Diabetes Outcome and Process Measures Among Patients Who Require Language Interpreter Services in Minnesota Primary Care Practices
This study aims to determine adherence with diabetes process and outcomes measures among LEP patients in primary care settings, and is a retrospective cohort study of patients with type II diabetes at two large primary care networks in Minnesota from January 1, 2012 through December 31, 2013. Diabetes outcome measure goals were defined as hemoglobin A1C
Source: Journal of Community Health - February 22, 2017 Category: Global & Universal Source Type: research

Antibiotic prescribing frequency amongst patients in primary care: a cohort study using electronic health records
Conclusions: Half of antibiotics prescribed to adults in primary care were for
Source: Journal of Antimicrobial Chemotherapy - February 21, 2017 Category: Microbiology Source Type: research

White cell count in the normal range and short-term and long-term mortality: international comparisons of electronic health record cohorts in England and New Zealand
Conclusions Clinically recorded WBC within the range considered ‘normal’ is associated with mortality in ethnically different populations from two countries, particularly within the first 6 months. Large-scale international comparisons of electronic health record cohorts might yield new insights from widely performed clinical tests. Trial registration number NCT02014610. (Source: BMJ Open)
Source: BMJ Open - February 17, 2017 Category: Journals (General) Authors: Shah, A. D., Thornley, S., Chung, S.-C., Denaxas, S., Jackson, R., Hemingway, H. Tags: Open access, Epidemiology, Health informatics Research Source Type: research

Walk-in clinics versus physician offices and emergency rooms for urgent care and chronic disease management.
CONCLUSIONS: Controlled trial evidence about the mortality, morbidity, quality of care, and patient satisfaction of walk-in clinics is currently not available. PMID: 28211045 [PubMed - as supplied by publisher] (Source: Cochrane Database of Systematic Reviews)
Source: Cochrane Database of Systematic Reviews - February 17, 2017 Category: Journals (General) Authors: Chen CE, Chen CT, Hu J, Mehrotra A Tags: Cochrane Database Syst Rev Source Type: research

A cross-sectional observational study of high override rates of drug allergy alerts in inpatient and outpatient settings, and opportunities for improvement
Conclusions The information contained in patients’ drug allergy lists needs to be regularly updated. Most of the drug allergy alerts were overridden, with the majority of alert overrides in the subsample considered appropriate. Some of the rules for these alerts should be carefully reviewed and modified, or removed. Further research is needed to understand providers’ overriding of alerts that warned against the risk of ‘anaphylaxis’, which are more concerning with respect to patient safety. (Source: BMJ Quality and Safety)
Source: BMJ Quality and Safety - February 16, 2017 Category: Journals (General) Authors: Slight, S. P., Beeler, P. E., Seger, D. L., Amato, M. G., Her, Q. L., Swerdloff, M., Dalleur, O., Nanji, K. C., Cho, I., Maniam, N., Eguale, T., Fiskio, J. M., Dykes, P. C., Bates, D. W. Tags: Original research Source Type: research

Improving EHR Capabilities to Facilitate Stage 3 Meaningful Use Care Coordination Criteria.
Authors: Cross DA, Cohen GR, Nong P, Day AV, Vibbert D, Naraharisetti R, Adler-Milstein J Abstract Primary care practices have been limited in their ability to leverage electronic health records (EHRs) and health information exchange (HIE) to improve care coordination, but will soon be incentivized to do so under proposed Stage 3 meaningful use criteria. We use mixed methods to understand how primary care practices manage, share and reconcile electronic patient information across care settings, and identify innovations in EHR design to support enhanced care coordination. Opportunities identified by practices focuse...
Source: AMIA Annual Symposium Proceedings - February 10, 2017 Category: Bioinformatics Tags: AMIA Annu Symp Proc Source Type: research

