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

The Impact of the Patient-Centered Medical Home on Asthma-Related Visits to the Emergency Room: A Fixed Effects Regression Approach
Conclusion for Practice Reducing asthma ER visits is a task that might be immediately actionable for PCMH practices, or those undergoing transformation. Our results adds to the others suggesting positive impacts of the PCMH. (Source: Maternal and Child Health Journal)
Source: Maternal and Child Health Journal - December 14, 2018 Category: Health Management Source Type: research

Predictors of Seeking Psychotherapy in Primary Care Patients with High Somatic Symptom Burden.
Abstract Many primary care patients with high somatic symptom burden do not initiate mental health treatment. Using a cross-sectional design, this study aimed to identify predictors of psychotherapy seeking behavior for patients with high somatic symptom burden within the last 12 months. Data from 20 primary care practices were analyzed. Patients with high somatic symptom burden were identified using the Patient Health Questionnaire, structured interviews, and information from primary care physicians (PCPs). Within the final sample of 142 patients, 54 (38.03%) had been seeking psychotherapy. More severe somatic sy...
Source: Behavioral Medicine - December 11, 2018 Category: Psychiatry Authors: Kuby AK, Loewe B, Fabisch AB, Piontek K, Haerter M, Koenig HH, Shedden-Mora MC Tags: Behav Med Source Type: research

Fall Prevention in Community-Dwelling Older Adults.
Abstract Falls are common among older adults. One in 3 adults aged 65 years or older and 1 in 2 adults aged 80 years or older fall each year. Interventions for prevention have been identified; however, they are often not addressed in primary care practice. Screening all older adults annually for falls can identify who will benefit from further clinical evaluation and management. Falls and the need for care from subsequent injury increase with age. They adversely affect quality of life and are a financial burden on the health care industry. As a result, risk reduction is a key focus of prevention efforts, even amon...
Source: Annals of Internal Medicine - December 4, 2018 Category: Internal Medicine Authors: Phelan EA, Ritchey K Tags: Ann Intern Med Source Type: research

Effectiveness of the Epley manoeuvre in posterior canal benign paroxysmal positional vertigo: a randomised clinical trial in primary care.
CONCLUSION: A single Epley manoeuvre performed in primary care is an effective treatment for reversing a positive DHT and reducing vertigo severity in patients with baseline nystagmus in the DHT. PMID: 30510098 [PubMed - as supplied by publisher] (Source: The British Journal of General Practice)
Source: The British Journal of General Practice - December 3, 2018 Category: Primary Care Authors: Moreno JLB, Muñoz RC, Matos YR, Balboa IV, Puértolas OC, Ortega JA, Perez ER, Curto XM, Ripollès CR, Farres NM, Agudelo OLA, Cantera CM, Ledesma RA Tags: Br J Gen Pract Source Type: research

Acceptability and Use of Evidence-Based Practices for Firearm Storage in Pediatric Primary Care
ConclusionAcceptability of screening for firearms and safe storage counseling was high; both components were used commonly but not routinely. The acceptability of providing firearm locks was neutral and use was rarely endorsed. This study provides important insights about areas of focus for future implementation efforts from policy and research perspectives. (Source: Academic Pediatrics)
Source: Academic Pediatrics - December 1, 2018 Category: Pediatrics Source Type: research

Patient experience during a large primary care practice transformation initiative.
CONCLUSIONS: Practice transformation did not alter patient experience. The lack of favorable findings raises questions about how future efforts in primary care can succeed in improving patient experience. PMID: 30586494 [PubMed - in process] (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - December 1, 2018 Category: Health Management Authors: Swankoski KE, Peikes DN, Morrison N, Holland JJ, Duda N, Clusen NA, Day TJ, Brown RS Tags: Am J Manag Care Source Type: research

