Improving HPV Vaccination Rates Using Maintenance-of-Certification Requirements
BACKGROUND: Many pediatricians are now required to participate in American Board of Pediatrics Maintenance of Certification (MOC) Part IV programs focused on improving health care quality, but the benefits of participation are unproven. METHODS: Twenty-seven primary care pediatricians from 11 primary care practices participated in a 1-year MOC program for human papillomavirus (HPV) vaccine. Participants received education and electronic health record (EHR)-generated performance feedback reports with their rates of captured HPV immunization opportunities (dose given at eligible visit) and those of peers. In each of 3 cycle...
Source: PEDIATRICS - May 12, 2016 Category: Pediatrics Authors: Fiks, A. G., Luan, X., Mayne, S. L. Tags: Administration/Practice Management, Quality Improvement, Infectious Disease, Vaccine/Immunization Quality Report Source Type: research

Determinants of Health and Pediatric Primary Care Practices
More than 20% of children nationally live in poverty. Pediatric primary care practices are critical points-of-contact for these patients and their families. Practices must consider risks that are rooted in poverty as they determine how to best deliver family-centered care and move toward action on the social determinants of health. The Practice-Level Care Delivery Subgroup of the Academic Pediatric Association’s Task Force on Poverty has developed a roadmap for pediatric providers and practices to use as they adopt clinical practice redesign strategies aimed at mitigating poverty’s negative impact on child heal...
Source: PEDIATRICS - May 12, 2016 Category: Pediatrics Authors: Beck, A. F., Tschudy, M. M., Coker, T. R., Mistry, K. B., Cox, J. E., Gitterman, B. A., Chamberlain, L. J., Grace, A. M., Hole, M. K., Klass, P. E., Lobach, K. S., Ma, C. T., Navsaria, D., Northrip, K. D., Sadof, M. D., Shah, A. N., Fierman, A. H. Tags: Advocacy, Preventive Medicine Special Article Source Type: research

The Adolescent "Expanded Medical Home": School-Based Health Centers Partner with a Primary Care Clinic to Improve Population Health and Mitigate Social Determinants of Health
We describe the implementation of an "expanded medical home" partnering a primary care practice (the Ypsilanti Health Center [YHC]) with local school-based health centers (the Regional Alliance for Healthy Schools [RAHS]), and to assess whether this model improves access to and quality of care for shared patients. Methods: Using the Consolidated Framework for Implementation Research, we define the steps in, barriers to, and facilitating factors in implementing the expanded medical home model. Visits and quality measures were assessed for patients seen by YHC only versus YHC/RAHS at baseline and during the interv...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Riley, M., Laurie, A. R., Plegue, M. A., Richarson, C. R. Tags: Original Research Source Type: research

Integrating Behavioral Health in Primary Care Using Lean Workflow Analysis: A Case Study
The objectives of this study were to observe BH integration into primary care and to measure its impact. Methods: This was a prospective, mixed-methods case study in a primary care practice that served 8,426 patients over a 17-month period, with 652 patients referred to BH services. Secondary measures included primary care visits resulting in BH referrals, referrals resulting in scheduled appointments, time from referral to the scheduled appointment, and time from the referral to the first visit. Providers and staff were surveyed on the Lean method. Results: Referrals increased from 23 to 37 per 1000 visits (P
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: van Eeghen, C., Littenberg, B., Holman, M. D., Kessler, R. Tags: Original Research Source Type: research

Hearing Loss Health Care for Older Adults
This article reviews hearing health care for older adults, focusing on what is most relevant for family physicians. The objective of hearing loss treatment is to ensure that a patient can communicate effectively in all settings. We present the 5 major obstacles to obtaining effective hearing and rehabilitative care: awareness, access, treatment options, cost, and device effectiveness. Hearing technologies are discussed, along with recommendations on when it is appropriate to screen, refer, or counsel a patient. The purpose of this article is to provide pragmatic recommendations for the clinical management of the older adul...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Contrera, K. J., Wallhagen, M. I., Mamo, S. K., Oh, E. S., Lin, F. R. Tags: Clinical Review Source Type: research

