Mothers ’ and Clinicians’ Priorities for Obesity Prevention Among Black, High-Risk Infants
Conclusions Low-income, obese, black mothers of infants highly prioritized learning about many effective obesity prevention strategies, including recognizing hunger and satiety cues, promoting infant activity, and maintaining regular routines. Clinicians may frame preventive guidance to be responsive to these priorities. (Source: American Journal of Preventive Medicine)
Source: American Journal of Preventive Medicine - July 21, 2016 Category: Global & Universal Source Type: research

Enhancing the value of integrated primary care: The role of occupational therapy.
Primary care practice transformation is a priority in our rapidly evolving and complex health care system. Medical practices must maximize the use of staff to develop effective and efficient interprofessional care teams to optimize patient care delivery and improve outcomes and access with less cost. Occupational therapists have training and expertise that can provide valuable contributions to integrated primary care teams. In this article, we review the educational background and core competencies of this group of professionals and compare them to the core competencies of integrated behavioral health in primary care. Addi...
Source: Families, Systems, and Health - July 21, 2016 Category: Global & Universal Authors: Dahl-Popolizio, Sue; Manson, Lesley; Muir, Sherry; Rogers, Oaklee Source Type: research

Working up rectal bleeding in adult primary care practices
ConclusionWorkup of rectal bleeding was inconsistent, incomplete and discordant with guidelines in one‐quarter of cases. Research and improvements strategies are needed to understand and manage practice and provider variation. (Source: Journal of Evaluation in Clinical Practice)
Source: Journal of Evaluation in Clinical Practice - July 20, 2016 Category: Journals (General) Authors: Saul N. Weingart, Elena M. Stoffel, Daniel C. Chung, Thomas D. Sequist, Ruth I. Lederman, Stephen R. Pelletier, Helen M. Shields Tags: Original Article Source Type: research

Depression Screening for Prescribed Medications with Mental Health Risk: Considerations for Clinical Decision Support, Workflow Redesign, and Health Information Exchange Arrangements
Depression screening should be increased when prevailing knowledge underscoring medication-associated mental health risk is highest. Depression screening in primary care practices when medications with mental health risk were prescribed was estimated while considering the absence and presence of clinical decision support systems. (Source: Research in Social and Administrative Pharmacy)
Source: Research in Social and Administrative Pharmacy - July 20, 2016 Category: Pharmaceuticals Authors: Michael J. Miller, Craig F. Burns, Joan Kapusnik-Uner, Roberto Carreno, Karl A. Matuszewski Source Type: research

Effectiveness of steam inhalation and nasal irrigation for chronic or recurrent sinus symptoms in primary care: a pragmatic randomized controlled trial.
Abstract BACKGROUND: Systematic reviews support nasal saline irrigation for chronic or recurrent sinus symptoms, but trials have been small and few in primary care settings. Steam inhalation has also been proposed, but supporting evidence is lacking. We investigated whether brief pragmatic interventions to encourage use of nasal irrigation or steam inhalation would be effective in relieving sinus symptoms. METHODS: We conducted a pragmatic randomized controlled trial involving adults (age 18-65 yr) from 72 primary care practices in the United Kingdom who had a history of chronic or recurrent sinusitis and rep...
Source: cmaj - July 18, 2016 Category: Journals (General) Authors: Little P, Stuart B, Mullee M, Thomas T, Johnson S, Leydon G, Rabago D, Richards-Hall S, Williamson I, Yao G, Raftery J, Zhu S, Moore M, SNIFS Study Team Tags: CMAJ Source Type: research