Does enrollment in multidisciplinary team-based primary care practice improve adherence to guideline-recommended processes of care? Quebec ’s Family Medicine Groups, 2002-2010
(Source: Health Policy)
Source: Health Policy - February 10, 2017 Category: Health Management Authors: Mamadou Diop, Julie Fiset-Laniel, Sylvie Provost, Pierre Tousignant, Roxane Borg ès Da Silva, Marie-Jo Ouimet, Eric Latimer, Erin Strumpf Source Type: research

Prevalence and characteristic of OSAFED syndrome in atrial fibrillation primary care patients.
CONCLUSIONS: Frequently coexisting OSAFED syndrome components in all AF patients from primary care setting should encourage more active search of OSA and ED in patients with documented any form of atrial fibrillation. Most of the studied patients did not have the diagnosis of OSA nor ED done prior to the participation in the study. PMID: 28181212 [PubMed - as supplied by publisher] (Source: Polish Heart Journal)
Source: Polish Heart Journal - February 9, 2017 Category: Cardiology Authors: Wolf J, Dereziński T, Szyndler A, Narkiewicz K Tags: Kardiol Pol Source Type: research

Learning organisations: the challenge of finding a safe space in a climate of accountability.
Authors: McKee A Abstract The effects of health policy reforms over a twenty-five year period have changed the NHS as a place in which to work and learn. Some of these changes have had unintentional consequences for learning in the workplace. A recent King's Fund contribution to quality improvement debates included an extensive review of NHS policies encouraging change 'from within' the NHS and renewed calls to develop learning organisations there. I draw upon an action research project designed to develop learning organisations in primary care to locate quality improvement debates amid the realities of practice. T...
Source: Education for Primary Care - February 8, 2017 Category: Primary Care Tags: Educ Prim Care Source Type: research

Capsule Commentary on Shortell et al., A Multilevel Analysis of Patient Engagement and Patient-Reported Outcomes in Primary Care Practices of Accountable Care Organizations
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - February 8, 2017 Category: Internal Medicine Source Type: research

Abstract A08: Leveraging technology to promote smoking cessation in primary care medical offices
Conclusions: An AVR based smoking cessation intervention provided added value beyond typical tobacco cessation efforts available in these primary care offices. This intervention required no additional clinical staff time and served to satisfy a component of patient center medical home requirements for many of these practices. Building partnerships with primary care medical offices can aid in the development and testing of community-based interventions such as smoking cessation delivered to medically underserved and diverse patient populations.Citation Format: Frances G. Saad-Harfouche, Elisa M. Rodriguez, Annamaria Masucci...
Source: Cancer Epidemiology Biomarkers and Prevention - February 5, 2017 Category: Cancer & Oncology Authors: Saad-Harfouche, F. G., Rodriguez, E. M., Twarozek, A. M., Widman, C. A., Erwin, D. O., Underwood, W., Fox, C., Mahoney, M. C. Tags: Alcohol, Tobacco, and Substance Abuse: Poster Presentations - Proffered Abstracts Source Type: research

Abstract B20: Optimizing endometrial cancer follow-up and survivorship care for rural and other underserved women: Patient and provider perspectives
CONCLUSIONSThe transition from cancer treatment to cancer survivor care is a complex time for the patient. Increasing the role of the PCP in the ongoing care of EC survivors was generally considered acceptable by both patients and providers in both rural and urban women. Findings from our study did inform strategies to facilitate this transition. Successful coordination of care between cancer survivors, oncologists and PCPs will be a critical step in improving the cancer care delivery of our rural patient and provider population.Citation Format: Teresa Rutledge, Miria Kano, Dolores Guest, Andrew Sussman, Anita Kinney. Opti...
Source: Cancer Epidemiology Biomarkers and Prevention - February 5, 2017 Category: Cancer & Oncology Authors: Rutledge, T., Kano, M., Guest, D., Sussman, A., Kinney, A. Tags: Novel Technologies: Poster Presentations - Proffered Abstracts Source Type: research

