Primary Care's Historic Role in Vaccination and Potential Role in COVID-19 Immunization Programs
CONCLUSIONS: Primary care physicians have played a crucial role in delivery of vaccinations to the US population, including the elderly, between 2012-2017. These findings indicate primary care practices may be a crucial element of vaccine counseling and delivery in the upcoming COVID-19 recovery and immunization efforts in the United States.PMID:33707190 | DOI:10.1370/afm.2679 (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 12, 2021 Category: Primary Care Authors: Elizabeth Wilkinson Anuradha Jetty Stephen Petterson Yalda Jabbarpour John M Westfall Source Type: research

Primary Care's Historic Role in Vaccination and Potential Role in COVID-19 Immunization Programs
CONCLUSIONS: Primary care physicians have played a crucial role in delivery of vaccinations to the US population, including the elderly, between 2012-2017. These findings indicate primary care practices may be a crucial element of vaccine counseling and delivery in the upcoming COVID-19 recovery and immunization efforts in the United States.PMID:33707190 | DOI:10.1370/afm.2679 (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 12, 2021 Category: Primary Care Authors: Elizabeth Wilkinson Anuradha Jetty Stephen Petterson Yalda Jabbarpour John M Westfall Source Type: research

Optimizing patient partnership in primary care improvement: A qualitative study
Conclusion Establishing practice improvement partnerships remains challenging, but partnering with patients on improvement journeys offers distinctive gains for high-quality patient-centered care. Practice Implications Engaging diverse patient partners requires significant disruption to organizational norms and routines, and the trend toward team-based primary care offers a fertile context for patient partnerships. Material, technical, and sociocultural resources should be evaluated not only for whether they overcome specific challenges but also for how they enhance the shared learning journey. (Source: Health C...
Source: Health Care Management Review - March 11, 2021 Category: American Health Tags: Features Source Type: research

The role of organizational learning and resilience for change in building quality improvement capacity in primary care
Background The extent that organizational learning and resilience for the change process, that is, adaptive reserve (AR), is a component of building practice capacity for continuous quality improvement (QI) is unknown. Purpose The aim of the study was to examine the association of AR and development of QI capacity. Methodology One hundred forty-two primary care practices were evaluated at baseline and 12 months in a randomized trial to improve care quality. Practice AR was measured by staff survey along with a validated QI capacity assessment (QICA). We assessed the association of baseline QICA with basel...
Source: Health Care Management Review - March 11, 2021 Category: American Health Tags: Online Only Source Type: research

Scaling Up Patient-Centered Interdisciplinary Care for Multimorbidity: A Pragmatic Mixed-Methods Randomized Controlled Trial
CONCLUSIONS: Quantitatively, this intervention showed a neutral effect on the primary outcomes and substantial improvement in 2 health behaviors as secondary outcomes. Qualitatively, the intervention was evaluated as positive. The combination of qualitative and quantitative designs proved to be a good design for evaluating this complex intervention.PMID:33685874 | DOI:10.1370/afm.2650 (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 9, 2021 Category: Primary Care Authors: Martin Fortin Moira Stewart Patrice Ngangue Jos é Almirall Mathieu B élanger Judith Belle Brown Martine Couture Frances Gallagher Alan Katz Christine Loignon Bridget L Ryan Tara Sampalli Sabrina T Wong Merrick Zwarenstein Source Type: research

Scaling Up Patient-Centered Interdisciplinary Care for Multimorbidity: A Pragmatic Mixed-Methods Randomized Controlled Trial
CONCLUSIONS: Quantitatively, this intervention showed a neutral effect on the primary outcomes and substantial improvement in 2 health behaviors as secondary outcomes. Qualitatively, the intervention was evaluated as positive. The combination of qualitative and quantitative designs proved to be a good design for evaluating this complex intervention.PMID:33685874 | PMC:PMC7939717 | DOI:10.1370/afm.2650 (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 9, 2021 Category: Primary Care Authors: Martin Fortin Moira Stewart Patrice Ngangue Jos é Almirall Mathieu B élanger Judith Belle Brown Martine Couture Frances Gallagher Alan Katz Christine Loignon Bridget L Ryan Tara Sampalli Sabrina T Wong Merrick Zwarenstein Source Type: research