Effectiveness of the Assessment of Burden of COPD (ABC) tool on health-related quality of life in patients with COPD: a cluster randomised controlled trial in primary and hospital care
Objective Assessing the effectiveness of the Assessment of Burden of COPD (ABC) tool on disease-specific quality of life in patients with chronic obstructive pulmonary disease (COPD) measured with the St. George's Respiratory Questionnaire (SGRQ), compared with usual care. Methods A pragmatic cluster randomised controlled trial, in 39 Dutch primary care practices and 17 hospitals, with 357 patients with COPD (postbronchodilator FEV1/FVC ratio
Source: BMJ Open - July 11, 2016 Category: Journals (General) Authors: Slok, A. H. M., Kotz, D., van Breukelen, G., Chavannes, N. H., Rutten-van Mölken, M. P. M. H., Kerstjens, H. A. M., van der Molen, T., Asijee, G. M., Dekhuijzen, P. N. R., Holverda, S., Salome, P. L., Goossens, L. M. A., Twellaar, M., in 't Veen, Tags: Open access, Patient-centred medicine, Respiratory medicine Research Source Type: research

CMS Announces Medicare Coverage of Psychiatric Consultations in Collaborative Care
Medicare will begin reimbursement next year for collaborative care services, according to an announcement by the Centers for Medicare and Medicaid Services (CMS). CMS, in its proposed Medicare Physician Fee Schedule rule, has included coverage for “Psychiatric Collaborative Care Management Services.” The coding for those services will support payments to psychiatrists for consultative services they provide to primary care physicians in the collaborative care model (CoCM). The model was developed by the late Wayne Katon, M.D., and Jürgen Unützer, M.D., M.P.H., at the AIMS Center of the University of Wa...
Source: Psychiatr News - July 8, 2016 Category: Psychiatry Source Type: research

A Multifaceted Approach to Revitalizing the Baby-Friendly Hospital Initiative in Croatia
The Baby-Friendly Hospital Initiative (BFHI) was launched in Croatia in 1993. By 1998, 15 of 34 maternity facilities were designated "Baby-Friendly." Introduction of hospital bags, violating the International Code of the Marketing of Breastmilk Substitutes, led to a standstill in the BFHI. The aim of this article is to describe the successful reintroduction of the BFHI in Croatia between 2007 and 2015. After hospital bags were abolished in 2007, UNICEF Croatia undertook an assessment of BFHI implementation. All maternity facilities were invited by UNICEF and the Ministry of Health to join the renewed BFHI. UNICEF...
Source: Journal of Human Lactation - July 7, 2016 Category: Nursing Authors: Grguric, J., Zakarija-Grkovic, I., Pavicic Bosnjak, A., Stanojevic, M. Tags: Insights in Policy Source Type: research

The Fit Family Challenge: A Primary Care Childhood Obesity Pilot Intervention
The objective of this study was to describe the implementation and results for the Fit Family Challenge (FFC), a primary care–based childhood obesity intervention. Methods: A single-intervention pilot project that trains primary care practices on childhood obesity guidelines and implementation of a family-focused behavior modification curriculum. A total of 29 family medicine and pediatric community practices in Colorado participated. Participants included 290 patients, aged 6 to 12 years, with a body mass index (BMI) above the 85th percentile. The main outcome measure included the feasibility of implementation of a...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Jortberg, B. T., Rosen, R., Roth, S., Casias, L., Dickinson, L. M., Coombs, L., Awadallah, N. S., Bernardy, M. K., Dickinson, W. P. Tags: Original Research Source Type: research

Provision of Recommended Chronic Pain Assessment and Management in Primary Care: Does Patient-Centered Medical Home (PCMH) Recognition Make a Difference?
Conclusions: These findings support the usefulness of the PCMH model in managing patients with CP, but patient outcomes need to be addressed in future studies. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Elder, N., Penm, M., Pallerla, H., Vonder Meulen, M. B., Short, A. D., Diers, T., Imhoff, R. J., Wilson, B., Boone, J. M. Tags: Original Research Source Type: research

A Primary Care Panel Size of 2500 Is neither Accurate nor Reasonable
Primary care panel sizes are an important component of primary care practices. Determining the appropriate panel size has implications for patient access, physician workload, and care comprehensiveness and will have an impact on quality of care. An often quoted standard panel size is 2500. However, this number seems to arise in the literature anecdotally, without a basis in research. Subsequently, multiple studies observed that a panel size of 2500 is not feasible because of time constraints and results in incomplete preventive care and health care screening services. In this article we review the origins of a panel size o...
Source: Journal of the American Board of Family Medicine - July 7, 2016 Category: Primary Care Authors: Raffoul, M., Moore, M., Kamerow, D., Bazemore, A. Tags: Special Communication Source Type: research

