A stepped-wedge cluster randomized trial designed to improve completion of HPV vaccine series and reduce missed opportunities to vaccinate in rural primary care practices
To test the effectiveness of a comprehensive team-based intervention to improve human papillomavirus (HPV) vaccination completion rates and reduce missed opportunities to vaccinate in rural Oregon. (Source: Implementation Science)
Source: Implementation Science - March 14, 2019 Category: Health Management Authors: Patricia A. Carney, Brigit Hatch, Isabel Stock, Caitlin Dickinson, Melinda Davis, Rex Larsen, Steele Valenzuela, Miguel Marino, Paul M. Darden, Rose Gunn, Laura Ferrara and Lyle J. Fagnan Tags: Study protocol Source Type: research

Implementation and Evaluation of a Laboratory Safety Process Improvement Toolkit
Conclusion: The usability and usefulness of the toolkit were related to the characteristics of the toolkit itself (adaptability, simplicity, and design quality and packaging, and guidance in planning) and practice processes (presence of practice champions and implementation teams). In a set of 2 practices in which laboratory testing process improvement was a high priority and where well-established QI infrastructure exists, the toolkit was easy to use with little technical assistance. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Kwan, B. M., Fernald, D., Ferrarone, P., Loskutova, N., Summers Holtrop, J., Staton, E. W., Westfall, J. M. Tags: Original Research Source Type: research

Improving the Adoption of Advance Directives in Primary Care Practices
Background: Oklahoma's Advance Directive completion rate is less than 10%. We compared the implementation performance of 2 advance directive forms to determine which form could be more successfully disseminated. Methods: The implementation of the Oklahoma Advance Directive (OKAD) and the Five Wishes form were compared in an 8-month pair-matched cluster randomized study in 6 primary care practices. The outcomes measured during the 22-week implementation included form offering rate, acceptance/completion rate by patients, and documentation in the chart. Twenty semistructured interviews with patients and clinicians were cond...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Wickersham, E., Gowin, M., Deen, M. H., Nagykaldi, Z. Tags: Original Research Source Type: research

The Burden of Childhood Atopic Dermatitis in the Primary Care Setting: A Report from the Meta-LARC Consortium
Background: Little is known about the burden of atopic dermatitis (AD) encountered in US primary care practices and the frequency and type of skin care practices routinely used in children. Objective: To estimate the prevalence of AD in children 0 to 5 years attending primary care practices in the United States and to describe routine skin care practices used in this population. Design: A cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason. Setting: Ten primary care practices in 5 US states. Results: Among 652 children attending primary car...
Source: Journal of the American Board of Family Medicine - March 8, 2019 Category: Primary Care Authors: Al-naqeeb, J., Danner, S., Fagnan, L. J., Ramsey, K., Michaels, L., Mitchell, J., Branca, K., Morris, C., Nease, D. E., Zittleman, L., Levy, B., Daly, J., Hahn, D., Dolor, R. J., Williams, H. C., Chalmers, J. R., Hanifin, J., Tofte, S., Zuckerman, K. E., Tags: Original Research Source Type: research

Subacute fatigue in primary care - two sides of the story.
Abstract OBJECTIVES: Fatigue is a common symptom in primary care. Chronic fatigue research highlights the value of preventing chronicity, but little research has investigated the early, subacute stage of the fatigue trajectory (
Source: British Journal of Health Psychology - March 8, 2019 Category: Psychiatry & Psychology Authors: Hulme K, Little P, Burrows A, Julia A, Moss-Morris R Tags: Br J Health Psychol Source Type: research