Scaling Up Patient-Centered Interdisciplinary Care for Multimorbidity: A Pragmatic Mixed-Methods Randomized Controlled Trial
CONCLUSIONS: Quantitatively, this intervention showed a neutral effect on the primary outcomes and substantial improvement in 2 health behaviors as secondary outcomes. Qualitatively, the intervention was evaluated as positive. The combination of qualitative and quantitative designs proved to be a good design for evaluating this complex intervention.PMID:33685874 | PMC:PMC7939717 | DOI:10.1370/afm.2650 (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - March 9, 2021 Category: Primary Care Authors: Martin Fortin Moira Stewart Patrice Ngangue Jos é Almirall Mathieu B élanger Judith Belle Brown Martine Couture Frances Gallagher Alan Katz Christine Loignon Bridget L Ryan Tara Sampalli Sabrina T Wong Merrick Zwarenstein Source Type: research

The Implications of the COVID-19 Pandemic for Pediatric Primary Care Practice in Europe
The COVID-19 pandemic has taken a heavy toll on the adult population1. In the US, out of 1.4 million diagnosed with COVID-19, 154 children have died2. In a large cohort study of 135,794 children tested for COVID-19, the infection rate was low (4%), many positive children remained asymptomatic, and if signs of illness were present, disease symptoms were typically mild. The case fatality rate in this group was 0.2%3. In Europe, early studies showed a low fatality rate (0.69%) in children who tested positive for COVID-19, and 4% developed severe illness4. (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - March 8, 2021 Category: Pediatrics Authors: Gottfried Huss, Christine Magendie, Massimo Pettoello –Mantovani, Elke Jaeger-Roman Source Type: research

Implications of the COVID-19 Pandemic for Pediatric Primary Care Practice in Europe
The COVID-19 pandemic has taken a heavy toll on the adult population.1 In the US, out of 1.4 million diagnosed with COVID-19, 154 children have died.2 In a large cohort study of 135 794 children tested for COVID-19, the infection rate was low (4%), many positive children remained asymptomatic, and if signs of illness were present, disease symptoms were typically mild. The case fatality rate in this group was 0.2%.3 In Europe, early studies showed a low fatality rate of 0.69% in children who tested positive for COVID-19, and 4% developed severe illness. (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - March 8, 2021 Category: Pediatrics Authors: Gottfried Huss, Christine Magendie, Massimo Pettoello-Mantovani, Elke Jaeger-Roman Tags: European Paediatric Association Source Type: research

Multiple Sclerosis and Incidence of Urinary and Fecal Incontinence in Almost 9,000 Patients Followed Up for up to 10 Years in Germany
Conclusions: UI and FI are frequent complications of MS, and the presence of these complications should be regularly assessed in primary care practices.Neuroepidemiology (Source: Neuroepidemiology)
Source: Neuroepidemiology - March 4, 2021 Category: Epidemiology Source Type: research

Point of Care Testing Improves Lead Screening Rates at 1 and 2 Year Well Visits
To increase blood lead level screening rates in children at 12 and 24 month well visits through provider education and the implementation of a point of care (POC) lead screening program in four primary care practice offices located in and neighbored by counties with ≥5% prevalence of blood lead levels ≥5 μg/dL. (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - March 3, 2021 Category: Pediatrics Authors: Benjamin Carnahan, Eric W. Schaefer, Benjamin N. Fogel Tags: Original Articles Source Type: research