Community Vital Signs: Taking the Pulse of the Community While Caring for Patients
In 2014 both the Institute of Medicine and the National Quality Forum recommended the inclusion of social determinants of health data in electronic health records (EHRs). Both entities primarily focus on collecting socioeconomic and health behavior data directly from individual patients. The burden of reliably, accurately, and consistently collecting such information is substantial, and it may take several years before a primary care team has actionable data available in its EHR. A more reliable and less burdensome approach to integrating clinical and social determinant data exists and is technologically feasible now. Comm...
Source: Journal of the American Board of Family Medicine - May 11, 2016 Category: Primary Care Authors: Hughes, L. S., Phillips, R. L., DeVoe, J. E., Bazemore, A. W. Tags: Special Communication Source Type: research

Electronic Health Record Availability and Anxiety Treatment in Office-Based Practices.
CONCLUSIONS: EHRs may have a negative impact on the delivery of care for anxiety during primary care visits. Future studies should monitor the impact of EHRs on delivery and quality of care. PMID: 27133721 [PubMed - as supplied by publisher] (Source: Psychiatric Services)
Source: Psychiatric Services - May 3, 2016 Category: Psychiatry Tags: Psychiatr Serv Source Type: research

Update on Novel Drugs for Primary Care Practice: Drugs Approved by the U.S. Food and Drug Administration in 2015.
PMID: 27136232 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - May 3, 2016 Category: Internal Medicine Authors: Smetana GW Tags: Ann Intern Med Source Type: research

Variations in Mental Health Diagnosis and Prescribing Across Pediatric Primary Care Practices
CONCLUSIONS: The prevalence of mental health diagnosis and psychotropic medication prescribing varies substantially across practices and is only partially explained by psychiatrist availability. Research is needed to better define the causes of variable practice-level diagnosis and prescribing and implications for child mental health outcomes. (Source: PEDIATRICS)
Source: PEDIATRICS - May 2, 2016 Category: Pediatrics Authors: Mayne, S. L., Ross, M. E., Song, L., McCarn, B., Steffes, J., Liu, W., Margolis, B., Azuine, R., Gotlieb, E., Grundmeier, R. W., Leslie, L. K., Localio, R., Wasserman, R., Fiks, A. G. Tags: Developmental/Behavioral Pediatrics, Health Information Technology, Electronic Health Records Article Source Type: research

Increasing Rates of Tobacco Treatment Delivery in Primary Care Practice: Evaluation of the Ottawa Model for Smoking Cessation.
We report on the effectiveness of the Ottawa Model for Smoking Cessation (OMSC), a multicomponent knowledge translation intervention, in increasing the rate at which primary care providers delivered smoking cessation interventions using the 3 A's model-Ask, Advise, and Act, and examine clinic-, provider-and patient-level determinants of 3 A's delivery. METHODS: We examined the effect of the knowledge translation intervention in 32 primary care practices in Ontario, Canada, by assessing a cross-sectional sample of patients before the implementation of the OMSC and a second cross-sectional sample following implementatio...
Source: Annals of Family Medicine - May 1, 2016 Category: Primary Care Authors: Papadakis S, Cole AG, Reid RD, Coja M, Aitken D, Mullen KA, Gharib M, Pipe AL Tags: Ann Fam Med Source Type: research

The Patient-Centered Medical Home. Part I: A Primer.
This article presents a general overview of the PCMH model and briefly explains how it relates to the other healthcare reforms currently taking place. PMID: 27443055 [PubMed - in process] (Source: The Journal of Medical Practice Management : MPM)
Source: The Journal of Medical Practice Management : MPM - May 1, 2016 Category: Practice Management Authors: Blubaugh S Tags: J Med Pract Manage Source Type: research