Patient attribution: why the method matters.
CONCLUSIONS: Reliable identification of the physician-patient relationship is necessary for accurate evaluation of healthcare processes, efficiencies, and outcomes. Optimization and standardization of attribution methods are therefore essential as health systems, payers, and policy makers seek to evaluate and improve the value of delivered care. PMID: 30586493 [PubMed - in process] (Source: The American Journal of Managed Care)
Source: The American Journal of Managed Care - December 1, 2018 Category: Health Management Authors: McCoy RG, Bunkers KS, Ramar P, Meier SK, Benetti LL, Nesse RE, Naessens JM Tags: Am J Manag Care Source Type: research

Clinical leadership and integrated primary care: A systematic literature review.
CONCLUSION: Good quality research on clinical leadership in integrated primary care is scarce. More profound knowledge is needed about leadership skills, required for integrated-care implementation, and leadership support aimed at developing these skills. PMID: 30474447 [PubMed - as supplied by publisher] (Source: European Journal of General Practice)
Source: European Journal of General Practice - November 28, 2018 Category: Primary Care Tags: Eur J Gen Pract Source Type: research

Development of the Japanese version of the general practice assessment questionnaire: measurement of patient experience and testing of data quality
Physicians ’ interpersonal performance is critical in medical practice, especially primary care practice. The General Practice Assessment Questionnaire (GPAQ) was developed in the United Kingdom to evaluate the... (Source: BMC Family Practice)
Source: BMC Family Practice - November 28, 2018 Category: Primary Care Authors: Tsunetaka Kijima, Kenju Akai, Akira Matsushita, Tsuyoshi Hamano, Keiichi Onoda, Shozo Yano, Toru Nabika, Yutaka Ishibashi and Shunichi Kumakura Tags: Research article Source Type: research

Mothers’ Mental Health Care Utilization 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 following PPD screening are needed. (Source: Academic Pediatrics)
Source: Academic Pediatrics - November 27, 2018 Category: Pediatrics Source Type: research

Trends in UK Primary Care Gabapentin and Pregabalin Prescriptions, 1993-2017
This pharmacoepidemiology study describes trends in first prescriptions for gabapentin and pregabalin in UK primary care practices and rates of these prescriptions for an off-label indication or with coprescription of opioids or benzodiazepines between 1993 and 2017. (Source: JAMA)
Source: JAMA - November 27, 2018 Category: General Medicine Source Type: research

[The practice staff in primary care dementia recognition-is there an untapped potential?]
CONCLUSION: The analysis showed that many GPs are not yet aware of the opportunities offered by a greater involvement of practice personnel in the recognition of dementia. Accordingly, GPs should be advised of the benefits of such a solution. At the same time, more attention should be paid to low-threshold training formats, which are tailored specifically to the perspective of practice employees and convey important dementia-specific diagnostics, action and communication skills. PMID: 30478791 [PubMed - as supplied by publisher] (Source: Zeitschrift fur Gerontologie und Geriatrie)
Source: Zeitschrift fur Gerontologie und Geriatrie - November 26, 2018 Category: Geriatrics Authors: Wangler J, Fellgiebel A, Jansky M Tags: Z Gerontol Geriatr Source Type: research

Improved quality of life associated with long-term use of guaifenesin in a patient with chronic obstructive pulmonary disease (COPD) & stable chronic bronchitis: A case report.
We report the long-term use of guaifenesin in one such patient with COPD, chronic bronchitis and seasonal allergies who presented with dyspnea and chronic, non-productive cough that impacted his activities of daily living. PMID: 30450278 [PubMed] (Source: Respiratory Care)
Source: Respiratory Care - November 21, 2018 Category: Respiratory Medicine Authors: Singer E, Miller JE Tags: Respir Med Case Rep Source Type: research