Point-of-Care Testing Improves Lead Screening Rates at 1- and 2-Year Well Visits
To increase blood lead level screening rates in children at 12- and 24-month well visits through provider education and the implementation of a point-of-care (POC) lead screening program in 4 primary care practice offices located in and neighbored by counties with ≥5% prevalence of blood lead levels ≥5 μg/dL. (Source: The Journal of Pediatrics)
Source: The Journal of Pediatrics - March 3, 2021 Category: Pediatrics Authors: Benjamin Carnahan, Eric W. Schaefer, Benjamin N. Fogel Tags: Original Article Source Type: research

Addressing Adolescent Depression in Primary Care: Building Capacity Through Psychologist and Pediatrician Partnership
AbstractEarly identification and treatment of depression during adolescence can contribute to healthier outcomes across the lifespan, yet adolescent depression has been underidentified and undertreated. The American Academy of Pediatrics ’ (AAP) Guidelines for Adolescent Depression in Primary Care (GLAD-PC) were created to enhance the identification and treatment of adolescent depression. Integrated psychologists in a pediatric primary care setting partnered with providers and clinic staff to implement an adolescent depression scr eening initiative and transform primary care practice around identification and managem...
Source: Journal of Clinical Psychology in Medical Settings - March 1, 2021 Category: Psychiatry & Psychology Source Type: research

Implementation of Behavioral Health Integration in Small Primary Care Settings: Lessons Learned and Future Directions
Community Ment Health J. 2021 Feb 27. doi: 10.1007/s10597-021-00802-z. Online ahead of print.ABSTRACTPrimary care practices are in great need of practical guidance on the steps they can take to build behavioral health integration (BHI) capacities, particularly for smaller practice settings with fewer resources. 11 small primary care sites (≤ 5 providers) throughout New York State utilized a continuum framework of core components of BHI in combination with technical assistance. Surveys were collected at baseline, 6-months, and 12-months. Semi-structured interviews and focus groups were conducted during site visits, and a...
Source: Community Mental Health Journal - February 27, 2021 Category: Psychiatry Authors: Matthew L Goldman Ekaterina Smali Talia Richkin Harold Alan Pincus Henry Chung Source Type: research

Implementation of Behavioral Health Integration in Small Primary Care Settings: Lessons Learned and Future Directions
Community Ment Health J. 2021 Feb 27. doi: 10.1007/s10597-021-00802-z. Online ahead of print.ABSTRACTPrimary care practices are in great need of practical guidance on the steps they can take to build behavioral health integration (BHI) capacities, particularly for smaller practice settings with fewer resources. 11 small primary care sites (≤ 5 providers) throughout New York State utilized a continuum framework of core components of BHI in combination with technical assistance. Surveys were collected at baseline, 6-months, and 12-months. Semi-structured interviews and focus groups were conducted during site visits, and a...
Source: Community Mental Health Journal - February 27, 2021 Category: Psychiatry Authors: Matthew L Goldman Ekaterina Smali Talia Richkin Harold Alan Pincus Henry Chung Source Type: research

Creation and validation of a citywide pediatric asthma registry for the District of Columbia
Conclusions: A population-level pediatric asthma registry captures more children and adolescents with asthma in DC then a BRFSS-derived estimate, and provides city-wide measures of asthma-related utilization. The registry allows for stratification by primary care practice locations and asthma characteristics, supporting the design, implementation, and evaluation of QI projects at the practice, health system, and population levels.PMID:33635727 | DOI:10.1080/02770903.2021.1895213 (Source: Journal of Asthma)
Source: Journal of Asthma - February 26, 2021 Category: Respiratory Medicine Authors: Deborah Q Shelef Gia M Badolato Ranjodh Badh Olusegun Owotomo Nikita Kachroo Mark Weissman Stephen J Teach Ankoor Y Shah Source Type: research

