Doctors' perspectives on PSA testing illuminate established differences in prostate cancer screening rates between Australia and the UK: a qualitative study
Conclusions The GP accounts suggested that healthcare systems, including historical and current organisational and funding structures and rules, collectively contribute to how and why clinicians use the PSA test and play a significant role in creating the mindlines that GPs employ in their clinic. Australia's recently released consensus guidelines may support more streamlined and consistent care. However, if GP mindlines and thus routine practice in Australia are to shift, to ultimately reduce unnecessary or harmful prostate screening, it is likely that other important drivers at all levels of the screening process will ne...
Source: BMJ Open - December 5, 2016 Category: Journals (General) Authors: Pickles, K., Carter, S. M., Rychetnik, L., Entwistle, V. A. Tags: Open access, Evidence based practice, General practice / Family practice, Health policy, Health services research, Public health, Qualitative research Source Type: research
Integrating Behavioral Health into Pediatric Primary Care: Implications for Provider Time and Cost.
CONCLUSIONS: The time savings demonstrated on days when the consultant was available point to the efficiency and potential financial viability of this model. These results have important implications for the feasibility of hiring behavioral health professionals in a fee-for-service system. They have equally useful implications for the utility of moving to a bundled system of care in which collaborative practice is valued. PMID: 27911972 [PubMed - in process] (Source: Southern Medical Journal)
Source: Southern Medical Journal - December 4, 2016 Category: Journals (General) Tags: South Med J Source Type: research
Team dynamics, clinical work satisfaction, and patient care coordination between primary care providers: A mixed methods study
Background: Team-based care is essential for delivering high-quality, comprehensive, and coordinated care. Despite considerable research about the effects of team-based care on patient outcomes, few studies have examined how team dynamics relate to provider outcomes. Purpose: The aim of this study was to examine relationships among team dynamics, primary care provider (PCP) clinical work satisfaction, and patient care coordination between PCPs in 18 Harvard-affiliated primary care practices participating in Harvard’s Academic Innovations Collaborative. Methodology: First, we administered a cross-sectional survey to...
Source: Health Care Management Review - December 2, 2016 Category: American Health Tags: Features Source Type: research
Preschool ADHD Diagnosis and Stimulant Use Before and After the 2011 AAP Practice Guideline
CONCLUSIONS: Release of the 2011 guideline that addressed ADHD in preschoolers was associated with the end of an increasing rate of diagnosis, and the rate of prescribing stimulants remained constant. These are reassuring results given that a standardized approach to diagnosis was recommended and stimulant treatment is not first-line therapy for this age group. (Source: PEDIATRICS)
Source: PEDIATRICS - December 1, 2016 Category: Pediatrics Authors: Fiks, A. G., Ross, M. E., Mayne, S. L., Song, L., Liu, W., Steffes, J., McCarn, B., Grundmeier, R. W., Localio, A. R., Wasserman, R. Tags: Developmental/Behavioral Pediatrics, Attention-Deficit/Hyperactivity Disorder (ADHD), Health Information Technology, Electronic Health Records Article Source Type: research
Measuring the patient experience in primary care: Comparing e-mail and waiting room survey delivery in a family health team.
CONCLUSION: Our findings suggest that respondent demographic characteristics might differ depending on the method of survey delivery, and these differences might affect survey responses. Methods of delivering patient experience surveys that require electronic literacy might underrepresent patients living in low-income neighbourhoods. Practices should consider evaluating for nonresponse bias and adjusting for patient demographic characteristics when interpreting survey results. Further research is needed to understand how primary care practices can optimize electronic survey delivery methods to survey a representative sampl...
Source: Canadian Family Physician Medecin de Famille Canadien - December 1, 2016 Category: Primary Care Authors: Slater M, Kiran T Tags: Can Fam Physician Source Type: research
Patient safety principles in family medicine residency accreditation standards and curriculum objectives: Implications for primary care.