Durability of a primary care-led weight-management intervention for remission of type 2 diabetes: 2-year results of the DiRECT open-label, cluster-randomised trial
Publication date: Available online 6 March 2019Source: The Lancet Diabetes & EndocrinologyAuthor(s): Michael E J Lean, Wilma S Leslie, Alison C Barnes, Naomi Brosnahan, George Thom, Louise McCombie, Carl Peters, Sviatlana Zhyzhneuskaya, Ahmad Al-Mrabeh, Kieren G Hollingsworth, Angela M Rodrigues, Lucia Rehackova, Ashley J Adamson, Falko F Sniehotta, John C Mathers, Hazel M Ross, Yvonne McIlvenna, Paul Welsh, Sharon Kean, Ian FordSummaryBackgroundThe DiRECT trial assessed remission of type 2 diabetes during a primary care-led weight-management programme. At 1 year, 68 (46%) of 149 intervention participants were in remis...
Source: The Lancet Diabetes and Endocrinology - March 7, 2019 Category: Endocrinology Source Type: research

Periodic health visits by primary care practice model, a population-based study using health administrative data
The general health check, which includes the periodic health visit and annual physical exam, is not recommended to maintain the health of asymptomatic adults with no risk factors. Different funding mechanisms ... (Source: BMC Family Practice)
Source: BMC Family Practice - March 5, 2019 Category: Primary Care Authors: Natasha Ruth Saunders, Jun Guan, Longdi Fu, Helen Guo, Xuesong Wang and Astrid Guttmann Tags: Research article Source Type: research

Enabling patients with advanced chronic obstructive pulmonary disease to identify and express their support needs to health care professionals: A qualitative study to develop a tool.
CONCLUSION:: The Support Needs Approach for Patients (SNAP) tool is a concise evidence-based tool designed to help patients with advanced chronic obstructive pulmonary disease identify and express their support needs to enable delivery of person-centred care. PMID: 30834813 [PubMed - as supplied by publisher] (Source: Palliative Medicine)
Source: Palliative Medicine - March 5, 2019 Category: Palliative Care Authors: Gardener AC, Ewing G, Farquhar M Tags: Palliat Med Source Type: research

The Primary Care Practice Improvement Tool (PC-PIT) process for organisational improvement in primary care: application by Australian Primary Health Networks
Samantha J. Borg, Lisa Crossland, Jo Risk, Julie Porritt, Claire L. Jackson (Source: Australian Journal of Primary Health)
Source: Australian Journal of Primary Health - March 1, 2019 Category: Primary Care Authors: Samantha J. Borg Lisa Crossland Jo Risk Julie Porritt Claire L. Jackson Source Type: research

The Practice Gap: National Estimates of Screening and Counseling for Alcohol, Tobacco, and Obesity.
Abstract Tobacco use, lack of physical activity and poor diet, and alcohol consumption are leading causes of death in the United States. We estimated screening and counseling rates by using a nationally representative sample of adults aged 35 years and older with a preventive care supplement to the 2014 Medical Expenditure Panel Survey. Receipt of the recommended level of services ranged from nearly two-thirds (64.2% for obesity, 61.9% for tobacco use) to less than one-half (41.0% for alcohol misuse). There is significant room for improving care delivery, but primary care practices probably also need additional re...
Source: Annals of Family Medicine - March 1, 2019 Category: Primary Care Authors: Shafer PR, Borsky A, Ngo-Metzger Q, Miller T, Meyers D Tags: Ann Fam Med Source Type: research

Geographic Characteristics of Loneliness in Primary Care.
Abstract Loneliness is associated with poor health outcomes, and there is growing attention on loneliness as a social determinant of health. Our study sought to determine the associations between community factors and loneliness. The Three-Item Loneliness Scale and zip codes of residence were collected in primary care practices in Colorado and Virginia. Living in zip codes with higher unemployment, poor access to health care, lower income, higher proportions of blacks, and poor transportation was associated with higher mean loneliness scores. Future studies that examine interventions addressing loneliness may be m...
Source: Annals of Family Medicine - March 1, 2019 Category: Primary Care Authors: Tong S, Mullen RA, Hochheimer CJ, Sabo RT, Liaw WR, Nease DE, Krist AH, Frey JJ Tags: Ann Fam Med Source Type: research