Impact of Physician Training on Diagnosis and Counseling of Overweight and Obese Asian Patients
This study investigated the effect of a physician training on accurately diagnosing obesity among and providing weight counseling to overweight and obese Asian patients. Methods Physicians (N = 16) from five primary care practices received 1 h of face-to-face training and other reminder resources (e.g., wallet card) describing the guidelines for the diagnosis of overweight/obesity among Asians, as well as weight counseling instruction. Chart reviews of overweight/obese Asian patients were conducted for the 12 months before the training (n = 198) and 3&nb...
Source: Journal of Racial and Ethnic Health Disparities - April 29, 2016 Category: Global & Universal Source Type: research

Career pathways for new graduates: exploring the options
Most veterinary professionals will work in primary care practice at some point in their career, but what other options are available? Laura Honey reports on a series of sessions in the student stream at this year's BSAVA congress, which examined some of the other career paths a vet might take (Source: Veterinary Record)
Source: Veterinary Record - April 28, 2016 Category: Veterinary Research Tags: News and Reports Source Type: research

Shared Decision Making and Treatment Decisions for Young Children with Autism Spectrum Disorder
Conclusions Much work is needed to effectively foster SDM in the context of ASD treatment decisions in primary care, including pediatrician training in ASD to enhance knowledge about evidence-based and novel treatments, clinical practice guidelines and community resources. (Source: Academic Pediatrics)
Source: Academic Pediatrics - April 28, 2016 Category: Pediatrics Source Type: research

Primary care physicians and oncologists are partners in cancer announcement
Conclusion PCPs announce the cancer diagnosis, even if they have not received the necessary information to do so. The DDP needs to be adapted for use in primary care practice. (Source: Supportive Care in Cancer)
Source: Supportive Care in Cancer - April 26, 2016 Category: Cancer & Oncology Source Type: research

Is Primary Care Practice Sustainable?
PMID: 27089075 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - April 19, 2016 Category: Internal Medicine Authors: Volpintesta E Tags: Ann Intern Med Source Type: research

Is Primary Care Practice Sustainable?
PMID: 27089074 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - April 19, 2016 Category: Internal Medicine Authors: Montecalvo MA Tags: Ann Intern Med Source Type: research

Cross-border comparison of antibiotic prescriptions among children and adolescents between the north of the Netherlands and the north-west of Germany
Conclusions This study is the first to compare outpatient antibiotic prescriptions among children in primary care practices in bordering regions of two countries. Large differences were seen within and between the countries, with overall higher prescription prevalence in Germany. Considering increasing cross-border healthcare, these comparisons are highly valuable and help act upon antibiotic resistance in the first line of care in an international approach. (Source: Antimicrobial Resistance and Infection Control)
Source: Antimicrobial Resistance and Infection Control - April 18, 2016 Category: Infectious Diseases Source Type: research

Embracing value co-creation in primary care services research: a framework for success.
Authors: Janamian T, Crossland L, Jackson CL Abstract Value co-creation redresses a key criticism of researcher-driven approaches to research - that researchers may lack insight into the end users' needs and values across the research journey. Value co-creation creates, in a step-wise way, value with, and for, multiple stakeholders through regular, ongoing interactions leading to innovation, increased productivity and co-created outcomes of value to all parties - thus creating a "win more-win more" environment. The Centre of Research Excellence (CRE) in Building Primary Care Quality, Performance and Susta...
Source: Medical Journal of Australia - April 15, 2016 Category: Journals (General) Tags: Med J Aust Source Type: research

A Delphi study assessing the utility of quality improvement tools and resources in Australian primary care.
CONCLUSIONS: This suite of tools and resources offers one approach to supporting the quality improvement initiatives currently in development in primary care reform. PMID: 27078789 [PubMed - as supplied by publisher] (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - April 15, 2016 Category: Journals (General) Tags: Med J Aust Source Type: research