CONCLUSION: Explicit inclusion of patient safety content such as the use of patient safety principles is needed for residency training programs across Canada to ensure the full spectrum of care is addressed, from community-based care to acute hospital-based care. This will ensure a patient safety culture can be cultivated from residency and sustained into primary care practice. PMID: 27965349 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - December 1, 2016 Category: Primary Care Authors: Kassam A, Sharma N, Harvie M, O'Beirne M, Topps M Tags: Can Fam Physician Source Type: research
Usual medical treatments or levonorgestrel-IUS for women with heavy menstrual bleeding: long-term randomised pragmatic trial in primary care.
Abstract BACKGROUND: Heavy menstrual bleeding (HMB) is a common, chronic problem affecting women and health services. However, long-term evidence on treatment in primary care is lacking. AIM: To assess the effectiveness of commencing the levonorgestrel-releasing intrauterine system (LNG-IUS) or usual medical treatments for women presenting with HMB in general practice. DESIGN AND SETTING: A pragmatic, multicentre, parallel, open-label, long term, randomised controlled trial in 63 primary care practices across the English Midlands. METHOD: In total, 571 women aged 25-50 years, with HMB were randomise...
Source: The British Journal of General Practice - November 27, 2016 Category: Primary Care Authors: Kai J, Middleton L, Daniels J, Pattison H, Tryposkiadis K, Gupta J, ECLIPSE trial collaborative group Tags: Br J Gen Pract Source Type: research
Real-world evidence studies into treatment adherence, thresholds for intervention and disparities in treatment in people with type 2 diabetes in the UK
Purpose The University of Surrey-Lilly Real World Evidence (RWE) diabetes cohort has been established to provide insights into the management of type 2 diabetes mellitus (T2DM). There are 3 areas of study due to be conducted to provide insights into T2DM management: exploration of medication adherence, thresholds for changing diabetes therapies, and ethnicity-related or socioeconomic-related disparities in management. This paper describes the identification of a cohort of people with T2DM which will be used for these analyses, through a case finding algorithm, and describes the characteristics of the identified cohort. Pa...
Source: BMJ Open - November 24, 2016 Category: Journals (General) Authors: McGovern, A., Hinton, W., Correa, A., Munro, N., Whyte, M., de Lusignan, S. Tags: Open access, Health informatics, Public health, Diabetes and Endocrinology Cohort profile Source Type: research
Investigating Patient Adherence With Pathology Testing in Primary Care and How Point of Care Testing Can Improve It
Conclusions: Despite complex workflow routines, compliance with laboratory testing remained suboptimal. Although point-of-care testing was seen as a way to improve practice workflows and increase staff efficiency, there remain some barriers to implementation that could be reduced by better staff understanding of the technology. (Source: Point of Care: The Journal of Near-Patient Testing and Technology)
Source: Point of Care: The Journal of Near-Patient Testing and Technology - November 23, 2016 Category: Pathology Tags: Original Articles Source Type: research
Effectiveness and cost-effectiveness of pessary treatment compared with pelvic floor muscle training in older women with pelvic organ prolapse: 2-year follow-up of a randomized controlled trial in primary care
Conclusions: In older women with symptomatic prolapse, there was no significant difference between pessary treatment and PFMT in reducing pelvic floor symptoms, but specific prolapse-related symptoms did improve more with pessary treatment. Pessary treatment was preferable in the cost-effectiveness analysis. When counseling women for prolapse treatment it should, however, be taken into account that pessary fitting fails in a considerable portion of women and that pessary treatment was associated with more side effects compared with PFMT. (Source: Menopause)
