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Journal of the American Board of Family Medicine: JABFM

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https://www.readbyqxmd.com/read/29743233/re-predicting-risk-for-opioid-misuse-in-chronic-pain-with-a-single-item-measure-of-catastrophic-thinking
#1
Ayodeji Otufowora
No abstract text is available yet for this article.
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743232/re-dysrhythmias-with-loperamide-used-for-opioid-withdrawal
#2
Sajan Nakka, Riverdale, Sparsha Reddy, Nishaki Mehta
No abstract text is available yet for this article.
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743231/improving-the-quality-of-primary-care-by-optimizing-implementation-research-reporting
#3
Gonzalo Grandes, Hilary Pinnock, Andrew Bazemore, Paul Meissner
The potential of implementation research in understanding strategies for changing practice is undermined by poor reporting, leaving readers unable to replicate such strategies and unclear whether they apply in the context of their practice. These challenges are particularly pertinent in the complex, diverse world of primary care. The recently published Standards for Reporting Implementation Studies (StaRI) provides a framework for comprehensive reporting of implementation research. A key concept is the consideration and reporting in "dual strands": on the one hand, the implementation strategy and on the other, the evidence-based intervention...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743230/proactive-strategies-to-address-health-equity-and-disparities-recommendations-from-a-bi-national-symposium
#4
Jeannie Haggerty, Marshall H Chin, Alan Katz, Kue Young, Jonathan Foley, Antoine Groulx, Eliseo J Pérez-Stable, Jeff Turnbull, Jennifer E DeVoe, Uche Uchendo
INTRODUCTION: Health inequities persist in Canada and the United States. Both countries show differential health status and health care quality by social characteristics, making zip or postal code a greater predictor of health than genetics. Many social determinants of health overlap in the same individuals or communities, exacerbating their vulnerability. Many of the contributing factors and problems are structural and evade simple solutions. METHODS: In March 2017 a binational Canada-US symposium was held in Washington DC involving 150 primary care thought leaders, including clinicians, researchers, patients, and policy makers to address transformation in integrated primary care...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743229/dissemination-and-implementation-science-in-primary-care-research-and-practice-contributions-and-opportunities
#5
Jodi Summers Holtrop, Borsika A Rabin, Russell E Glasgow
Dissemination and Implementation Science (DIS) is a growing research field that seeks to inform how evidence-based interventions can be successfully adopted, implemented, and maintained in health care delivery and community settings. In this article, an overview of DIS and how it has contributed to primary care delivery improvement, future opportunities for its use, and DIS resources for learning are described. Case examples are provided to illustrate how DIS can be used to solve the complex implementation and dissemination problems that emerge in primary care...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743228/implementation-of-the-geriatric-patient-aligned-care-team-model-in-the-veterans-health-administration-va
#6
Jennifer L Sullivan, Rina Eisenstein, Thomas Price, Samantha Solimeo, Kenneth Shay
BACKGROUND: Here, we describe the implementation of a specialty primary care medical home (PCMH) model called Geriatric Patient-Aligned Care Teams (GeriPACT) in the Veterans' Health Administration (VA) that is focused on serving older complex patients. In particular, our aims in this article are to describe how the GeriPACT model was developed and implemented in VA sites, provide a closer look at how GeriPACT functions by presenting a case study, and highlight data showing national variation in the implementation of GeriPACT staffing models and PCMH practices...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743227/using-the-quadruple-aim-framework-to-measure-impact-of-heath-technology-implementation-a-case-study-of-econsult
#7
Clare Liddy, Erin Keely
BACKGROUND: Health technology solutions are too often implemented without a true understanding of the system-level problem they seek to address, resulting in excessive costs, poor adoption, ineffectiveness, and ultimately failure. Before implementing or adopting health care innovations, stakeholders should complete a thorough assessment to ensure effectiveness and value. In this article, we describe how to evaluate the impact of a health technology innovation through the 4 dimensions of care outlined by the Quadruple Aim Framework, using our experience with the Champlain Building Access to Specialists through eConsultation (BASE) eConsult service as a case example...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743226/understanding-implementation-of-complex-interventions-in-primary-care-teams