Faecal immunochemical testing (FIT): Sources of result variation based on three years of routine testing of symptomatic patients in English primary care
Discussion: The FIT immunoassay evaluated is capable of detecting faecal Hb at concentrations well below the DG30 threshold of 10 µg/g and is suitable for application in this context. The greatest practical challenge to FIT performance is reproducible sampling, the pre-analytical step associated with most variability. Further research should focus on reducing sampling variability, particularly as post COVID-19 guidance recommends greater FIT utilisation.PMID:33627037 | DOI:10.1080/09674845.2021.1896204 (Source: British Journal of Biomedical Science)
Source: British Journal of Biomedical Science - February 25, 2021 Category: Laboratory Medicine Authors: T James B D Nicholson R Marr M Paddon J E East S Justice J L Oke B Shine Source Type: research

Attitudes and perceived barriers toward store-and-forward teledermatology among primary care providers of the rural Mississippi
AbstractTelehealth expands the capacity to care for patients in rural and underserved settings. Store-and-forward teledermatology is a simple and effective approach which enables remote dermatological diagnosis and treatment. Implementing store-and-forward technology in rural Mississippi has the potential to expand access to dermatology services at locations, where an in-person dermatologist is not available including: emergency rooms, urgent care centers, and primary care practices. A survey study was conducted to assess perceived obstacles and attitudes about store-and-forward teledermatology among primary care providers...
Source: Archives of Dermatological Research - February 25, 2021 Category: Dermatology Source Type: research

A Qualitative Study of Primary Care Physicians' Experiences With Telemedicine During COVID-19
CONCLUSIONS: Physicians reported that telemedicine visits offer new opportunities to improve the quality of patient care but noted changes to their interactions with patients. Many of these changes are positive, but it remains to be seen whether others such as lack of physical examination and loss of physical presence and touch adversely influence provider-patient communication, patient willingness to disclose concerns that may affect their care, and, ultimately, patient health outcomes.PMID:33622820 | DOI:10.3122/jabfm.2021.S1.200517 (Source: American Family Physician)
Source: American Family Physician - February 24, 2021 Category: Primary Care Authors: Teresita Gomez Yohualli B Anaya Kevin J Shih Derjung M Tarn Source Type: research

A Qualitative Study of Primary Care Physicians' Experiences With Telemedicine During COVID-19
CONCLUSIONS: Physicians reported that telemedicine visits offer new opportunities to improve the quality of patient care but noted changes to their interactions with patients. Many of these changes are positive, but it remains to be seen whether others such as lack of physical examination and loss of physical presence and touch adversely influence provider-patient communication, patient willingness to disclose concerns that may affect their care, and, ultimately, patient health outcomes.PMID:33622820 | DOI:10.3122/jabfm.2021.S1.200517 (Source: American Family Physician)
Source: American Family Physician - February 24, 2021 Category: Primary Care Authors: Teresita Gomez Yohualli B Anaya Kevin J Shih Derjung M Tarn Source Type: research

Site of Care for COVID-19-Like Respiratory Illnesses
COVID-19 is primarily a respiratory illness. Historically, upper and lower respiratory illness has been cared for at home or in the ambulatory primary care setting. It is likely that patients experiencing COVID-19-like symptoms may first contact their primary care provider. The Medical Expenditure Panel Survey (MEPS) is a representative sample of patients from the United States that regularly assesses their use of medical care services. We analyzed 2017 MEPS data to determine the number and proportion of patients who were seen in primary care or family medicine ambulatory settings or hospitalized for upper or lower respira...
Source: Journal of the American Board of Family Medicine - February 23, 2021 Category: Primary Care Authors: Westfall, J. M., Jetty, A., Petterson, S., Jabbarpour, Y. Tags: COMMENTARY Source Type: research

Capacity of Primary Care to Deliver Telehealth in the United States
Conclusions: This study provides an estimate of the primary care capacity to deliver telehealth and can guide practices and payers as care delivery models change in a post-COVID 19 environment. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - February 23, 2021 Category: Primary Care Authors: Jetty, A., Jabbarpour, Y., Westfall, M., Kamerow, D. B., Petterson, S., Westfall, J. M. Tags: ORIGINAL RESEARCH Source Type: research

