primary care As both a full-time employee and a primary caregiver to one of my family members, I am worried about potentially exposing my family to COVID. Is there anything I can do? Elaine Varelas guides By www.boston.com Published On :: Wed, 02 Feb 2022 14:51:10 +0000 Being a primary caregiver while working full time is a challenge in itself and even more so during the pandemic. Elaine Varelas guides on how to best keep your family members safe while maintaining your work responsibilities. The post As both a full-time employee and a primary caregiver to one of my family members, I am worried about potentially exposing my family to COVID. Is there anything I can do? Elaine Varelas guides appeared first on Boston.com. Full Article Jobs Job Doc Jobs News
primary care Antidepressant Adherence for Depressed Adults in Primary Care By ifp.nyu.edu Published On :: Fri, 08 Nov 2024 01:43:53 +0000 The post Antidepressant Adherence for Depressed Adults in Primary Care was curated by information for practice. Full Article Clinical Trials
primary care High-Quality Primary Care Should Be Available to Every Individual in the U.S., Says New Report - Payment Reform, Telehealth Expansion, State and Federal Policy Changes Recommended By Published On :: Tue, 04 May 2021 04:00:00 GMT Ensuring access to high-quality primary care for all people in the United States will require reforming payment models, expanding telehealth services, and supporting integrated, team-based care, says a new report from the National Academies of Sciences, Engineering, and Medicine. Full Article
primary care Primary care professionals key to helping people achieve & maintain heart health By newsroom.heart.org Published On :: Wed, 13 Nov 2024 10:00:00 GMT Statement Highlights: A new scientific statement outlines the role of primary care professionals in helping their patients achieve Life's Essential 8, the key measures for improving and maintaining cardiovascular health defined by the American Heart ... Full Article
primary care Rammya Mathew: GPs have to be able to request MRI scans for patients in primary care By www.bmj.com Published On :: 2024-11-12T09:11:25-08:00 At a recent clinical meeting, I heard that GPs local to me are about to lose the ability to request magnetic resonance imaging (MRI) scans for patients presenting with musculoskeletal symptoms. We’re instead advised to refer our patients to a musculoskeletal clinical assessment and triage service (CATS)—staffed largely by musculoskeletal advanced practitioners, who will assess our patients and determine whether imaging is warranted.The hope is that fewer patients will have unnecessary imaging and that this will reduce the potential harms of overdiagnosis. Radiologists rarely report musculoskeletal MRI scans as entirely normal, and it can be hard to know what to do with abnormal findings on an MRI. More often than not, patients with abnormal scans are referred to orthopaedic teams, even though there may not necessarily be a surgical target.At a population level, this is problematic on two fronts. Firstly, MRI scans are expensive and need to be used judiciously.... Full Article
primary care Delaware Child Psychiatry Access Program Looks to Remove Barriers, Empower Primary Care Providers By news.delaware.gov Published On :: Thu, 01 Oct 2020 13:49:00 +0000 WILMINGTON – The Delaware Children’s Department has launched a program that links pediatric primary care providers with free psychiatry consultations and assistance to streamline behavioral health care for children and youth. Implemented in 2019, the Delaware Child Psychiatry Access Program (DCPAP) is a beneficial resource for primary care providers serving young people with behavioral health needs. […] Full Article Department of Services for Children Youth and their Families children's mental health Health care
primary care New Report Outlines Plan for Strengthening Primary Care in Delaware By news.delaware.gov Published On :: Mon, 21 Dec 2020 14:54:03 +0000 Provisional Affordability Standards aim to strengthen primary care in Delaware through increased investment Insurance Commissioner Trinidad Navarro announced the release of the Office of Value-Based Health Care Delivery’s initial provisional Affordability Standards as part of a new report, Delaware Health Care Affordability Standards: An Integrated Approach to Improve Access, Quality and Value, which includes plans […] Full Article Captive Captive Insurance Insurance Commissioner affordable healthcare Commissioner Navarro Department of Insurance DOI healthcare Insurance Department Office of Value-Based Health Care Delivery Primary Care Trinidad Navarro value-based payment reform
