Primary Care Opioid Taper Plans Are Associated with Sustained Opioid Dose Reduction
AbstractBackgroundPrimary care providers prescribe most long-term opioid therapy and are increasingly asked to taper the opioid doses of these patients to safer levels. A recent systematic review suggests that multiple interventions may facilitate opioid taper, but many of these are not feasible within the usual primary care practice.ObjectiveTo determine if opioid taper plans documented by primary care providers in the electronic health record are associated with significant and sustained opioid dose reductions among patients on long-term opioid therapy.DesignA nested case-control design was used to compare cases (patient...
Source: Journal of General Internal Medicine - January 6, 2020 Category: Internal Medicine Source Type: research

Physician-Nurse Practitioner Teamwork in Primary Care Practices in New York: A Cross-Sectional Survey
ConclusionsThis study produced evidence about NP-physician teamwork in primary care practices. We found the vast majority of NPs and physicians reported favorable teamwork, and that teamwork affects clinician job satisfaction and intent to leave as well as perceived quality of care in their practices. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - January 6, 2020 Category: Internal Medicine Source Type: research

Differences in Frequency of Visits to Pediatric Primary Care Practices and Emergency Departments by Body Mass Index
ConclusionsChildren's BMI categories were associated with health care utilization, specifically primary care visits, ED visits, and hospitalizations. Further investigation is needed to explore the drivers of these differences in utilization, such as the impact of stigma and perceived weight bias on care-seeking patterns, and to examine the role of settings outside of primary care in pediatric weight management. (Source: Academic Pediatrics)
Source: Academic Pediatrics - January 3, 2020 Category: Pediatrics Source Type: research

The Effect of Hypertension Duration and the Age of Onset on CV Risk Factors Expression in Perimenopausal Women.
Conclusion: Hypertension onset at the time around menopause appears together with abdominal obesity and may be a driving force for CV risk factor accumulation in postmenopausal women. PMID: 31885899 [PubMed] (Source: International Journal of Hypertension)
Source: International Journal of Hypertension - January 1, 2020 Category: Cardiology Tags: Int J Hypertens Source Type: research

A Blueprint for Planning and Implementing a Transgender Health Program.
This article presents a blueprint for planning and implementing a transgender health program within a primary care practice in order to enhance the capacity of the health care system to meet the medical and mental health needs of this underserved population. The steps described, with emphasis on elements specific to transgender care, include conducting a community needs assessment, gaining commitment from leadership and staff, choosing a service model and treatment protocols, defining staff roles, and creating a welcoming environment. PMID: 31937536 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - January 1, 2020 Category: Primary Care Authors: Morenz AM, Goldhammer H, Lambert CA, Hopwood R, Keuroghlian AS Tags: Ann Fam Med Source Type: research

Differences in Diabetes Care With and Without Certification as a Medical Home.
Abstract PURPOSE: The purpose of this study was to assess whether primary care practices certified as medical homes differ in having the practice systems required for that designation and in attaining favorable outcomes for their patients with diabetes, and whether those systems are associated with better diabetes outcomes. METHODS: We undertook a cross-sectional observational study, Understanding Infrastructure Transformation Effects on Diabetes (UNITED), of 586 Minnesota adult primary care practices, comparing those that were certified vs uncertified as medical homes in 2017, with analyses supplemented by p...
Source: Annals of Family Medicine - January 1, 2020 Category: Primary Care Authors: Solberg LI, Carlin C, Peterson KA, Eder M Tags: Ann Fam Med Source Type: research

Comparison of Primary Care Experience in Hospital-Based Practices and Community-Based Office Practices in Japan.
CONCLUSIONS: Our study elucidates differences in the strengths and challenges of primary care between hospital-based practices and community-based office practices, with a focus on patient centeredness. Improving community orientation in hospital-based practices and improving accessibility, including out-of-hours care, in community-based office practices may enhance the quality of primary care and promote standardization of care across settings. PMID: 31937529 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - January 1, 2020 Category: Primary Care Authors: Aoki T, Yamamoto Y, Fukuhara S Tags: Ann Fam Med Source Type: research