Abstract A49: Shared decision-making about weight loss and weight maintenance among a diverse sample of obese primary care patients
Conclusions: Patient perceptions of SDM was low in our sample. Greater efforts are needed to enhance SDM about weight management/control between patients and providers, particularly among those who do not believe they are overweight/obese.Citation Format: Melanie S. Jefferson, Lashanta Rice, Kemi Chukwuka, Holly Pierce, Jodie Riley, Chanita Hughes-Halbert. Shared decision-making about weight loss and weight maintenance among a diverse sample of obese primary care patients. [abstract]. In: Proceedings of the Ninth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Under...
Source: Cancer Epidemiology Biomarkers and Prevention - February 5, 2017 Category: Cancer & Oncology Authors: Jefferson, M. S., Rice, L., Chukwuka, K., Pierce, H., Riley, J., Hughes-Halbert, C. Tags: Community-based Participatory Research: Poster Presentations - Proffered Abstracts Source Type: research

Correlates of Patient Intent and Preference on Colorectal Cancer Screening
Conclusions Self-efficacy mediated the association between race, attitude, and test worries and patient intent. (Source: American Journal of Preventive Medicine)
Source: American Journal of Preventive Medicine - February 3, 2017 Category: Global & Universal Source Type: research

A Multilevel Analysis of Patient Engagement and Patient-Reported Outcomes in Primary Care Practices of Accountable Care Organizations
ConclusionsDiabetic and CVD patients who received care from ACO-affiliated practices with more developed patient-centered cultures reported lower PHQ-4 depression symptom scores and better physical functioning. Diabetic and CVD patients who were more highly activated to participate in their care reported lower PHQ-4 scores and better physical and social outcomes of care. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - February 3, 2017 Category: Internal Medicine Source Type: research

How nurse-led practices perceive implementation of the patient-centered medical home
The Affordable Care Act (ACA) promotes the Patient-Centered Medical Home (PCMH) model as a way to improve healthcare quality, the patient experience, and has identified nurse-led primary care as a mechanism meeting the increasing demand for quality primary care. The purpose of this study was to investigate the implementation of a PCMH model in nurse-led primary care practices and to identify facilitators and barriers to the implementation of this model. (Source: Applied Nursing Research : ANR)
Source: Applied Nursing Research : ANR - February 2, 2017 Category: Nursing Authors: Rosemary Frasso, A. Golinkoff, Heather Klusaritz, Katherine Kellom, Helen Kollar-McArthur, Michelle Miller-Day, Robert Gabbay, Peter F. Cronholm Source Type: research

Risk and Benefit Information and Use of Aspirin
To the Editor The Viewpoint by Drs Mora and Manson in a recent issue ofJAMA Internal Medicine recognizes that aspirin use for primary prevention of atherosclerotic cardiovascular disease (ASCVD) needs to be highly individualized to accurately balance benefits and risks. They suggest a practical approach to aid clinicians with calculating ASCVD and bleeding risk using an app for mobile devices to facilitate patient discussion and shared decision making. While this could facilitate the benefit-risk assessment, the lack of integration of the app with the electronic health record and need for extensive data input are barriers ...
Source: JAMA Internal Medicine - February 1, 2017 Category: Internal Medicine Source Type: research

Defining a typology of primary care practices: a novel approach
ConclusionsThis innovative approach allows defining a global typology of PC practices. Based upon Swiss data, two axes were identified to globally describe PC organization: comprehensiveness of services and workforces development. This exploratory study demonstrates a promising way, first to characterize globally one or several PC models that emerge from complex features, second to compare more accurately PC organization between countries and finally to assess how these models might be associated with patients’ outcomes. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - February 1, 2017 Category: Global & Universal Source Type: research