primary care Advances in Primary Care Reform Made Possible by Legislature By news.delaware.gov Published On :: Mon, 12 Jul 2021 13:34:43 +0000 General Assembly sent key bill to the Governor The Delaware General Assembly passed legislation to increase Delawareans’ access to high quality, affordable health care through a series of reforms that will refocus Delaware’s healthcare system on primary care and improvements in value. Senate Substitute 1 for Senate Bill 120 requires commercial health insurance companies to […] Full Article Captive Captive Insurance Insurance Commissioner Bryan Townsend Commissioner Navarro David Bentz General Assembly Health Insurance healthcare Hospitals Legislature Office of Value-Based Health Care Delivery Primary Care Trinidad Navarro Value-Based Care
primary care A Comprehensive Guide to Long-Acting Injectable Antipsychotics for Primary Care Clinicians By www.jabfm.org Published On :: 2024-10-25T09:26:14-07:00 We propose a paper that provides education on commonly used long-acting injectable antipsychotics (LAIs) to improve primary care based mental health interventions in patients with severe mental illnesses (SMIs) such as schizophrenia, schizoaffective disorder, and bipolar disorders. With the expanding interface of primary care and psychiatry across all healthcare settings, it has become increasingly important for primary care clinicians to have a broader understanding of common psychiatric treatments, including LAIs. Long-acting injectable antipsychotics have been shown to be helpful in significantly improving treatment adherence, preventing disease progression, improving treatment response, decreasing readmission rates, and reducing social impairment. We discuss evidence-based indications and guidelines for use of long-acting injectable antipsychotics. We provide an overview of the treatment of SMI with LAIs, mainly focusing on the most commonly used long-acting injectable antipsychotics, advantages and disadvantages of each, along with outlining important clinical pearls for ease of practical application. Equipped with increased familiarity and understanding of these essential therapies, primary care clinicians can better facilitate early engagement with psychiatric care, promote more widespread use, and thus significantly improve the wellbeing and quality of life of patients with severe mental illness. Full Article
primary care Primary Care Clinicians' Interest In, and Barriers To, Medication Abortion By www.jabfm.org Published On :: 2024-10-25T09:26:14-07:00 Purpose: Providing medication abortion in the primary care setting is a promising way to increase access to abortion, a threatened service in many States. This study aimed to characterize primary care clinicians’ interest in prescribing medication abortion, what barriers they face in adding this service, and what support they need. Methods: Data were collected from 162 practicing primary care clinicians in Minnesota using an online survey with closed- and open-ended response options. Data were analyzed using descriptive statistics, group comparison analyses, and content analysis for the open-ended questions. Results: Participants represented a diverse range of ages, years in practice, credentials, genders, and urban/rural practice settings, and held mixed knowledge and attitudes around medication abortion. All demographic groups surveyed expressed interest in prescribing medication abortion, with the strongest interest represented among younger respondents, women, and those practicing in urban settings. Clinicians who provide prenatal care or who already work with these medications in other contexts were more likely to want to add medication abortion to their practices. The most common barrier to providing medication abortion was a lack of knowledge about organizational policies and about the medications themselves. To empower clinicians to provide medication abortion, respondents voiced needing their health systems to build clear processes and wanting supportive networks of other clinicians for collaboration. Conclusions: Given the interest of primary care clinicians in providing medication abortion, health systems have a valuable opportunity to increase access. Full Article
primary care A Qualitative Analysis of a Primary Care Medical-Legal Partnership: Impact, Barriers, and Facilitators By www.jabfm.org Published On :: 2024-10-25T09:26:14-07:00 Background: Certain health-related risk factors require legal interventions. Medical-legal partnerships (MLPs) are collaborations between clinics and lawyers that address these health-harming legal needs (HHLNs) and have been shown to improve health and reduce utilization. Objective: The objective of this study is to explore the impact, barriers, and facilitators of MLP implementation in primary care clinics. Methods: A qualitative design using a semistructured interview assessed the perceived impact, barriers, and facilitators of an MLP, among clinicians, clinic and MLP staff, and clinic patients. Open AI software (otter.ai) was used to transcribe interviews, and NVivo was used to code the data. Braun & Clarke’s framework was used to identify themes and subthemes. Results: Sixteen (n = 16) participants were included in this study. Most respondents were women (81%) and white (56%). Four respondents were clinic staff, and 4 were MLP staff while 8 were clinic patients. Several primary themes emerged including: Patients experienced legal issues that were pernicious, pervasive, and complex; through trusting relationships, the MLP was able to improve health and resolve legal issues, for some; mistrust, communication gaps, and inconsistent staffing limited the impact of the MLP; and, the MLP identified coordination and communication strategies to enhance trust and amplify its impact. Conclusion: HHLNs can have a significant, negative impact on the physical and mental health of patients. Respondents perceived that MLPs improved health and resolved these needs, for some. Despite perceived successes, integration between the clinical and legal organizations was elusive. Full Article