Identifying Adverse Drug Events in Older Community-Dwelling Patients.
CONCLUSION: Older community-dwelling patients were often not correct in recognizing ADEs. The ADE instrument demonstrated good predictive value and could be used to differentiate between symptoms of ADEs and chronic disease in the community setting. PMID: 30858256 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 1, 2019 Category: Primary Care Authors: Cahir C, Wallace E, Cummins A, Teljeur C, Byrne C, Bennett K, Fahey T Tags: Ann Fam Med Source Type: research

Loneliness in Primary Care Patients: A Prevalence Study.
This study describes the prevalence of loneliness in patients presenting for primary care and associations with self-reported demographic factors, health care utilization, and health-related quality of life. METHODS: We conducted cross-sectional surveys of adults presenting for routine care to outpatient primary care practices in 2 diverse practice-based research networks. The 3-item University of California, Los Angeles Loneliness Scale was utilized to determine loneliness. RESULTS: The prevalence of loneliness was 20% (246/1,235). Loneliness prevalence was inversely associated with age (P
Source: Annals of Family Medicine - March 1, 2019 Category: Primary Care Authors: Mullen RA, Tong S, Sabo RT, Liaw WR, Marshall J, Nease DE, Krist AH, Frey JJ Tags: Ann Fam Med Source Type: research

The Impact of Oral Health Training for Primary Care Clinicians: A Systematic Review.
CONCLUSIONS: Oral health curricula for primary care clinicians are too heterogeneous to determine the effects on practice behavior. Future research should focus on developing a clear evaluation framework for measuring practice level changes in primary care settings as a result of implementing an oral health curriculum. PMID: 30861080 [PubMed - in process] (Source: Famly Medicine)
Source: Famly Medicine - March 1, 2019 Category: Primary Care Authors: Dwiel K, Hesketh MA, Alpert JL, Cellini J, Goodell K, Phillips RS, Sullivan EE Tags: Fam Med Source Type: research

Assessing wellness in the well-child check: What about social and emotional development?
CONCLUSION: This study offers an initial approach to exploring resilience in children and therefore addressing recognized and alterable predictors of adult well-being. Early social and emotional development predicts resilience that, in turn, foreshadows future health. The PERIK questionnaire facilitated discussions that could add tremendous value to the well-child checks of children aged 4 to 6. PMID: 30867191 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - March 1, 2019 Category: Primary Care Authors: Phillips SP, Jiang M, Lakkadghatwala R, Wang S Tags: Can Fam Physician Source Type: research

Using Electronic Clinical Decision Support in Patient-Centered Medical Homes to Improve Management of Diabetes in Primary Care: The DECIDE Study
This prospective, randomized, real-world study aimed to examine the impact of electronic health record–based clinical decision support (CDS) tools on the management of diabetes in small- to medium-sized primary care practices participating in Delaware's patient-centered medical home project. Overall, use of CDS systems was associated with greater reductions from baseline in hemoglobin A1c and low-density lipoprotein cholesterol, and more patients achieving treatment goals. Physicians and staff reported that the CDS toolkit empowered them to be more involved in clinical decision-making, thereby helping to improve diab...
Source: The Journal of Ambulatory Care Management - February 28, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Evaluating a Community-Placed and Clinically Integrated Community Health Worker Program: A Realist Approach
Community health worker (CHW) programs can act as bridges between patients and health care teams, but the complexity and variability of program components and outcomes make them difficult to evaluate. This evaluation used a realist approach to identify underlying mechanisms and contextual factors associated with successful implementation of a community-placed CHW program affiliated with a primary care practice in the Midwest United States. The analysis identified mechanisms by which stakeholders built trust, self-efficacy, and empowerment to improve patient-centered outcomes and experiences. It also identified conditions t...
Source: The Journal of Ambulatory Care Management - February 28, 2019 Category: Emergency Medicine Tags: Original Articles Source Type: research