#8
Thea Luig, Jodie Asselin, Arya M Sharma, Denise L Campbell-Scherer
BACKGROUND: The implementation of interventions to support practice change in primary care settings is complex. Pragmatic strategies, grounded in empiric data, are needed to navigate real-world challenges and unanticipated interactions with context that can impact implementation and outcomes. OBJECTIVE: This article uses the example of the "5As Team" randomized control trial to explore implementation strategies to promote knowledge transfer, capacity building, and practice integration, and their interaction within the context of an interdisciplinary primary care team...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743225/ambulatory-antibiotic-stewardship-through-a-human-factors-engineering-approach-a-systematic-review
#9
Sara C Keller, Pranita D Tamma, Sara E Cosgrove, Melissa A Miller, Heather Sateia, Julie Szymczak, Ayse P Gurses, Jeffrey A Linder
INTRODUCTION: In the United States, most antibiotics are prescribed in ambulatory settings. Human factors engineering, which explores interactions between people and the place where they work, has successfully improved quality of care. However, human factors engineering models have not been explored to frame what is known about ambulatory antibiotic stewardship (AS) interventions and barriers and facilitators to their implementation. METHODS: We conducted a systematic review and searched OVID MEDLINE, Embase, Scopus, Web of Science, and CINAHL to identify controlled interventions and qualitative studies of ambulatory AS and determine whether and how they incorporated principles from a human factors engineering model, the Systems Engineering Initiative for Patient Safety 2...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743224/implementation-of-health-insurance-support-tools-in-community-health-centers
#10
Nathalie Huguet, Brigit Hatch, Aleksandra Sumic, Carrie Tillotson, Elizabeth Hicks, Joan Nelson, Jennifer E DeVoe
BACKGROUND: Health information technology (HIT) provides new opportunities for primary care clinics to support patients with health insurance enrollment and maintenance. We present strategies, early findings, and clinic reflections on the development and implementation of HIT tools designed to streamline and improve health insurance tracking at community health centers. METHODS: We are conducting a hybrid implementation-effectiveness trial to assess novel health insurance enrollment and support tools in primary care clinics...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743223/practice-facilitator-strategies-for-addressing-electronic-health-record-data-challenges-for-quality-improvement-evidencenow
#11
Jennifer R Hemler, Jennifer D Hall, Raja A Cholan, Benjamin F Crabtree, Laura J Damschroder, Leif I Solberg, Sarah S Ono, Deborah J Cohen
PURPOSE: Practice facilitators ("facilitators") can play an important role in supporting primary care practices in performing quality improvement (QI), but they need complete and accurate clinical performance data from practices' electronic health records (EHR) to help them set improvement priorities, guide clinical change, and monitor progress. Here, we describe the strategies facilitators use to help practices perform QI when complete or accurate performance data are not available...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743222/missed-opportunities-for-depression-screening-and-treatment-in-the-united-states
#12
Elisabeth Kato, Amanda E Borsky, Samuel H Zuvekas, Anita Soni, Quyen Ngo-Metzger
PURPOSE: This study estimates the prevalence of depression assessment in adults age 35 and older and how prevalence varies by sociodemographic characteristics and depressive symptoms. METHODS: We used a nationally representative survey, the Agency for Healthcare Research and Quality's Medical Expenditure Panel Survey, to evaluate if adults 35+ were being assessed for depression by their health care providers in 2014 and 2015. Using multivariate logistic regression, we examined the health and sociodemographic characteristics of patients associated with depression assessment...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743221/measuring-and-managing-blood-pressure-in-a-primary-care-setting-a-pragmatic-implementation-study
#13
John Doane, Jenni Buu, M Jason Penrod, Michelle Bischoff, Molly B Conroy, Barry Stults
BACKGROUND: Accurate blood pressure (BP) measurement is essential to hypertension diagnosis and management. Automated office blood pressure (AOBP) and home blood pressure measurement (HBPM) may improve assessment, but barriers exist in primary care settings. METHODS: We implemented an AOBP/HBPM program in a primary care clinic in 2015 to 2016. Patients with elevated BP determined by guideline-quality observed BP measurement and/or AOBP entered the HBPM program. Patients with average home BP ≥ 135/85 mm Hg provided HBPM results for medication adjustment...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743220/a-latino-patient-centered-evidence-based-approach-to-diabetes-prevention