REducing Delay through edUcation on eXacerbations (REDUX) in patients with COPD
Introduction: Early recognition of COPD exacerbations and prompt treatment may reduce recovery time, hospitalization risk and improve quality of life. However, primary care strategies to early identify COPD exacerbations are largely lacking.Objective: To assess whether patient and healthcare provider education could reduce the time between onset of COPD exacerbation symptoms and patient presentation in primary care.Methods: In this pilot study, nine Dutch primary care practices received the REducing Delay through edUcation on eXacerbations (REDUX) program. REDUX was targeted at GPs and primary care nurses and involved an e...
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Hallensleben, C., Biewenga, J., van Boven, J. F. M., Chavannes, N. H. Tags: General Practice and Primary Care Source Type: research

Do Malaysian asthma patients use asthma action plan? A cross sectional study in Malaysian primary care setting.
Conclusion: Education, usage and confidence in using an AAP for asthma self-management is sub-optimal among asthma patients in Malaysian primary care. Supported asthma self-management in this population must be strengthened. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Salim, H., Lee, P. Y., Shariff Ghazali, S., Cheong, A. T., Pinnock, H., Harrun, N. H., Mohamed Isa, S., Aris, J., Seetharaman, V. R., Nordin, S., Mahmud, M., Lee, Y. S. Tags: General Practice and Primary Care Source Type: research

Perceptions among primary care staff towards financial incentives to promote implementation of asthma self-management: a qualitative study in Northern Ireland
Conclusion: Financial incentives are viewed positively in primary care, however patient health was the highest priority. Practices are continually developing strategies to increase patient attendance at annual reviews, particularly among those with poorly controlled asthma. Understanding how practices responded to this scheme could inform future policy on similar initiatives. (Source: European Respiratory Journal)
Source: European Respiratory Journal - November 19, 2018 Category: Respiratory Medicine Authors: Jackson, T., Kendall, M., Heaney, L., Shields, M., Pinnock, H. Tags: General Practice and Primary Care Source Type: research

Quality of hypertension care: An improvement initiative in two outpatient health care centers
AbstractRationale, aims, and objectivesHypertension control is an important public health goal; however, significant barriers remain in primary care practice.Our objective was to identify areas for improvement in hypertension care and implement changes in management to improve outcomes. We also aimed to evaluate whether quality improvement influences physician attitudes towards and adherence to current hypertension guidelines.MethodWe conducted a non ‐experimental pre‐ vs post‐ design quality improvement study for ambulatory patients with a history of hypertension. Specific measures of hypertension care were assessed...
Source: Journal of Evaluation in Clinical Practice - November 18, 2018 Category: General Medicine Authors: Eleanor Yusupov, Bhuma Krishnamachari, Sarah Rand, Mirette Abdalla, Hallie Zwibel Tags: ORIGINAL PAPER Source Type: research

Rationale and design for eHealth Familias Unidas Primary Care: A drug use, sexual risk behavior, and sti preventive intervention for hispanic youth in Pediatric primary care clinics
Family-based behavioral interventions are efficacious and effective in preventing drug use and sexual risk behaviors; unfortunately, they have not been evaluated and disseminated in pediatric primary care practice, where they can have a significant impact. There is an increased focus on integrating parenting interventions into primary care to reduce health disparities among ethnic minorities such as Hispanics. Although Hispanic youth demonstrate higher levels of drug use and sexual risk behaviors than their non-Hispanic counterparts, few parenting interventions are available for Hispanic youth, and none have been delivered...
Source: Contemporary Clinical Trials - November 16, 2018 Category: Radiology Authors: Guillermo Prado, Yannine Estrada, Lourdes M. Rojas, Monica Bahamon, Hilda Pantin, Meera Nagarsheth, Lisa Gwynn, Audrey Y. Ofir, Lourdes Q. Forster, Nicole Torres, C. Hendricks Brown Source Type: research

Practice Expenses Associated with Comprehensive Primary Care Capabilities
To help the Centers for Medicare& Medicaid Services (CMS) reimburse primary care practices for investing in " comprehensive primary care " capabilities, the authors developed and piloted a method for estimating related practice expenses. (Source: RAND Research Health and Health Care)
Source: RAND Research Health and Health Care - November 15, 2018 Category: Health Management Authors: Mark W. Friedberg; Grant R. Martsolf; Andrada Tomoaia-Cotisel; Peter Mendel; Ryan K. McBain; Laura Raaen; Ryan Kandrack; Nabeel Shariq Qureshi; Jason Michel Etchegaray; Brian Briscombe; Peter S. Hussey Source Type: research