primary care The treatment of latent tuberculosis infection in migrants in primary care versus secondary care By erj.ersjournals.com Published On :: 2024-11-07T00:35:56-08:00 Extract With a disproportionate burden of tuberculosis (TB) amongst migrants in Europe [1], Burman et al. [2] have highlighted the pressing need for alternative approaches to make TB infection (TBI) screening comprehensive and accessible. Across high-income Organisation for Economic Co-operation and development countries, a median of 52% of TB cases occur in foreign-born individuals, who are at their highest risk of developing TB disease within the first 5 years of migration [3]. Molecular epidemiological studies indicate that the majority of these cases occur as a result of TBI reactivation, often acquired overseas [4]. Within the UK, overseas-born migrants have a 14-fold higher TB incidence than UK-born individuals [5]. The World Health Organization therefore recommends that migrants from countries with a high TB burden may be prioritised for TBI screening [6, 7]. Full Article
primary care Treatment of latent tuberculosis infection in migrants in primary care versus secondary care By erj.ersjournals.com Published On :: 2024-11-07T00:35:55-08:00 Background Control of latent tuberculosis infection (LTBI) is a priority in the World Health Organization strategy to eliminate TB. Many high-income, low TB incidence countries have prioritised LTBI screening and treatment in recent migrants. We tested whether a novel model of care, based entirely within primary care, was effective and safe compared to secondary care. Methods This was a pragmatic cluster-randomised, parallel group, superiority trial (ClinicalTrials.gov: NCT03069807) conducted in 34 general practices in London, UK, comparing LTBI treatment in recent migrants in primary care to secondary care. The primary outcome was treatment completion, defined as taking ≥90% of antibiotic doses. Secondary outcomes included treatment acceptance, adherence, adverse effects, patient satisfaction, TB incidence and a cost-effectiveness analysis. Analyses were performed on an intention-to-treat basis. Results Between September 2016 and May 2019, 362 recent migrants with LTBI were offered treatment and 276 accepted. Treatment completion was similar in primary and secondary care (82.6% versus 86.0%; adjusted OR (aOR) 0.64, 95% CI 0.31–1.29). There was no difference in drug-induced liver injury between primary and secondary care (0.7% versus 2.3%; aOR 0.29, 95% CI 0.03–2.84). Treatment acceptance was lower in primary care (65.2% (146/224) versus 94.2% (130/138); aOR 0.10, 95% CI 0.03–0.30). The estimated cost per patient completing treatment was lower in primary care, with an incremental saving of GBP 315.27 (95% CI 313.47–317.07). Conclusions The treatment of LTBI in recent migrants within primary care does not result in higher rates of treatment completion but is safe and costs less when compared to secondary care. Full Article
primary care Geographic inequalities in need and provision of social prescribing link workers a retrospective study in primary care By bjgp.org Published On :: 2024-10-31T16:05:26-07:00 BackgroundLong-term health conditions are major challenges for care systems. Social prescribing link workers have been introduced via primary care networks (PCNs) across England since 2019 to address the wider determinants of health by connecting individuals to activities, groups, or services within their local community.AimTo assess whether the rollout of social prescribing link workers was in areas with the highest need.Design and settingA retrospective study of social prescribing link workers in England from 2019 to 2023.MethodWorkforce, population, survey, and area-level data at the PCN-level from April 2020 to October 2023 were combined. Population need before the rollout of link workers was measured using reported lack of support from local services in the 2019 General Practice Patient Survey. To assess if rollout reflected need, linear regression was used to relate provision of link workers (measured by full-time equivalent [FTE] per 10 000 patients) in each quarter to population need for support.ResultsPopulations in urban, more deprived areas and with higher proportions of people from minority ethnic groups had the highest reported lack of support. Geographically these were in the North West and London. Initially, there was no association between need and provision; then from July 2022, this became negative and significant. By October 2023, a 10-percentage point higher need for support was associated with a 0.035 (95% confidence interval = −0.634 to −0.066) lower FTE per 10 000 patients.ConclusionRollout of link workers has not been sufficiently targeted at areas with the highest need. Future deployments should be targeted at those areas. Full Article