Incentive schemes to increase dementia diagnoses in primary care in England: a retrospective cohort study of unintended consequences.
CONCLUSION: The primary care incentive schemes for dementia appear to have enhanced QOF performance for the dementia review, and have had beneficial spillover effects on QOF performance in other clinical areas. However, the schemes may have had negative impacts on several aspects of patient experience. PMID: 30803980 [PubMed - as supplied by publisher] (Source: The British Journal of General Practice)
Source: The British Journal of General Practice - February 25, 2019 Category: Primary Care Authors: Liu D, Green E, Kasteridis P, Goddard M, Jacobs R, Wittenberg R, Mason A Tags: Br J Gen Pract Source Type: research

Feasibility testing of the Core set of quality Indicators for Paediatric Primary Care in Europe, COSI-PPC-EU
Conclusion: European paediatric primary care practices generally agree with the proposed quality indicator set. They document most of the parameters. However, the collection of specific needed values from available routine patient-data is considered technically difficult and time-consuming.What is Known?•Paediatric primary care systems in Europe show striking differences in their performance. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care.•A Core Set of 42 quality indicators for paediatric primary care in Europe was developed by Europ...
Source: European Journal of Pediatrics - February 23, 2019 Category: Pediatrics Source Type: research

A Trial Integrating Different Methods to Assess Psychosocial Problems in Primary Care
Conclusions: In a busy clinical setting, a simple self-rated questionnaire such as the PsychoSocial Index may afford a useful tool to unveil patient current distress. The DCPR can provide clinical information for a substantial number of patients who do not satisfy DSM-5 classification criteria and yet present with psychosocial problems, as measured by self-rated scales. The DCPR may improve the assessment and treatment plan of primary care psychologists or consulting psychiatrists.Psychother Psychosom (Source: Psychotherapy and Psychosomatics)
Source: Psychotherapy and Psychosomatics - February 19, 2019 Category: Psychiatry & Psychology Source Type: research

Patients ’ and Providers’ Views on Causes and Consequences of Healthcare Fragmentation in the Ambulatory Setting: a Qualitative Study
ConclusionsThe results of this study offer a granular roadmap for how to decrease healthcare fragmentation. The large number and severity of negative consequences (including medical errors, misdiagnosis, increased cost, and provider burnout) underscore the urgent need for interventions to address this problem directly. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - February 19, 2019 Category: Internal Medicine Source Type: research

The Future of US Primary Care Depends on Payment Reform
In this issue ofJAMA Internal Medicine, Basu and colleagues report that greater density of primary care physicians is associated with better population health in the United States. Their findings are consistent with an extensive body of literature linking access to primary care with better individual- and population-level health outcomes. Unfortunately, their study also confirms that the primary care workforce is maldistributed, with many rural communities having no primary care physicians. To increase access to primary care, especially in underserved areas, we must align incentives to attract individuals into primary care...
Source: JAMA Internal Medicine - February 18, 2019 Category: Internal Medicine Source Type: research

Effectiveness of individual and group multicomponent interventions for smoking cessation in primary care: a quasi-experimental study
AbstractBackgroundThe efficacy of smoking cessation interventions can be quite diverse in day-to-day clinical practice.ObjectiveTo analyse the effectiveness in smoking cessation of multicomponent interventions carried out in groups or individually in primary care practices.MethodsA quasi-experimental, multicentre study of 12-month follow-up of patients treated in multicomponent smoking cessation interventions was carried out in Urban health care centres in Sevilla, Spain. Two hundred and twenty smoking patients, ≥18 years of age, participated either in a multicomponent intervention group (n = 145; mean age 51.7 years; 5...
Source: Family Practice - February 17, 2019 Category: Primary Care Source Type: research

Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: confirmation between eye screening and comprehensive eye examination diagnoses.
CONCLUSIONS: This screening model may be adapted and scaled nationally and internationally. Referral to an ophthalmologist is warranted if abnormal or unreadable fundus images are detected or IOP is>21 mm Hg. TRIAL REGISTRATION NUMBER: NCT02390245. PMID: 30770354 [PubMed - as supplied by publisher] (Source: The British Journal of Ophthalmology)
Source: The British Journal of Ophthalmology - February 15, 2019 Category: Opthalmology Authors: Hark LA, Myers JS, Ines A, Jiang A, Rahmatnejad K, Zhan T, Leiby BE, Hegarty S, Fudemberg SJ, Mantravadi AV, Waisbourd M, Henderer JD, Burns C, Divers M, Molineaux J, Pizzi LT, Murchison AP, Saaddine J, Pasquale LR, Haller JA, Katz LJ Tags: Br J Ophthalmol Source Type: research

Addressing Mental Health Concerns in Primary Care: Practices Among Medical Residents in a Rural Setting
This study aimed to examine internal and family medicine residents ’: (1) patterns of addressing mental health concerns (e.g., frequency of referral for psychotherapy and/or medication), (2) self-perceptions of competency in assessment and treatment of specific mental health disorders, and (3) frequency of utilization of efficacious therapeutic strategies during clinical encounters. Self-report surveys were administered to Family Medicine and Internal Medicine residents (N = 39). Descriptive analyses indicated that 81% of the time, residents discussed mental health concerns when it was the presenting co...
Source: Journal of Clinical Psychology in Medical Settings - February 13, 2019 Category: Psychiatry & Psychology Source Type: research

Prompting Patients with Poorly Controlled Diabetes to Identify Visit Priorities Before Primary Care Visits: a Pragmatic Cluster Randomized Trial
ConclusionsA “light touch” email-based pre-visit intervention resulted in improved measures of visit interaction but did not significantly improve glycemic control relative to usual care. Improving diabetes clinical outcomes through more effective primary care visits may require more intensive approaches to patient visit preparation.Trial RegistryNCT02375932 (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - February 11, 2019 Category: Internal Medicine Source Type: research

Challenges and strategies for hypertension management: qualitative analysis of small primary care practices with varying blood pressure control
AbstractBackgroundElectronic health record (EHR) data on blood pressure (BP) control among patients with hypertension show that practices ’ rates vary greatly. This suggests providers use different approaches in managing hypertension, and so we aimed to explore challenges small primary care practice providers face and strategies they use to manage patients’ BP. We explored differences between providers with high and low BP control rates to help inform future quality improvement work.MethodsIn 2015, we recruited practices in New York City with five or fewer providers. We employed a stratified purposeful sampling...
Source: Family Practice - February 8, 2019 Category: Primary Care Source Type: research

Clinically Infrequent Arcanobacterium haemolyticumBacteremia Complicated by Foot Decubitus Ulcer: An Educational Reminder for Primary Care Physicians.
Authors: Takamura N, Tada K, Ishioka H, Gomi H Abstract An 81-year-old Japanese man with no history of diabetes mellitus was admitted to our hospital for a fever with a new ulcerative lesion on the left heel. Blood cultures on admission grew Arcanobacterium haemolyticum in aerobic bottles. He was therefore diagnosed with A. haemolyticum bacteremia and osteomyelitis complicated with foot decubitus ulcer. He was successfully treated with intravenous antibiotic therapy and debridement of the left heel. Our case and literature review show that it is important to recognize that A. haemolyticum is a systemic causative pa...
Source: Internal Medicine - February 6, 2019 Category: Internal Medicine Tags: Intern Med Source Type: research

Substance Use Stigma, Primary Care, and the New York State Prescription Drug Monitoring Program.
This study explores the implementation of mandatory PDMP technology in primary care practice and the effects on treatment of people with possible substance use disorders. Findings are based on 53 in-depth interviews with primary care providers in New York City, collected shortly following the passage of legislation mandating use of a PDMP by health care providers in New York State. Findings suggest that use of the PDMP highlighted tensions between provider stigma toward substance use disorders and the clinical care of people who use drugs, challenging their stereotypes and biases. The parallel clinical and law enforcement ...
Source: Behavioral Medicine - February 6, 2019 Category: Psychiatry Authors: Allen B, Harocopos A, Chernick R Tags: Behav Med Source Type: research