Mailed Letter Versus Phone Call to Increase Uptake of Cancer Screening: A Pragmatic, Randomized Trial
Background: There is good evidence that cancer-specific patient outreach improves rates of cervical, breast, and colorectal cancer screening. However, it is unclear how primary care practices should implement integrated outreach for all 3 types of cancer screening. We aimed to understand whether integrated outreach using mailed letters or phone calls were more effective at increasing screening uptake in a primary care organization. Method: We conducted a pragmatic randomized trial comparing outreach by mailed letter or personalized phone call for patients overdue for cervical, breast, or colorectal cancer screening. The s...
Source: Journal of the American Board of Family Medicine - November 9, 2018 Category: Primary Care Authors: Kiran, T., Davie, S., Moineddin, R., Lofters, A. Tags: Original Research Source Type: research

Recruiting Primary Care Practices for Research: Reflections and Reminders
Conclusions: When undertaking a pragmatic clinical trial requiring substantial practice change in a PBRN setting across a large number of practices, it is important that PBRN leaders develop a comprehensive strategy to identify and engage a broad group of stakeholders within each practice, understand their needs and priorities around research, and design and implement a structured communications strategy to maintain engagement throughout every phase of the project. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - November 9, 2018 Category: Primary Care Authors: Fernald, D. H., Jortberg, B. T., Hessler, D. M., Wearner, R., Dickinson, L. M., Fisher, L., Dickinson, W. P. Tags: Special Communication Source Type: research

Sweden has passed a law that will shift the responsibility of managing high rates of absenteeism from employers to the primary care sector. Starting in 2019, primary care practices will be mandated by law to have rehabilitation coordinators, who will be responsible for creating reentry plans for individuals returning to work after a lengthy sick leave.         (Source: The Commonwealth Fund: Publications)
Source: The Commonwealth Fund: Publications - November 8, 2018 Category: International Medicine & Public Health Source Type: research

Team-based care: an expanded medical assistant role - enhanced rooming and visit assistance.
Authors: Harper PG, Van Riper K, Ramer T, Slattengren A, Adam P, Smithson A, Wicks C, Martin C, Wootten M, Carlson S, Miller E, Fallert C Abstract Primary care practices face significant challenges as they pursue the Quadruple Aim. Redistributing care across the interprofessional primary care team by expanding the role of the medical assistant (MA) is a potential strategy to address these challenges. Two sequential, linked processes to expand the role of the MA, called Enhanced Rooming and Visit Assistance, were implemented in four family medicine residency clinics in Minnesota. In Enhanced Rooming, MAs addressed p...
Source: Journal of Interprofessional Care - November 7, 2018 Category: Health Management Tags: J Interprof Care Source Type: research

Improved quality of life associated with long-term use of guaifenesin in a patient with chronic obstructive pulmonary disease (COPD) & stable chronic bronchitis: A case report
We report the long-term use of guaifenesin in one such patient with COPD, chronic bronchitis and seasonal allergies who presented with dyspnea and chronic, non-productive cough that impacted his activities of daily living. (Source: Respiratory Medicine Case Reports)
Source: Respiratory Medicine Case Reports - November 3, 2018 Category: Respiratory Medicine Source Type: research