Source: Menopause - November 23, 2016 Category: OBGYN Tags: Original Articles Source Type: research
Effects of culture-sensitive adaptation of patient information material on usefulness in migrants: a multicentre, blinded randomised controlled trial
Conclusion Cultural adaptation of patient information material provides benefits over high quality translations. Clinicians are encouraged to use culture-sensitive material in their consultations, particularly with low-acculturated patients. Trial registration number German Register for Clinical Trials: DRKS00004241, Universal Trial Number: U1111-1135-8043, Results. (Source: BMJ Open)
Source: BMJ Open - November 23, 2016 Category: Journals (General) Authors: Hölzel, L. P., Ries, Z., Kriston, L., Dirmaier, J., Zill, J. M., Rummel-Kluge, C., Niebling, W., Bermejo, I., Härter, M. Tags: Open access, Communication, General practice / Family practice, Mental health, Patient-centred medicine Research Source Type: research
A prospective observational cohort study in primary care practices to identify factors associated with treatment failure in Staphylococcus aureus skin and soft tissue infections
The incidence of outpatient visits for skin and soft tissue infections (SSTIs) has substantially increased over the last decade. The emergence of community-associated methicillin-resistant Staphylococcus aureus (... (Source: Annals of Clinical Microbiology and Antimicrobials)
Source: Annals of Clinical Microbiology and Antimicrobials - November 22, 2016 Category: Microbiology Authors: Grace C. Lee, Ronald G. Hall, Natalie K. Boyd, Steven D. Dallas, Liem C. Du, Lucina B. Trevi ño, Sylvia B. Treviño, Chad Retzloff, Kenneth A. Lawson, James Wilson, Randall J. Olsen, Yufeng Wang and Christopher R. Frei Source Type: research
Implementation of chronic care management services in primary care practice.
PMID: 27864200 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - November 21, 2016 Category: Drugs & Pharmacology Authors: Garwood CL, Korkis B, Mohammad I, Lepczyk M, Risko K Tags: Am J Health Syst Pharm Source Type: research
Improving adolescent HPV vaccination in a randomized controlled cluster trial using the 4 Pillars ™ practice Transformation Program.
CONCLUSIONS: Using>10 strategies from the 4 Pillars™ Practice Transformation Program is effective for increasing HPV series initiation among adolescents. Clinical trial registry number: NCT02165722. PMID: 27876200 [PubMed - as supplied by publisher] (Source: Vaccine)
Source: Vaccine - November 18, 2016 Category: Allergy & Immunology Authors: Zimmerman RK, Moehling KK, Lin CJ, Zhang S, Raviotta JM, Reis EC, Humiston SG, Nowalk MP Tags: Vaccine Source Type: research
Dyslipidaemia: Optimizing child –parent screening for FH
Nature Reviews Cardiology 14, 2 (2017). doi:10.1038/nrcardio.2016.187 Author: Dario Ummarino Child–parent screening is effective and feasible to detect familial hypercholesterolaemia (FH) in primary care practice, according to a new study involving 10,095 children aged 1–2 years. A screening strategy of a cholesterol level ≥1.53 multiples of the median (MoM), plus either the presence of an (Source: Nature Reviews Cardiology)
Source: Nature Reviews Cardiology - November 17, 2016 Category: Cardiology Authors: Dario Ummarino Tags: Research Highlight Source Type: research
Coprescribing naloxone for patients on chronic opioid therapy: Les-sons learned from a patient-safety initiative in primary care training sites.
CONCLUSIONS: Primary care practices, particularly primary care training sites, looking to implement a coprescription initiative should take several important factors into consideration during the planning stages, including naloxone availability and availability of the patient for naloxone education. More extensive research on best practices is needed. PMID: 27844476 [PubMed - in process] (Source: Journal of Opioid Management)
Source: Journal of Opioid Management - November 16, 2016 Category: Addiction Tags: J Opioid Manag Source Type: research
Association Between Patient-Centered Medical Homes and Adherence to Chronic Disease Medications: A Cohort Study.
