Hanifin, S. Tofte, K. Zuckerman, K. Hansis, M. Gundersen, K. Dillon, J. Block, F. Karr, S. Dunbr Tags: Clinical Research: Epidemiology of Skin Diseases Source Type: research