primary care Support for primary care prescribing for adult ADHD in England: national survey By bjgp.org Published On :: 2024-10-31T16:05:26-07:00 BackgroundAttention deficit hyperactivity disorder (ADHD) is a common neurodevelopmental disorder, for which there are effective pharmacological treatments that improve symptoms and reduce complications. Guidelines published by the National Institute for Health and Care Excellence recommend that primary care practitioners prescribe medication for adult ADHD under shared-care agreements with Adult Mental Health Services (AMHS). However, provision remains uneven, with some practitioners reporting a lack of support.AimThis study aimed to describe elements of support, and their availability/use, in primary care prescribing for adult ADHD medication in England to improve access for this underserved population and inform service improvement.Design and settingCross-sectional surveys were used to elicit data from commissioners, health professionals (HPs), and people with lived experience of ADHD (LE) across England about elements supporting pharmacological treatment of ADHD in primary care.MethodThree interlinked cross-sectional surveys were used to ask every integrated care board in England (commissioners), along with convenience samples of HPs and LEs, about prescribing rates, AMHS availability, wait times, and shared-care agreement protocols/policies for the pharmacological treatment of ADHD in primary care. Descriptive analyses, percentages, and confidence intervals were used to summarise responses by stakeholder group. Variations in reported provision and practice were explored and displayed visually using mapping software.ResultsData from 782 responders (42 commissioners, 331 HPs, 409 LEs) revealed differences in reported provision by stakeholder group, including for prescribing (95% of HPs versus 64% of LEs). In all, >40% of responders reported extended AMHS wait times of ≥2 years. There was some variability by NHS region – for example, London had the lowest reported extended wait time (25%), while East of England had the highest (55%).ConclusionElements supporting appropriate shared-care prescribing of ADHD medication via primary care are not universally available in England. Coordinated approaches are needed to address these gaps. Full Article
primary care Collaborative discussions between GPs and pharmacists to optimise patient medication: a qualitative study within a UK primary care clinical trial By bjgp.org Published On :: 2024-10-31T16:05:26-07:00 BackgroundThere has been significant investment in pharmacists working in UK general practice to improve the effective and safe use of medicines. However, evidence of how to optimise collaboration between GPs and pharmacists in the context of polypharmacy (multiple medication) is lacking.AimTo explore GP and pharmacist views and experiences of in-person, interprofessional collaborative discussions (IPCDs) as part of a complex intervention to optimise medication use for patients with polypharmacy in general practice.Design and settingA mixed-method process evaluation embedded within the Improving Medicines use in People with Polypharmacy in Primary Care (IMPPP) trial conducted in Bristol and the West Midlands, between February 2021 and September 2023.MethodAudio-recordings of IPCDs between GPs and pharmacists, along with individual semi-structured interviews to explore their reflections on these discussions, were used. All recordings were transcribed verbatim and analysed thematically.ResultsA total of 14 practices took part in the process evaluation from February 2022 to September 2023; 17 IPCD meetings were audio-recorded, discussing 30 patients (range 1–6 patients per meeting). In all, six GPs and 13 pharmacists were interviewed. The IPCD was highly valued by GPs and pharmacists who described benefits, including: strengthening their working relationship; gaining in confidence to manage more complex patients; and learning from each other. It was often challenging, however, to find time for the IPCDs.ConclusionThe model of IPCD used in this study provided protected time for GPs and pharmacists to work together to deliver whole-patient care, with both professions finding this beneficial. Protected time for interprofessional liaison and collaboration, and structured interventions may facilitate improved patient care. Full Article