Philadelphia Telemedicine Glaucoma Detection and Follow-up Study: Analysis of Unreadable Fundus Images
Purpose: The purpose of this study was to ascertain determinants of unreadable fundus images for participants enrolled in the Philadelphia Telemedicine Glaucoma Detection and Follow-up Study. Methods: Individuals were screened for glaucoma at 7 primary care practices and 4 Federally Qualified Health Centers using telemedicine. Screening (visit 1) included fundus photography, assessing family history of glaucoma, and intraocular pressure (IOP) measurements. Participants with an unreadable image in at least one eye were deemed unreadable and invited to return for a confirmatory eye examination (visit 2). Results: A t...
Source: Journal of Glaucoma - November 1, 2018 Category: Opthalmology Tags: Original Studies Source Type: research

Assessing Nutritional Risk Among Infants and Toddlers in Primary Care Practice.
Abstract Traditionally, nutritional risk has been defined by growth failure, with clinical intervention indicated when a child falls below the third to fifth percentile on growth charts. Although the velocity of linear growth and weight gain during the first years are unparalleled at any other time of life, this period is also unique for other reasons. Nutrition not only supports increased bone length, muscle mass, and tissue growth, but also continued development of several highly metabolic organs such as the gastrointestinal tract, the immune system, the cardiorespiratory system, the kidneys, and the central ner...
Source: Pediatric Annals - November 1, 2018 Category: Pediatrics Authors: Murray RD Tags: Pediatr Ann Source Type: research

Legacy Drug-Prescribing Patterns in Primary Care.
Abstract PURPOSE: Polypharmacy is a key clinical challenge for primary care. Drugs that should be prescribed for an intermediate term (longer than 3 months, but not indefinitely) that are not appropriately discontinued could contribute to polypharmacy. We named this type of prescribing legacy prescribing. Commonly prescribed drugs with legacy prescribing potential include antidepressants, bisphosphonates, and proton pump inhibitors (PPIs). We evaluated the proportion of legacy prescribing within these drug classes. METHODS: We conducted a population-based retrospective cohort study using prospectively collect...
Source: Annals of Family Medicine - November 1, 2018 Category: Primary Care Authors: Mangin D, Lawson J, Cuppage J, Shaw E, Ivanyi K, Davis A, Risdon C Tags: Ann Fam Med Source Type: research

From Good to Great: The Role of Performance Coaching in Enhancing Tobacco-Dependence Treatment Rates.
CONCLUSIONS: Performance coaching significantly increased rates of tobacco-dependence treatment by primary care clinicians when delivered as part of a multicomponent intervention. PMID: 30420364 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - November 1, 2018 Category: Primary Care Authors: Papadakis S, Cole AG, Reid RD, Assi R, Gharib M, Tulloch HE, Mullen KA, Wells G, Pipe AL Tags: Ann Fam Med Source Type: research

Antidepressant and antipsychotic prescribing in primary care for people with dementia.
CONCLUSION: A substantial number of patients with dementia are being prescribed antidepressant or antipsychotic medications by their primary care practitioners without evidence of depression or psychosis in their electronic medical records. PMID: 30429194 [PubMed - in process] (Source: Canadian Family Physician Medecin de Famille Canadien)
Source: Canadian Family Physician Medecin de Famille Canadien - November 1, 2018 Category: Primary Care Authors: Drummond N, McCleary L, Freiheit E, Molnar F, Dalziel W, Cohen C, Turner D, Miyagishima R, Silvius J Tags: Can Fam Physician Source Type: research

Association of Structured Virtual Visits for Hypertension Follow-Up in Primary Care with Blood Pressure Control and Use of Clinical Services
ConclusionsAmong patients with reasonably well-controlled hypertension, virtual visit participation was associated with equivalent blood pressure control and reduced in-office primary care utilization. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 30, 2018 Category: Internal Medicine Source Type: research

Mental health care technologies: Primary Care practices and processes.
Abstract OBJECTIVE: To analyze the technologies of mental health care used in the practices and processes that constitute Primary Health Care from the discourses of nurses of the Family Health Strategy. METHOD: Qualitative approach based on the dialectical hermeneutic composition which aims to perform a comprehensive and critical analysis of semi-structured interviews, and free field observation. RESULTS: From the empirical material analyzed, two essential analytical categories emerged: "Health technologies used in PHC for the care of users with psychological distress" and "To stop medicat...
Source: Revista Brasileira de Enfermagem - October 28, 2018 Category: Nursing Authors: Campos DB, Bezerra IC, Jorge MSB Tags: Rev Bras Enferm Source Type: research