Quality tools and resources to support organisational improvement integral to high-quality primary care: a systematic review of published and grey literature.
CONCLUSIONS: This systematic review identified 53 tools and resources that can potentially be provided as part of a suite of tools and resources to support primary care practices in improving the quality of their practice, to achieve improved health outcomes. PMID: 27078788 [PubMed - as supplied by publisher] (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - April 15, 2016 Category: Journals (General) Tags: Med J Aust Source Type: research

Trial of the Primary Care Practice Improvement Tool: building organisational performance in Australian general practice and primary health care.
CONCLUSIONS: The PC-PIT is an organisational performance tool that is acceptable, valid and relevant to our range of partners and the end users (general practices). Work is continuing with our partners and end users to embed the PC-PIT in existing organisational improvement programs. PMID: 27078787 [PubMed - as supplied by publisher] (Source: Medical Journal of Australia)
Source: Medical Journal of Australia - April 15, 2016 Category: Journals (General) Tags: Med J Aust Source Type: research

Integrating Psychiatric Care into Primary Care Practice
For too many years, mental health and physical health have been addressed in separate silos within the health care system. Due to stigma, many patients suffering with mental health issues are never diagnosed or treated. By integrating the care of mental and behavioral health into the patient-centered medical home, outcomes are greatly improved. Due to time constraints and discomfort with content, many primary care providers find it difficult to address these important issues. An integrated care team—including primary care physicians, nurses, advanced practice professionals, behavioral health providers (licensed clini...
Source: Primary Care: Clinics in Office Practice - April 15, 2016 Category: Primary Care Authors: Janet R. Albers Tags: Preface Source Type: research

Abstract A08: Concordance in patient and provider priorities and preferences to address behavioral risk factors for cancer health disparities interventions
Conclusions: Our findings emphasize the importance of actively engaging patient and provider stakeholders in efforts to develop interventions that address behavioral risk factors for cancer health disparities. While there is concordance between patients and providers in terms of the behavioral focus of interventions and barriers and facilitators to implementation, there may be discordance in terms of how the effects of interventions are monitored. Efforts to disseminate and implement evidence-based interventions into primary care should consider the preferences of both patients and providers.Citation Format: LaShanta J. Ri...
Source: Cancer Epidemiology Biomarkers and Prevention - April 15, 2016 Category: Cancer & Oncology Authors: Rice, L. J., Jefferson, M., Melvin, C. L., Halbert, C. H. Tags: Community-Based Interventions: Poster Presentations - Proffered Abstracts Source Type: research

Abstract IA18: Patient navigation and colorectal cancer screening among African Americans and Latinos
Colorectal cancer (CRC) is one of the leading causes of cancer mortality in the US. While there have been significant advances in CRC screening technology over the past decades, and despite the known survival benefits when cancer is detected early, low CRC screening rates persist among minority and underserved populations(1,2) .African Americans have the highest CRC incidence and mortality of any racial/ethnic group in the United States (1,3,4). The American Cancer Society (1) reports that African Americans have a 20% higher incidence rate and a 45% higher mortality rate than non-Hispanic whites. In fact, although CRC mort...
Source: Cancer Epidemiology Biomarkers and Prevention - April 15, 2016 Category: Cancer & Oncology Authors: Jandorf, L. Tags: Colorectal Cancer: Oral Presentations - Invited Abstracts Source Type: research

Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders.
CONCLUSIONS: Cardiovascular risk factors require special clinical attention among patients with psychiatric disorders. Further research could study the effect of antidepressants and antipsychotics on cardiovascular risk factors. PMID: 27061372 [PubMed - as supplied by publisher] (Source: Journal of the Association of European Psychiatrists)
Source: Journal of the Association of European Psychiatrists - April 12, 2016 Category: Psychiatry Tags: Eur Psychiatry Source Type: research

