The impact of tailored intervention services on charges and mortality for adult super-utilizers
Publication date: Available online 25 August 2017Source: HealthcareAuthor(s): Josh Durfee, Tracy Johnson, Holly Batal, Jeremy Long, Deborah Rinehart, Rachel Everhart, Carlos Irwin Oronce, Ivor Douglas, Kimberly Moore, Adam AtherlyAbstractBackgroundInterventions designed to improve care and reduce costs for patients with the highest rates of hospital utilization (super-utilizers) continue to proliferate, despite conflicting evidence of cost savings.MethodsWe evaluated a practice transformation intervention that implemented team-based care and risk-stratification to match specific primary care resources based on need. This i...
Source: Healthcare - July 6, 2018 Category: Middle East Health Source Type: research

Rural And Nonrural Primary Care Physician Practices Increasingly Rely On Nurse Practitioners
Data from 2008-2016 show that both rural and non-rural primary care practices increasingly involve nurse practitioners (NPs) to deliver care. (Source: RAND Research Health and Health Care)
Source: RAND Research Health and Health Care - July 6, 2018 Category: Health Management Authors: Hilary Barnes; Michael R. Richards; Matthew D. McHugh; Grant Martsolf Source Type: research

Leveraging technology to promote smoking cessation in urban and rural primary care medical offices
We examined the use of automated voice recognition (AVR) messages targeting smokers from primary care practices located in underserved urban and rural communities to promote smoking cessation. We partnered with urban and rural primary care medical offices (n = 7) interested in offering this service to patients. Current smokers, 18 years and older, who had completed an office visit within the previous 12 months, from these sites were used to create a smoker's registry. Smokers were recruited within an eight county region of western New York State between June 2012 and August 2013. Participants were contacted over si...
Source: Preventive Medicine - July 6, 2018 Category: International Medicine & Public Health Source Type: research

Mean HbA1c, HbA1c variability, and mortality in people with diabetes aged 70 years and older: a retrospective cohort study
Publication date: June 2018Source: The Lancet Diabetes & Endocrinology, Volume 6, Issue 6Author(s): Angus Forbes, Trevor Murrells, Henrietta Mulnier, Alan J SinclairSummaryBackgroundGlycaemic targets for older people have been revised in recent years because of concern that more stringent targets are associated with increased mortality. We aimed to investigate the association between glycaemic control (mean HbA1c) and variability (variability of HbA1c over time) and mortality in older people with diabetes.MethodsWe did a 5-year retrospective cohort study using The Health Improvement Network database, which includes dat...
Source: The Lancet Diabetes and Endocrinology - July 5, 2018 Category: Endocrinology Source Type: research

Promoting MedlinePlus utilization in a federally qualified health center using a multimodal approach.
Conclusions: A multimodal approach can promote use of MedlinePlus among community health center patients. However, the process is labor- and resource-intensive and requires careful attention to work flow and leveraging of brief opportunities. PMID: 29962914 [PubMed - in process] (Source: Journal of the Medical Library Association : JMLA)
Source: Journal of the Medical Library Association : JMLA - July 4, 2018 Category: Databases & Libraries Tags: J Med Libr Assoc 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 - July 3, 2018 Category: Internal Medicine Source Type: research

Continuity and Access in the Era of Part-Time Practice.
Abstract The number of physicians seeing patients part time is growing, an evolution that challenges the primary care pillars of continuity and access. The growth of part-time practice is a response to burnout and to the pressures facing primary care physicians. Physicians who work fewer clinical hours and thereby reduce burnout are more satisfied with their careers, less likely to leave their jobs, and provide a better patient experience. Primary care practices can make a number of adjustments to optimize continuity and access in this era of part-time practice. Moreover, physicians who work fewer clinical hours a...
Source: Annals of Family Medicine - July 1, 2018 Category: Primary Care Authors: Bodenheimer T, Haq C, Lehmann W Tags: Ann Fam Med Source Type: research

Finance and Time Use Implications of Team Documentation for Primary Care: A Microsimulation.
CONCLUSIONS: Financial viability of team documentation under fee-for-service payment may require more physician time to be reallocated to patient encounters than under a capitated payment model. PMID: 29987078 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - July 1, 2018 Category: Primary Care Authors: Basu S, Phillips RS, Bitton A, Song Z, Landon BE Tags: Ann Fam Med Source Type: research