How Radiology Maintains Relative Value Units But Could Lose Big in Reimbursement: The Power of the Conversion  Factor
Within health care reform, it is widely accepted that primary care practice transformation and delivery are essential  to achieving the nation’s quadruple aim—improving patient and provider experience and the health of the population while decreasing cost. Although accountable care organizations and alternative payment models have been lauded as the summit of this proverbial value escalator [1], much of our cu rrent health care system can be found at lower levels on the ascent [2]. For those who are not there yet, how does CMS adjust how primary care services are paid in a fee-for-service environment ...
Source: Journal of the American College of Radiology : JACR - December 31, 2019 Category: Radiology Authors: Lauren Parks Golding, Andrew B. Rosenkrantz, Gregory N. Nicola, Kurt A. Schoppe, Joshua A. Hirsch Tags: Opinion Source Type: research

Using the Consolidated Framework for Implementation Research (CFIR) to evaluate implementation effectiveness of a facilitated approach to an asthma shared decision making intervention.
Conclusions: The CFIR was used to evaluate the asthma SDM intervention implementation at 10 facilitator-led practices. While there was no significant correlation between higher implementation effectiveness and greater improvement in clinical outcomes, practices with a higher proportion of pediatric patients did experience a significant reduction in overall exacerbations post-implementation. PMID: 31868043 [PubMed - as supplied by publisher] (Source: Journal of Asthma)
Source: Journal of Asthma - December 25, 2019 Category: Respiratory Medicine Tags: J Asthma Source Type: research

A multicomponent intervention to improve adherence to opioid prescribing and monitoring guidelines in primary care.
Authors: Huang KTL, Blazey-Martin D, Chandler D, Wurcel A, Gillis J, Tishler J Abstract OBJECTIVE: Guidelines for appropriate management of chronic opioid therapy are underutilized by primary care physicians (PCPs). The authors hypothesized that developing a multicomponent, team-based opioid management system with electronic health record (EHR) support would allow our clinicians to improve adherence to chronic opioid prescribing and monitoring guidelines. DESIGN: This was a retrospective pre-post study. SETTING: The authors performed this intervention at our large, urban, academic primary care practice. ...
Source: Journal of Opioid Management - December 19, 2019 Category: Addiction Tags: J Opioid Manag Source Type: research

Treatment of Cystitis by Hungarian General Practitioners: A Prospective Observational Study
Conclusions: Many aspects of suboptimal cystitis management were identified (e.g. unnecessarily broad spectra agents, too long antibiotic courses). In this study, patient characteristics has weakly influenced fluoroquinolone prescribing. Based on these results there is considerable room for improvement in primary care antibiotic therapy of cystitis in Hungary. (Source: Frontiers in Pharmacology)
Source: Frontiers in Pharmacology - December 19, 2019 Category: Drugs & Pharmacology Source Type: research

Physician and nurse practitioner perceptions of social worker and community health worker roles in primary care practices caring for frail elders: Insights for social work
. (Source: Social Work in Health Care)
Source: Social Work in Health Care - December 17, 2019 Category: International Medicine & Public Health Authors: Julie Berrett-Abebe Karen Donelan Barbara Berkman David Auerbach Peter Maramaldi Source Type: research

Integrating Community Health Workers into Safety-Net Primary Care for Diabetes Prevention: Qualitative Analysis of Clinicians ’ Perspectives
ConclusionsClinicians found CHWs appropriate for diabetes prevention in safety-net settings. However, disseminating high-quality evidence about CHWs ’ effectiveness and operations is needed to overcome concerns about integrating CHWs in primary care. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - December 17, 2019 Category: Internal Medicine Source Type: research