primary care CGRP therapy in primary care for migraine: prevention and acute medication By bjgp.org Published On :: 2024-10-31T16:05:26-07:00 Full Article
primary care Primary care health professionals’ approach to clinical coding: a qualitative interview study By bjgp.org Published On :: 2024-10-31T16:05:26-07:00 Full Article
primary care Challenging the status quo: deprescribing antihypertensive medication in older adults in primary care By bjgp.org Published On :: 2024-10-31T16:05:26-07:00 Full Article
primary care Improving Access to Disability Assessment for US Citizenship Applicants in Primary Care: An Embedded Neuropsychological Assessment Innovation [Innovations in Primary Care] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 Full Article
primary care Using the Electronic Health Record to Facilitate Patient-Physician Relationship While Establishing Care [Innovations in Primary Care] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 Full Article
primary care Deep End Kawasaki/Yokohama: A New Challenge for GPs in Deprived Areas in Japan [Innovations in Primary Care] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 Full Article
primary care Face-to-Face Relationships Still Matter in a Digital Age: A Call for a 5th C in the Core Tenets of Primary Care [Reflections] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 We primary care clinicians, scholars, and leaders ascribe value to Barbara Starfield’s core tenets of primary care—the 4 Cs: first contact, comprehensiveness, coordination, and continuity. In today’s era of rapid technological advancements and dwindling resources, what are the implications for face-to-face interactions of patient-clinician relationships? We propose adding a 5th C: "Contiguity." Contiguity—or physical proximity and presence—is a key dimension that not only enables the necessary technical aspects of a physical exam but also authenticates the most human aspects of a relationship and occurs specifically when we are physically vulnerable and responsible for the other before us. This, in turn, may best enable us to bridge difference and nurture trust with our patients. We measure what we value and, thus, naming Contiguity as a core tenet assures that we will not lose sight of this keystone in a patient’s relationship with their personal physician. Full Article
primary care Chest Pain in Primary Care: A Systematic Review of Risk Stratification Tools to Rule Out Acute Coronary Syndrome [Systematic Review] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 PURPOSE Chest pain frequently poses a diagnostic challenge for general practitioners (GPs). Utilizing risk stratification tools might help GPs to rule out acute coronary syndrome (ACS) and make appropriate referral decisions. We conducted a systematic review of studies evaluating risk stratification tools for chest pain in primary care settings, both with and without troponin assays. Our aims were to assess the performance of tools for ruling out ACS and to provide a comprehensive review of the current evidence. METHODS We searched PubMed and Embase for articles up to October 9, 2023 concerning adult patients with acute chest pain in primary care settings, for whom risk stratification tools (clinical decision rules [CDRs] and/or single biomarker tests) were used. To identify eligible studies, a combination of active learning and backward snowballing was applied. Screening, data extraction, and quality assessment (following the Quality Assessment of Diagnostic Accuracy Studies-2 tool) were performed independently by 2 researchers. RESULTS Of the 1,204 studies screened, 14 were included in the final review. Nine studies validated 7 different CDRs without troponin. Sensitivities ranged from 75.0% to 97.0%, and negative predictive values (NPV) ranged from 82.4% to 99.7%. None of the CDRs outperformed the unaided judgment of GP’s. Five studies reported on strategies using troponin measurements. Studies using high-sensitivity troponin showed highest diagnostic accuracy with sensitivity 83.3% to 100% and NPV 98.8% to 100%. CONCLUSION Clinical decision rules without troponin and the use of conventional troponin showed insufficient sensitivity to rule out ACS in primary care and are not recommended as standalone tools. High-sensitivity troponin strategies are promising, but studies are limited. Further prospective validation in primary care is needed before implementation. Full Article