Essential factors demonstrating readiness of primary care practices for clinical pharmacy services.
CONCLUSION: An expert panel of ambulatory care pharmacists identified 6 factors that should be considered prior to establishing ambulatory care services in primary care practices. Of these, foundational elements included full integration into the care team, presence of a physician or administrative champion, and a practice that is ready for team-based care. Operational elements included access to the practice's EHR, equipment provided by the practice, and private space to see patients. PMID: 30355599 [PubMed - in process] (Source: American Journal of Health-System Pharmacy : AJHP)
Source: American Journal of Health-System Pharmacy : AJHP - October 26, 2018 Category: Drugs & Pharmacology Authors: Carrington A, Pokallus A, Ulrich IP, Scott MA, Fay AE, Drake ES, Wilson CG Tags: Am J Health Syst Pharm Source Type: research

Prospective observational cohort study of symptom control prediction in paediatric asthma by using the Royal College of Physicians three questions.
This study compared the RCP3Q as a tool for assessing asthma control in children (5-16 years) against the validated Asthma Control Test (ACT), Childhood Asthma Control Test (C-ACT), and Mini-Paediatric Quality of Life Questionnaire (MiniPAQLQ). We conducted a prospective observational cohort study involving children from eight primary care practices in Leicestershire. Children with doctor diagnosed asthma, or receiving regular asthma medication, were invited to participate. A total of 319 participants completed the MiniPAQLQ and the C-ACT/ACT questionnaires, before RCP3Q responses were collected as part of their routine as...
Source: Primary Care - October 24, 2018 Category: Primary Care Authors: Andrews G, Lo DKH, Richardson M, Wilson A, Gaillard EA Tags: NPJ Prim Care Respir Med Source Type: research

Potencialities of ciberspaSUS: social networks as devices of public health policies in Brazil
Resumo Este artigo examina duas experi ências de redes sociais desenvolvidas como espaço de fortalecimento das políticas públicas de saúde no contexto brasileiro. O objetivo é descrever e analisar algumas possibilidades de uso das redes sociais como dispositivos vinculados às políticas públicas de saúde, a partir da experiênci a de dois casos comparados em curso no Brasil: a Rede Humaniza SUS e a Comunidade de Práticas da Atenção Básica. Trata-se de uma pesquisa qualitativa que parte da abordagem de estudo de caso compara...
Source: Ciencia e Saude Coletiva - October 18, 2018 Category: Occupational Health Source Type: research

Validity and Reliability of Rapid Cognitive Screening Test for Turkish Older Adults
AbstractObjectivesPractical cognitive screening tests, brief and easy-to-administer are needed for primary care. The Rapid Cognitive Screen (RCS) is one of the cognitive screening tests used. The present study aimed to establish the validity and reliability of the Turkish version of RCS (RCS-T) in patients with impaired cognitive status.DesignProspective validation study.Setting and ParticipantsTotal 323 outpatients aged 60 or older, who were performed comprehensive geriatric assessment, were included in the studyMeasurementsPatients were screened by RCS-T, Turkish version of Saint Louis University Mental Status Examinatio...
Source: The Journal of Nutrition, Health and Aging - October 13, 2018 Category: Nutrition Source Type: research

Survival after diagnosis of hypertension in cats attending primary care practice in the United Kingdom
Journal of Veterinary Internal Medicine, EarlyView. (Source: Journal of Veterinary Internal Medicine)
Source: Journal of Veterinary Internal Medicine - October 13, 2018 Category: Veterinary Research Authors: Megan Conroy, Yu ‐Mei Chang, Dave Brodbelt, Jonathan Elliott Source Type: research