Increased rates of sequelae post-encephalitis in individuals attending primary care practices in the United Kingdom: a population-based retrospective cohort study
This study aimed to quantify increased risks of epilepsy, depressive disorders, anxiety disorders, psychotic disorders, bipolar disorder, cognitive problems, dementia, headache, and alcohol abuse among encephalitis cases. 2460 exposed individuals diagnosed with incident encephalitis in the Clinical Practice Research Datalink and 47,914 unexposed individuals without a history of encephalitis were included. Multivariable Poisson regression was used to estimate adjusted rate ratios in individuals with encephalitis compared to the general population and to estimate whether the effect of these outcomes varied over time. Individ...
Source: Journal of Neurology - February 1, 2017 Category: Neurology Source Type: research

Sustained participation in a pay-for-value program: impact on high-need patients.
Abstract OBJECTIVE: To assess whether multi-year engagement by primary care practices in a pay-for-value program was associated with improved care for high-need patients. STUDY DESIGN: Longitudinal cohort study of 17,443 patients with 2 or more conditions who were assigned to primary care providers (PCPs) within 1582 practices that did and did not continuously participate in Blue Cross Blue Shield of Michigan's pay-for-value program (the Physician Group Incentive Program [PGIP]) between 2010 and 2013. METHODS: We used generalized linear mixed models, with patient-level random effects, to assess the relat...
Source: The American Journal of Managed Care - February 1, 2017 Category: Health Management Authors: Cross DA, Cohen GR, Harris Lemak C, Adler-Milstein J Tags: Am J Manag Care Source Type: research

Perceptions of the medical home by parents of children with chronic illnesses.
Abstract OBJECTIVES: The patient-centered medical home (PCMH) strives to improve the quality of care in the primary care setting. Recently, certification programs for patient-centered coordinated care have expanded to subspecialty care. Children with chronic conditions are particularly in need of patient-centered and coordinated care. Our objective was to compare parent perceptions of PCMH elements at primary care and specialty practices for children receiving specialty care. STUDY DESIGN: Cross-sectional survey study. METHODS: We surveyed the parents of children returning for specialty care in a hospita...
Source: The American Journal of Managed Care - February 1, 2017 Category: Health Management Authors: Vander Schaaf EB, Dellon EP, Carr RA, deJong NA, Skinner AC, Steiner MJ Tags: Am J Manag Care Source Type: research

A randomized pilot trial of a telephone-based collaborative care management program for caregivers of individuals with dementia.
This article describes a pilot project aimed at evaluating the effectiveness of an accessible, telephone-based, patient- and caregiver (CG)-centered, collaborative care management program that involves CG education and psychosocial support in improving CG and patient outcomes. CGs (n = 75) of older veterans with dementia receiving care from Veterans Affairs (VA) Medical Center primary care practices were randomized to receive either dementia care management or usual care (UC). Of interest in this study were the frequency and severity of patients ’ dementia-related symptom, CG distress related to patients’ behav...
Source: Psychological Services - January 30, 2017 Category: Psychiatry & Psychology Authors: Mavandadi, Shahrzad; Wright, Erin M.; Graydon, Meagan M.; Oslin, David W.; Wray, Laura O. Source Type: research

Lessons Learned from an Advanced Access Trial Within a Canadian Armed Forces Primary Care Clinic
Accessibility is a key element of an effective primary care system. Literature has outlined that primary care practices have successfully employed an advanced access scheduler to improve accessibility to booked appointments and consequently enhance patient experience and outcomes. In 2015, a Canadian Armed Forces (CAF) primary care facility in Ottawa trialed an advanced access scheduler. Based on the unique characteristics of a CAF medical clinic and the patient population, this trial produced six critical lessons, which include maintenance of a stable base of clinicians, correcting rostering mismatches, eliminating appoin...
Source: Healthcare Quarterly - January 27, 2017 Category: Global & Universal Source Type: research