Threats to safe transitions from hospital to home: a consensus study in North West London primary care.
CONCLUSION: This study identified specific threats to safe patient transitions from hospital to primary care, providing policymakers and healthcare providers with targets for quality improvement strategies. Further work would need to identify factors underpinning these threats so that interventions can be tailored to the relevant behavioural and environmental contexts in which these threats arise. PMID: 31848201 [PubMed - as supplied by publisher] (Source: The British Journal of General Practice)
Source: The British Journal of General Practice - December 17, 2019 Category: Primary Care Authors: Markiewicz O, Lavelle M, Lorencatto F, Judah G, Ashrafian H, Darzi A Tags: Br J Gen Pract Source Type: research

Is delayed cardioversion the better approach in recent-onset atrial fibrillation? Yes
AbstractAtrial fibrillation is the most common sustained arrhythmia encountered in primary care practice and represents a significant burden on the health care system with a higher than expected hospitalization rate from the emergency department. The first goal of therapy is to assess the patient ’s symptoms and hemodynamic status. There are multiple acute management strategies for atrial fibrillation including heart rate control, immediate direct-current cardioversion, or pharmacologic cardioversion. Given the variety of approaches to acute atrial fibrillation, it is often difficult to co nsistently provide cost-eff...
Source: Internal and Emergency Medicine - December 13, 2019 Category: Emergency Medicine Source Type: research

Lung Screen Uptake Trial (LSUT): Randomised Controlled Trial Testing Targeted Invitation Materials.
Abstract RATIONALE: Low uptake of low-dose CT (LDCT) lung cancer screening, particularly by current smokers of a low socioeconomic position, compromises effectiveness and equity. OBJECTIVES: To compare the effect of a 'targeted, low burden and stepped' invitation strategy versus control, on uptake of hospital-based 'Lung Health Check' appointments offering (LDCT) screening. METHODS: A two-arm, blinded, between-subjects, randomised controlled trial. 2012 participants were selected from 16 primary care practices using these criteria: i) aged 60-75, ii) recorded as a current smoker within the last seven yea...
Source: American Journal of Respiratory and Critical Care Medicine - December 11, 2019 Category: Respiratory Medicine Authors: Quaife SL, Ruparel M, Dickson JL, Beeken RJ, McEwen A, Baldwin DR, Bhowmik A, Navani N, Sennett K, Duffy SW, Waller J, Janes SM Tags: Am J Respir Crit Care Med Source Type: research

Translating CKD Research into Primary Care Practice: a Group-Randomized Study
AbstractBackgroundChronic kidney disease (CKD) is common in the primary care setting. Early interventions may prevent progression of renal disease and reduce risk for cardiovascular complications, yet quality gaps have been documented. Successful approaches to improve identification and management of CKD in primary care are needed.ObjectiveTo assess whether implementation of a primary care improvement model results in improved identification and management of CKDDesign18-month group-randomized studyParticipants21 primary care practices in 13 US states caring for 107,094 patientsInterventionsTo promote implementation of CKD...
Source: Journal of General Internal Medicine - December 10, 2019 Category: Internal Medicine Source Type: research

THE VITAMIN D ASSESSMENT (ViDA) STUDY – DESIGN AND MAIN FINDINGS
Publication date: Available online 3 December 2019Source: The Journal of Steroid Biochemistry and Molecular BiologyAuthor(s): Robert ScraggAbstractAccumulating evidence from observational studies indicates that vitamin D status is inversely associated with a many non-skeletal diseases. This has initiated the conduct of several large clinical trials to determine if high dose vitamin D supplementation (≥ 2000 IU/day or monthly equivalent) prevents non-skeletal disease including cardiovascular disease, cancer and mortality. One of these trials is the Vitamin D Assessment (ViDA) Study which recruited 5,110 participants, age...
Source: The Journal of Steroid Biochemistry and Molecular Biology - December 3, 2019 Category: Biochemistry Source Type: research