Trazodone use and risk of dementia: A population-based cohort study
by Ruth Brauer, Wallis C. Y. Lau, Joseph F. Hayes, Kenneth K. C. Man, David P. J. Osborn, Robert Howard, Joseph Kim, Ian C. K. Wong BackgroundIn vitro and animal studies have suggested that trazodone, a licensed antidepressant, may protect against dementia. However, no studies have been conducted to assess the effect of trazodone on dementia in humans. This electronic health records study assessed the association between trazodone use and the risk of developing dementia in clinical practice. Methods and findingsThe Health Improvement Network (THIN), an archive of anonymised medical and prescribing records from primary care...
Source: PLoS Medicine - February 5, 2019 Category: Internal Medicine Authors: Ruth Brauer Source Type: research

The design and conduct of Project RedDE: A cluster-randomized trial to reduce diagnostic errors in pediatric primary care.
CONCLUSION:: Project RedDE, a virtual quality improvement collaborative aimed at reducing diagnostic errors in pediatric primary care, successfully recruited and retained a diverse, national group of pediatric primary care practices. The stepped-wedge, cluster-randomized controlled trial design allowed for enhanced scientific efficiency. PMID: 30720339 [PubMed - as supplied by publisher] (Source: Clinical Trials)
Source: Clinical Trials - February 5, 2019 Category: Research Authors: Bundy DG, Singh H, Stein RE, Brady TM, Lehmann CU, Heo M, O'Donnell HC, Rice-Conboy E, Rinke ML Tags: Clin Trials Source Type: research

The Screening and Prevention of Diabetes Mellitus.
This article reviews the screening guidelines and prevention strategies for type 2 diabetes mellitus and discusses the risks and benefits of screening. PMID: 30704659 [PubMed - in process] (Source: Primary Care)
Source: Primary Care - February 3, 2019 Category: Primary Care Authors: Martinez LC, Sherling D, Holley A Tags: Prim Care Source Type: research

Prevalence of Physician-Reported Food Allergy in Canadian Primary Care Practices
To date, prevalence data for food allergy (FA) in Canada is limited to self-report, with a previous survey documenting self-reported FA prevalence of 8.3%. Our study is the first in Canada aiming to determine the prevalence of physician-reported FA using Electronic Medical Record (EMR) data from providers participating in the Manitoba Primary Care Research Network (MaPCReN). We expect a lower prevalence of FA compared to self-reported rates. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - February 1, 2019 Category: Allergy & Immunology Authors: Nerissa Nankissoor, Alexander G. Singer, Elissa M. Abrams Source Type: research

Prevalence of physician-documented beta-lactam allergy in Canadian primary care practices
Research conducted in the U.S has determined the prevalence of reported beta-lactam allergy to be between 10-17%. Currently, there is a lack of available Canadian data on beta-lactam allergy prevalence. The purpose of this study is to describe the prevalence of physician documented beta-lactam allergies in a Canadian outpatient population and to comment on associated characteristics of patients and providers. (Source: Journal of Allergy and Clinical Immunology)
Source: Journal of Allergy and Clinical Immunology - February 1, 2019 Category: Allergy & Immunology Authors: Ryan R. Phung, Alexander G. Singer, Elissa M. Abrams Source Type: research

Prevention into Practice, Practicing Prevention
Primary care practices are tasked with centering the health care of adults and children, women and men, on the prevention of disease and cancer. Guidelines change, quality metrics loom, and patients continue to occupy a spectrum of interest and engagement relative to prevention and screening. With increasingly complicated agendas during patient encounters coupled with limited time per office visit, meeting the appropriate needs of our patients in teaching disease prevention and in discussing current guidelines while offering unbiased shared decision making remains a formidable challenge. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - January 30, 2019 Category: Primary Care Authors: Joel J. Heidelbaugh Tags: Foreword Source Type: research