primary care Lack of Knowledge of Antibiotic Risks Contributes to Primary Care Patients Expectations of Antibiotics for Common Symptoms [Research Briefs] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 Patient expectations of receiving antibiotics for common symptoms can trigger unnecessary use. We conducted a survey (n = 564) between January 2020 to June 2021 in public and private primary care clinics in Texas to study the prevalence and predictors of patients’ antibiotic expectations for common symptoms/illnesses. We surveyed Black patients (33%) and Hispanic/Latine patients (47%), and over 93% expected to receive an antibiotic for at least 1 of the 5 pre-defined symptoms/illnesses. Public clinic patients were nearly twice as likely to expect antibiotics for sore throat, diarrhea, and cold/flu than private clinic patients. Lack of knowledge of potential risks of antibiotic use was associated with increased antibiotic expectations for diarrhea (odds ratio [OR] = 1.6; 95% CI, 1.1-2.4) and cold/flu symptoms (OR = 2.9; 95% CI, 2.0-4.4). Lower education and inadequate health literacy were predictors of antibiotic expectations for diarrhea. Future antibiotic stewardship interventions should tailor patient education materials to include information on antibiotic risks and guidance on appropriate antibiotic indications. Full Article
primary care A Cluster-Randomized Study of Technology-Assisted Health Coaching for Weight Management in Primary Care [Original Research] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 PURPOSE We undertook a trial to test the efficacy of a technology-assisted health coaching intervention for weight management, called Goals for Eating and Moving (GEM), within primary care. METHODS This cluster-randomized controlled trial enrolled 19 primary care teams with 63 clinicians; 9 teams were randomized to GEM and 10 to enhanced usual care (EUC). The GEM intervention included 1 in-person and up to 12 telephone-delivered coaching sessions. Coaches supported goal setting and engagement with weight management programs, facilitated by a software tool. Patients in the EUC arm received educational handouts. We enrolled patients who spoke English or Spanish, were aged 18 to 69 years, and either were overweight (body mass index 25-29 kg/m2) with a weight-related comorbidity or had obesity (body mass index ≥30 kg/m2). The primary outcome (weight change at 12 months) and exploratory outcomes (eg, program attendance, diet, physical activity) were analyzed according to intention to treat. RESULTS We enrolled 489 patients (220 in the GEM arm, 269 in the EUC arm). Their mean (SD) age was 49.8 (12.1) years; 44% were male, 41% Hispanic, and 44% non-Hispanic Black. At 12 months, the mean adjusted weight change (standard error) was –1.4 (0.8) kg in the GEM arm vs –0.8 (1.6) kg in the EUC arm, a nonsignificant difference (P = .48). There were no statistically significant differences in secondary outcomes. Exploratory analyses showed that the GEM arm had a greater change than the EUC arm in mean number of weekly minutes of moderate to vigorous physical activity other than walking, a finding that may warrant further exploration. CONCLUSIONS The GEM intervention did not achieve clinically important weight loss in primary care. Although this was a negative study possibly affected by health system resource limitations and disruptions, its findings can guide the development of similar interventions. Future studies could explore the efficacy of higher-intensity interventions and interventions that include medication and bariatric surgery options, in addition to lifestyle modification. Full Article
primary care Challenges in Receiving Care for Long COVID: A Qualitative Interview Study Among Primary Care Patients About Expectations and Experiences [Original Research] By www.annfammed.org Published On :: 2024-09-23T14:00:14-07:00 BACKGROUND For many patients with post–COVID-19 condition (long COVID), primary care is the first point of interaction with the health care system. In principle, primary care is well situated to manage long COVID. Beyond expressions of disempowerment, however, the patient’s perspective regarding the quality of long COVID care is lacking. Therefore, this study aimed to analyze the expectations and experiences of primary care patients seeking treatment for long COVID. METHODS A phenomenological approach guided this analysis. Using purposive sampling, we conducted semistructured interviews with English-speaking, adult primary care patients describing symptoms of long COVID. We deidentified and transcribed the recorded interviews. Transcripts were analyzed using inductive qualitative content analysis. RESULTS This article reports results from 19 interviews (53% female, mean age = 54 years). Patients expected their primary care practitioners (PCPs) to be knowledgeable about long COVID, attentive to their individual condition, and to engage in collaborative processes for treatment. Patients described 2 areas of experiences. First, interactions with clinicians were perceived as positive when clinicians were honest and validating, and negative when patients felt dismissed or discouraged. Second, patients described challenges navigating the fragmented US health care system when coordinating care, treatment and testing, and payment. CONCLUSION Primary care patients’ experiences seeking care for long COVID are incongruent with their expectations. Patients must overcome barriers at each level of the health care system and are frustrated by the constant challenges. PCPs and other health care professionals might increase congruence with expectations and experiences through listening, validating, and advocating for patients with long COVID. Annals Early Access article Full Article