Conclusion: Receipt of care in a patient-centered medical home is associated with better adherence, a vital measure of health care quality, among patients initiating treatment with medications for common high-cost chronic diseases. Primary Funding Source: CVS Health. PMID: 27842386 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - November 15, 2016 Category: Internal Medicine Authors: Lauffenburger JC, Shrank WH, Bitton A, Franklin JM, Glynn RJ, Krumme AA, Matlin OS, Pezalla EJ, Spettell CM, Brill G, Choudhry NK Tags: Ann Intern Med Source Type: research
Long-term chamomile (Matricaria chamomilla L.) treatment for generalized anxiety disorder: A randomized clinical trial
Conclusions Long-term chamomile was safe and significantly reduced moderate-to-severe GAD symptoms, but did not significantly reduce rate of relapse. Our limited sample size and lower than expected rate of placebo group relapse likely contributed to the non-significant primary outcome finding. Possible chamomile superiority over placebo requires further examination in large-scale studies. Graphical abstract (Source: Phytomedicine)
Source: Phytomedicine - November 9, 2016 Category: Drugs & Pharmacology Source Type: research
Patient Perceptions About Prediabetes and Preferences for Diabetes Prevention
Conclusions This qualitative study highlights potential opportunities to promote patient-centered dialogue about prediabetes in primary care settings. Providing patients specific information about the risk of developing diabetes and evidence-based treatment options to prevent or delay its onset may encourage action. Physicians’ prediabetes counseling efforts should be informed by the finding that most patients consider both intensive lifestyle intervention and metformin acceptable treatment options. (Source: The Diabetes Educator)
Source: The Diabetes Educator - November 9, 2016 Category: Endocrinology Authors: OBrien, M. J., Moran, M. R., Tang, J. W., Vargas, M. C., Talen, M., Zimmermann, L. J., Ackermann, R. T., Kandula, N. R. Tags: Features Source Type: research
Care Coordination for Primary Care Practice
(Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - November 9, 2016 Category: Primary Care Authors: Phillips, C. Tags: Commentaries Source Type: research
Care Coordination and Population Management Services Are More Prevalent in Large Practices and Patient-centered Medical Homes
Despite efforts to better coordinate health care and improve population health, primary care practices may face difficulty dedicating an individual to provide these services. Using data from the American Board of Family Medicine, we found that the presence of care coordinators or population health managers was higher in larger practices and those with patient-centered medical home certification. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - November 9, 2016 Category: Primary Care Authors: Moore, M., Peterson, L., Coffman, M., Jabbarpour, Y. Tags: Policy Brief Source Type: research
Medical Home Implementation in Small Primary Care Practices: Provider Perspectives
Conclusions: Implementation of PCMH program elements can be facilitated in small primary care practices even if third-party certification is not a requirement. Participating providers viewed having an external nurse care coordinator as the key element of the PCMH program. Small practices were receptive to external supports, but a lack of trust was viewed as a barrier to implementing a payer-based medical home program. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - November 9, 2016 Category: Primary Care Authors: Gimm, G., Want, J., Hough, D., Polk, T., Rodan, M., Nichols, L. M. Tags: Original Research Source Type: research
Screening for Parental Depression in Urban Primary Care Practices: A Mixed Methods Study.
Abstract We sought to determine feasibility and acceptability of parental depression screening in urban pediatric practices. We recruited seven practices to participate. Patient Health Questionnaire-2, a validated two-item screening tool, was used to screen for depressive symptoms at 1-3 year old well visits. We conducted semi-structured interviews with clinicians to identify barriers and facilitators to screening. Of 8,621 eligible parents, 21.1% completed screening with site-specific rates ranging from 10.1% to 48.5%. Among those screened, 8.1% screened positive for depressive symptoms with site-specific rates r...
Source: Journal of Health Care for the Poor and Underserved - November 8, 2016 Category: Global & Universal Authors: Guevara JP, Gerdes M, Rothman B, Igbokidi V, Doughterty S, Localio R, Boyd RC Tags: J Health Care Poor Underserved Source Type: research
Implementation of the Patient-Centered Medical Home Model in Facilities Providing Comprehensive Care to Medically Underserved Populations.