Interprofessional primary care team meetings: a qualitative approach comparing observations with personal opinions
Conclusion. IPT meetings could benefit from improvements in structure, patient-centredness and leadership by the chairpersons. Given the discrepancy between observations and interviews, it would appear useful to improve team members’ awareness of aspects that could be improved before training them in dealing with specific challenges. (Source: Family Practice)
Source: Family Practice - January 25, 2017 Category: Primary Care Authors: van Dongen, J. J. J., van Bokhoven, M. A., Daniëls, R., Lenzen, S. A., van der Weijden, T., Beurskens, A. Tags: Qualitative Research Source Type: research

The Potential Role for Smartphones Among Older Adults with Chronic Noncancer Pain: A Qualitative Study.
CONCLUSION:  Smartphones that focus on supporting medication management, enhancing communication with providers, and facilitating connectedness within social networks to reduce feelings of isolation may help to improve CNCP outcomes in older adults. PMID: 28108642 [PubMed - as supplied by publisher] (Source: Pain Physician)
Source: Pain Physician - January 20, 2017 Category: Anesthesiology Authors: Richardson JE, Lee JI, Nirenberg A, Reid MC Tags: Pain Med Source Type: research

Implementation and Evaluation of Two Educational Strategies to Improve Screening for Eating Disorders in Pediatric Primary Care
Routine screening for disordered eating or body image concerns is recommended by the American Academy of Pediatrics. We evaluated the ability of two educational interventions to increase screening for eating disorders in pediatric primary care practice, predicting that the “active-learning” group would have an increase in documented screening after intervention. (Source: Journal of Adolescent Health)
Source: Journal of Adolescent Health - January 18, 2017 Category: Child Development Authors: Holly C. Gooding, Elizabeth Cheever, Sara F. Forman, Jonathan Hatoun, Farah Jooma, Currie Touloumtzis, Louis Vernacchio Tags: Original article Source Type: research

Exploring Variation in Transformation of Primary Care Practices to Patient-Centered Medical Homes: A Mixed Methods Approach
Population Health Management , Vol. 0, No. 0. (Source: Population Health Management)
Source: Population Health Management - January 18, 2017 Category: Global & Universal Authors: Robert D. Lieberthal Tom Karagiannis Evan Bilheimer Manisha Verma Colleen Payton Mona Sarfaty George Valko Source Type: research

Impact of a tailored program on the implementation of evidence-based recommendations for multimorbid patients with polypharmacy in primary care practices —results of a cluster-randomized controlled trial
Multimorbid patients receiving polypharmacy represent a growing population at high risk for negative health outcomes. Tailoring is an approach of systematic intervention development taking account of previousl... (Source: Implementation Science)
Source: Implementation Science - January 13, 2017 Category: Health Management Authors: Cornelia J äger, Tobias Freund, Jost Steinhäuser, Christian Stock, Johannes Krisam, Petra Kaufmann-Kolle, Michel Wensing and Joachim Szecsenyi Source Type: research

Clinic Versus Daytime Ambulatory Blood Pressure Difference in Hypertensive PatientsNovelty and Significance [Epidemiology/Population]
Clinic blood pressure (BP) is usually higher than daytime ambulatory BP in hypertensive patients, but some recent studies have challenged this view, suggesting that this relationship is strongly influenced by age. We used the Spanish ambulatory BP monitoring cohort to examine differences between clinic and daytime BP by age among 104 639 adult hypertensive patients (office systolic/diastolic BP ≥140/90 mm Hg or treated) in usual primary-care practice, across the wide age spectrum. To assess the impact of age, cardiovascular variables, and clinic BP on the clinic–daytime BP differences, we built multi...
Source: Hypertension - January 11, 2017 Category: Cardiology Authors: Jose R. Banegas, Luis M. Ruilope, Aleȷandro de la Sierra, Ernest Vinyoles, Manuel Gorostidi, Juan J. de la Cruz, Julian Segura, Anna Oliveras, Nieves Martell, Juan Garcia–Puig, Bryan Williams Tags: Epidemiology, Hypertension Original Articles Source Type: research