Engagement of primary care practice in Australia: learnings from a diabetes care project
Rajna Ogrin, Tracy Aylen, Toni Rice, Ralph Audehm, Arti Appannah (Source: Australian Journal of Primary Health)
Source: Australian Journal of Primary Health - January 30, 2019 Category: Primary Care Authors: Rajna Ogrin Tracy Aylen Toni Rice Ralph Audehm Arti Appannah Source Type: research

Engagement of primary care practice in Australia: learnings from a diabetes care project.
This article outlines a case study on contributing factors to insufficient participant recruitment through general practice for an evidence-based diabetes care pilot project. Key stakeholder semi-structured interviews and focus groups were undertaken at cessation of the pilot project. Participants (15 GPs, five practice nurses, eight diabetes educators) were healthcare providers engaged in patient recruitment. Through descriptive analysis, common themes were identified. Four major themes were identified: (1) low perceived need for intervention; (2) communication of intervention problematic; (3) translation of research into...
Source: Primary Care - January 30, 2019 Category: Primary Care Authors: Ogrin R, Aylen T, Rice T, Audehm R, Appannah A Tags: Aust J Prim Health Source Type: research

Cost-effectiveness analysis of collaborative treatment of late-life depression in primary care (GermanIMPACT).
CONCLUSION: Evidence for cost-effectiveness of GermanIMPACT relative to treatment as usual is not clear. Only if societal WTP was ≥€180 for an additional DFD, GermanIMPACT could be considered cost-effective with certainty. PMID: 30658275 [PubMed - as supplied by publisher] (Source: Journal of the Association of European Psychiatrists)
Source: Journal of the Association of European Psychiatrists - January 20, 2019 Category: Psychiatry Tags: Eur Psychiatry Source Type: research

Impact of orthostatic hypotension and antihypertensive drug treatment on total and cardiovascular mortality in a very elderly community-dwelling population
Conclusion: Although orthostatic hypotension is very common among the very elderly, its presence is not related to increased risk of death (all-cause/cardiovascular). Intensively treated elderly patients had significantly longer survival time than untreated individuals. (Source: Journal of Hypertension)
Source: Journal of Hypertension - January 17, 2019 Category: Cardiology Tags: ORIGINAL PAPERS: Epidemiology Source Type: research

Mothers’ Mental Health Care Use After Screening for Postpartum Depression at Well-Child Visits
ConclusionsFew mothers who screened positive for PPD received mental health services. Mothers without a recent history of depression treatment may be especially at risk for inadequate care. Additional mechanisms to improve access to mental health services after PPD screening are needed. (Source: Academic Pediatrics)
Source: Academic Pediatrics - January 16, 2019 Category: Pediatrics Source Type: research

Cost-effectiveness analysis of collaborative treatment of late-life depression in primary care (GermanIMPACT)
ConclusionEvidence for cost-effectiveness of GermanIMPACT relative to treatment as usual is not clear. Only if societal WTP was ≥€180 for an additional DFD, GermanIMPACT could be considered cost-effective with certainty. (Source: European Psychiatry)
Source: European Psychiatry - January 16, 2019 Category: Psychiatry Source Type: research

Beyond JAAD April 2019: Articles of interest to dermatologists from the nondermatologic literature
The authors studied data from UK electronic health records of primary care practices, matching 387,439 patients with atopic dermatitis to 1,528,477 patients without atopic dermatitis to determine whether adults with atopic dermatitis are at increased risk of cardiovascular disease and whether the risk varies by severity of atopic dermatitis and activity of the condition over time. The study showed that atopic dermatitis is associated with a moderately increased  risk of nonfatal cardiovascular outcomes, with a dose-response for atopic dermatitis severity and cumulated activity. (Source: Journal of the American Academy of Dermatology)
Source: Journal of the American Academy of Dermatology - January 10, 2019 Category: Dermatology Authors: Andrew Bronin, Robert Phelps, Robert Sidbury Tags: Beyond JAAD Source Type: research