What Drives Variation in Antibiotic Prescribing for Acute Respiratory Infections?
Abstract Background Acute respiratory infections are the most common symptomatic reason for seeking care among patients in the US, and account for the majority of all antibiotic prescribing, yet a large fraction of antibiotic prescriptions are inappropriate. Objective We sought to identify the underlying factors driving variation in antibiotic prescribing across clinicians and settings. Design, Participants Using electronic health data for adult ambulatory visits for acute respiratory infections to a retail clinic ...
Source: Journal of General Internal Medicine - April 11, 2016 Category: Internal Medicine Source Type: research

Cardiovascular risk factors among patients with schizophrenia, bipolar, depressive, anxiety, and personality disorders
Conclusions Cardiovascular risk factors require special clinical attention among patients with psychiatric disorders. Further research could study the effect of antidepressants and antipsychotics on cardiovascular risk factors. (Source: European Psychiatry)
Source: European Psychiatry - April 8, 2016 Category: Psychiatry Source Type: research

Medical Student Volunteerism Addresses Patients' Social Needs: A Novel Approach to Patient-Centered Care.
CONCLUSION: The MSA program provides students with a unique educational opportunity that encompasses early exposure to patient interaction, social determinants of health, population health, and interdisciplinary collaboration. Students develop skills to help them build patient relationships, understand the psychosocial factors shaping health outcomes, and engage with other healthcare professionals. This work in the preclinical years provides students with the knowledge to help them perform more effectively in the changing healthcare environment. PMID: 27046404 [PubMed] (Source: Ochsner Journal)
Source: Ochsner Journal - April 7, 2016 Category: Journals (General) Tags: Ochsner J Source Type: research

Community characteristics associated with where urgent care centers are located: a cross-sectional analysis
Objectives To determine the community characteristics associated with non-hospital-based urgent care centres wherever they are located. Design National cross-sectional study evaluating the association between non-hospital-based urgent care centers, and their demographic characteristics in a community, using descriptive statistics and multivariate logistic regressions. Setting Communities in the USA with non-hospital-based urgent care centers, as identified using a 2014 national database from the Urgent Care Association of America. Participants 31 022 communities encompassing 6898 urgent care centers across the USA....
Source: BMJ Open - April 7, 2016 Category: Journals (General) Authors: Le, S. T., Hsia, R. Y. Tags: Open access, Emergency medicine, Health services research Source Type: research

What drives quality improvement in chronic kidney disease (CKD) in primary care: process evaluation of the Quality Improvement in Chronic Kidney Disease (QICKD) trial
Conclusions Improving quality in CKD is complex. Lack of awareness of clinical guidelines and scepticism about their validity are barriers to change. While pay-for-performance incentives are the main driver for change, quality improvement interventions can have a complementary influence. (Source: BMJ Open)
Source: BMJ Open - April 6, 2016 Category: Journals (General) Authors: Nihat, A., de Lusignan, S., Thomas, N., Tahir, M. A., Gallagher, H. Tags: Open access, General practice / Family practice, Health policy, Qualitative research, Renal medicine Source Type: research

Impact of an Atrial Fibrillation Decision Support Tool on thromboprophylaxis for atrial fibrillation
Conclusions Among patients whose physicians reviewed recommendations of the decision support tool discordant therapy decreased significantly over 1 year. However, in nonstratified analyses, the intervention did not result in significant improvements in discordant antithrombotic therapy. (Source: American Heart Journal)
Source: American Heart Journal - April 5, 2016 Category: Cardiology Source Type: research

Ten Years, Forty Decision Aids, And Thousands Of Patient Uses: Shared Decision Making At Massachusetts General Hospital [Engaging Patients In Clinical Care]
Shared decision making is a core component of population health strategies aimed at improving patient engagement. Massachusetts General Hospital’s integration of shared decision making into practice has focused on the following three elements: developing a culture receptive to, and health care providers skilled in, shared decision making conversations; using patient decision aids to help inform and engage patients; and providing infrastructure and resources to support the implementation of shared decision making in practice. In the period 2005–15, more than 900 clinicians and other staff members were trained in...
Source: Health Affairs - April 4, 2016 Category: Global & Universal Authors: Sepucha, K. R., Simmons, L. H., Barry, M. J., Edgman-Levitan, S., Licurse, A. M., Chaguturu, S. K. Tags: Consumer Issues, Evidence-Based Medicine Engaging Patients In Clinical Care Source Type: research