Survey of family history taking and genetic testing in pediatric practice
AbstractFamily health history collection and genetic testing are core elements for the successful translation of genomics into primary care practice. Yet, little is known about how pediatric providers implement these elements in practice. We surveyed the membership of the American Academy of Pediatrics regarding family health history (FHH) collection and genetic testing in the primary care setting. Three hundred forty-nine (349) responses were analyzed with the initial response rate of 43.3%. Four principal findings were noted —(1) family health history is still recognized as a critical part of the medical evaluation...
Source: Journal of Community Genetics - January 7, 2017 Category: Genetics & Stem Cells Source Type: research

Moving Upstream--Health Extension and Primary Care
Health extension programs represent an opportunity for practice-based research networks (PBRNs) and primary care practices to develop collaborations reaching beyond the clinic walls to address the upstream social determinants of health and engage in community-based research. The Health Extension Regional Officers (HEROs) program at the University of New Mexico described in this issue of the JABFM is an innovative model with a bidirectional approach to linking academic health centers to community-based practices and organizations. Health extension programs are local, influenced by history, relationships, and support. Oregon...
Source: Journal of the American Board of Family Medicine - January 6, 2017 Category: Primary Care Authors: Fagnan, L. J. Tags: Commentaries Source Type: research

Content and Outcomes of Social Work Consultation for Patients with Diabetes in Primary Care
Conclusions: In this sample with a preponderance of Medicare and Medicaid patients, social workers most often assisted patients with diabetes in obtaining medications or health insurance. For patients with uncontrolled diabetes or cholesterol, a temporal association between SW consultation and improved disease control was noted. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 6, 2017 Category: Primary Care Authors: Rabovsky, A. J., Rothberg, M. B., Rose, S. L., Brateanu, A., Kou, L., Misra-Hebert, A. D. Tags: Original Research Source Type: research

Effect of a Primary Care Walking Intervention with and without Nurse Support on Physical Activity Levels in 45- to 75-Year-Olds: The < i > P < /i > edometer < i > A < /i > nd < i > C < /i > onsultation < i > E < /i > valuation (PACE-UP) Cluster Randomised Clinical Trial
ConclusionsA primary care pedometer-based walking intervention in predominantly inactive 45- to 75-y-olds increased step-counts by about one-tenth and time in MVPA in bouts by about one-third. Nurse and postal delivery achieved similar 12-mo PA outcomes. A primary care pedometer intervention delivered by post or with minimal support could help address the public health physical inactivity challenge. Clinical Trial Registrationisrctn.com ISRCTN98538934. (Source: PLoS Medicine)
Source: PLoS Medicine - January 3, 2017 Category: Internal Medicine Authors: Tess Harris Source Type: research

Stakeholder engagement in diabetes self-management: patient preference for peer support and other insights
Conclusions.Patients and family engaged in diabetes care research value peer support, group visits, and multidisciplinary care teams as key features of SMS models. SMS should be tailored to an individual patient ’s health literacy. BCT can be used to engage multiple stakeholders in translation of evidence into practice and to inform PCOR. (Source: Family Practice)
Source: Family Practice - January 2, 2017 Category: Primary Care Source Type: research

Implementation and Sequencing of Practice Transformation in Urban Practices with Underserved Patients
Conclusions: NCQA PCMH level 3 recognition is only the beginning of a continuous improvement process to become patient centered. Full PCMH transformation took time and effort and relied on a sequential approach, with an early focus on foundational changes that included use of a robust quality improvement strategy before changes to delivery of and access to care. (Source: Quality Management in Healthcare)
Source: Quality Management in Healthcare - January 1, 2017 Category: Health Management Tags: Original Articles Source Type: research

Screening for frailty in primary care: Accuracy of gait speed and hand-grip strength.
CONCLUSION: There is a need for frailty measures that are psychometrically sound and feasible to administer in primary care. While use of gait speed or grip strength alone was found to be sensitive and specific as a proxy for the Fried frailty phenotype, use of both measures together was found to be accurate, precise, specific, and more sensitive than other possible combinations. Assessing both measures is feasible within primary care. PMID: 28115460 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - January 1, 2017 Category: Primary Care Authors: Lee L, Patel T, Costa A, Bryce E, Hillier LM, Slonim K, Hunter SW, Heckman G, Molnar F Tags: Can Fam Physician Source Type: research

