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Management: Family Practices

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Building International Partnerships in Family Medicine Development (Jeffrey Markuns MD, EdM)
Successful partnerships between local stakeholders and international consultants can be an important catalyst in creating sustainable programs responsive to unique local contexts, although there can be challenges as well. In this discussion, we aim to discuss challenges and benefits in building collaborations between local and international partners. We will share examples of productive partnerships, and share successes and setbacks in navigating these collaborations and utilizing them to meet local partners ' specific goals in developing and expanding Family Medicine. Specific programs unique to different countries will b...
Source: Family Medicine Digital Resources Library (FMDRL) Recently Uploaded - September 12, 2016 Category: Primary Care Source Type: news

CARTI Doctors Highest-Paid on Nonprofits List
The highest-paid nonprofit physicians in Arkansas can be found at CARTI Inc. in Little Rock. Of the top six positions on this year’s list of the highest-paid nonprofit employees ranked by total compensation, four are occupied by CARTI physicians. CARTI’s Dr. Brad Baltz topped the list with total compensation of $2.3 million for the fiscal year that ended June 30, 2015. Arkansas Business used nonprofits’ latest IRS Form 990s filed with Guidestar.org to compile the ranking. St. Vincent Medical Group’s highest-compensated doctor, Ali Krisht, received $1.7 million. Krisht’s specialty is neurosurge...
Source: Arkansas Business - Health Care - November 21, 2016 Category: American Health Source Type: news

Older patient considering treatment for advanced renal disease: protocol for a scoping review of the information available for shared decision-making
This article discusses our protocol. Methods This scoping review will be undertaken in accordance with the Joanna Briggs Institute's methodology for scoping reviews. A directed search will look for relevant articles in English (within electronic databases and the grey literature), written between 2000 and 2016, which have studied older patients with advanced renal disease (estimated glomerular filtration rate <30 mL/min/1.73 m2). After screening by two independent reviewers, selected articles will be analysed using a data charting tool. Reporting will include descriptions, analysis of themes using qualitative...
Source: BMJ Open - December 7, 2016 Category: Journals (General) Authors: Raj, R., Ahuja, K. D. K., Frandsen, M., Jose, M. Tags: Open access, Communication, General practice / Family practice, Geriatric medicine, Palliative care, Patient-centred medicine, Renal medicine Protocol Source Type: research

A systematic review of womens and health professionals attitudes and experience of preconception care service delivery
Conclusions. Despite the mounting evidence supporting the value and importance of PCC, there is insufficient research attention given to the clinical reality of PCC service and programme delivery. The transfer of PCC guidelines from broad policy to grass roots practice requires a more detailed consideration of the practicalities of implementing PCC within contemporary women’s health care.
Source: Family Practice - December 15, 2016 Category: Primary Care Authors: Steel, A., Lucke, J., Reid, R., Adams, J. Tags: Review Source Type: research

Clinical impact of lifestyle interventions for the prevention of diabetes: an overview of systematic reviews
Conclusions Relatively long-duration lifestyle interventions can limit or delay progression to diabetes under trial conditions. However, outcomes from more time-limited interventions, and those applied in routine clinical settings, appear more variable, in keeping with the findings of recent pragmatic trials. There is little evidence of intervention impact on vascular outcomes or mortality end points in any context. ‘Real-world’ implementation of lifestyle interventions for diabetes prevention may be expected to lead to modest outcomes.
Source: BMJ Open - December 20, 2016 Category: Journals (General) Authors: Howells, L., Musaddaq, B., McKay, A. J., Majeed, A. Tags: Open access, Evidence based practice, General practice / Family practice, Public health, Diabetes and Endocrinology Research Source Type: research

Generic prognostic factors for musculoskeletal pain in primary care: a systematic review
Conclusions This large review provides new evidence for generic prognostic factors for MSK conditions in primary care. Such factors include pain intensity, widespread pain, high functional disability, somatisation and movement restriction. This information can be used to screen and select patients for targeted treatment in clinical research as well as to inform the management of MSK conditions in primary care.
Source: BMJ Open - January 16, 2017 Category: Journals (General) Authors: Artus, M., Campbell, P., Mallen, C. D., Dunn, K. M., van der Windt, D. A. W. Tags: Open access, Epidemiology, General practice / Family practice Research Source Type: research

