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Journal of the American Board of Family Medicine: JABFM

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https://www.readbyqxmd.com/read/30201682/re-wide-gap-between-preparation-and-scope-of-practice-of-early-career-family-physicians
#1
LETTER
John J Frey
No abstract text is available yet for this article.
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201681/re-evaluation-of-an-ongoing-diabetes-group-medical-visit-in-a-family-medicine-practice
#2
LETTER
Valerie S Ganetsky, Steven Kaufman
No abstract text is available yet for this article.
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201680/interruption-and-reversal-of-direct-oral-anticoagulants-in-preprocedural-and-acute-settings
#3
REVIEW
Abhishek Kulkarni, Megha Manek
With increasing physician and patient awareness, the use of direct oral anticoagulants (DOACs) has been steadily increasing in recent years. Unfortunately, given their recent introduction, the reversal of anticoagulation attained with DOACs is not well studied. Given the diverse mechanisms of action of these newer agents, no universal antidote is available for reversal. Laboratory assays that can accurately quantify the anticoagulation status of patients on DOAC therapy are not readily available, which presents a challenge in situations demanding rapid reversal...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201679/effectiveness-of-clinical-decision-support-based-intervention-in-the-improvement-of-care-for-adult-sickle-cell-disease-patients-in-primary-care
#4
Arch G Mainous, Peter J Carek, Kim Lynch, Rebecca J Tanner, Mary M Hulihan, Jacquelyn Baskin, Thomas D Coates
INTRODUCTION: Although most patients with rare diseases like sickle cell disease (SCD) are treated in the primary care setting, primary care physicians may find it challenging to keep abreast of medication improvements and complications associated with treatment for rare and complex diseases. The purpose of this study was to evaluate the effectiveness of a clinical decision support (CDS) -based intervention system for transfusional iron overload in adults with SCD to improve management in primary care...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201678/edema-from-taking-cinnamon-for-treatment-of-diabetes-similar-biochemistry-and-pathophysiology-to-thiazolidinedione-medications
#5
Paul Crawford, Amanda J Crawford
We present a report of cinnamon bark powder 1000 mg daily associated with edema that resolved after stopping the supplement in an adult male. Thiazolidinediones (TZDs) cause fluid retention in those with diabetes or prediabetes. Some medications in this class have been implicated in increased cardiac deaths from this side effect. While medications are effective for diabetes, many people have turned to natural remedies to treat their diabetes instead of conventional pharmaceuticals. Cinnamon is a common agent used, and it has received extensive lay press attention...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201677/lack-of-communication-about-medical-marijuana-use-between-doctors-and-their-patients
#6
Elin C Kondrad, Alex J Reed, Matthew J Simpson, Donald E Nease
INTRODUCTION: Medical marijuana is now permitted in most states, but it is not clear whether primary care physicians (PCPs) are aware of or recommend its use in their patients. METHODS: We distributed paired surveys to PCPs and their patients to assess the frequency of patient marijuana use and communication with PCPs about use. RESULTS: Of 242 patients surveyed, 22% reported marijuana use in the past 6 months, and 61% of these identified as medical marijuana users...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201676/improving-effective-magnetic-resonance-imaging-mri-application-in-soft-tissue-wrist-injury
#7
Alfred P Yoon, Alexandra L Mathews, Helen E Huetteman, Brett F Michelotti, Kevin C Chung
INTRODUCTION: Magnetic resonance imaging (MRI) for soft-tissue wrist injury may be overprescribed, contributing to ineffective health care resource use. We aimed to discern predictive factors that may improve MRI's application in soft-tissue wrist injury. METHODS: We conducted a retrospective chart review of adults who underwent MRIs for possible soft-tissue wrist injury between June 2009 and June 2014. Clinical data and treatment recommendations before and after MRI were analyzed...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201675/novel-exercises-for-restless-legs-syndrome-a-randomized-controlled-trial
#8
Eloise G Harrison, Jennifer L Keating, Prue Morgan
BACKGROUND: Restless legs syndrome (RLS) is a sensorimotor disorder that can have a considerable negative impact on quality of life and sleep. Management is primarily pharmacological; nonpharmacological options are limited. The objective of the present study was to determine the effect of tension and trauma release exercises on RLS severity compared with discussion group controls. METHODS: Participants satisfied RLS diagnostic criteria, did not have acute mental health conditions, and reported being physically able to complete exercises...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201674/if-we-don-t-ask-they-won-t-tell-screening-for-urinary-and-fecal-incontinence-by-primary-care-providers