A Qualitative Study of Primary Care Physicians Experiences With Telemedicine During COVID-19
Conclusions: Physicians reported that telemedicine visits offer new opportunities to improve the quality of patient care but noted changes to their interactions with patients. Many of these changes are positive, but it remains to be seen whether others such as lack of physical examination and loss of physical presence and touch adversely influence provider-patient communication, patient willingness to disclose concerns that may affect their care, and, ultimately, patient health outcomes. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - February 23, 2021 Category: Primary Care Authors: Gomez, T., Anaya, Y. B., Shih, K. J., Tarn, D. M. Tags: ORIGINAL RESEARCH Source Type: research

Lessons Learned During COVID-19 That Can Move Telehealth in Primary Care Forward
Introduction: Our university hospital-based primary care practices transitioned a budding interest in telehealth to a largely telehealth-based approach in the face of the COVID-19 pandemic. Initial work: Implementation of telehealth began in 2017. Health system barriers, provider and patient reluctance, and inadequate reimbursement prevented widespread adoption at the time. COVID-19 served as the catalyst to accelerate telehealth efforts. Implementation: COVID-19 resulted in the need for patient care with "social distancing." In addition, due to the pandemic, the Centers for Medicare and Medicaid Services and o...
Source: Journal of the American Board of Family Medicine - February 23, 2021 Category: Primary Care Authors: Knierim, K., Palmer, C., Kramer, E. S., Rodriguez, R. S., VanWyk, J., Shmerling, A., Smith, P., Holmstrom, H., Bacak, B. S., Brown Levey, S. M., Staton, E. W., Holtrop, J. S. Tags: FAMILY MEDICINE AND THE HEALTH CARE SYSTEM Source Type: research

Referral rates of patients with diabetes to secondary care are inversely related to the prevalence of diabetes in each primary care practice and confidence in treatment, not to HbA1c level
In the UK, the number of patients diagnosed with diabetes has doubled over the last two decades (1.4 million diagnosed cases in 1996 versus 3.8 million in 2019) [1], and currently, one in every 15 people in the UK population has diabetes. Management of diabetes in the UK is predicted to cost more than £39.8 billion by 2035–36 (estimated at £23.7 billion in 2014) [1], posing serious public health challenges to the UK. In Wales, around 10% (£500 million) of the annual NHS Wales budget is used for patients with diabetes managed in primary and secondary care [2]. (Source: Primary Care Diabetes)
Source: Primary Care Diabetes - February 20, 2021 Category: Primary Care Authors: Q.Z. Siah, N.H. Ubeysekara, P.N. Taylor, S.J. Davies, F.S. Wong, C.M. Dayan, M. Alhadj Ali Tags: Original research Source Type: research

Addressing the Social Determinants of Health During the COVID-19 Pandemic: Ensuring Equity, Quality, and Sustainability
The COVID-19 pandemic has highlighted the importance of social determinants of health in affecting health outcomes. Populations with high social risk are disproportionately impacted by the virus and its economic consequences. Primary care practices have a unique opportunity to implement interventions to mitigate their patients' unmet social needs, such as food and income insecurity. In this commentary, we outline key considerations for clinics implementing programs that identify and address patients' social needs in a way that promotes equity, quality, and sustainability. We provide examples from our own experience at a fe...
Source: Family and Community Health - February 18, 2021 Category: Primary Care Tags: Original Articles Source Type: research

Family medicine residents ’ skill levels in emergency chest X-ray interpretation
Family medicine physicians may encounter a wide variety of conditions, including acute and urgent cases. Considering the limited access to diagnostic investigations in primary care practice, chest X-ray remain... (Source: BMC Family Practice)
Source: BMC Family Practice - February 17, 2021 Category: Primary Care Authors: Malak Al Shammari, Ali Hassan, Nouf AlShamlan, Sarah Alotaibi, Manar Bamashmoos, Amani Hakami, Abdullatif Althunyan, Shymaa Basager, Sameerah Motabgani, Sawsan Aljubran and Hind S. Alsaif Tags: Research article Source Type: research