Examining differential performance of 3 medical home recognition programs.
We examined differences in patient outcomes associated with 3 patient-centered medical home (PCMH) recognition programs-National Committee for Quality Assurance (NCQA) Level 3, The Joint Commission (TJC), and Accreditation Association for Ambulatory Health Care (AAAHC)-among Medicare beneficiaries receiving care at federally qualified health centers (FQHCs). STUDY DESIGN: We used data from CMS' FQHC Advanced Primary Care Practice Demonstration, in which participating FQHCs received assistance to achieve NCQA Level 3 PCMH recognition. We assessed the impact of the 3 recognition programs on utilization, quality, and Med...
Source: The American Journal of Managed Care - July 1, 2018 Category: Health Management Authors: Mahmud A, Timbie JW, Malsberger R, Setodji CM, Kress A, Hiatt L, Mendel P, Kahn KL Tags: Am J Manag Care Source Type: research

Leveraging technology to promote smoking cessation in urban and rural primary care medical offices
We examined the use of automated voice recognition (AVR) messages targeting smokers from primary care practices located in underserved urban and rural communities to promote smoking cessation. We partnered with urban and rural primary care medical offices (n = 7) interested in offering this service to patients. Current smokers, 18 years and older, who had completed an office visit within the previous 12 months, from these sites were used to create a smoker's registry. Smokers were recruited within an eight county region of western New York State between June 2012 and August 2013. Participants were contacted over si...
Source: Preventive Medicine - June 30, 2018 Category: International Medicine & Public Health Source Type: research

General practitioners' and nurses' views on medication reviews and potentially inappropriate medicines in elderly patients - a qualitative study of reports by educating pharmacists.
CONCLUSION: GPs and nurses should participate in the construction and release of guidelines in order to increase their usability in clinical practice. Future research should analyse if alternative strategies such as condensed medical reviews and feedback on prescribing are easier to implement in primary care. Key points Complex medication reviews have been introduced on a large scale in Swedish primary care, but knowledge on GPs' and nurses' views on such reviews is lacking. In the context of primary care alternative strategies such as condensed medication reviews and feedback on prescribing may be more applicable than med...
Source: Primary Care - June 29, 2018 Category: Primary Care Authors: Schmidt-Mende K, Hasselström J, Wettermark B, Andersen M, Bastholm-Rahmner P Tags: Scand J Prim Health Care Source Type: research

Implementing Lean in Academic Primary Care
Conclusion: Lean had an uneven effect on QI in an academic primary care practice during the first year of implementation. (Source: Quality Management in Healthcare)
Source: Quality Management in Healthcare - June 27, 2018 Category: Health Management Tags: Quality Management in Primary Care Source Type: research

Creating and Sustaining Care Teams in Primary Care: Perspectives From Innovative Patient-Centered Medical Homes
Conclusions: Team-based care is possible and valuable in primary care. It is difficult to develop and sustain, however, and requires dedicated time and resources. The challenges these highly motivated practices described raise the question of feasibility for more average practices in the current funding environment. (Source: Quality Management in Healthcare)
Source: Quality Management in Healthcare - June 27, 2018 Category: Health Management Tags: Quality Management in Primary Care Source Type: research

Improving family medicine resident training in dementia care: an experiential learning opportunity in Primary Care Collaborative Memory Clinics.
This article describes the curriculum for a resident training intervention in Primary Care Collaborative Memory Clinics (PCCMC), outlines its underlying educational principles, and examines its impact on residents' ability to provide dementia care. PCCMCs are family physician-led interprofessional clinic teams that provide evidence-informed comprehensive assessment and management of memory concerns. Within PCCMCs residents learn to apply a structured approach to assessment, diagnosis, and management; training consists of a tutorial covering various topics related to dementia followed by work-based learning within the clini...
Source: Gerontology and Geriatrics Education - June 26, 2018 Category: Geriatrics Tags: Gerontol Geriatr Educ Source Type: research