What is the Current Value Equation for Dementia Diagnosis and Management: Variation in Costs Across Practice Types (S1.007)
Conclusions: PCPs are consistent in diagnosing and managing patients with dementia but vary in costs using time-base rather than claims-based costing. These variations are due mostly to costs related to patients receiving drug treatment, timing and frequency of neurological consultations, and proportion of active versus stable dementia patients. A significant amount of physician time is related to administrative tasks required for patients to receive insurance coverage for home care needs.Disclosure: Dr. Wilson has received research support from Quest Diagnostics. Dr. Bonasera has received research support from the Intel C...
Source: Neurology - April 4, 2016 Category: Neurology Authors: Wilson, L., Bonasera, S., Davis, M., Balsamo, D., Kassan, D., Stallone, J., Harry, J., Kurzweil, P., Higgins, J., Rankin, K., Warsh, J., Kaplan, R. Tags: Aging and Dementia: Therapeutics and Management Source Type: research

Collaborative, Co-Located Neurology-Primary Care: Maximizing Value Utilizing Curbside, Electronic, and Traditional Consultations (P3.398)
Objective: Similar to the integration of behavioral health services in primary care, we describe a novel model of collaborative, co-located, neurology care integrated in a community-based, primary care practice setting utilizing curbside, electronic, and traditional consultations. Our objective was to examine the potential impact on healthcare resource utilization of diagnostic testing and referrals for face-to-face neurological consultation, and adverse outcomes associated with electronic and curbside consultations. Background: New, high value models of neurological care are needed to meet the growing burden of neurologic...
Source: Neurology - April 4, 2016 Category: Neurology Authors: Young, N., Elrashidi, M. Tags: General Neurology: Clinical Practice Source Type: research

Attention-Deficit/Hyperactivity Disorder, Behavior Regulation and Virtual School Support
CASE: Tony is a 6-year-old multiracial boy diagnosed as having attention-deficit/hyperactivity disorder—combined type who is followed in your primary care practice and has started on a stimulant medication. Tony continues to have difficulty with emotion regulation and impulse control both at home and at school. He was asked to leave his private school soon after beginning first grade because of physical fighting, emotional outbursts, and arguing with teachers. His mother made the decision to enroll Tony in online virtual schooling for the remainder of the academic year, with the plan to transition back to traditiona...
Source: Journal of Developmental and Behavioral Pediatrics - April 1, 2016 Category: Child Development Tags: Challenging Case Source Type: research

The benefits of respectful interactions: fluid alliancing and inter‐occupational information sharing in primary care
Abstract Though inter‐occupational interactions in health care have been the focus of increasing attention, we still know little about how such interactions shape information sharing in clinical settings. This is particularly true in primary care where research on teams and collaboration has been based on individual perceptions of work (using surveys and interviews) rather than observing the interactions that directly mediate the inter‐occupational flow of information. To explore how interactions shape information sharing, we conducted a secondary analysis of ethnographic data from 27 primary care practices. Ease of in...
Source: Sociology of Health and Illness - March 28, 2016 Category: Global & Universal Authors: Barbara DiCicco‐Bloom, Benjamin DiCicco‐Bloom Tags: Original Article Source Type: research

The benefits of respectful interactions: fluid alliancing and inter ‐occupational information sharing in primary care
Abstract Though inter‐occupational interactions in health care have been the focus of increasing attention, we still know little about how such interactions shape information sharing in clinical settings. This is particularly true in primary care where research on teams and collaboration has been based on individual perceptions of work (using surveys and interviews) rather than observing the interactions that directly mediate the inter‐occupational flow of information. To explore how interactions shape information sharing, we conducted a secondary analysis of ethnographic data from 27 primary care practices. Ease of in...
Source: Sociology of Health and Illness - March 28, 2016 Category: Global & Universal Authors: Barbara DiCicco ‐Bloom, Benjamin DiCicco‐Bloom Tags: Original Article Source Type: research