Primary Care Requirements for Pharmacists-Clinical Reasoning Education at Schools of Pharmaceutical Sciences.
Abstract For appropriate primary care practice corresponding to the various symptoms of a patient, team medicine on that combines the expertise of physicians and other medical staff has been recommended in recent years. It results in (1) higher quality of medical care, (2) lower burden on the physician, (3) better medical safety, and (4) reduced medical expenses. In order to promote team medicine through inter-professional collaboration, the responsibilities of the medical staff need to be reviewed to expand their respective roles. The Ministry of Health, Labour and Welfare designated nine specific medical acts by...
Source: Yakugaku Zasshi : Journal of the Pharmaceutical Society of Japan - July 5, 2016 Category: Drugs & Pharmacology Authors: Ashizawa T Tags: Yakugaku Zasshi Source Type: research

Assessment and improvement of HIV screening rates in a Midwest primary care practice using an electronic clinical decision support system: a quality improvement study
Universal human immunodeficiency virus (HIV) screening remains low in many clinical practices despite published guidelines recommending screening for all patients between ages 13–65. Electronic clinical decisi... (Source: BMC Medical Informatics and Decision Making)
Source: BMC Medical Informatics and Decision Making - July 4, 2016 Category: Information Technology Authors: Jasmine R. Marcelin, Eugene M. Tan, Alberto Marcelin, Marianne Scheitel, Praveen Ramu, Ronald Hankey, Pritesh Keniya, Majken Wingo, Stacey A. Rizza, Frederick North and Rajeev Chaudhry Source Type: research

Cognitive reflection and antibiotic prescribing for acute respiratory infections
Conclusions. In contrast to our hypothesis, there appears to be a ‘sweet-spot’ of cognitive reflection for antibiotic prescribing for non-antibiotic-appropriate ARIs. Differences in clinicians’ cognitive reflection may be associated with other variations in care. (Source: Family Practice)
Source: Family Practice - July 4, 2016 Category: Primary Care Authors: Pineros, D. B., Doctor, J. N., Friedberg, M. W., Meeker, D., Linder, J. A. Tags: Health Service Research Source Type: research

Necessity of office visits for acute respiratory infections in primary care
Conclusion. About two-thirds of primary care ARI visits may not be necessary for appropriate antibiotic management. (Source: Family Practice)
Source: Family Practice - July 4, 2016 Category: Primary Care Authors: Renati, S., Linder, J. A. Tags: Health Service Research Source Type: research

Do integrated care structures foster processes of integration? A quasi-experimental study in frail elderly care from the professional perspective
Conclusions This study confirms that integrated care structures foster processes of integration among professionals. Trial registration Current Controlled Trials ISRCTN05748494. (Source: International Journal for Quality in Health Care)
Source: International Journal for Quality in Health Care - July 4, 2016 Category: Global & Universal Authors: Janse, B., Huijsman, R., de Kuyper, R. D. M., Fabbricotti, I. N. Tags: Article Source Type: research

Concept Mapping as a Method to Engage Patients in Clinical Quality Improvement.
We present an overview of group concept mapping as a method for engaging patients in primary care practice improvement. We detail the group concept mapping process as a tool for use in primary care practice improvement, research, and evaluation, and we present resources to enable researchers and practice leaders to use this tool in practice improvement. To illustrate the method, we present a practice-based quality improvement project conducted with patients and staff at a large urban academic primary care practice. PMID: 27401427 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - July 1, 2016 Category: Primary Care Authors: LaNoue M, Mills G, Cunningham A, Sharbaugh A Tags: Ann Fam Med Source Type: research