Time Pressure During Primary Care Office Visits: a Prospective Evaluation of Data from the Healthy Work Place Study
AbstractBackgroundThe relationship between worklife factors, clinician outcomes, and time pressure during office visits is unclear.ObjectiveTo quantify associations between time pressure, workplace characteristics ,and clinician outcomes.DesignProspective analysis of data from the Healthy Work Place randomized trial.Participants168 physicians and advanced practice clinicians in 34 primary care practices in Upper Midwest and East Coast.Main Measures and MethodsTime pressure was present when clinicians needed more time than allotted to provide quality care. Other metrics included work control, work pace (calm to chaotic), or...
Source: Journal of General Internal Medicine - December 3, 2019 Category: Internal Medicine Source Type: research

Antihypertensive Prescribing Pattern in Older Adults: Implications of Age and the Use of Dual Single-Pill Combinations
This study evaluated antihypertensive prescribing patterns in older adults ( ≥ 65 years) versus young adults based on the current guidelines with an emphasis on the use of dual single-pill combinations (SPCs).MethodsA nationwide audit of 8746 primary care prescriptions of hypertensive patients with comorbidities in Bahrain was performed.ResultsAntihypertensive combination therapy was prescribed more often to older (77.1%) than young adults (68.6%;P  
Source: High Blood Pressure and Cardiovascular Prevention - December 3, 2019 Category: Cardiology Source Type: research

Hepatitis C Virus Screening and Care: Complexity of Implementation in Primary Care Practices Serving Disadvantaged Populations.
Conclusion: Despite a similar framework for STOP HCC implementation, performance varied widely across safety-net practices, which may reflect practice engagement as well as infrastructure or cost challenges beyond practice control. Primary Funding Source: Cancer Prevention & Research Institute of Texas and Centers for Medicare & Medicaid Services. PMID: 31791065 [PubMed - as supplied by publisher] (Source: Annals of Internal Medicine)
Source: Annals of Internal Medicine - December 3, 2019 Category: Internal Medicine Authors: Turner BJ, Rochat A, Lill S, Bobadilla R, Hernandez L, Choi A, Guerrero JA Tags: Ann Intern Med Source Type: research

Physician and nurse practitioner perceptions of social worker and community health worker roles in primary care practices caring for frail elders: Insights for social work
. (Source: Social Work in Health Care)
Source: Social Work in Health Care - November 30, 2019 Category: International Medicine & Public Health Authors: Julie Berrett-Abebe Karen Donelan Barbara Berkman David Auerbach Peter Maramaldi Source Type: research

Clinical Training Innovation for Prelicensure Graduate Nursing Students to Expand Roles in Primary Care
Conclusions Reshifting the focus of nursing education to integrate primary care nursing, it is important to embed nursing students into primary care practices where they can learn about the longitudinal care of patients with chronic conditions. (Source: Nurse Educator)
Source: Nurse Educator - November 29, 2019 Category: Nursing Tags: Feature Articles Source Type: research

[Theoretical models of health promotion in primary healthcare everyday practice].
CONCLUSIONS: Primary prevention and health promotion practice of primary healthcare professionals follow mainly intrapersonal models, few cases use interpersonal models and community models are only occasionally employed. Advance of public participation and community orientation in primary healthcare services is needed. PMID: 31753510 [PubMed - as supplied by publisher] (Source: Gaceta Sanitaria)
Source: Gaceta Sanitaria - November 23, 2019 Category: International Medicine & Public Health Tags: Gac Sanit Source Type: research

Impact of Stressful Climates on Provider Perceptions of Integrated Behavioral Health Services in Pediatric Primary Care: An Exploratory Study
Conclusions: Providers experiencing more stressful practice climates developed more positive perceptions of collaborative care. This may encourage stressed providers to make effective practice changes and promote practice integration of BH services. (Source: Journal of Developmental and Behavioral Pediatrics)
Source: Journal of Developmental and Behavioral Pediatrics - November 22, 2019 Category: Child Development Tags: ORIGINAL ARTICLE Source Type: research