Do accountable care organizations (ACOs) help or hinder primary care physicians' ability to deliver high-quality care?
Conclusions Interviewees generally thought joining an ACO could complement a practice’s efforts to deliver high-quality care, yet noted some concerns that could undermine these synergies. Both the advantages and disadvantages of joining an ACO seemed exacerbated for small practices, since they are most likely to benefit from additional resources yet are most likely to chafe under added bureaucratic requirements. Implications Our identification of the potential pros and cons of joining an ACO may help providers identify areas to examine when weighing whether to enter into such an arrangement, and may help ACOs identi...
Source: Healthcare - March 22, 2016 Category: Middle East Health Source Type: research

Unintentional ingestion of cleaners and other substances in an immigrant Mexican population: a qualitative study
Paediatric poisoning is a salient issue worldwide and also affects the USA. In past years, ingestion of household cleaners was the second leading cause of unintentional poisonings in children. All children are at risk for ingestions, although immigrant children may be at greater risk. The purpose of this study was to document child ingestion experiences from toxic household substances via semistructured interviews with immigrant Mexican mothers. Participants were recruited from a paediatric primary care practice in Dallas/Fort Worth, Texas (N=35). Eighteen of 35 respondents (51%) reported that their child, nephew/niece or ...
Source: Injury Prevention - March 21, 2016 Category: Accident Prevention Authors: Crosslin, K., Tsai, R. Tags: Poisoning/Injestion Brief report Source Type: research

The completeness of electronic medical record data for patients with Type 2 Diabetes in primary care and its implications for computer modelling of predicted clinical outcomes
The prevalence of and health burden associated with Type 2 Diabetes Mellitus (T2D) is increasing and its management poses great challenges for primary care practitioners [1] with large differences in metabolic control existing between countries [2]. Over recent decades many countries including Australia have attempted to address these by introducing primary care programs [3] aimed at improving the quality and coordination of routine care for people with T2D [4,5]. However, a significant gap still exists between recommended guidelines and primary care practice in countries such as Australia [6,7]. (Source: Primary Care Diabetes)
Source: Primary Care Diabetes - March 21, 2016 Category: Primary Care Authors: Michael Staff, Christopher Roberts, Lyn March Tags: Original research Source Type: research

Audit and feedback of patient reported outcomes in knee osteoarthritis to improve management in primary care: A pilot project
Purpose: Osteoarthritis (OA) affects 13% of the Canadian population and is expected to increase over the next decades. There are evidence based guidelines for the management of knee OA but these are infrequently applied in practice for various reasons. Previous studies have noted that different aspects of knee OA management occur approximately 47% of the time. The aim of this pilot project was to develop and test a strategy to optimize the quality of care of knee OA in a large, urban, academic primary care practice. (Source: Osteoarthritis and Cartilage)
Source: Osteoarthritis and Cartilage - March 20, 2016 Category: Rheumatology Authors: N.K. Gakhal, R. Propp, L. Keshavjee, L. Hayden, S. Da Silva, G. Hawker, N. Ivers Source Type: research

Matrix Support in mental health: The experience in Vitoria, Espirito Santo
This study discusses the implementation of Matrix Support in Vitória, Espírito Santo, Brazil, through analysis of documents and semi-structured interviews. Results indicate that Matrix Support evolved over time to provide community services that reflect local reality, enabling the integration of mental health into primary care practices as well as boosting reduction in the number of psychiatric hospital admissions. Results suggest that the use of collaborative spaces to evaluate Matrix Support network and the services it provides helps to ensure that this strategy is not lost in hierarchies and specialisms. (...
Source: Journal of Health Psychology - March 17, 2016 Category: Psychiatry & Psychology Authors: Iglesias, A., Avellar, L. Z. Tags: Articles Source Type: research