Abstract During the three-year Centers for Medicare & Medicaid Services Federally Qualified Health Center (FQHC) Advanced Primary Care Practice (APCP) Demonstration, 393 FQHCs (78.6% of the original 500 and 90.6% of the 434 continually-enrolled FQHCs) achieved patient-centered medical home (PCMH) recognition. Facilitators included survey fee coverage and technical assistance. PMID: 27818428 [PubMed - in process] (Source: Journal of Health Care for the Poor and Underserved)
Source: Journal of Health Care for the Poor and Underserved - November 8, 2016 Category: Global & Universal Authors: Henke RM, Johann J, Senathirajah M, Crandell M, Parker L, Riley L, Adams G, Echoles F, Mack M, Donovan J, Fleming R, Tulloch W Tags: J Health Care Poor Underserved Source Type: research
LATE-BREAKING ABSTRACT: Early DIAgnosis of obstructive Lung disease at primary care level. The E-DIAL study
Conclusions: In our sample, concordance between the CP and the GP's diagnosis was 70.5%. But 21.9% (196/897) symptomatic pts were not referred to PU. 18% of obstructed pts were unaware of their condition. Early diagnosis of COPD by GP seems feasible but perfectible. Further patients' and GP' education on respiratory diseases and symptoms seems necessary.Bibliography: Protocol for Assessment of Burden of Major Respiratory Diseases at the PHC Level. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 8, 2016 Category: Respiratory Medicine Authors: Nardini, S., De Benedetto, F., Reggiardo, G., Mirisola, V., Sanguinetti, C. M., Annesi-Maesano, I. Tags: 6.1 Epidemiology Source Type: research
Risk of CAP in COPD stratified by smoking status: A population-based cohort study in the UK
Conclusion: COPD patients have a fourfold increased risk to develop CAP, independent of smoking status. Identification of factors related with the increased risk of CAP in COPD is warranted, in order to improve the management of patients at risk. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 8, 2016 Category: Respiratory Medicine Authors: Braeken, D., Rohde, G., Franssen, F., Driessen, J., van Staa, T., Souverein, P., Wouters, E., de Vries, F. Tags: 1.12 Clinical Problems - COPD Source Type: research
Physical activity and risk of comorbidities in patients with chronic obstructive pulmonary disease
Background Comorbidities are highly prevalent in patients with chronic obstructive pulmonary disease (COPD). Low physical activity (PA), a critical feature of COPD, is hypothesized to be an important risk factor for comorbidities.Aims To assess the association of PA with prevalence and incidence of 7 categories of comorbidities in COPD.Methods The study included 409 patients from primary care practice in the Netherlands and Switzerland. We assessed PA using the Longitudinal Ageing Study Amsterdam Physical Activity Questionnaire at baseline and followed patients for up to 5 years. During follow-up, patients reported their c...
Source: European Respiratory Journal - November 8, 2016 Category: Respiratory Medicine Authors: Yu, T., Ter Riet, G., Puhan, M., Frei, A. Tags: 1.2 Rehabilitation and Chronic Care Source Type: research
"Don't get me wrong, I think case finding is okay" Exploring healthcare professionals' perspectives on target case-finding for COPD
Conclusion: Providing cost and resource solutions, training and education opportunities for HCPs on COPD will facilitate targeted case-finding of COPD in primary care practices. Research is needed to explore patient perspectives on COPD and targeted case-finding, and identify ways to optimise public engagement with case-finding initiatives. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 8, 2016 Category: Respiratory Medicine Authors: Sharmeen, T., Summers, R., Astles, C., Gillett, K., Lippiett, K., Stafford-Watson, M., Bruton, A., Thomas, M., Wilkinson, T. Tags: 1.6 General Practice and Primary Care Source Type: research
5As (ask, advise, assess, assist, arrange) tobacco treatment delivery in primary care settings in Greece
Conclusions: To our knowledge this is the first study to report on rates of tobacco treatment delivery in primary care practice settings in Greece. Increasing the rates of 5As treatment in primary care settings in Greece are important targets for quality improvement. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 8, 2016 Category: Respiratory Medicine Authors: Papadakis, S., Girvalaki, C., Vardavas, C., Pipe, A., Lionis, C. Tags: 6.3 Tobacco, Smoking Control and Health Education Source Type: research
Respiratory function and the risk of lung cancer in COPD patients: A population-based cohort study
Background: Self-reported smoking status is clear risk factor for lung cancer. However, the degree of airways obstruction may capture additional objective information on smoking history as well as biological susceptibility.Aims and objectives: To examine whether FEV1 measured in COPD patients is an independent risk factor for lung cancer in the UK primary care setting.Methods: A cohort of COPD patients was extracted from a primary care research database containing the anonymised medical records of over 11 million UK residents (The Health Improvement Network). Patients were included if the diagnosis was made between January...