Integration of chronic disease prevention and management services into primary care (PR1MaC): findings from an embedded qualitative study
The PR1MaC study was conducted to evaluate the integration of Chronic Disease Prevention and Management services into primary care practices and was reported effective. The aim of this study was to further exp... (Source: BMC Family Practice)
Source: BMC Family Practice - January 9, 2019 Category: Primary Care Authors: Martin Fortin, Maud-Christine Chouinard, Bayero Boubacar Diallo and Tarek Bouhali Tags: Research article Source Type: research

The medical home functions of primary care practices that care for adults with psychological distress: a cross-sectional study
Primary care practices are changing the way that they provide care by increasing their medical home functionality. Medical home functionality can improve access to care and increase patient-centeredness, which... (Source: BMC Health Services Research)
Source: BMC Health Services Research - January 9, 2019 Category: General Medicine Authors: Shawn Linman, Ivy Benjenk and Jie Chen Tags: Research article Source Type: research

Colorado Asthma Toolkit Implementation Improves Some Process Measures of Asthma Care
Conclusions: Implementation of the CATP in a primary care setting led to some improved processes of asthma care, but no changes in measured outcomes. Recommendations for future work include supplemental follow-up training including case review. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 4, 2019 Category: Primary Care Authors: Colborn, K. L., Helmkamp, L., Bender, B. G., Kwan, B. M., Schilling, L. M., Sills, M. R. Tags: Original Research Source Type: research

Increasing Advance Care Planning in Primary Care Practices: a Multi-site Quality Improvement Initiative
(Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - January 2, 2019 Category: Internal Medicine Source Type: research

Patient-centered care innovations by accountable care organizations: Lessons from leaders
Publication date: Available online 26 December 2018Source: HealthcareAuthor(s): Michael L. Millenson, David B. Muhlestein, Emily M. O’Donnell, Daniel A. Northam Jones, R. Sterling Haring, Thomas Merrill, Joel S. WeissmanAbstractAlthough there is a widespread belief that ACOs must be patient-centered to be successful, evidence to guide them in achieving that goal has been lacking. This case report examines four ACO innovators in patient-centered care that together represent urban, suburban and rural populations with a broad range of economic, racial, ethnic and geographic diversity. Seven patient-centeredness strategi...
Source: Healthcare - December 27, 2018 Category: Middle East Health Source Type: research

Incorporating Adolescent Sexual and Reproductive Health in Pediatric Primary Care
Female adolescents in the United States are at high risk for adverse sexual and reproductive health (SRH) outcomes. Few pediatric primary care practices offer contraceptive and gynecological services, presenting a gap in care. The purpose of this project was to evaluate the feasibility of a new adolescent SRH program at a private pediatric primary care practice. Results reveal that there is demand for SRH care, and meeting these needs in a primary care setting is appropriate and feasible. Evaluating financial sustainability and advocating for policy change to increase private clinics ’ ability to provide SRH care are...
Source: The Journal for Nurse Practitioners - December 24, 2018 Category: Nursing Authors: Anneka Landgraf, Alison Edie, Eric Shaw, Leigh Ann Simmons Tags: Brief Report Source Type: research

The Screening and Prevention of Diabetes Mellitus
This article reviews the screening guidelines and prevention strategies for type 2 diabetes mellitus and discusses the risks and benefits of screening. (Source: Primary Care: Clinics in Office Practice)
Source: Primary Care: Clinics in Office Practice - December 22, 2018 Category: Primary Care Authors: Lisa C. Martinez, Dawn Sherling, Allison Holley Source Type: research

Postpartum monitoring of women with a history of gestational diabetes — A cross-sectional study of an inner-city population
This cross-sectional study conducted across ten primary care practices in UK, found that women with a history of gestational diabetes were not adequately screened for type 2 diabetes in primary care. 62% did not have postpartum screening and 84% did not have the recommended annual screening. (Source: Primary Care Diabetes)
Source: Primary Care Diabetes - December 21, 2018 Category: Primary Care Authors: Radia Fahami, Nafeesa Dhalwani, Sam Seidu, Kamlesh Khunti, Melanie Davies Tags: Brief Report Source Type: research