A High Sense of Coherence as Protection Against Adverse Health Outcomes in Patients Aged 80 Years and Older.
CONCLUSION: Even very elderly persons with high SOC scores were shown to have lower mortality rates and less functional decline. These effects were independent of multimorbidity, depression, cognition, disability, and sociodemographic characteristics. PMID: 27401421 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - July 1, 2016 Category: Primary Care Authors: Boeckxstaens P, Vaes B, De Sutter A, Aujoulat I, van Pottelbergh G, Matheï C, Degryse JM Tags: Ann Fam Med Source Type: research

A Randomized Clinical Trial of a Tailored Lifestyle Intervention for Obese, Sedentary, Primary Care Patients.
Abstract PURPOSE: The aim of the study was to test a tailored lifestyle intervention for helping obese primary care patients achieve weight loss and increase physical activity. METHODS: We conducted a 24-month randomized clinical trial in Rhode Island. Primary care physicians identified obese, sedentary patients motivated to lose weight and increase their moderate to vigorous physical activity. These patients were randomized to 1 of 2 experimental groups: enhanced intervention (EI) or standard intervention (SI). Both groups received 3 face-to-face weight loss meetings. The enhanced intervention group also rec...
Source: Annals of Family Medicine - July 1, 2016 Category: Primary Care Authors: Eaton CB, Hartman SJ, Perzanowski E, Pan G, Roberts MB, Risica PM, Gans KM, Jakicic JM, Marcus BH Tags: Ann Fam Med Source Type: research

A Chronic Disease Management Student–Faculty Collaborative Practice: Educating Students on Innovation in Health Care Delivery
Problem: In the current transformative health care landscape, it is imperative that clinician educators inspire future clinicians to practice primary care in a dynamic environment. A focus on patient-centered, goal-oriented care for patients with chronic conditions is critical. Approach: In 2009, Harvard Medical School founded the Crimson Care Collaborative, a student–faculty collaborative practice (SFCP) network. With the aim of expanding clinical and educational opportunities for medical students and improving patient control of chronic disease (i.e., hypertension, obesity, and diabetes) in an innovative learning ...
Source: Academic Medicine - June 30, 2016 Category: Universities & Medical Training Tags: Innovation Reports Source Type: research

Quality Over Quantity: Integrating Mental Health Assessment Tools into Primary Care Practice.
Authors: Hudson DL Abstract Depression is one of the most common, costly, and debilitating psychiatric disorders in the US. There are also strong associations between depression and physical health outcomes, particularly chronic diseases such as diabetes mellitus. Yet, mental health services are underutilized throughout the US. Recent policy changes have encouraged depression screening in primary care settings. However, there is not much guidance about how depression screeners are administered. There are people suffering from depression who are not getting the treatment they need. It is important to consider whethe...
Source: The Permanente journal - June 30, 2016 Category: Journals (General) Tags: Perm J Source Type: research

A national evaluation of a dissemination and implementation initiative to enhance primary care practice capacity and improve cardiovascular disease care: the ESCALATES study protocol
The Agency for Healthcare Research and Quality (AHRQ) launched the EvidenceNOW Initiative to rapidly disseminate and implement evidence-based cardiovascular disease (CVD) preventive care in smaller primary car... (Source: Implementation Science)
Source: Implementation Science - June 29, 2016 Category: Health Management Authors: Deborah J. Cohen, Bijal A. Balasubramanian, Leah Gordon, Miguel Marino, Sarah Ono, Leif I. Solberg, Benjamin F. Crabtree, Kurt C. Stange, Melinda Davis, William L. Miller, Laura J. Damschroder, K. John McConnell and John Creswell Source Type: research

Prevalence of clinically significant decisional conflict: an analysis of five studies on decision-making in primary care
Conclusions Prevalence of CSDC in patients who had enrolled in studies conducted in primary care contexts was substantial and appeared to vary according to the type of decision as well as to patient characteristics such as sex, living arrangement and age. Patients presenting risk factors of CSDC should be offered tools to increase their involvement in decision-making. (Source: BMJ Open)
Source: BMJ Open - June 28, 2016 Category: Journals (General) Authors: Thompson-Leduc, P., Turcotte, S., Labrecque, M., Legare, F. Tags: Open access, Epidemiology, General practice / Family practice, Patient-centred medicine Research Source Type: research