Source: European Respiratory Journal - November 8, 2016 Category: Respiratory Medicine Authors: Horsfall, L., Nazareth, I. Tags: 11.1 Lung Cancer Source Type: research
Results from a prospective cohort study: shared decision making improves outcomes for children with asthma.
CONCLUSIONS: The evidence-based SDM intervention implemented in this study was associated with improved asthma outcomes for pediatric patients but not adult patients in a real world clinical setting. CLINICAL TRIAL REGISTRATION: NCT01280500. PMID: 27813670 [PubMed - as supplied by publisher] (Source: Journal of Asthma)
Source: Journal of Asthma - November 6, 2016 Category: Respiratory Medicine Tags: J Asthma Source Type: research
Observation of interprofessional collaboration in primary care practice: A multiple case study.
Authors: Pullon S, Morgan S, Macdonald L, McKinlay E, Gray B Abstract Interprofessional collaboration (IPC) is known to improve and enhance care for people with complex healthcare and social care needs and is ideally anchored in primary care. Such care is complex, challenging, and often poorly undertaken. In countries such as Canada, the United Kingdom, the Netherlands, Australia, and New Zealand, primary care is provided predominantly via general practices, where groups of general practitioners and nurses typically work. Using a case study design, direct observations were made of interprofessional activity in thre...
Source: Journal of Interprofessional Care - November 2, 2016 Category: Health Management Tags: J Interprof Care Source Type: research
Monitoring safety in a phase III real ‐world effectiveness trial: use of novel methodology in the Salford Lung Study
ConclusionIntegration of multiple data sources in the SLS may provide more comprehensive safety information than usually collected in standard randomised controlled trials. Application of the principles of safety monitoring methodology from the SLS could facilitate safety monitoring processes for future pragmatic randomised controlled trials and yield important complementary safety and effectiveness data. © 2016 The Authors Pharmacoepidemiology and Drug Safety Published by John Wiley & Sons Ltd. (Source: Pharmacoepidemiology and Drug Safety)
Source: Pharmacoepidemiology and Drug Safety - November 1, 2016 Category: Drugs & Pharmacology Authors: Sue Collier, Catherine Harvey, Jill Brewster, Nawar Diar Bakerly, Hanaa F. Elkhenini, Roxana Stanciu, Claire Williams, Jacqui Brereton, John P. New, John McCrae, Sheila McCorkindale, David Leather Tags: Original Report Source Type: research
Medical home transformation and breast cancer screening.
CONCLUSIONS: Preventative care, such as breast cancer screening, may not improve in early PCMH implementation. PMID: 27849352 [PubMed - in process] (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - November 1, 2016 Category: Health Management Authors: Baughman AW, Brawarsky P, Onega T, Tosteson TD, Wang Q, Tosteson AN, Haas JS Tags: Am J Manag Care Source Type: research
Implementation of a Depression Screening Protocol and Tools to Improve Screening for Depression in Patients With Diabetes in the Primary Care Setting
In this study we incorporate depression screening questionnaires/tools and a screening protocol into primary care practice. The effectiveness of the intervention was evaluated in establishing depression screening practice in the clinic. Implementation of the depression screening questionnaires in patients ’ electronic health records along with the depression screening protocol resulted in increased screening. Using this approach led to increased detection of depression risk in adult patients with chronic medical conditions, such as type 2 diabetes, in the primary care setting. (Source: The Journal for Nurse Practitioners)
Source: The Journal for Nurse Practitioners - November 1, 2016 Category: Nursing Authors: Priya Bajracharya, Linda Summers, Anup K. Amatya, Conni DeBlieck Tags: Feature Article Source Type: research
Practice Facilitation for PCMH Implementation in Residency Practices.