Alignment of breast cancer screening guidelines, accountability metrics, and practice patterns.
CONCLUSIONS: Primary care practice patterns for breast cancer screening are not well aligned with some evidence-based guidelines and accountability metrics. Metrics and incentives should be designed with more uniformity and should also include shared decision making when the evidence does not clearly support one single conclusion. PMID: 28141929 [PubMed - in process] (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - January 1, 2017 Category: Health Management Authors: Onega T, Haas JS, Bitton A, Brackett C, Weiss J, Goodrich M, Harris K, Pyle S, Tosteson AN Tags: Am J Manag Care Source Type: research

Depression Screening in an Academic Family Practice.
In this study we wanted to assess the effectiveness of a depression screening program in an academic family practice. RESULTS: Depression screening occurred in 98.4% of all adult encounters (n=3,341). Of these patients, 7.3% screened positive for depression and were not presenting for mood problems. Only 33.7% of patients with positive screens had their results addressed. Patients who had their results addressed were twice as likely to return for follow-up as those who did not (34.1% versus 17.4%). Patients with severe depression were more likely to follow-up than patients with mild depression (53% versus 15%). R...
Source: Famly Medicine - January 1, 2017 Category: Primary Care Authors: Tiemstra JD, Fang K Tags: Fam Med Source Type: research

A systematic model improves hepatitis C virus birth cohort screening in hospital ‐based primary care
Abstract Despite national and local governing board recommendations in the United States of America to perform an HCV screening test in baby boomers, screening rates remain low. Our goal was to study the impact of an HCV screening and link to care program with patient navigation in two New York City primary care practices. This was a two‐year prospective study of patients born between 1945‐1965 (“baby boomers”) with encounters at two primary care practices at the Mount Sinai Hospital between November 1, 2013 and November 30, 2015. Baseline HCV screening rates were collected for four months. A multifaceted i...
Source: Journal of Viral Hepatitis - December 31, 2016 Category: Infectious Diseases Authors: Aparna Goel, Jennifer Sanchez, Lismeiry Paulino, Colin Feuille, Jonathan Arend, Brijen Shah, Douglas Dieterich, Ponni V. Perumalswami Tags: Original Paper Source Type: research

Engaging patients in primary care practice transformation: theory, evidence and practice
AbstractPatient engagement is a fundamental strategy for achieving patient centred care and is receiving increasing attention in primary care reform efforts such as the patient-centred medical home and related care models. Much of the prior published theory and evidence supporting patient engagement has focused on improving engagement in individual care. Much less is understood about engaging patients as partners in practice improvement at the primary care clinic or practice level. We review the historical and policy context for the growing interest in the USA and UK in patient engagement at the primary care practice level...
Source: Family Practice - December 29, 2016 Category: Primary Care Source Type: research

Cost ‐Effectiveness of the 4 Pillars Practice Transformation Program to Improve Vaccination of Adults Aged 65 and Older
ConclusionsImplementing an intervention based on the 4 Pillars Practice Transformation Program is a cost‐effective undertaking in primary care practices for individuals aged 65 and older, with predicted public health benefits. (Source: Journal of the American Geriatrics Society)
Source: Journal of the American Geriatrics Society - December 26, 2016 Category: Geriatrics Authors: Kenneth J. Smith, Richard K. Zimmerman, Mary Patricia Nowalk, Chyongchiou J. Lin Tags: Clinical Investigation Source Type: research