#9
Heidi W Brown, Wen Guan, Nicholas B Schmuhl, Paul D Smith, William E Whitehead, Rebecca G Rogers
BACKGROUND: More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI. METHODS: We conducted a cross-sectional electronic survey of PCPs within a Midwest academic institution to ascertain and compare PCPs' beliefs, attitudes, and behaviors regarding screening and treatment for UI and FI; determine factors associated with screening for FI; and identify potential barriers to and facilitators of FI screening and treatment...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201673/epidural-analgesia-and-any-vaginal-laceration
#10
Timothy G Myrick, Kelly J Sandri
BACKGROUND: Studies have shown increased incidence of severe vaginal lacerations (third and fourth degree) in women under the influence of epidural analgesia. This increase has been attributed to the increased the use of operative vaginal delivery (OVD), with attendant increased risk of laceration. Although mild and moderate vaginal lacerations requiring suturing are clinically significant, their relationship to epidural analgesia has not been extensively studied. OBJECTIVE: The purpose of this study is to examine relationships between epidural analgesia in laboring women and vaginal lacerations at delivery...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201672/opioid-and-drug-prevalence-in-top-40-s-music-a-30-year-review
#11
Curtis Hanba, Daniel Hanba
OBJECTIVES/HYPOTHESIS: Our objective was to identify current trends in the prose of popular music and, specifically, to identify if a relationship exists between the mention of opioid narcotics in Top 40's music and a rising prevalence of opioid use disorder in the United States. METHODS: A list of Billboard's top 100 songs for each year of the past 30 years (1986 to 2016) was collected. Lyrics from the 40 most popular songs of each year were queried for reference to drugs and alcohol...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201671/medication-adherence-improvement-similar-for-shared-decision-making-preference-or-longer-patient-provider-relationship
#12
Antoinette Schoenthaler, Diana Margot Rosenthal, Mark Butler, Lauren Jacobowitz
BACKGROUND: While increasing evidence supports the beneficial effects of shared decision making (SDM) on patient outcomes, the mechanisms underlying this relationship is unclear. This study evaluated length of the patient-provider relationship as one potential factor that may explain how SDM affects medication adherence in patients with hypertension. METHODS: An observational study of 75 hypertensive patients and 27 providers in 3 primary care practices in New York City...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201670/the-role-of-gender-in-cost-related-medication-nonadherence-among-patients-with-diabetes
#13
Soumitra S Bhuyan, Olayinka Shiyanbola, Pallav Deka, Oluwaseyi O Isehunwa, Aastha Chandak, Sean Huang, Yang Wang, Jay Bhatt, Lu Ning, Wang Jun Lin, David Wyant, Satish Kedia, Cyril F Chang
OBJECTIVE: Under 50% of type 2 diabetic patients achieve the recommended glycemic control. One barrier to glycemic control is patients' cost-related nonadherence to medications. We hypothesize gender differences in medication nonadherence due to costs among diabetic patients. METHODS: US National Health Interview Survey (2011 to 2014) data yielded 5260 males and 6188 females with diabetes for over a year. We applied 2 analytic methods (A and B below) across multiple outcome measures (1 to 4) of medication nonadherence due to cost...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201669/how-is-family-medicine-engaging-patients-at-the-practice-level-a-national-sample-of-family-physicians
#14
Anjana E Sharma, Margae Knox, Lars E Peterson, Rachel Willard-Grace, Kevin Grumbach, Michael B Potter
INTRODUCTION: Emerging policy consensus advocates that patient-centered care should include an active, practice-level patient role, but it is unknown how commonly these roles are implemented. We sought to understand current prevalence and predictors of practice-level patient engagement in US primary care settings. METHODS: We assessed practice-level patient engagement by using 2016 American Board of Family Medicine Certification Examination registration data, restricted to ambulatory primary care site respondents randomly selected for a patient-centered medical home (PCMH) question module...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201668/depression-screening-rates-and-symptom-severity-by-alcohol-use-among-primary-care-adult-patients
#15
Matthew E Hirschtritt, Andrea H Kline-Simon, Kurt Kroenke, Stacy A Sterling