Does cigarette reduction while using nicotine replacement therapy prior to a quit attempt predict abstinence following quit date?
ConclusionsSmoking reduction prior to a target quit date while on a smoking cessation medication may only predict subsequent abstinence when smokers are consciously attempting to reduce. (Source: Addiction)
Source: Addiction - March 16, 2016 Category: Addiction Authors: Nicola Lindson‐Hawley, Bethany Shinkins, Robert West, Susan Michie, Paul Aveyard Tags: Research Report Source Type: research

Enhancing the use of Asthma and COPD Assessment Tools in Balearic Primary Care (ACATIB): a region-wide cluster-controlled implementation trial.
The objective of this study was to assess the effect of an educational intervention programme on the use of the Asthma Control Test (ACT), modified Medical Research Council (mMRC) and COPD Assessment Test (CAT) among primary care settings of the Balearic Islands, Spain. In this region-wide cluster-controlled implementation study, an educational intervention on the use of respiratory health status tools was provided to primary care practices in Mallorca (intervention group). Practices in Ibiza and Menorca functioned as control practices. Written and multimedia materials were provided to all participants to educate their col...
Source: Primary Care - March 12, 2016 Category: Primary Care Authors: Román-Rodríguez M, Pardo MG, López LG, Ruiz AU, van Boven JF Tags: NPJ Prim Care Respir Med Source Type: research

Exploring Barriers Among Primary Care Providers in Referring Patients to Hospice
The increasing baby boomer population entering Medicare will increase the number of patients with complex chronic conditions who can potentially benefit from hospice care. Hospice continues to be underused in the United States, and primary care providers have been identified as being a possible barrier for referring to hospice. The purpose of this project is to explore attitudes, knowledge about, referral practices, and other barriers to hospice care among providers in a primary care practice setting. A cross-sectional quantitative study using a previously designed survey by Mayo Clinic (Jacksonville, Florida) was used to ...
Source: Journal of Hospice and Palliative Nursing - March 11, 2016 Category: Nursing Tags: Feature Articles Source Type: research

Why is there variation in the practice of evidence-based medicine in primary care? A qualitative study
Conclusions Despite being aware of and having a positive attitude towards EBM, doctors in this study seldom practised EBM in their routine clinical practice. Besides commonly cited barriers such as having a heavy workload and lack of training, workplace ‘EBM culture’ had an important influence on the doctors’ behaviour. Strategies targeting barriers at the practice level should be considered when implementing EBM in primary care. (Source: BMJ Open)
Source: BMJ Open - March 9, 2016 Category: Journals (General) Authors: Hisham, R., Ng, C. J., Liew, S. M., Hamzah, N., Ho, G. J. Tags: Open access, Evidence based practice, General practice / Family practice, Health services research, Qualitative research Source Type: research

Continuity and Access in an Academic Family Medicine Center.
CONCLUSIONS: Despite multiple challenges in academic teaching practices, the continuous use of improvement methods to apply proven change concepts minimizes delay for care and maximizes continuity of care. The residency continuity practice can and should be a cornerstone of residency curriculum. PMID: 26950780 [PubMed - as supplied by publisher] (Source: Family Medicine)
Source: Family Medicine - March 8, 2016 Category: Primary Care Tags: Fam Med Source Type: research

"I Don't Want to Go Anywhere Else": Patient Experiences of Abortion in Family Medicine.
CONCLUSIONS: Women in our study reported high levels of satisfaction with care and would recommend this setting to others. In a context of increasing restrictions on abortion, family physicians are well-positioned to increase access by including abortion care in the range of reproductive health services offered in their primary care practice settings. PMID: 26950663 [PubMed - as supplied by publisher] (Source: Family Medicine)
Source: Family Medicine - March 8, 2016 Category: Primary Care Tags: Fam Med Source Type: research