CONCLUSIONS: Residency programs provide a unique environment that is particularly well-suited for transformation, though it also presents challenges. External practice facilitators that demonstrate key roles and qualities can support residency practices through this complex transformation process. PMID: 27875602 [PubMed - in process] (Source: Famly Medicine)
Source: Famly Medicine - November 1, 2016 Category: Primary Care Authors: Buscaj E, Hall T, Montgomery L, Fernald DH, King J, Deaner N, Dickinson WP Tags: Fam Med 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 - October 18, 2016 Category: Primary Care Source Type: research
Impact of Financial Incentives on Alcohol Consumption Recording in Primary Health Care Among Adults with Schizophrenia and Other Psychoses: A Cross-Sectional and Retrospective Cohort Study
ConclusionFinancial incentives offered by the QOF appear to have a substantial impact on alcohol screening among people with schizophrenia in UK primary care.Short summaryAlcohol screening among people with schizophrenia increased dramatically in primary health care following the introduction of the UK pay for performance incentive scheme (Quality and Outcomes Framework) for severe mental illness, with an 839% rise (>8-fold increase) compared with a 62% increase among people without a over the 13-year study period (2000–2013). (Source: Alcohol and Alcoholism)
Source: Alcohol and Alcoholism - October 13, 2016 Category: Addiction Source Type: research
Cancer Screening Among Patients Who Self-Identify as Muslim: Combining Self-Reported Data with Medical Records in a Family Practice Setting
AbstractCancer screening is a core component of family medicine but screening inequalities are well documented in Canada for foreign-born persons. Although people of Muslim faith and culture are the fastest growing immigrant population in Canada, there is little information in the literature about their cancer screening practices. Determining screening gaps could inform practice-based quality improvement initiatives. We conducted a retrospective chart review combining patient-level medical record data with self-reported religious affiliation to examine the relationship between religion and cancer screening in a large multi...
Source: Journal of Immigrant and Minority Health - October 6, 2016 Category: Global & Universal Source Type: research
Racial/Ethnic Differences in the Prevalence of Anxiety Using the Vanderbilt ADHD Scale in a Diverse Community Outpatient Setting
Conclusion: Anxiety is detected at a lower rate among Hispanic pediatric patients using the VADRS. This may suggest differences in the performance of the VADRS among Spanish-speaking families. (Source: Journal of Developmental and Behavioral Pediatrics)
Source: Journal of Developmental and Behavioral Pediatrics - October 1, 2016 Category: Child Development Tags: Original Articles Source Type: research
New Roles for Medical Assistants in Innovative Primary Care Practices
ConclusionsNew MA roles are part of a larger attempt to reform workflow and relieve primary care providers. Despite some evidence of success, spread has been limited. Key challenges to adoption included leadership and provider resistance to change, cost of additional MA training, and lack of reimbursement for nonbillable services. (Source: Health Services Research)
Source: Health Services Research - October 1, 2016 Category: Health Management Authors: Susan A. Chapman, Lisel K. Blash Tags: Special Issue ‐ Workforce Source Type: research
48 Herpes Zoster Infection in People with Diabetes in Canadian Primary Care Practice
Publication date: October 2016 Source:Canadian Journal of Diabetes, Volume 40, Issue 5, Supplement Author(s): John A. Queenan, Pendar Farahani, Shahriar Khan, Richard Birtwhistle (Source: Canadian Journal of Diabetes)
Source: Canadian Journal of Diabetes - September 30, 2016 Category: Endocrinology Source Type: research
Exercise ‐induced inspiratory symptoms in school children
Conclusions: Continuous laryngoscopy during exercise is feasible and useful for identifying children with EILO. A correct diagnosis of EILO can help relieve patient anxiety, improve their coping with symptoms, and prevent unnecessary long‐term and potentially harmful asthma treatments involving high‐dose inhaled steroids. Pediatr Pulmonol. © 2016 Wiley Periodicals, Inc. (Source: Pediatric Pulmonology)