Recognition and management of perinatal depression and anxiety by general practitioners: a systematic review
Conclusions. Data on GPs’ awareness and management of perinatal depression were sparse and unlikely to be generalizable. Future directions for research are proposed; such as exploring the management of anxiety disorders which are largely missing from the literature, and understanding more about barriers to disclosure and recognition in primary care. More standardized training could help to improve recognition and management practices.
Source: Family Practice - January 24, 2017 Category: Primary Care Authors: Ford, E., Shakespeare, J., Elias, F., Ayers, S. Tags: Review Source Type: research

Don ’t Get Too Distracted By the Smoke Coming Out of Washington
By CECI CONNOLLY & MARGARET MURRAY Health care has risen to the top of the national agenda and Washington policymakers are once again debating how to affordably provide coverage and care for Americans. It is a discussion we welcome. But in the meantime, let’s not lose sight of the fundamentals that will ultimately produce greater value for our health care dollars. At the heart of a high-performing health system is quality outcomes. For consumers to make informed decisions, they’ll need more data—reliable, actionable data. Health plans operating in managed care are accustomed to demonstrating their value and in fa...
Source: The Health Care Blog - February 16, 2017 Category: Consumer Health News Authors: John Irvine Tags: Uncategorized Source Type: blogs

Inappropriate prescribing among older persons in primary care: protocol for systematic review and meta-analysis of observational studies
In this study we aim to conduct a comprehensive systematic review and meta-analysis of the prevalence, risk factors and adverse outcome associated with inappropriate prescribing, specifically among older persons in primary care. Methods and analysis We will search PubMed, Embase, CINAHL, Web of Science, Scopus, PsycINFO and references of other review articles for observational studies related to the keywords ‘older persons’, ‘primary care’ and ‘inappropriate prescribing’. Two reviewers will independently select the eligible articles. For each included article, the two reviewers will ind...
Source: BMJ Open - February 23, 2017 Category: Journals (General) Authors: Lee, C. S., Liew, T. M. Tags: Open access, General practice / Family practice, Geriatric medicine, Health services research Protocol Source Type: research

Diagnosing malignant melanoma in ambulatory care: a systematic review of clinical prediction rules
Conclusions At their recommended cut-points, the ABCD dermoscopy rule is more useful for ruling out melanoma than the 7-point dermoscopy checklist. A focus on impact analysis will help translate melanoma risk prediction rules into useful tools for clinical practice.
Source: BMJ Open - March 5, 2017 Category: Journals (General) Authors: Harrington, E., Clyne, B., Wesseling, N., Sandhu, H., Armstrong, L., Bennett, H., Fahey, T. Tags: Open access, Dermatology, Evidence based practice, General practice / Family practice Research Source Type: research

Amitriptyline for musculoskeletal complaints: a systematic review
Conclusion. </div>Few studies have evaluated the use of amitriptyline in musculoskeletal complaints. Although amitriptyline may be effective in musculoskeletal complaints, more studies are required to establish for whom amitriptyline works better than other analgesics.</span>
Source: Family Practice - January 30, 2017 Category: Primary Care Source Type: research

Self-medication among people living with hypertension: a review
Conclusion.</div>This review highlights a high proportion of people with hypertension practise self-medication. Further studies are needed to assess the impact of self-medication with OTC and anti-hypertensive medications on hypertension treatment. Health professionals involved in hypertension management should be mindful of any types of self-medication practices.</span>
Source: Family Practice - January 24, 2017 Category: Primary Care Source Type: research

Protective factors against disordered eating in family systems: a systematic review of research
Conclusions and ImplicationsMany of the potential protective factors identified, such as family support and connectedness, may be non-specific to eating difficulties, promoting general adaptive development and a range of positive development outcomes. Factors in the family environment around food, eating and weight, such as frequent family meals and avoiding comments about weight, may be more specific to ED and disordered eating. Issues with the methodologies used severely impact on the ability to draw conclusions about whether factors are ‘protective’.
Source: Journal of Eating Disorders - March 28, 2017 Category: Eating Disorders and Weight Management Source Type: research

Patient-reported outcome measures for monitoring primary care patients with depression: PROMDEP feasibility randomised trial
Conclusions PROMs may improve depression outcome in the short term, even if PROM scores do not inform practitioners' management. Challenges in recruiting and following up patients need addressing for a definitive trial of relatively brief measures which can potentially inform management. https://www.isrctn.com/search?q=97492541 Trial registration number ISRCTN 97492541; Pre-results.
Source: BMJ Open - March 30, 2017 Category: Journals (General) Authors: Kendrick, T., Stuart, B., Leydon, G. M., Geraghty, A. W. A., Yao, L., Ryves, R., Williams, S., Zhu, S., Dowrick, C., Lewis, G., Moore, M. Tags: Open access, General practice / Family practice, Mental health Research Source Type: research