Integrating trans health knowledge through instructional design: preparing learners for a continent - not an island - of primary care with trans people.
Authors: MacKinnon KR, Kia H, Rai N, Abramovich A, Cheung JJH Abstract In recent years the need to teach primary care providers to better care for transgender and non-binary (trans) patients has garnered significant scholarly and public attention. The alarming why motivating this surge in trans health primary care education has already been firmly established and needs no further comment. Instead, we offer new perspectives on how to do trans health primary care education. From treasured 'trans 101' educational interventions to trans health 'clinical pearls', the prevailing model used to teach primary care learners ...
Source: Education for Primary Care - February 13, 2021 Category: Primary Care Tags: Educ Prim Care Source Type: research

IJERPH, Vol. 18, Pages 1817: The Missed Opportunity of Patient-Centered Medical Homes to Thrive in an Asian Context
hoon Huat Koh In recent years, there is growing interest internationally to implement patient-centered medical homes (PCMHs), and Singapore is no exception. However, studies understanding the influence of contextual policy factors on the implementation of PCMHs are limited. We conducted 10 semi-structured in-depth interviews with general practitioners working in seven out of the nine PCMHs. Audio recordings were transcribed and analyzed by two study team members in NVivo 12 Software using grounded theory techniques. Power dynamics between the stakeholders and lack of shared decision-making among them in selecting the l...
Source: International Journal of Environmental Research and Public Health - February 13, 2021 Category: Environmental Health Authors: Shilpa Surendran Chuan De Foo Chen Hee Tam Elaine Qiao Ying Ho David Bruce Matchar Josip Car Gerald Choon Huat Koh Tags: Article Source Type: research

Does a Multidisciplinary Triage Pathway Facilitate Better Outcomes After Spine Surgery?
Study Design. Single-center prospective non-randomized matched cohort comparison. Objective. To compare elective lumbar spine surgery outcomes for cases triaged through a multidisciplinary spine pathway versus conventional referral processes. Summary of Background Data. Many health care systems have facilitated low back pain (LBP) guidelines into primary care practice by creating local or regional “pathways” with the goal of enhanced quality of care, improved patient satisfaction and optimal resource utilization, particularly for imaging and surgery. Few comparative outcomes exist for LBP path...
Source: Spine - February 10, 2021 Category: Orthopaedics Tags: HEALTH SERVICES RESEARCH Source Type: research

Should You Recommend Cannabinoids for This Patient With Painful Neuropathy? : Grand Rounds Discussion From Beth Israel Deaconess Medical Center.
Discussion From Beth Israel Deaconess Medical Center. Ann Intern Med. 2021 Feb 09;: Authors: Smetana GW, Tetrault JM, Hill KP, Burns RB Abstract Cannabis includes 140 active cannabinoid compounds, the most important of which are tetrahydrocannabinol and cannabidiol (CBD). Tetrahydrocannabinol is primarily responsible for the intoxicating effects of cannabis; CBD has potential therapeutic effects, including reduction in chronic pain. Recent legislative changes have resulted in the legal availability of cannabinoids in all 50 states, as well as a marked increase in patients' interest in their use. Despi...
Source: Annals of Internal Medicine - February 9, 2021 Category: Internal Medicine Authors: Smetana GW, Tetrault JM, Hill KP, Burns RB Tags: Ann Intern Med Source Type: research