Development of the Birmingham Lung Improvement Studies (BLISS) prognostic score for COPD patients in primary care: data from the Birmingham COPD cohort
Prognostic scores could be used to guide management of COPD patients and reduce risk of hospital admission but existing scores do not perform well enough and are not practical for primary care.Using data from the Birmingham primary care COPD cohort we developed and internally validated the new BLISS prognostic score from 23 candidate variables. 1558 patients on COPD registers of 71 GP practices and 331 newly-identified patients from a linked case-finding trial were included and their self-reported and clinical data were combined with routine hospital episode statistics. Primary outcome was the record of at least one respir...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Jordan, R., Fitzmaurice, D., Martin, J., Ayres, J., Cheng, K., Cooper, B., Daley, A., Dickens, A., Enocson, A., Greenfield, S., Miller, M., Riley, R., Siebert, S., Stockley, R., Turner, A., Adab, P. Tags: General practice and primary care Source Type: research

Efficacy of German Disease Management Program Asthma and COPD - a cross sectional evaluation
Current available data regarding the efficacy of German Disease Management Programs (DMP) are only related to data which are entered into official documentations of health care providers or health care insurances. However, no data are available that evaluate the efficacy of DMP or education programs and no documentation show the patients perspective of the DMP.Therefore a cross-sectional trial in patients with Asthma (AB) and COPD, respectively, in 13 primary care practices and 26 specialist practices in Germany was performed. Patients took part in the DMP for> 1 year (DMP +) or took not part (DMP -). (AB: n=721 DMP+ / ...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Kanniess, F., Ruckes, C., Regenfuss, N., Schmidt, T. Tags: Rehabilitation and chronic care Source Type: research

Stability of blood eosinophils in stable Chronic Obstructive Pulmonary Disease: a retrospective study in primary care
Conclusion: The large RSD values recorded, imply that blood eosinophil counts are highly variable in individual COPD patients. Therefore the use of a single measurement to guide therapeutic decisions remains debatable. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Van Rossem, I., Hanon, S., Meskens, W., Deridder, S., Vandevoorde, J., Vanderhelst, E. Tags: Monitoring airway disease Source Type: research

Disease management program COPD in Germany: benefit for the patient in respect of GOLD-stages?
Current available data regarding the efficacy of german Disease Management Programs (DMP) are only related to data which are entered into official documentation sheets of health care insurance / health care providers. However, no data evaluate the DMP or the incorporated educational programs from patients perspective.Therefore a cross-sectional trial in patients with Asthma (AB) and COPD, respectively, in 13 primary care practices and 26 specialist practices in Germany was performed. This subgroup analysis evaluates the effects of the DMP COPD in respect to the different disease severity in COPD.Patients took part in the D...
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Kanniess, F., Ruckes, C., Regenfuss, N., Schmidt, T. Tags: Rehabilitation and chronic care Source Type: research

Relationship between asthma control and medication adherence in children managed in primary care
Conclusion: Adherence in our cohort was generally poor. In a high proportion of children poor control and high BDR are likely the result of poor adherence. Under-prescribing of asthma treatments may be a factor contributing to poor ACT scores and BDR in some children. This data highlights the importance of reviewing individual prescription data before increasing medical therapy. Follow-up adherence, ACT and BDR data will be collected. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Paracha, R., Lo, D., Montgomery, U., Gaillard, E. Tags: General practice and primary care Source Type: research

Developing an education package for the IMP2ART programme; implementing supported asthma self-management in primary care
Conclusions: Practice-based testing will pilot and refine the prototype for inclusion within the IMP2ART (IMPlementing IMProved Asthma self-management as RouTine) implementation strategy.Funding: NIHR PGfAR (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 21, 2019 Category: Respiratory Medicine Authors: Marsh, V., Neal, J., Mcclatchey, K., Steed, E., Taylor, S., Pinnock, H. Tags: General practice and primary care Source Type: research