STREAM: Elucidating How Alcohol Use Disorders are Managed in UK General Practice Today
Conclusions Targeted case identification in general practice identifies patients with alcohol use disorder in need of treatment. (Source: Alcohol and Alcoholism)
Source: Alcohol and Alcoholism - June 27, 2016 Category: Addiction Authors: Coste, F., Rahhali, N., Wallace, P. Tags: Article Source Type: research

Risk factors for dementia diagnosis in German primary care practices
Research Articles Anke Booker, Louis EC Jacob, Michael Rapp, Jens Bohlken, Karel Kostev, International Psychogeriatrics, Volume 28 Issue 07, pp 1059-1065Abstract (Source: International Psychogeriatrics)
Source: International Psychogeriatrics - June 26, 2016 Category: Geriatrics Source Type: research

Prevalence of self-reported multimorbidity in the general population and in primary care practices: a cross-sectional study
Settings affect estimation of multimorbidity prevalence. Multimorbidity prevalence was reported to be substantially higher among family practice-based patients than in the general population, but prevalence es... (Source: BMC Research Notes)
Source: BMC Research Notes - June 17, 2016 Category: Research Authors: Nadjib-Mohamed Mokraoui, Jeannie Haggerty, José Almirall and Martin Fortin Source Type: research

Mothers’ and Clinicians’ Priorities for Obesity Prevention Among Black, High-Risk Infants
Conclusions Low-income, obese, black mothers of infants highly prioritized learning about many effective obesity prevention strategies, including recognizing hunger and satiety cues, promoting infant activity, and maintaining regular routines. Clinicians may frame preventive guidance to be responsive to these priorities. (Source: American Journal of Preventive Medicine)
Source: American Journal of Preventive Medicine - June 16, 2016 Category: Global & Universal Source Type: research

Examining the Feasibility of a Simple Intervention to Improve Blood Pressure Control for Primary Care Patients
Conclusion: In this pilot study, we established the feasibility of a brief, simple intervention to improve blood pressure control implemented by existing primary care practice clinical support staff, and preliminary data show that it can be effective in improving blood pressure control. (Source: Journal of Cardiovascular Nursing)
Source: Journal of Cardiovascular Nursing - June 14, 2016 Category: Nursing Tags: ARTICLES: Prevention Source Type: research

NCCN Guidelines Insights: Survivorship, Version 1.2016.
This article summarizes the NCCN Survivorship panel's discussions for the 2016 update of the guidelines regarding the management of anxiety, depression, posttraumatic stress disorder-related symptoms, and emotional distress in survivors. PMID: 27283164 [PubMed - in process] (Source: Journal of the National Comprehensive Cancer Network : JNCCN)
Source: Journal of the National Comprehensive Cancer Network : JNCCN - June 11, 2016 Category: Cancer & Oncology Tags: J Natl Compr Canc Netw 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 - June 11, 2016 Category: Primary Care Source Type: research

The effect of an automated point of care tool on diagnosis and management of childhood obesity in primary care
Abstract BackgroundChildhood obesity is underdiagnosed in primary care practices. Our study aimed to compare rates of documentation of diagnosis of obesity and counselling for nutrition and physical activity at an academic primary care practice prior to and following implementation of a body mass index (BMI)‐based electronic point of care clinical reminder tool. MethodsWe performed a retrospective record review of children aged 2–18 years undergoing well child visits during any of three calendar years (2009, 2011 and 2013). The electronic clinical reminder tool was implemented in September 2010. Records of c...
Source: Journal of Evaluation in Clinical Practice - June 10, 2016 Category: Journals (General) Authors: Natalie Gentile, Valeria Cristiani, Brian A Lynch, Patrick M Wilson, Amy L Weaver, Lila J Rutten, Debra J Jacobson, Rajeev Chaudhry, Swetha Sriram, Seema Kumar Tags: Original Article Source Type: research