Physician Assessment and Feedback During Quality Circle to Reduce Low-Value Services in Outpatients: a Pre-Post Quality Improvement Study
AbstractBackgroundThe impact of the Choosing Wisely (CW) campaign is debated as recommendations alone may not modify physician behavior.ObjectiveThe aim of this study was to assess whether behavioral interventions with physician assessment and feedback during quality circles (QCs) could reduce low-value services.Design and ParticipantsPre-post quality improvement intervention with a parallel comparison group involving outpatients followed in a Swiss-managed care network, including 700 general physicians (GPs) and 150,000 adult patients.InterventionsInterventions included performance feedback about low-value activities and ...
Source: Journal of General Internal Medicine - February 8, 2021 Category: Internal Medicine Source Type: research

The Growing Primary Care Nurse Practitioner Workforce: A Solution for the Aging Population Living with Dementia
Currently, more than 5.7 million Americans have Alzheimer's disease and related dementias (referred to as persons living with dementia [PLWD]), and this number is expected to double by 2030 and triple by 2050.1,2 Almost two-thirds of PLWD live in the community and receive health and disease management in primary care practices.3 Primary care is also the first place where community-dwelling PLWD and their families raise initial concerns about cognition, attention, and behavioral issues and where the majority are diagnosed with cognitive impairment. (Source: The American Journal of Geriatric Psychiatry)
Source: The American Journal of Geriatric Psychiatry - February 3, 2021 Category: Geriatrics Authors: Lusine Poghosyan, Jessica M. Brooks, Vaneh Hovsepian, Madeline Pollifrone, Amelia E. Schlak, Tatiana Sadak Source Type: research

COVID-19 Adaptations in the Care of Patients with Opioid Use Disorder: a Survey of California Primary Care Clinics
ConclusionsMany adaptations in the primary care approach to patients with opioid use disorder may be temporary reactions to COVID-19. Further evaluation of the impact of these adaptations on patient outcomes is needed to determine whether changes should be maintained post-COVID-19. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - January 28, 2021 Category: Internal Medicine Source Type: research

Improving Regional Blood Pressure Control: a Positive Deviance Tiered Intensity Approach
AbstractBackgroundAccelerated translation of real-world interventions for hypertension management is critical to improving cardiovascular outcomes and reducing disparities.ObjectiveTo determine whether a positive deviance approach would improve blood pressure (BP) control across diverse health systems.DesignQuality improvement study using 1-year cross sections of electronic health record data over 5 years (2013 –2017).ParticipantsAdults ≥ 18 with hypertension with two visits in 2 years with at least one primary care visit in the last year (N = 114,950 at baseline) to a primary care practice in Better Health Partne...
Source: Journal of General Internal Medicine - January 26, 2021 Category: Internal Medicine Source Type: research

Exploring and Overcoming the Challenges Primary Care Practices Face with Care Management of High-Risk Patients in CPC+: a Mixed-Methods Study
ConclusionsDespite substantial financial and other supports, and practices ’ perceived benefits of LCM, insufficient care manager staffing and other barriers have limited its potential in CPC+ to date. To expand LCM’s reach, practices need additional care managers, training to overcome barriers to patient engagement, better identification of patients who might benefit from LCM, improved information technology tools for risk stratification and care plans, and more practitioner buy-in to risk stratification. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - January 26, 2021 Category: Internal Medicine Source Type: research

A Survey of Primary Care Practices on Their Use of the Intensive Behavioral Therapy for Obese Medicare Patients
ConclusionsAlthough the Centers for Medicare and Medicaid Services established payment codes for PCPs to deliver IBT for obesity in 2011, very few providers submitted fee-for-service claims for these services after almost 10  years. A survey completed by both a random and convenience sample of practices using and not using IBT for obesity payment codes revealed that billing for these services was problematic, and many providers that began using the codes discontinued using them over the past 7 years. (Source: Journal of General Internal Medicine)
Source: Journal of General Internal Medicine - January 22, 2021 Category: Internal Medicine Source Type: research