Reply
We thank van Summeren et  al for their interest in our systematic review on health-related quality of life (HRQoL) in children with functional constipation. They expressed their concerns on the use of either self-report or parent proxy report to assess HRQoL of children with functional constipation, and stress that a combi nation of both reports should be used in current clinical practice. This notion is largely based on their study on HRQoL in children with functional constipation and their parents in primary care practices. (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - November 20, 2019 Category: Pediatrics Authors: Mana H. Vriesman, Ilan J. Koppen, Marieke van Dijk, Marc A. Benninga Tags: Letter to the Editor Source Type: research

Development of a Multidisciplinary Medical Home Program for NICU Graduates
This article discusses a multidisciplinary, family-centered medical home designed to address the needs of this special population.MethodsThis is a descriptive analysis of a cohort of patients in the Next Steps Program (NSP), a multidisciplinary primary care medical home. Key program elements include: continuity of care from the NICU to primary care, routine developmental surveillance, care coordination, and proactive screening to address medical and social needs.ResultsThe NSP has become a primary referral source for local NICUs, with a total of 549 medically fragile infants enrolled from its inception in 2011 through 2016...
Source: Maternal and Child Health Journal - November 19, 2019 Category: Health Management Source Type: research

Prevalence of documented alcohol and opioid use disorder diagnoses and treatments in a regional primary care practice-based research network
This study takes a critical step toward quantifying service gaps and directing improvement efforts for AUD and OUD by using electronic health record (EHR) data from diverse primary care organizations to quantify the extent to which AUD and OUD are underdiagnosed and undertreated in primary care practices. (Source: Journal of Substance Abuse Treatment)
Source: Journal of Substance Abuse Treatment - November 16, 2019 Category: Addiction Authors: Kevin A. Hallgren, Elizabeth Witwer, Imara West, Laura-Mae Baldwin, Dennis Donovan, Brenda Stuvek, Gina A. Keppel, Brenda Mollis, Kari A. Stephens Source Type: research

Coaching Primary Care Clinicians in the Ambulatory Setting: Direct Observation and Deliberate Practice.
CONCLUSIONS: Coaching busy primary care clinicians is feasible and a valued experience. Focusing on specific observable behaviors can identify clinicians' strengths and opportunities for improvement. Patients are pleased to learn that their clinicians are receiving coaching as part of their professional development. PMID: 31722100 [PubMed - in process] (Source: Family Medicine)
Source: Family Medicine - November 14, 2019 Category: Primary Care Tags: Fam Med Source Type: research

Accounting for Blood Pressure Seasonality Alters Evaluation of Practice-Level Blood Pressure Control Intervention.
Abstract BACKGROUND: Despite the large body of literature evaluating interventions to improve hypertension management, few studies have addressed seasonal variation in blood pressure (BP) control. This underreported phenomenon has implications for interpreting study findings and informing clinical care. We share a methodology that accounts for BP seasonality, presented through a case study - HealthyHearts NYC, an intervention aimed at increasing adherence to the Million Hearts BP control evidence-based guidelines in primary care practices. METHODS: We used a randomized stepped-wedge design (n = 257 practices)...
Source: American Journal of Hypertension - November 10, 2019 Category: Cardiology Authors: Gepts T, Nguyen AM, Cleland C, Wu W, Pham-Singer H, Shelley D Tags: Am J Hypertens Source Type: research

Creating change, challenging structure: graduate and faculty perspectives on the implementation of an interprofessional education program in veterans affairs primary care.
Authors: Hulen E, Edwards ST, Poppe AP, Singh MK, Shunk R, Tuepker A Abstract Interprofessional clinical education programs have the potential to impact participants' professional expectations and practices related to team-based care. In this qualitative study, research team members interviewed 38 graduates and 19 faculty members from such an interprofessional training program, the Department of Veterans Affairs (VA) Centers of Excellence in Primary Care Education (CoEPCE). Semi-structured interviews with participants enquired about skills gained, impact on career expectations, and barriers to implementing interpro...
Source: Journal of Interprofessional Care - November 9, 2019 Category: Health Management Tags: J Interprof Care Source Type: research