Making patient values visible in healthcare: a systematic review of tools to assess patient treatment priorities and preferences in the context of multimorbidity
Conclusions Given the importance of eliciting patient priorities and preferences in providing patient-centred care in the context of multimorbidity and polypharmacy, we found surprisingly few relevant tools. Some aspects of the tools used for single-disease contexts may also be useful in the context of multimorbidity. There is an urgent need to develop ways to make patient priorities explicitly visible in the clinical record and medical decision-making and to test the effect on patient-relevant outcomes. (Source: BMJ Open)
Source: BMJ Open - June 10, 2016 Category: Journals (General) Authors: Mangin, D., Stephen, G., Bismah, V., Risdon, C. Tags: Open access, General practice / Family practice, Patient-centred medicine Research Source Type: research

Learning the landscape: implementation challenges of primary care innovators around cancer survivorship care
Conclusions Cancer survivorship delivery models are potentially feasible in primary care; however, significant barriers to widespread implementation exist. Implementation efforts would benefit from increasing the awareness and potential value-add of primary care-focused strategies to address survivors’ needs. Implications for Cancer Survivors Current models of primary care-based cancer survivorship care may not be sustainable. Innovative strategies to provide quality care to this growing population of survivors need to be developed and integrated into primary care set...
Source: Journal of Cancer Survivorship - June 8, 2016 Category: Cancer & Oncology Source Type: research

Nurse perspectives on the implementation of routine telemonitoring for high-risk diabetes patients in a primary care setting.
CONCLUSIONS: This qualitative study identified challenges and unexpected benefits that might inform future efforts. Communication and integration between the TM agency and the practice, including the designation of a point person within the office to coordinate TM and help address the broader contextual needs of patients, are important considerations for future implementation. The role of the TM nurse in developing trust with patients and uncovering the social and economic context within which patients manage their diabetes was an unexpected benefit. PMID: 27269513 [PubMed - as supplied by publisher] (Source: Primary Care)
Source: Primary Care - June 8, 2016 Category: Primary Care Authors: Vest BM, Hall VM, Kahn LS, Heider AR, Maloney N, Singh R Tags: Prim Health Care Res Dev Source Type: research

Weak evidence on nalmefene creates dilemmas for clinicians and poses questions for regulators and researchers
ConclusionsProblems with the registration, design, analysis and reporting of clinical trials of nalmefene did not prevent it being licensed and recommended for treating alcohol dependence. This creates dilemmas for primary care clinicians and commissioning organisations where nalmefene has been heavily promoted, and poses wider questions about the effectiveness of the medicines regulation system and how to develop the alcohol treatment evidence base. (Source: Addiction)
Source: Addiction - June 5, 2016 Category: Addiction Authors: Niamh Fitzgerald, Kathryn Angus, Andrew Elders, Marisa Andrade, Duncan Raistrick, Nick Heather, Jim McCambridge Tags: Vested Interests Series Source Type: research

Demonstration of the Health Literacy Universal Precautions Toolkit: Lessons for Quality Improvement
The Agency for Healthcare Research and Quality Health Literacy Universal Precautions Toolkit was developed to help primary care practices assess and make changes to improve communication with and support for patients. Twelve diverse primary care practices implemented assigned tools over a 6-month period. Qualitative results revealed challenges practices experienced during implementation, including competing demands, bureaucratic hurdles, technological challenges, limited quality improvement experience, and limited leadership support. Practices used the Toolkit flexibly and recognized the efficiencies of implementing tools ...
Source: The Journal of Ambulatory Care Management - June 2, 2016 Category: Emergency Medicine Tags: Original Articles Source Type: research

Ambulatory Computerized Prescribing and Preventable Adverse Drug Events
Background: Adverse drug events (ADEs) represent a significant cause of injury in the ambulatory care setting. Computerized physician order entry reduces rates of serious medication errors that can lead to ADEs in the inpatient setting, but few studies have evaluated whether computerized prescribing in the ambulatory setting reduces preventable ADE rates in ambulatory care. Objective: To determine the rates of preventable ADEs before and after the implementation of computerized prescribing with basic clinical decision support for ordering medications. Design: Before-after study of ADE rates in practices implementing comp...
Source: Journal of Patient Safety - June 1, 2016 Category: Health Management Tags: Original Articles Source Type: research