primary care Pharmacy negotiators in talks over plans to distribute COVID-19 treatments in primary care By www.pharmaceutical-journal.com Published On :: Wed, 10 Feb 2021 15:25 GMT The Pharmaceutical Services Negotiating Committee is in talks with the government over potential plans to distribute COVID-19 treatments in primary care. Full Article
primary care Primary Care Providers Can Help Steer People to Opioid Addiction Treatment By www.pewtrusts.org Published On :: Mon, 25 Jan 2021 09:13:00 -0500 The United States is grappling with two severe health crises: the COVID-19 pandemic and an opioid epidemic that appears to be worsening as more people deal with stress and isolation as they face increased barriers to medical care. Preliminary numbers for 2020 show that overdose deaths were outpacing the record-setting number of more than 71,000 fatalities in 2019. Full Article
primary care Helping Patients With Emotional Eating: A Primary Care Approach By www.medindia.net Published On :: Primary care providers are ideally suited to tackle medlinkemotional eating/medlink due to their ongoing relationships with patients, as highlighted by Jana DeSimone Wozniak, Ph. Full Article
primary care Physician workload and treatment choice: the case of primary care [electronic journal]. By encore.st-andrews.ac.uk Published On :: Full Article
primary care Guide for COVID-19 remote consultation by primary carers designed by NTU Singapore scientist and peers By news.ntu.edu.sg Published On :: Wed, 15 Apr 2020 16:00:00 GMT ... Full Article All
primary care Guide for COVID-19 remote consultation by primary carers designed by NTU Singapore scientist and peers By news.ntu.edu.sg Published On :: Thu, 16 Apr 2020 16:00:00 GMT Primary care health workers now have a guide for conducting remote consultation of suspected COVID-19 patients, developed by a team of researchers from Singapore and the UK.... Full Article All
primary care Direct Primary Care Provider ImagineMD Now Offering Covid-19 Antibody Tests Via Partnership with Quest Diagnostics By www.24-7pressrelease.com Published On :: Thu, 30 Apr 2020 07:00:00 GMT Patients Now Able to Determine If Symptoms Actually Represented a COVID-19 Infection Full Article
primary care Small Dreams: Mental Illness and Primary Care By Published On :: Matt Freitas, nurse practitioner, treats people with mental illness, including his daughter, who has schizophrenia. The number of patients seeking treatment for mental illness has tripled over the past three years, Freitas says. Photography, audio and production by Lauren M. Whaley, CHCF Center for Health Reporting. Full Article
primary care Primary care in Scotland: workforce, funding and delivery of care By feeds.iriss.org.uk Published On :: Thu, 10 Sep 2015 06:26:58 PDT When: Wed Jan 27, 2016 Where: Scotland: workforce, funding and delivery of care Event Status: confirmed Event Description: This conference will provide a timely opportunity for delegates to consider the future of primary care in Scotland. For further information, please visit the event website Full Article http://schemas.google.com/g/2005#event
primary care Implementing Diabetes Self-Management Education in Primary Care By spectrum.diabetesjournals.org Published On :: 2006-04-01 Sharlene EmersonApr 1, 2006; 19:79-83Articles Full Article
primary care Managing multimorbidity in primary care By feeds.bmj.com Published On :: Fri, 23 Jan 2015 11:56:24 +0000 Multimorbidity presents a number of different challenges, for the patients living with the conditions, but also for the health professionals caring for them in systems that often are not designed with these more complex needs in mind. Emma Wallace, general practice lecturer, and Susan Smith, a professor of general practice at the Royal College of... Full Article
primary care Diagnosing COPD in primary care By feeds.bmj.com Published On :: Fri, 04 Dec 2015 10:04:39 +0000 Francesca Conway, from the Department of Primary Care and Public Health at Imperial College London is co-author of an article on diagnosis of COPD. She joins us to discuss the major guideline recommendations, and highlights where they concur and where they differ. Read the full article: http://www.bmj.com/content/351/bmj.h6171 Full Article