Hungarian Managed Care initiatives between 2000 and 2007: regional health outcomes of the Hungarian Care Organizations.
CONCLUSIONS: According to the data of the National Health Insurance Fund, the average savings rate for all CMOs for the fiscal years 1999-2007 was 4.94%. The highest rates of savings were realized in chronic and acute inpatient care and medical devices. In the end of 2008, by which time 14 CMOs had already covered 2.1million people, the programme was discontinued by the government, without a comprehensive evaluation of the experience and outcomes. PMID: 30295225 [PubMed - as supplied by publisher] (Source: Primary Care)
Source: Primary Care - October 8, 2018 Category: Primary Care Authors: Móczár C, Rurik I Tags: Prim Health Care Res Dev Source Type: research

Spinal Emergencies in Primary Care Practice
Atraumatic spinal emergencies often present a diagnostic and management dilemma for healthcare practitioners. Spinal epidural abscess, cauda equina syndrome, and spinal epidural hematoma are conditions that can insidiously present to outpatient medical offices, urgent care centers, and emergency rooms. Unless a high level of clinical suspicion is maintained, these clinical entities may be initially misdiagnosed and mismanaged. Permanent neurologic sequela and even death can result if delays in appropriate treatment occur. (Source: The American Journal of Medicine)
Source: The American Journal of Medicine - October 3, 2018 Category: General Medicine Authors: Jacob M. Babu, Shyam A. Patel, Mark A. Palumbo, Alan H. Daniels Tags: Review Article Source Type: research

Race-Specific Patterns of Treatment Intensification Among Hypertensive Patients Using Home Blood Pressure Monitoring: Analysis Using Defined Daily Doses in the Heart Healthy Lenoir Study.
Conclusion/Relevance: Treatment intensification in HBPM users was similar by race, differed significantly by gender, and may produce a greater response in white patients. Differential AMI in HBPM users does not appear to contribute to persistent racial disparities in BP control. PMID: 30282468 [PubMed - as supplied by publisher] (Source: The Annals of Pharmacotherapy)
Source: The Annals of Pharmacotherapy - October 3, 2018 Category: Drugs & Pharmacology Authors: Cummings DM, Adams A, Halladay J, Hinderliter A, Donahue KE, Cene CW, Li Q, Miller C, Garcia B, Tillman J, Little E, DeWalt D Tags: Ann Pharmacother Source Type: research

Workforce Configurations to Provide High-Quality, Comprehensive Primary Care: a Mixed-Method Exploration of Staffing for Four Types of Primary Care Practices
ConclusionsOur estimates provide health care decision-makers with needed guideposts for considering primary care staffing and financing and inform broader discussions on primary care innovations and the necessary resources to provide high-quality, comprehensive primary care in the USA. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - October 1, 2018 Category: Internal Medicine Source Type: research

The association between sex, age and health literacy and the uptake of cardiovascular prevention: a cross-sectional analysis in a primary care setting
ConclusionSex, age and health literacy affect engagement in healthy lifestyle choices and expectations towards preventative measure design. Consideration of these differences will allow better tailoring of preventative offers to the users ’ needs to increase their uptake. (Source: Journal of Public Health)
Source: Journal of Public Health - October 1, 2018 Category: Health Management Source Type: research

The Collaborative Care Model for Integrated Mental Health Practice in the Pediatric Primary Care Setting: Key Skills and Approaches for Child and Adolescent Psychiatrists
The objective of this Symposium is to provide evidence-based training in integrated care for members of AACAP. The APA (Psychiatry), in partnership with the Advancing Integrated Mental Health Solutions Center at the University of Washington, has received a grant to train  3500 psychiatrists in the clinical and leadership skills needed to support primary care practices that are implementing integrated behavioral health programs. (Source: Journal of the American Academy of Child and Adolescent Psychiatry)
Source: Journal of the American Academy of Child and Adolescent Psychiatry - October 1, 2018 Category: Psychiatry Authors: Barry Sarvet, Anna Ratzliff Tags: Workshop 7 Source Type: research