Improving Early Identification and Ongoing Care of Children With Autism Spectrum Disorder
This study aimed to increase the proportion of toddlers screened for ASD and improve physicians’ self-efficacy in providing care to children with ASD. METHODS: Twenty-six Utah primary care practices participated in a 3 to 6 month learning collaborative (LC) to improve identification and ongoing care of children with ASD. Monthly chart audits assessed whether an ASD screening tool was administered at 18- and 24-month visits. Physicians completed pre-LC and post-LC surveys to assess changes in self-efficacy in providing care and changes in perceived barriers to implementation of screening and caring for children with ...
Source: PEDIATRICS - June 1, 2016 Category: Pediatrics Authors: Carbone, P. S., Norlin, C., Young, P. C. Tags: Developmental/Behavioral Pediatrics, Autism/ASD, Administration/Practice Management, Standard of Care Quality Report Source Type: research

Psychiatric Care in Primary Care Practice
PRIMARY CARE: CLINICS IN OFFICE PRACTICE (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - June 1, 2016 Category: Primary Care Authors: Janet R. Albers Source Type: research

Role expansion on interprofessional primary care teams: Barriers of role self-efficacy among clinical associates
Conclusions These identified themes have implications for healthcare professionals working in interprofessional teams in a variety of settings and indicate the need for interdisciplinary leadership based solutions. Implications Clarifying the factors that impact self-efficacy for the role expansion of PACT staff can inform strategies for role transformation for enhanced primary care delivery. (Source: Healthcare)
Source: Healthcare - May 28, 2016 Category: Middle East Health Source Type: research

Protocol for a pragmatic cluster randomised controlled trial for reducing irrational antibiotic prescribing among children with upper respiratory infections in rural China
Introduction Irrational use of antibiotics is a serious issue within China and internationally. In 2012, the Chinese Ministry of Health issued a regulation for antibiotic prescriptions limiting them to
Source: BMJ Open - May 27, 2016 Category: Journals (General) Authors: Zou, G., Wei, X., Hicks, J. P., Hu, Y., Walley, J., Zeng, J., Elsey, H., King, R., Zhang, Z., Deng, S., Huang, Y., Blacklock, C., Yin, J., Sun, Q., Lin, M. Tags: Open access, Health policy, Health services research, Paediatrics, Public health, Respiratory medicine Protocol Source Type: research

Refining Reporting Mechanisms in Oregon's Patient-Centered Primary Care Home Program to Improve Performance.
CONCLUSIONS: The PCPCH Program could be replicated in other states. This article offers insights on implementation strategies, efficacy of the PCPCH model, and lessons learned. PMID: 27213488 [PubMed - as supplied by publisher] (Source: The Permanente journal)
Source: The Permanente journal - May 25, 2016 Category: Journals (General) Tags: Perm J Source Type: research

Nurse practitioner screening for childhood adversity among adult primary care patients: A mixed‐method study
ConclusionsA total of 188 complete NP surveys were analyzed along with data from focus groups with 12 NPs. One third of the NPs regularly screened for childhood abuse and believed screening was their responsibility. Six barriers, including insufficient time and lack of confidence when inquiring about abuse, were significantly associated with NP screening practices. The focus group participants discussed how and when one should ask about childhood abuse, and the need for education about screening. Implications for practiceTime constraints and NPs’ lack of confidence in their ability to screen for histories of childhoo...
Source: Journal of the American Academy of Nurse Practitioners - May 25, 2016 Category: Nursing Authors: Karen A. Kalmakis, Genevieve E. Chandler, Susan Jo Roberts, Katherine Leung Tags: ORIGINAL RESEARCH Source Type: research