Transition Experiences of New Rural Nurse Practitioners
Nurse practitioners (NPs) make up the most rapidly expanding primary care workforce and are being utilized to meet the increased demand for primary care in rural settings. The researcher explored 10 registered nurses ’ perceptions of their experiences while transitioning to their NP identities and first year of primary care practice in rural healthcare settings. The Rural Nurse Practitioner Transition and Professional Identity Development Model emerged. Critical to the NP’s successful transitions were an inc entive to learn, a passion to work in rural healthcare, and the relationships with their patients, nurse...
Source: The Journal for Nurse Practitioners - June 25, 2018 Category: Nursing Authors: Rhoda A. Owens Tags: Original Research Source Type: research

Patient and provider perspectives on uptake of a shared decision making intervention for asthma in primary care practices.
CONCLUSIONS: Emergent themes allowed for further understanding of how the SDM implementation was perceived at the patient and provider level. The facilitated implementation was associated with higher adoption of the SDM intervention. These themes and supporting quotes add to knowledge of best practices associated with implementing an evidence-based SDM intervention for asthma into primary care and will inform researchers, practices, and providers as they work to improve adoption of evidence-based interventions into practice. PMID: 29927661 [PubMed - as supplied by publisher] (Source: Journal of Asthma)
Source: Journal of Asthma - June 23, 2018 Category: Respiratory Medicine Tags: J Asthma Source Type: research

Exploring the Telepsychiatry Experience: Primary Care Provider Perception of the Michigan Child Collaborative Care (MC3) Program
Pediatric mental healthcare is a growing component of primary care practice. However, there is a lack of access to mental health services, particularly Child and Adolescent Psychiatrists (CAPs). The Michigan Child Collaborative Care (MC3) Program is a telepsychiatry service that offers embedded behavioral health consultants (BHCs) within primary care practices, telephonic consultation, video consultation and embedded care. PCP utilization of telepsychiatry services is predicated on perceiving the consultation service as user-friendly, helpful, and feasible in their practice. (Source: Psychosomatics)
Source: Psychosomatics - June 20, 2018 Category: Psychiatry & Psychology Authors: Malas Nasuh, Edwin Klein, Elizabeth Tengelitsch, Anne Kramer, Sheila Marcus, Quigley Joanna Tags: Original Research Article Source Type: research

Patient Engagement in ACO Practices and Patient-reported Outcomes Among Adults With Co-occurring Chronic Disease and Mental Health Conditions
Conclusions: ACO patients with comorbid physical and mental health diagnoses report better physical functioning when practices have patient-centered cultures. More activated/engaged patients report better patient emotional, physical, and social health outcomes. (Source: Medical Care)
Source: Medical Care - June 14, 2018 Category: Health Management Tags: Original Article Source Type: research

Health Plan Enrollees with Disability Informing Primary Care Practices and Providers about Their Quality of Care: A Randomized Trial
In October 2013, Massachusetts initiated the One Care demonstration, which enrolls beneficiaries ages 21 to 64 dually-eligible for Medicare and Medicaid. Local disability advocates argued that persons with disability should assess their own One Care quality. (Source: Disability and Health Journal)
Source: Disability and Health Journal - June 13, 2018 Category: Disability Authors: Lisa I. Iezzoni, Yuchiao Chang, Holly Matulewicz, Dennis Heaphy, Kimberley S. Warsett, Karen Donelan Source Type: research

Using the CollaboraKTion framework to report on primary care practice recruitment and data collection: costs and successes in a cross-sectional practice-based survey in British Columbia, Ontario, and Nova Scotia, Canada
Across Canada and internationally we have poor infrastructure to regularly collect survey data from primary care practices to supplement data from chart audits and physician billings. The purpose of this work ... (Source: BMC Family Practice)
Source: BMC Family Practice - June 13, 2018 Category: Primary Care Authors: Sabrina T. Wong, William Hogg, Fred Burge, Sharon Johnston, Ilisha French and Stephanie Blackman Tags: Research article Source Type: research

Workflow process mapping to characterize office-based primary care medication use and safety: A conceptual approach
We developed the PCMedSafety conceptual framework to illustrate primary care medication safety practice transformation opportunities. PCMedSafety demonstrates the interrelationship between the practice-level, primary care delivery system; medication workflow processes; and medication use and safety outcomes. This framework was used to conceptualize a workflow process mapping approach to characterize and evaluate the safety of medication-related activities performed in primary care practices. (Source: Research in Social and Administrative Pharmacy)
Source: Research in Social and Administrative Pharmacy - June 12, 2018 Category: Pharmaceuticals Authors: Kathryn Steckowych, Marie Smith Source Type: research