Accuracy of diagnosis of COPD and factors associated with misdiagnosis in primary care setting. E-DIAL (Early DIAgnosis of obstructive lung disease) study group.
Abstract BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality worldwide and results in both substantial and increasing socioeconomic burden. Guidelines on COPD encourage primary care physicians to detect the disease at an early stage. Our main aim was to evaluate the accuracy of the diagnosis of COPD at the primary health care. METHODS: 6466 patients were randomly selected in 22 Italian primary care practices (46% males, mean age 56 ± 16 years) and were asked about respiratory symptoms and risk for any chronic respiratory disease including COPD. Aft...
Source: Respiratory Care - September 30, 2018 Category: Respiratory Medicine Authors: Nardini S, Annesi-Maesano I, Simoni M, Ponte AD, Sanguinetti CM, De Benedetto F Tags: Respir Med Source Type: research

Asthma dissemination around patient-centered treatments in North Carolina (ADAPT-NC): a cluster randomized control trial evaluating dissemination of an evidence-based shared decision-making intervention for asthma management.
CONCLUSION: Facilitator-led dissemination was associated with a significantly higher proportion of patients sharing equally in decision-making with the provider compared to a traditional lunch-and-learn approach. While there was no significant difference in health outcomes between the three arms, the results were most likely confounded by a concurrent statewide asthma initiative and the pragmatic implementation of the intervention. These results offer support for the use of structured approaches such as facilitator-led dissemination of complex interventions into primary care practices. PMID: 30252544 [PubMed - as suppl...
Source: Journal of Asthma - September 28, 2018 Category: Respiratory Medicine Tags: J Asthma Source Type: research

Community participation in primary care: willingness to participate, a web survey in the Netherlands.
CONCLUSIONS: This study showed that half of the respondents are willing to participate, but they are less sure about their ability to do so and that finding time to participate is seen as problematic. Future research should focus on which characteristics influence willingness. This knowledge might help primary care facilities to recruit people more easily and successfully. PMID: 30259824 [PubMed - as supplied by publisher] (Source: Primary Care)
Source: Primary Care - September 27, 2018 Category: Primary Care Authors: Kroneman M, van Erp K, Groenewegen P Tags: Prim Health Care Res Dev Source Type: research

Insights into frequent asthma exacerbations from a primary care perspective and the implications of UK National Review of Asthma Deaths recommendations.
Abstract The United Kingdom National Review of Asthma Deaths (NRAD) recommends that patients who require ≥3 courses of oral corticosteroids (OCS) for exacerbations in the past year or those on British Thoracic Society (BTS) Step 4/5 treatment must be referred to a specialist asthma service. The aim of the study was to identify the proportion of asthma patients in primary care that fulfil NRAD criteria for specialist referral and factors associated with frequent exacerbations. A total of 2639 adult asthma patients from 10 primary care practices in Glasgow, UK were retrospectively studied between 2014 and 2015. F...
Source: Primary Care - September 19, 2018 Category: Primary Care Authors: Yang JF, Chaudhuri R, Thomson NC, Ramparsad N, O'Pray H, Barclay S, MacBride-Stewart S, McCallum C, Sharma V, McSharry C, Murray D, Shepherd M, Lee WN Tags: NPJ Prim Care Respir Med Source Type: research

Posttraumatic Stress Disorder in Primary Care Practice
Imagine this. You are watching a movie. It is a grainy black-and-white film, clearly not a Hollywood production. The first thing you see in the center of the screen is a raised desk supporting an old-fashioned Underwood typewriter. Behind the typewriter sits a woman intermittently pecking at the keys. Each time she taps a key, there is a distinct sharp click —it is not too loud, but it is a sudden brief, crisp interruption of the silence. (Source: JAMA Internal Medicine)
Source: JAMA Internal Medicine - September 17, 2018 Category: Internal Medicine Source Type: research