Nurse practitioner screening for childhood adversity among adult primary care patients: A mixed ‐method study
ConclusionsA total of 188 complete NP surveys were analyzed along with data from focus groups with 12 NPs. One third of the NPs regularly screened for childhood abuse and believed screening was their responsibility. Six barriers, including insufficient time and lack of confidence when inquiring about abuse, were significantly associated with NP screening practices. The focus group participants discussed how and when one should ask about childhood abuse, and the need for education about screening. Implications for practiceTime constraints and NPs’ lack of confidence in their ability to screen for histories of childhoo...
Source: Journal of the American Academy of Nurse Practitioners - May 25, 2016 Category: Nursing Authors: Karen A. Kalmakis, Genevieve E. Chandler, Susan Jo Roberts, Katherine Leung Tags: ORIGINAL RESEARCH Source Type: research

Survey of ankle-brachial pressure index use and its perceived barriers by general practitioners in the UK
Conclusions Targeted training of nursing staff may improve ABPI usage, although a less time-consuming test for PAD may be another option. (Source: Postgraduate Medical Journal)
Source: Postgraduate Medical Journal - May 24, 2016 Category: Journals (General) Authors: Yap Kannan, R., Dattani, N., Sayers, R. D., Bown, M. J. Tags: General practice / family medicine Original article Source Type: research

[Comment] Six ways for governments to get value from health IT
Substantial progress is being made in the implementation of electronic health records (EHRs) in hospitals, ambulatory care, and primary care practices globally, but uncertainty remains about how these large financial investments will translate into tangible patient, population, and societal benefits.1 This question is topical for all governments, but particularly pertinent for the UK and the USA, since important decisions on government health information technology (HIT) strategies related to EHRs are imminent. (Source: LANCET)
Source: LANCET - May 20, 2016 Category: Journals (General) Authors: Kathrin Cresswell, David W Bates, Aziz Sheikh Tags: Comment Source Type: research

White Blood Cell Count in Primary Care: Comparison of Manual Microscopic Count to a Point-of-Care Instrument and a Central Laboratory Analyzer
Abstract: In primary care, our local pediatricians still perform white blood cell (WBC) count obtained by manual microscopy. The goal of this study was to compare microscopic WBC count and HemoCue WBC System point-of-care device in reliability and clinical use. We found a slope of 0.93 (95% confidence interval [CI], 0.79 to 1.14) and an intercept of 0.12 (95% CI, −2.21 to 1.61) for the comparison of ADVIA 2120i and HemoCue WBC system (n = 14), a slope of 1.09 (95% CI, 0.94 to 1.26) and an intercept of −1.08 (95% CI, −2.46 to 0.07) for the comparison of ADVIA 2120i and microscopic WBC count (n = 52), and a...
Source: Point of Care: The Journal of Near-Patient Testing and Technology - May 19, 2016 Category: Pathology Tags: Original Articles Source Type: research

Utilization of Patient Electronic Messaging to Promote Advance Care Planning in the Primary Care Setting.
CONCLUSION: Among primary care patients aged 65 years and older, use of AD-specific electronic messaging statistically significantly increased the rate of AD completion, but the absolute number of completed AD remained relatively low. These data suggest that this valuable communication tool holds opportunities for further improvement. Older, frailer adults were more likely to complete an AD, and prompted directives were more likely to include a written expression of the individual's health-care values and preference. PMID: 27188759 [PubMed - as supplied by publisher] (Source: The American Journal of Hospice and Palliative Care)
Source: The American Journal of Hospice and Palliative Care - May 17, 2016 Category: Palliative Care Authors: Tieu C, Chaudhry R, Schroeder DR, Bock FA, Hanson GJ, Tung EE Tags: Am J Hosp Palliat Care Source Type: research

Efficiency of the implementation of cardiovascular risk management in primary care practices: an observational study
This study aimed to document the variation in technical efficiency of primary care (PC) practices in delivering evidence-based cardiovascular risk management (CVRM) and to identify associated factors. (Source: Implementation Science)
Source: Implementation Science - May 13, 2016 Category: Health Management Authors: Eddy M. M. Adang, Anne Gerritsma, Elvira Nouwens, Jan van Lieshout and Michel Wensing Source Type: research