Evaluating the effect of metronidazole plus amoxicillin ‐clavulanate versus amoxicillin‐clavulanate alone in canine haemorrhagic diarrhoea: a randomised controlled trial in primary care practice
Journal of Small Animal Practice, EarlyView. (Source: The Journal of Small Animal Practice)
Source: The Journal of Small Animal Practice - June 8, 2018 Category: Veterinary Research Authors: V. Ortiz , L. Klein , S. Channell , B. Simpson , B. Wright , C. Edwards , R. Gilbert , R. Day , S. L. Caddy Source Type: research

United States Pediatricians' Attitudes Regarding Public Policies for Low-Income Children and Their Profession's Advocacy Priorities
Conclusions Pediatricians strongly support government policies that affect child poverty and the provision of basic needs to families. This support should be used to inform professional organizations, advocates, and policy-makers focused on children and families. (Source: Academic Pediatrics)
Source: Academic Pediatrics - June 6, 2018 Category: Pediatrics Source Type: research

Community-based pre-pregnancy care programme improves pregnancy preparation in women with pregestational diabetes
Conclusions/interpretationA pragmatic community-based PPC programme was associated with clinically relevant improvements in pregnancy preparation in women with type 2 diabetes. To our knowledge, this is the first community-based PPC intervention to improve pregnancy preparation for women with type 2 diabetes.Data availabilityFurther details of the data collection methodology, individual clinic data and the full audit reports for healthcare professionals and service users are available fromhttps://digital.nhs.uk/data-and-information/clinical-audits-and-registries/our-clinical-audits-and-registries/national-pregnancy-in-diab...
Source: Diabetologia - June 4, 2018 Category: Endocrinology Source Type: research

Design of healthy hearts in the heartland (H3): A practice-randomized, comparative effectiveness study
The Healthy Hearts in the Heartland (H3) study is part of a nationwide effort, EvidenceNOW, seeking to better understand the ability of small primary care practices to improve “ABCS” clinical quality measures: appropriate Aspirin therapy, Blood pressure control, Cholesterol management, and Smoking cessation. H3 aimed to assess feasibility of implementing Point-of-Care (POC) or POC plus Population Management (POC + PM) quality improvement (QI) strategies to improve ABCS at practices in Illinois, Indiana, and Wisconsin. (Source: Contemporary Clinical Trials)
Source: Contemporary Clinical Trials - June 2, 2018 Category: Radiology Authors: Jody D. Ciolino, Kathryn L. Jackson, David T. Liss, Tiffany Brown, Theresa L. Walunas, Linda Murakami, Isabel Chung, Stephen D. Persell, Abel N. Kho Source Type: research

Parental Expectation of Side Effects Following Vaccination Is Self-fulfilling: A Prospective Cohort Study.
Conclusions: Side effect perception following vaccination is influenced by psychological factors, in particular expectations. Perceiving side effects reduces future vaccination intention. Future public health communications should aim to decrease unrealistic expectations of side effects to increase vaccine uptake. PMID: 29868792 [PubMed - as supplied by publisher] (Source: Annals of Behavioral Medicine)
Source: Annals of Behavioral Medicine - June 2, 2018 Category: Psychiatry & Psychology Authors: Smith LE, Weinman J, Amlôt R, Yiend J, Rubin GJ Tags: Ann Behav Med Source Type: research

Supporting Development During Military Deployment and After April 2018
CASE: Ryan is a 6-year-old child new to your primary care practice after relocating from out of state with his father and younger sister. Ryan's grandmother recently expressed concerns about Ryan's social skills and behavior. He was subsequently diagnosed by a developmental and behavioral pediatrician with autism spectrum disorder, global developmental delay, and attention deficit hyperactivity disorder. At your first visit with Ryan, his father provides the following history: When Ryan was 3 years old, he was living with his mother and infant sister while his father was serving his fourth tour of duty with the marines in ...
Source: Journal of Developmental and Behavioral Pediatrics - June 1, 2018 Category: Child Development Tags: Challenging Case Source Type: research