An Expanded Paradigm of Primary Care Diabetes Chronic Disease Management
The ability to address the comprehensive needs of diabetes chronic disease management is seriously challenged by staffing and time constraints within primary care visits. The purpose of this article is to outline the evidence for the use of community referrals to diabetes education, medical nutrition therapy, and mental health care providers. These referrals can expand the reach of achievable diabetes chronic care management to mitigate barriers to care and to improve outcomes. There is a strong evidence base to support these referrals, as well as the added benefits of patient safety and satisfaction, and decrease constrai...
Source: The Journal for Nurse Practitioners - January 20, 2021 Category: Nursing Authors: Sharon A. Watts, Dana Yelverton Tags: Feature article Source Type: research

A Taxonomy for External Support for Practice Transformation
Conclusions: This taxonomy and its use in more consistently documenting and characterizing external support interventions should facilitate communication and synergies between 3 areas (quality improvement, practice change research, and implementation science) that have historically tended to work independently. The taxonomy was designed to be as useful for practices or health systems managing change as it is for research. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 15, 2021 Category: Primary Care Authors: Solberg, L. I., Kuzel, A., Parchman, M. L., Shelley, D. R., Dickinson, W. P., Walunas, T. L., Nguyen, A. M., Fagnan, L. J., Cykert, S., Cohen, D. J., Balasubramanaian, B. A., Fernald, D., Gordon, L., Kho, A., Krist, A., Miller, W., Berry, C., Duffy, D., N Tags: Original Research Source Type: research

Engagement of Small to Medium-Sized Primary Care Practices in Quality Improvement Efforts
Conclusions: Clinicians and leadership involvement in QI efforts is critical. The findings suggest that QI plans should involve clinicians and leaders early in the process to foster commitment, establish practice readiness, and sustain improvement efforts. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 15, 2021 Category: Primary Care Authors: Soylu, T. G., Cuellar, A. E., Goldberg, D. G., Kuzel, A. J. Tags: Original Research Source Type: research

Challenges and Approaches to Population Management of Long-Term Opioid Therapy Patients
Conclusions: We identified common challenges and approaches to tracking and monitoring patients using long-term opioid therapy for CNCP in primary care. Based on these findings we provide recommendations to build capacity for tracking and monitoring for organizations that are engaged in improving safe opioid-prescribing practices for CNCP in primary care. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - January 15, 2021 Category: Primary Care Authors: Stephens, K. A., Ike, B., Baldwin, L.-M., Packer, C., Parchman, M. Tags: Original Research Source Type: research

Engaging primary care providers in managing pediatric eating disorders: a mixed methods study
ConclusionsInvestigations seeking to build capacities in primary care settings to address eating disorders must address these barriers. (Source: Journal of Eating Disorders)
Source: Journal of Eating Disorders - January 14, 2021 Category: Eating Disorders & Weight Management Source Type: research

Primary Care Practice Environment and Burnout Among Nurse Practitioners
Poor practice environments contribute to burnout, but favorable environments containing support, resources, autonomy, and optimal relations with colleagues may prevent burnout. Compared with all nurse practitioners (NPs), 69% of these NPs provide primary care to patients, yet whether the practice environment is associated with NP burnout is unknown. A study to examine environmental factors related to NP burnout was conducted. Overall, 396 NPs completed the survey, and 25.3% were burnt-out. Higher scores on the professional visibility, NP-physician relations, NP-administration relations, independent practice, and support su...
Source: The Journal for Nurse Practitioners - January 11, 2021 Category: Nursing Authors: Cilgy M. Abraham, Katherine Zheng, Allison A. Norful, Affan Ghaffari, Jianfang Liu, Lusine Poghosyan Tags: Featured Article Source Type: research

A methodological review protocol of the use of Bayesian factor analysis in primary care research
DiscussionThis methodological review will provide a comprehensive overview of the current use and reporting of Bayesian factor analysis in primary care and will provide recommendations for its proper future use.Systematic review registrationPROSPEROCRD42018114978 (Source: Systematic Reviews)
Source: Systematic Reviews - January 8, 2021 Category: International Medicine & Public Health Source Type: research