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Journal of the American Board of Family Medicine: JABFM

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https://www.readbyqxmd.com/read/28484074/improving-performance-improvement
#1
Michael Hagen
No abstract text is available yet for this article.
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484073/effect-of-continuity-of-care-on-emergency-department-visits-in-elderly-patients-with-asthma-in-taiwan
#2
Yu-Hsiang Kao, Shiao-Chi Wu
BACKGROUND: Continuity of care (COC) is positively associated with health care outcomes. However, the effect of COC on the reduction of asthma-related emergency department (ED) visits among older asthmatic patients is not clearly understood. METHODS: We conducted a retrospective cohort study using the Taiwan nationwide health insurance claims database between 2004 and 2013. Patients aged 65 years with asthma during 2005 to 2011 were selected. The COC index (COCI) is used to measure the number of individual physicians a patient sees in the first year and we identified asthma-related ED visit in the subsequent year...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484072/a-primary-care-system-to-improve-health-care-efficiency-lessons-from-ecuador
#3
Sommer Aldulaimi, Francisco E Mora
Ecuador is a country with few resources to spend on health care. Historically, Ecuador has struggled to find a model for health care that is efficient, effective, and available to all people in the country, even those in underserved and rural communities. In 2000, the Ecuador Ministry of Public Health implemented a new system of health care that used primary care as its platform. Since then, Ecuador has been able to increase its health care efficiency, increasing its ranking from 111 of 211 countries worldwide in 2000, to 20 of 211 countries in 2014...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484071/the-new-genetics-in-clinical-practice-a-brief-primer
#4
Aubrey Milunsky
Major advances in human genetics have led to the identification of 4451 genes to date with disease-carrying mutations, thereby enabling precise diagnoses of all of these monogenic disorders. Limitations to the use of the "new genetics" do exist, however, including the recognition of genetic heterogeneity, many variants of unknown significance, and incidental diagnoses. This article reviews information to help use these advances to aid accurate diagnoses, identify carriers, and determine prenatal diagnoses, providing opportunities to avoid or prevent serious and fatal genetic disorders...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484070/therapeutic-dermoscopy-to-facilitate-detection-and-extraction-of-foreign-bodies
#5
Sody A Naimer
Foreign bodies are occasionally seen by family physicians. Plantar foreign bodies in particular pose a special challenge because they involve weight-bearing regions that are difficult to access. If left undetected long enough, these may lead to hospitalization, surgery, or even longstanding complications such as tumors, contractures, infections, and chronic ulcers. Dermoscopy of the cutaneous surface allows early detection of indwelling foreign bodies with a far greater degree of accuracy than with the naked eye...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484069/physician-perceptions-of-surveillance-follow-up-colonoscopy-in-older-adults
#6
Stephanie T Le, Brenna R Lash, Paul C Schroy, Audrey H Calderwood
BACKGROUND: Few data exist regarding when to stop surveillance colonoscopy among older adults with a history of adenomatous colorectal polyps. Our goal was to understand decision making around surveillance colonoscopy among primary care providers (PCPs) and gastroenterologists. METHODS: We designed a 15-item survey for PCPs and gastroenterologists that evaluated factors important in decision making about surveillance colonoscopy in older adults. RESULTS: In October 2015, 88 PCPs and 30 gastroenterologists completed the survey...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484068/delivery-of-health-coaching-by-medical-assistants-in-primary-care
#7
Zora Djuric, Michelle Segar, Carissa Orizondo, Jeffrey Mann, Maya Faison, Nithin Peddireddy, Matthew Paletta, Amy Locke
BACKGROUND: Health coaching is potentially a practical method to assist patients in achieving and maintaining healthy lifestyles. In health coaching, the coach partners with the patient, helping patients discover their own strengths, challenges, and solutions. METHODS: Two medical assistants were provided with brief training. The 12-week program consisted of telephone coaching with in-person visits at the beginning and end of the program. Coaching targeted improvements in diet, physical activity, and/or sleep habits using a self-care planning form...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484067/patient-entered-wellness-data-and-tailored-electronic-recommendations-increase-preventive-care
#8
Julie Foucher-Urcuyo, David Longworth, Michael Roizen, Bo Hu, Michael B Rothberg
PURPOSE: We investigated whether a tool using patient-entered wellness data to generate tailored electronic recommendations improved preventive care delivery. METHODS: We conducted a mixed-methods retrospective study of primary care encounters utilizing an Integrated Wellness Tool with a matched-comparison before-and-after study design. Encounters took place at a single clinic within the Cleveland Clinic Health System. The primary outcome was preventive orders placed...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484066/factors-related-to-implementation-and-reach-of-a-pragmatic-multisite-trial-the-my-own-health-report-mohr-study
#9
Bijal A Balasubramanian, Suzanne Heurtin-Roberts, Sarah Krasny, Catherine L Rohweder, Kayla Fair, Tanya T Olmos-Ochoa, Kurt C Stange, Sherri Sheinfeld Gorin
BACKGROUND: Contextual factors relevant to translating healthcare improvement interventions to different settings are rarely collected systematically. This study articulates a prospective method for assessing and describing contextual factors related to implementation and patient reach of a pragmatic trial in primary care. METHODS: In a qualitative case-series, contextual factors were assessed from the My Own Health Report (MOHR) study, focused on systematic health risk assessments and goal setting for unhealthy behaviors and behavioral health in nine primary care practices...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484065/patient-beliefs-have-a-greater-impact-than-barriers-on-medication-adherence-in-a-community-health-center