primary care Diabetes INSIDE: Improving Population HbA1c Testing and Targets in Primary Care With a Quality Initiative By care.diabetesjournals.org Published On :: 2020-01-20T12:00:30-08:00 OBJECTIVE To improve outcomes of patients with adult type 2 diabetes by decreasing HbA1c undertesting, reducing the proportion of patients with poor glycemic control, and lowering mean HbA1c levels using a quality improvement (QI) program. RESEARCH DESIGN AND METHODS Six years of outpatient electronic health record (EHR) data were analyzed for care gaps before and 2 years after implementing a QI initiative in an urban academic medical center. QI strategies included 1) individual provider and departmental outcome reports, 2) patient outreach programs to address timely follow-up care, 3) a patient awareness campaign to improve understanding of achieving clinical goals, 4) improving EHR data capture to improve population monitoring, and 5) professional education. RESULTS Analysis (January 2010 to May 2018) of 7,798 patients from Tulane Medical Center (mean age 61 years, 57% female, 62% black, 97% insured) with 136,004 visits showed target improvements. A Cox proportional hazards model controlling for age, sex, race, and HbA1c level showed a statistically significant reduction in HbA1c undertesting >6 months (hazard ratio 1.20 ± 0.07). Statistical process control charts showed 15.5% relative improvement in the patient proportion with HbA1c >9% (75 mmol/mol) from 13% to 11% (P < 10–6) following QI interventions and a 2.1% improvement of population mean HbA1c from 7.4% (57 mmol/mol) to 7.2% (55 mmol/mol) (P < 10–6). CONCLUSIONS Multidisciplinary QI teams using EHR data to design interventions for providers and patients produced statistically significant improvements in both care process and clinical outcome goals. Full Article
primary care Standards of Medical Care in Diabetes--2018 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2018-01-01 American Diabetes AssociationJan 1, 2018; 36:14-37Position Statements Full Article
primary care Standards of Medical Care in Diabetes--2019 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2019-01-01 American Diabetes AssociationJan 1, 2019; 37:11-34Position Statements Full Article
primary care Standards of Medical Care in Diabetes--2020 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2020-01-01 American Diabetes AssociationJan 1, 2020; 38:10-38Standards of Care Full Article
primary care Redesigning Primary Care to Improve Diabetes Outcomes (the UNITED Study) By care.diabetesjournals.org Published On :: 2020-02-20T11:55:29-08:00 OBJECTIVE The effective redesign of primary care delivery systems to improve diabetes care requires an understanding of which particular components of delivery consistently lead to better clinical outcomes. We identified associations between common systems of care management (SysCMs) and the frequency of meeting standardized performance targets for Optimal Diabetes Care (NQF#0729) in primary care practices. RESEARCH DESIGN AND METHODS A validated survey of 585 eligible family or general internal medicine practices seeing ≥30 adult patients with diabetes in or near Minnesota during 2017 evaluated the presence of 62 SysCMs. From 419 (72%) practices completing the survey, NQF#0729 was determined in 396 (95%) from electronic health records, including 215,842 patients with type 1 or type 2 diabetes. RESULTS Three SysCMs were associated with higher rates of meeting performance targets across all practices: 1) a systematic process for shared decision making with patients (P = 0.001), 2) checklists of tests or interventions needed for prevention or monitoring of diabetes (P = 0.002), and 3) physician reminders of guideline-based age-appropriate risk assessments due at the patient visit (P = 0.002). When all three were in place, an additional 10.8% of the population achieved recommended performance measures. In subgroup analysis, 15 additional SysCMs were associated with better care in particular types of practices. CONCLUSIONS Diabetes care outcomes are better in primary care settings that use a patient-centered approach to systematically engage patients in decision making, remind physicians of age-appropriate risk assessments, and provide checklists for recommended diabetes interventions. Practice size and location are important considerations when redesigning delivery systems to improve performance. Full Article
primary care Interdisciplinary Team Care for Diabetic Patients by Primary Care Physicians, Advanced Practice Nurses, and Clinical Pharmacists By clinical.diabetesjournals.org Published On :: 2011-04-01 David WillensApr 1, 2011; 29:60-68Feature Articles Full Article
primary care Insulin Strategies for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2002-01-01 Karen L. HerbstJan 1, 2002; 20:Feature Articles Full Article
primary care Standards of Medical Care in Diabetes--2019 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2019-01-01 American Diabetes AssociationJan 1, 2019; 37:11-34Position Statements Full Article
primary care Standards of Medical Care in Diabetes--2016 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2016-01-01 American Diabetes AssociationJan 1, 2016; 34:3-21Position Statements Full Article
primary care A Real-World Approach to Insulin Therapy in Primary Care Practice By clinical.diabetesjournals.org Published On :: 2005-04-01 Irl B. HirschApr 1, 2005; 23:78-86Practical Pointers Full Article
primary care Standards of Medical Care in Diabetes--2018 Abridged for Primary Care Providers By clinical.diabetesjournals.org Published On :: 2018-01-01 American Diabetes AssociationJan 1, 2018; 36:14-37Position Statements Full Article