Active participation of patients with type 2 diabetes in consultations with their primary care practice nurses – what helps and what hinders: a qualitative study
Patients with type 2 diabetes mellitus (T2DM) receiving primary care regularly visit their practice nurses (PNs). By actively participating during medical consultations, patients can better manage their diseas... (Source: BMC Health Services Research)
Source: BMC Health Services Research - November 8, 2019 Category: General Medicine Authors: E. du Pon, A. T. Wildeboer, A. A. van Dooren, H. J. G. Bilo, N. Kleefstra and S. van Dulmen Tags: Research article Source Type: research

Translating Team-Based Breastfeeding Support into Primary Care Practice
Conclusion: Team-based LC and PCP health care is a promising approach for delivering efficient, patient-centered, face-to-face counseling and support. Practice assessment informs financial feasibility and confirms provider interest in change. An integrated LC/PCP model can be implemented in a FQHC while enhancing patient breastfeeding support and provider satisfaction. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - November 8, 2019 Category: Primary Care Authors: Witt, A. M., Witt, R., Lasko, L., Flocke, S. Tags: Original Research Source Type: research

Features of U.S. Primary Care Physicians and Their Practices Associated with Advance Care Planning Conversations
Conclusions: In this sample of US primary care physicians, the types of patients seen, practice location, and physician compensation influenced whether physicians routinely discuss ACP with patients who are older and sicker. Practices demonstrating more features of APCP/PCMH models of primary care are also associated with ACP discussions. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - November 8, 2019 Category: Primary Care Authors: Nowels, D., Nowels, M. A., Sheffler, J. L., Kunihiro, S., Lum, H. D. Tags: Original Research Source Type: research

Accountable Care Organizations Serving Deprived Communities Are Less Likely to Share in Savings
Conclusions: ACOs serving deprived communities generate less savings. These findings are important to primary care practices, payers, and policy makers anticipating continued ACO expansion, if population health is to be achieved equitably. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - November 8, 2019 Category: Primary Care Authors: Webb, A. R., Liaw, W., Chung, Y., Petterson, S., Bazemore, A. Tags: Original Research Source Type: research

Centralized Reminder/Recall to Increase Influenza Vaccination Rates: A Two-State Pragmatic Randomized Trial
ConclusionsC-R/R for influenza vaccine using autodial had low-level effects on increasing influenza rates in 2 states. Given the feasibility and low cost of C-R/R in previous trials, its utility for influenza should be re-examined using different modalities. (Source: Academic Pediatrics)
Source: Academic Pediatrics - November 5, 2019 Category: Pediatrics Source Type: research

Health Care Use by Muslim Patients During Ramadan.
CONCLUSIONS: Important demographic differences exist between Muslim and non-Muslim patients. Muslims, compared with non-Muslims, had higher health care utilization during Ramadan. PMID: 31680102 [PubMed - in process] (Source: Journal of Health Care for the Poor and Underserved)
Source: Journal of Health Care for the Poor and Underserved - November 5, 2019 Category: International Medicine & Public Health Authors: Ali NB, Nieva HR, Percac-Lima S, Shields HM, Linder JA, Osman NY Tags: J Health Care Poor Underserved Source Type: research

SERIES: eHealth in primary care. Part 2: Exploring the ethical implications of its application in primary care practice.
Conclusion: Our analysis is an essential first step towards setting up a dedicated ethics research agenda that should be examined in parallel to the development and implementation of eHealth. The ultimate goal is to inspire the development of practice-specific ethical recommendations. PMID: 31663394 [PubMed - as supplied by publisher] (Source: European Journal of General Practice)
Source: European Journal of General Practice - November 1, 2019 Category: Primary Care Tags: Eur J Gen Pract Source Type: research