Source: Pediatric Pulmonology - September 22, 2016 Category: Respiratory Medicine Authors: Frederik Buchvald, Lue Drasb æk Phillipsen, Thomas Hjuler, Kim G. Nielsen Tags: Original Article: Diagnostic Testing Source Type: research
Clinical Productivity of Primary Care Nurse Practitioners in Ambulatory Settings
Nurse practitioners are increasingly being integrated into primary care delivery to help meet the growing demand for primary care. It is therefore important to understand nurse practitioners ’ productivity in primary care practice. (Source: Nursing Outlook)
Source: Nursing Outlook - September 22, 2016 Category: Nursing Authors: Ying Xue, Jane Tuttle Source Type: research
Registered Nurses in Primary Care: A Value Proposition
I feel as if we are finally acting on evidence that has been known for some time; there is significant value to enhancing the contributions of registered nurses practicing in primary care. The outcome of increased efforts to engage RNs in primary care practice could be gains in the health status of patients, reduced dissatisfaction of providers (physicians, nurse practitioners, and physician assistants) and an improved value proposition for primary care. Redesigning primary care through new models that utilize teams of primary care practitioners and high functioning registered nurses could change a dynamic that has plagued...
Source: Nursing Outlook - September 21, 2016 Category: Nursing Authors: Bobbie Berkowitz Source Type: research
Chronic Kidney Disease in Primary Care: Outcomes after Five Years in a Prospective Cohort Study
In this study, 1,741 people with CKD stage 3 were individually recruited from 32 primary care practices in Derbyshire, United Kingdom. Study visits were undertaken at baseline, year 1, and year 5. Binomial logistic regression and Cox proportional hazards models were used to model progression, CKD remission, and all-cause mortality. We used Kidney Disease: Improving Global Outcomes (KDIGO) criteria to define CKD progression and defined CKD remission as the absence of diagnostic criteria (estimated glomerular filtration rate [eGFR]>60 ml/min/1.73 m2 and urine albumin-to-creatinine ratio [uACR] (Source: PLoS Medicine)
Source: PLoS Medicine - September 20, 2016 Category: Internal Medicine Authors: Adam Shardlow Source Type: research
Capsule Commentary on Schapira et al., Inadequate Systems to Support Breast and Cervical Cancer Screening in Primary Care Practice
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - September 15, 2016 Category: Internal Medicine Source Type: research
A Cluster Randomized Trial of a Personalized Multi-Condition Risk Assessment in Primary Care
Conclusions Patient-reported risk factors and EHR-linked multi-condition HRAs in primary care can modestly improve communication and promote accuracy of self-perceived risk. (Source: American Journal of Preventive Medicine)
Source: American Journal of Preventive Medicine - September 15, 2016 Category: Global & Universal Source Type: research
Job satisfaction of primary care physicians in Switzerland: an observational study
Conclusions. The presented results contribute to an understanding of factors that influence levels of satisfaction of female and male physicians. Therefore, research and intervention about job satisfaction should consider gender as well as the stereotypes that come along with these social roles. (Source: Family Practice)
Source: Family Practice - September 14, 2016 Category: Primary Care Authors: Goetz, K., Jossen, M., Szecsenyi, J., Rosemann, T., Hahn, K., Hess, S. Tags: Health Service Research Source Type: research
Soft tissue sarcoma in the dog – part 1: a current review
Soft tissue sarcomas are derived from tissues of mesenchymal origin. Although local recurrence following surgical resection is the characteristic challenge in their management, 40% dogs with high‐grade tumours may also develop metastatic disease, despite successful local control. Soft tissue sarcoma is a complex disease and there are many uncertainties regarding the biology and optimal clinical management. There are currently no diagnostic tests that can reliably predict the amount of surgical margin required for a particular tumour, so there can be a mismatch between treatment and disease. Historically, the tendency has...
Source: The Journal of Small Animal Practice - September 14, 2016 Category: Veterinary Research Authors: J. P. Bray Tags: REVIEW Source Type: research