#14
Lisa G Rosas, Nan Lv, Megan A Lewis, Elizabeth M Venditti, Patricia Zavella, Veronica Luna, Jun Ma
INTRODUCTION: Cultural tailoring of evidence-based diabetes prevention program (DPP) interventions is needed to effectively address obesity and its related chronic diseases among Latinos in primary care. This article describes the patient-centered process used to adapt the DPP and reports cultural adaptations. METHODS: We used a 2-stage formative research process to culturally adapt an evidence-based DPP intervention in the context of primary care. The first stage involved 5 focus groups of Latino patients and interviews with 5 stakeholders (3 with primary care physicians and 2 with medical directors) to inform a first round of adaptations...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743219/clinician-experiences-with-screening-for-social-needs-in-primary-care
#15
Sebastian T Tong, Winston R Liaw, Paulette Lail Kashiri, James Pecsok, Julia Rozman, Andrew W Bazemore, Alex H Krist
BACKGROUND: Despite clear evidence demonstrating the influence of social determinants on health, whether and how clinicians should address these determinants remain unclear. We aimed to understand primary care clinicians' experiences of administering a social needs screening instrument. METHODS: Using a prospective, observational design, we identified patients living in communities with lower education and income seen by 17 clinicians from 12 practices in northern Virginia...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743218/living-in-cold-spot-communities-is-associated-with-poor-health-and-health-quality
#16
Winston Liaw, Alex H Krist, Sebastian T Tong, Roy Sabo, Camille Hochheimer, Jennifer Rankin, David Grolling, Jene Grandmont, Andrew W Bazemore
PURPOSE: Little is known about incorporating community data into clinical care. This study sought to understand the clinical associations of cold spots (census tracts with worse income, education, and composite deprivation). METHODS: Across 12 practices, we assessed the relationship between cold spots and clinical outcomes (obesity, uncontrolled diabetes, pneumonia vaccination, cancer screening-colon, cervical, and prostate-and aspirin chemoprophylaxis) for 152,962 patients...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743217/strategies-for-addressing-the-challenges-of-patient-centered-medical-home-implementation-lessons-from-oregon
#17
Sherril Gelmon, Nicole Bouranis, Billie Sandberg, Shauna Petchel
BACKGROUND: Patient-centered medical homes (PCMHs) are at the forefront of the transformation of primary care as part of health systems reform. Despite robust literature describing implementation challenges, few studies describe strategies being used to overcome these challenges. This article addresses this gap through observations of exemplary PCMHs in Oregon, where the Oregon Health Authority supports and recognizes Patient-Centered Primary Care Homes (PCPCH). METHODS: Twenty exemplary PCPCHs were selected using program scores, with considerations for diversity in clinic characteristics...
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743216/barriers-faced-by-family-medicine-graduates-interested-in-performing-obstetric-deliveries
#18
Tyler W Barreto, Aimee R Eden, Elizabeth Rose Hansen, Lars E Peterson
Fewer family physicians are providing deliveries, which raises concern for access to obstetric care. We found that among recent family medicine graduates who would like to do deliveries, difficulty finding a position that supports including deliveries was a major barrier.
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743215/family-medicine-and-obstetrics-let-s-stop-pretending
#19
Richard A Young, R Levi Sundermeyer
No abstract text is available yet for this article.
May 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29743214/advancing-primary-care-through-alternative-payment-models-lessons-from-the-united-states-canada
#20
Andrew Bazemore, Robert L Phillips, Richard Glazier, Joshua Tepper
The United States and Canada share high costs, poor health system performance, and challenges to the transformation of primary care, in part due to the limitations of their fee-for-service payment models. Rapidly advancing alternative payment models (APMs) in both countries promise better support for the essential tasks of primary care. These include interdisciplinary teams, care coordination, self-management support, and ongoing communication. This article reviews learnings from a 2017 binational symposium of 150 experts in policy and research that included a discussion of ongoing APM experiments in the United States and Canada...
May 2018: Journal of the American Board of Family Medicine: JABFM
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