The role of organizational context in the implementation of a statewide initiative to integrate mental health services into pediatric primary care
Conclusion: Organizational culture, structures/processes, and technologies are important determinants of the uptake of activities to implement mental health services in pediatric primary care. Interventions may be able to change these aspects of context to make them more favorable to integration, but baseline characteristics more heavily influence the more proximal uptake of program activities. Practice Implications: Pediatric primary care practices would benefit from assessing their organizational context and taking steps to address it prior to or in a phased approach with mental health service implementation. (Sourc...
Source: Health Care Management Review - June 1, 2018 Category: American Health Tags: Features Source Type: research

Contextual factors that influence quality improvement implementation in primary care: The role of organizations, teams, and individuals
Conclusions: Successful QI implementation requires effective collaboration within cross-functional teams. Additional research is needed to assess how best to employ implementation strategies that promote cross-understanding of QI among team members and, ultimately, effective implementation of QI programs. Practice Implications: Health care managers in primary care settings should strive to create a strong teamwork climate, reinforced by opportunities for staff in various roles to discuss QI as a collective. (Source: Health Care Management Review)
Source: Health Care Management Review - June 1, 2018 Category: American Health Tags: Features Source Type: research

Challenges to the Israeli healthcare system: attracting medical students to primary care and to the periphery
ConclusionsThis study provides the healthcare leadership with information on the characteristics of the students at a centrally-located medical school who tend to be more interested in primary care and in working in the periphery. Specifically, the study found that students interested in primary care desire a positive life/work balance, something that Israeli non-hospital primary care practice provides. Students considering residencies in the periphery were similarly inclined. Moreover, about a third of students had positive thoughts about monetary incentives for residencies in peripheral hospitals. These students should b...
Source: Israel Journal of Health Policy Research - May 29, 2018 Category: International Medicine & Public Health Source Type: research

Financial Analysis of Pediatric Resident Physician Primary Care Longitudinal Outpatient Experience
Conclusions Pediatric resident LOE clinic had a greater average number of patient visits and revenue per faculty member but higher costs and lower operating margin than faculty clinic. (Source: Academic Pediatrics)
Source: Academic Pediatrics - May 17, 2018 Category: Pediatrics Source Type: research

Impact of Medical Homes on Expenditures and Utilization for Beneficiaries With Behavioral Health Conditions.
CONCLUSIONS: Even though PCMHs made concerted efforts to improve access to care for their patients with behavioral health conditions, few substantial changes in patterns of care were noted. PMID: 29759058 [PubMed - as supplied by publisher] (Source: Psychiatric Services)
Source: Psychiatric Services - May 16, 2018 Category: Psychiatry Tags: Psychiatr Serv Source Type: research

Organizational Processes and Patient Experiences in the Patient-centered Medical Home
Conclusion: Although some organizational processes relate to patients’ experiences with care irrespective of the background of the patient, further efforts are needed to align practice efforts with patient experience. (Source: Medical Care)
Source: Medical Care - May 15, 2018 Category: Health Management Tags: Original Article Source Type: research

Interprofessional population health advocacy: Developing and implementing a panel management curriculum in five Veterans Administration primary care practices.
In conclusion, collaboratively identified DLOs for PM guided development of assessment instruments and instructional approaches for panel management activities in interprofessional teams. This PM curriculum and associated tools provide resources for educators in other settings. PMID: 29746221 [PubMed - as supplied by publisher] (Source: Journal of Interprofessional Care)
Source: Journal of Interprofessional Care - May 12, 2018 Category: Health Management Tags: J Interprof Care Source Type: research

Brief assessments and screening for geriatric conditions in older primary care patients: a pragmatic approach.
This article discusses the epidemiologic rationale for screening functional, cognitive, affective, hearing and visual impairments, and nutritional status as well as fall risk and social status. It proposes using brief screening tests in primary care practice to identify patients who may need further comprehensive geriatric assessment or specific interventions. PMID: 29744236 [PubMed] (Source: Public Health Reviews)
Source: Public Health Reviews - May 12, 2018 Category: International Medicine & Public Health Tags: Public Health Rev Source Type: research

Screening for dysglycaemia in dental primary care practice settings: systematic review of the evidence
International Dental Journal, EarlyView. (Source: International Dental Journal)
Source: International Dental Journal - May 9, 2018 Category: Dentistry Authors: Ingrid Glurich , Barbara Bartkowiak , Richard L. Berg , Amit Acharya Source Type: research