Prevalence of comorbidity in primary care patients with type 2 diabetes and its association with elevated HbA1c: A cross-sectional study in Croatia.
This study aimed to investigate the prevalence of comorbidities and their association with elevated (≥ 7.0%) haemoglobin A1c (HbA1c) using a large sample of T2DM patients from primary care practices. DESIGN: A cross-sectional study in which multivariate logistic regression was applied to explore the association of comorbidities with elevated HbA1c. SETTING: Primary care practices in Croatia. SUBJECTS: Altogether, 10 264 patients with diabetes in 449 practices. MAIN OUTCOME MEASURES: Comorbidities and elevated HbA1c. RESULTS: In total 7979 (77.7%) participants had comorbidity. The mean num...
Source: Primary Care - December 21, 2016 Category: Primary Care Authors: Bralić Lang V, Bergman Marković B Tags: Scand J Prim Health Care Source Type: research

Prescription of renin-angiotensin system blockers and risk of acute kidney injury: a population-based cohort study
Conclusions Treatment with ACEI/ARB is associated with only a small increase in AKI risk while individual patient characteristics are much more strongly associated with the rate of AKI. The degree of increased risk varies between patient groups. (Source: BMJ Open)
Source: BMJ Open - December 21, 2016 Category: Journals (General) Authors: Mansfield, K. E., Nitsch, D., Smeeth, L., Bhaskaran, K., Tomlinson, L. A. Tags: Open access, Epidemiology, General practice / Family practice, Pharmacology and therapeutics, Renal medicine Research Source Type: research

The & quot;One Care & quot; Program at Commonwealth Care Alliance: Partnering with Medicare and Medicaid to Improve Care for Nonelderly Dual Eligibles
At the One Care: MassHealth plus Medicare program at Commonwealth Care Alliance, interprofessional care teams provide integrated, high-touch care to patients in homes, primary care practices, and community settings, using flexible benefits that cover services not traditionally reimbursed by Medicare or Medicaid.         (Source: The Commonwealth Fund: Publications)
Source: The Commonwealth Fund: Publications - December 8, 2016 Category: Global & Universal Source Type: research

Care Management Plus: Strengthening Primary Care for Patients with Multiple Chronic Conditions
In the Care Management Plus program at Intermountain Healthcare in Utah, a care manager, embedded in a primary care practice and supported by specialized information technology tools, works with patients who have complex needs to develop and implement plans for care, coaches patients and their caregivers, and more.         (Source: The Commonwealth Fund: Publications)
Source: The Commonwealth Fund: Publications - December 7, 2016 Category: Global & Universal Source Type: research

Evaluating point-of-care testing for glycosylated haemoglobin in public sector primary care facilities in the Western Cape, South Africa.
CONCLUSION: This study does not support the introduction of POC testing for HbA1c in public sector primary care practice in the current context. POC testing should be evaluated further in combination with interventions to overcome clinical inertia and strengthen primary healthcare. PMID: 27917770 [PubMed - in process] (Source: South African Medical Journal)
Source: South African Medical Journal - December 6, 2016 Category: African Health Tags: S Afr Med J Source Type: research

Can Primary Care Practices Help Address the Health Crisis Fueled by Prescription Opioids?
PMID: 27919106 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - December 6, 2016 Category: Internal Medicine Authors: Edelman EJ, Fiellin DA Tags: Ann Intern Med Source Type: research

Should We Screen for Vitamin D Deficiency?: Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2016 Dec 06;165(11):800-807 Authors: Libman H, Malabanan AO, Strewler GJ, Reynolds EE Abstract The U.S. Preventive Services Task Force (USPSTF) recently issued guidelines on screening for vitamin D deficiency. The guidelines were based on randomized trials of vitamin D deficiency screening and treatment, as well as on case-control studies nested within the Women's Health Initiative. The USPSTF concluded that current evidence is insufficient to assess the benefits and harms of screening for vitamin D deficiency in asymptomatic adults...
Source: Annals of Internal Medicine - December 6, 2016 Category: Internal Medicine Authors: Libman H, Malabanan AO, Strewler GJ, Reynolds EE Tags: Ann Intern Med Source Type: research