BACKGROUND: Hazardous alcohol use with depression may exacerbate health conditions and complicate medical care. We examined the rate of depression screening by alcohol use severity among primary care patients screened for hazardous alcohol use and, among those screened, examined patterns of significant depressive symptoms. METHODS: Using cross-sectional data from primary care patients (n = 2,894,906), we examined past-90-day alcohol use (number of typical drinking days/week and typical number of drinks consumed daily); depression screening rates (using the Patient Health Questionnaire 9 [PHQ-9]); and symptom severity, demographics, and prevalence of selected psychiatric diagnoses...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201667/evaluation-of-an-electronic-health-record-ehr-tool-for-integrated-behavioral-health-in-primary-care
#16
Katelyn K Jetelina, Tanisha Tate Woodson, Rose Gunn, Brianna Muller, Khaya D Clark, Jennifer E DeVoe, Bijal A Balasubramanian, Deborah J Cohen
BACKGROUND: Integrating behavioral health into primary care can improve care quality; however, most electronic health records are not designed to meet the needs of integrated teams. We worked with practices and behavioral health (BH) clinicians to design a suite of electronic health record tools to address these needs ("BH e-Suite"). The purpose of this article is to examine whether implementation of the BH e-Suite changes process of care, intermediate clinical outcomes, and patient experiences, and whether its use is acceptable to practice members and BH clinicians...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201666/large-scale-implementation-of-collaborative-care-management-for-depression-and-diabetes-and-or-cardiovascular-disease
#17
Arne Beck, Jennifer M Boggs, Angelika Alem, Karen J Coleman, Rebecca C Rossom, Claire Neely, Mark D Williams, Robert Ferguson, Leif I Solberg
BACKGROUND: Collaborative care models have been shown to improve mental and physical health, but their effectiveness varies. Implementation science frameworks identify measures at the structural (eg, sociocultural context, public policies), organizational, provider, innovation, and patient levels that may facilitate or impede collaborative care effectiveness. OBJECTIVE: To describe commonalities and variation in multilevel measures associated with the implementation of Care of Mental, Physical, and Substance-Use Syndromes (COMPASS), a large-scale collaborative care intervention for depression, diabetes, and cardiovascular disease...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201665/approaches-to-behavioral-health-integration-at-high-performing-primary-care-practices
#18
Paula R Blasi, DeAnn Cromp, Sarah McDonald, Clarissa Hsu, Katie Coleman, Margaret Flinter, Edward H Wagner
INTRODUCTION: Behavioral health (BH) integration has been proposed as an important strategy to help primary care practices meet the needs of their patient population, but there is little research on the ways in which practices are integrating BH services. This article describes the goals for BH integration at 30 high-performing primary care practices and strategies to operationalize these goals. METHODS: We conducted a qualitative analysis of BH integration at 30 US primary care practices that had been selected for the Learning from Effective Ambulatory Practices (LEAP) project following an interview-based assessment and rating process...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201664/-it-s-really-overwhelming-patient-perspectives-on-care-coordination
#19
Lawrence Chang, Kathryn J Wanner, Danielle Kovalsky, Kristofer L Smith, Karin V Rhodes
PURPOSE: Failures of care coordination among health care providers are known to lead to poorer health outcomes for patients with complex medical needs. However, there has been limited research into the perspectives of patients who receive care from a variety of health care providers. This qualitative study sought to characterize the factors leading to emergency department (ED) patient satisfaction and dissatisfaction with their care coordination. METHODS: Semistructured telephone interviews were conducted with 25 adult patients following ED visits about their experiences with their care coordination...
September 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/30201663/characteristics-of-young-family-physician-hospitalists
#20
Douglas B Kamerow, Peter Wingrove, Stephen Petterson, Lars Peterson, Andrew Bazemore
Based on a 2016 survey of family physicians who were then three years out of residency training, we found that almost 9 percent self-identified as hospitalists. These family physician hospitalists were significantly more likely than their non-hospitalist peers to be male, work longer hours, be better paid, and be more satisfied with their work. These attributes may attract more family physicians to hospital medicine, with negative implications for the supply of primary care physicians. (J Am Board Fam Med 2018;31:680-681...
September 2018: Journal of the American Board of Family Medicine: JABFM
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