Advancing the Science of Implementation in Primary Health Care
Implementation Science is commonly described as the study of methods and approaches that promote the uptake and use of evidence-based interventions into routine practice and policymaking. In this issue of JABFM, investigators share a wealth of new insights from the frontlines of Implementation Science in primary care: what it is, how we are doing it, and how it is advancing the evidence base of primary care. The breadth of implementation science in primary care is affirmed by the range of topics covered, from thought leader recommendations on future directions for the field, to reports on how best practices in policy and p...
Source: Journal of the American Board of Family Medicine - May 9, 2018 Category: Primary Care Authors: Bazemore, A., Neale, A. V., Lupo, P., Seehusen, D. Tags: Editorial Source Type: research

Practice Facilitator Strategies for Addressing Electronic Health Record Data Challenges for Quality Improvement: EvidenceNOW
Conclusion: Facilitators can use a range of strategies to help practices perform data-driven QI when performance data are inaccurate, incomplete, or missing. Support is necessary to help practices, particularly those with EHR data challenges, build their capacity for conducting data-driven QI that is required of them for participating in practice transformation and performance-based payment programs. It is questionable how practices with data challenges will perform in programs without this kind of support. (Source: Journal of the American Board of Family Medicine)
Source: Journal of the American Board of Family Medicine - May 9, 2018 Category: Primary Care Authors: Hemler, J. R., Hall, J. D., Cholan, R. A., Crabtree, B. F., Damschroder, L. J., Solberg, L. I., Ono, S. S., Cohen, D. J. Tags: Original Research Source Type: research

Screening for dysglycaemia in dental primary care practice settings: systematic review of the evidence
International Dental Journal, EarlyView. (Source: International Dental Journal)
Source: International Dental Journal - May 9, 2018 Category: Dentistry Authors: Ingrid Glurich, Barbara Bartkowiak, Richard L. Berg, Amit Acharya Source Type: research

Predicting declines in perceived relationship continuity using practice deprivation scores: a longitudinal study in primary care.
CONCLUSION: The decline in relationship continuity of care has been marked and widespread. Measures to maximise continuity will need to be feasible for individual practices with diverse population and organisational characteristics. PMID: 29739778 [PubMed - as supplied by publisher] (Source: The British Journal of General Practice)
Source: The British Journal of General Practice - May 8, 2018 Category: Primary Care Authors: Levene LS, Baker R, Walker N, Williams C, Wilson A, Bankart J Tags: Br J Gen Pract Source Type: research

Barriers and facilitators to HPV vaccination in primary care practices: a mixed methods study using the Consolidated Framework for Implementation Research
In the United States, the effective, safe huma papilloma virus (HPV) vaccine is underused and opportunities to prevent cancer continue to be missed. National guidelines recommend completing the 2 –3 dose HPV va... (Source: BMC Family Practice)
Source: BMC Family Practice - May 7, 2018 Category: Primary Care Authors: Jane M. Garbutt, Sherry Dodd, Emily Walling, Amanda A. Lee, Katharine Kulka and Rebecca Lobb Tags: Research article Source Type: research

Impact of tobacco smoking on the risk of developing 25 different cancers in the UK: a retrospective study of 422,010 patients followed for up to 30 years.
Conclusions: Smoking increased the overall risk of cancer in primary care practices in the UK. In addition, smoking was predominantly positively and less frequently negatively associated with numerous specific cancers. PMID: 29707117 [PubMed] (Source: Oncotarget)
Source: Oncotarget - May 2, 2018 Category: Cancer & Oncology Tags: Oncotarget Source Type: research

Older patient engagement in advance care planning in Canadian primary care practices: Results of a multisite survey.
Abstract OBJECTIVE: To assess primary care patients' engagement in advance care planning (ACP) and predictors of engagement. DESIGN: Cross-sectional survey using a revised version of a validated questionnaire. SETTING: Alberta, Ontario, and British Columbia. PARTICIPANTS: Convenience sample of 20 family practices that provided a consecutive sample of 810 patients aged 50 years and older. MAIN OUTCOME MEASURES: Engagement in ACP activities, and sociodemographic and health-related predictors of having engaged in ACP activities. RESULTS: Patients had a mean age of 66 years (55.6% women). Two-...
Source: Canadian Family Physician Medecin de Famille Canadien - May 1, 2018 Category: Primary Care Authors: Howard M, Bernard C, Klein D, Tan A, Slaven M, Barwich D, You JJ, Asselin G, Simon J, Heyland DK Tags: Can Fam Physician Source Type: research