Features of U.S. Primary Care Physicians and Their Practices Associated with Advance Care Planning Conversations.
CONCLUSIONS: In this sample of US primary care physicians, the types of patients seen, practice location, and physician compensation influenced whether physicians routinely discuss ACP with patients who are older and sicker. Practices demonstrating more features of APCP/PCMH models of primary care are also associated with ACP discussions. PMID: 31704752 [PubMed - in process] (Source: American Family Physician)
Source: American Family Physician - November 1, 2019 Category: Primary Care Authors: Nowels D, Nowels MA, Sheffler JL, Kunihiro S, Lum HD Tags: J Am Board Fam Med Source Type: research

Improving Asthma in Pediatric Practice
Pediatric asthma is a significant public health problem. It is the third cause of pediatric hospitalizations, costing $20 billion in 2016. In the US, approximately 6 million children have asthma. Despite available guidelines, implementation is lagging with only 35 % of providers using guidelines. The question was does provider compliance of the NAEPP 2007 asthma guidelines improve through an electronic health record (EHR) template in a pediatric primary care practice?" (Source: Journal of Pediatric Nursing)
Source: Journal of Pediatric Nursing - November 1, 2019 Category: Nursing Authors: Tiffany Leigh Kidd Source Type: research

Results and Lessons of a Pilot Study of Cascade Screening for Familial Hypercholesterolemia in US Primary Care Practices
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 30, 2019 Category: Internal Medicine Source Type: research

Stresses, Strengths and Resilience in Adolescents: A Qualitative Study
AbstractResilience, or positive adaptation in the face of adversity, mitigates the negative effects of stress and promotes lifelong physical and mental wellbeing. Identifying adolescents who are struggling with stress could provide opportunities for individual clinical preventive interventions. However, resilience assessments are rarely performed in clinical settings and no clear, evidence-based protocols or language for such exploration exist. The aim of this qualitative study was to identify both clinically feasible methods for assessment, and actual findings, regarding stress, supports, attributes, and strategies youth ...
Source: The Journal of Primary Prevention - October 28, 2019 Category: Sleep Medicine Source Type: research

ECG AI-guided screening for low ejection fraction (EAGLE): Rationale and design of a pragmatic cluster randomized trial
Publication date: Available online 25 October 2019Source: American Heart JournalAuthor(s): Xiaoxi Yao, Rozalina G. McCoy, Paul A. Friedman, Nilay D. Shah, Barbara A. Barry, Emma M. Behnken, Jonathan W. Inselman, Zachi I. Attia, Peter A. NoseworthyAbstractBackgroundA deep learning algorithm to detect low ejection fraction (EF) using routine 12-lead electrocardiogram (ECG) has recently been developed and validated. The algorithm was incorporated into the electronic health record (EHR) to automatically screen for low EF, encouraging clinicians to obtain a confirmatory transthoracic echocardiogram (TTE) for previously undiagno...
Source: American Heart Journal - October 27, 2019 Category: Cardiology Source Type: research

Gynecologic Oncology Care in the World of Accountable Care Organizations
Publication date: Available online 24 October 2019Source: Gynecologic Oncology ReportsAuthor(s): K.M. Dorney, S.K. Rao, R.C. Sisodia, M.G. del CarmenAbstractAccountable Care Organizations (ACOs) are an example of alternative payment models that are becoming increasingly common in our healthcare system. ACOs focus on increasing value through cost reduction and improved outcomes, and historically focus on Medicare patients within primary care practices. As ACOs grow, attention will likely turn to costly subspecialty care as an area for improvement and standardization. This brief communication addresses the potential benefits...
Source: Gynecologic Oncology Reports - October 24, 2019 Category: OBGYN Source Type: research