Measuring and improving continuity in residency primary care practice.
MEASURING AND IMPROVING CONTINUITY IN RESIDENCY PRIMARY CARE PRACTICE. Ann Fam Med. 2018 May;16(3):273-274 Authors: Brown SR, Irwin G PMID: 29760037 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - May 1, 2018 Category: Primary Care Authors: Brown SR, Irwin G Tags: Ann Fam Med Source Type: research

Nurse Practitioner-Physician Comanagement: A Theoretical Model to Alleviate Primary Care Strain.
CONCLUSIONS: Future research should focus on developing instruments to measure and further assess nurse practitioner-physician comanagement in the primary care practice setting. PMID: 29760030 [PubMed - in process] (Source: Annals of Family Medicine)
Source: Annals of Family Medicine - May 1, 2018 Category: Primary Care Authors: Norful AA, de Jacq K, Carlino R, Poghosyan L Tags: Ann Fam Med Source Type: research

The Cost Effectiveness of Embedding a Behavioral Health Clinician into an Existing Primary Care Practice to Facilitate the Integration of Care: A Prospective, Case –Control Program Evaluation
AbstractThis project evaluated the cost effectiveness of integrating behavioral health services into a primary care practice using a prospective, case –control design. New Directions Behavioral Health collaborated with a large Kansas City primary care practice to integrate a licensed psychologist (i.e., behavioral health clinician) into the practice. Patient claims data were examined 21 months prior to and 14 months after the psychologist began providing full-time behavioral health services within the practice. Claims data from patients with Blue Cross Blue Shield of Kansas City insurance (BCBSKC) who had at least on...
Source: Journal of Clinical Psychology in Medical Settings - April 30, 2018 Category: Psychiatry & Psychology Source Type: research

543 Evaluating the burden of prior authorization in the treatment of psoriasis
(PAs) compared to other medical specialties and even primary care practices. A recent survey study revealed an increasing number of PAs being required over the past year, and the negative effects on patients include delaying or preventing proper treatment. This is especially problematic for psoriasis patients. Psoriasis affects over 7.4 million people in the United States, and many remain untreated or undertreated. We conducted a retrospective review of all dermatology visits in an academic practice from May 1, 2017 to July 31, 2017 to investigate the PA burden in psoriasis and other dermatologic conditions. (Source: Journ...
Source: Journal of Investigative Dermatology - April 27, 2018 Category: Dermatology Authors: S. Popatia, A. Kimball, S. Olbricht, M. Porter Tags: Clinical Research: Patient Outcomes Research Source Type: research

Mean HbA1c, HbA1c variability, and mortality in people with diabetes aged 70 years and older: a retrospective cohort study
Publication date: Available online 16 April 2018 Source:The Lancet Diabetes & Endocrinology Author(s): Angus Forbes, Trevor Murrells, Henrietta Mulnier, Alan J Sinclair Background Glycaemic targets for older people have been revised in recent years because of concern that more stringent targets are associated with increased mortality. We aimed to investigate the association between glycaemic control (mean HbA1c) and variability (variability of HbA1c over time) and mortality in older people with diabetes. Methods We did a 5-year retrospective cohort study using The Health Improvement Network database, which include...
Source: The Lancet Diabetes and Endocrinology - April 19, 2018 Category: Endocrinology Source Type: research

Development of a core set of quality indicators for paediatric primary care practices in Europe, COSI-PPC-EU
Conclusion: COSI-PPC-EU represents a consented set of a limited number of valid quality indicators for the application in paediatric primary care in different healthcare systems throughout Europe.What is Known:• Paediatric ambulatory healthcare systems in Europe are diverse and show strikingly different outcomes.• There are known gaps in quality performance measures of paediatric primary care in Europe. Pre-existing sets of quality indicators are predominantly limited to national populations, specific diseases and hospital care.What is New:• A set of 42 quality indicators for primary paediatric care in Europ...
Source: European Journal of Pediatrics - April 14, 2018 Category: Pediatrics Source Type: research