#10
Monica D Gagnon, Eve Waltermaurer, Adam Martin, Colette Friedenson, Eric Gayle, Diane L Hauser
PURPOSE: Nonadherence to medicines contributes to poor health outcomes, especially for patients with complicated medicine regimens. We examined adherence among patients at a family health center and the impact that barriers to getting medicines and negative beliefs about medicines have on adherence. METHODS: A survey was administered incorporating the 8-item Morisky Medication Adherence Scale, questions from the Beliefs about Medicine Questionnaire, and questions about patients' external barriers to getting medicines...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484064/family-physicians-report-considerable-interest-in-but-limited-use-of-telehealth-services
#11
Miranda A Moore, Megan Coffman, Anuradha Jetty, Kathleen Klink, Stephen Petterson, Andrew Bazemore
PURPOSE: Little is known about the attitudes toward and adoption of telehealth services among family physicians (FPs), the largest primary care physician group. We conducted a national survey of FPs, randomly sampled from membership organization files, to investigate use of and barriers to using telehealth services. METHODS: Using bivariate analyses, we examined how telehealth usage affected FPs' identified barriers to using telehealth services. Logistic regressions show the factors associated both with using telehealth services and with barriers to using telehealth services...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484063/clinical-diagnosis-of-bordetella-pertussis-infection-a-systematic-review
#12
Mark H Ebell, Christian Marchello, Maria Callahan
BACKGROUND: Bordetella pertussis (BP) is a common cause of prolonged cough. Our objective was to perform an updated systematic review of the clinical diagnosis of BP without restriction by patient age. METHODS: We identified prospective cohort studies of patients with cough or suspected pertussis and assessed study quality using QUADAS-2. We performed bivariate meta-analysis to calculate summary estimates of accuracy and created summary receiver operating characteristic curves to explore heterogeneity by vaccination status and age...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484062/when-primary-care-providers-pcps-help-patients-choose-prostate-cancer-treatment
#13
Archana Radhakrishnan, David Grande, Michelle Ross, Nandita Mitra, Justin Bekelman, Christian Stillson, Craig Evan Pollack
BACKGROUND: The role of primary care providers (PCPs) in decision making around cancer care remains largely unknown. We evaluated how frequently men with localized prostate cancer report receiving help from their PCP about their treatment, and whether those men who do are less likely to receive definitive treatment. METHODS: We mailed surveys to men newly diagnosed with localized prostate cancer between 2012 and 2014 in the greater Philadelphia region. Participants were asked whether their PCP helped decide how to treat their cancer...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484061/patient-knowledge-and-qualities-of-treatment-decisions-for-localized-prostate-cancer
#14
Lisa M Daum, Elyse N Reamer, Julie J Ruterbusch, Joe Liu, Margaret Holmes-Rovner, Jinping Xu
BACKGROUND: Controversy surrounds treatment for localized prostate cancer (LPC). OBJECTIVES: To assess men's localized prostate cancer (LPC) knowledge and its association with decision-making difficulty, satisfaction and regret. METHODS: Population-based sample of 201 men (104 white, 97 black), ≤ 75 years with newly diagnosed LPC completed a self-administered survey. RESULTS: Mean age was 61(±7.6) years; two-thirds had less than a Bachelor's degree...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484060/prediction-of-primary-care-depression-outcomes-at-six-months-validation-of-doc-6-%C3%A2
#15
Kurt B Angstman, Gregory M Garrison, Cesar A Gonzalez, Daniel W Cozine, Elizabeth W Cozine, David J Katzelnick
BACKGROUND: The goal of this study was to develop and validate an assessment tool for adult primary care patients diagnosed with depression to determine predictive probability of clinical outcomes at 6 months. METHODS: We retrospectively reviewed 3096 adult patients enrolled in collaborative care management (CCM) for depression. Patients enrolled on or before December 31, 2013, served as the training set (n = 2525), whereas those enrolled after that date served as the preliminary validation set (n = 571)...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484059/funding-instability-reduces-the-impact-of-the-federal-teaching-health-center-graduate-medical-education-program
#16
Troy Kurz, Winston Liaw, Peter Wingrove, Stephen Petterson, Andrew Bazemore
The Teaching Health Center Graduate Medical Education (THCGME) program is a decentralized residency training component of the Affordable Care Act, created to combat critical shortages and maldistribution of primary care physicians. The Accreditation Council of Graduate Medical Education and federal data reveal that the THCGME program accounted for 33% of the net increase in family medicine residency positions between 2011 and 2015. However, amid concerns about the program's stability, the contribution of the THCGME program to the net increase fell to 7% after 2015...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484058/uncertainty-in-teaching-health-center-thc-funding-still-crazy-after-all-these-years
#17
Joseph W Gravel
No abstract text is available yet for this article.
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484057/content-usage-and-the-most-frequently-read-articles-of-2016
#18
EDITORIAL
Phil Lupo, Anne Victoria Neale, Marjorie A Bowman
No abstract text is available yet for this article.
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28484056/research-on-clinical-decisions-made-daily-in-family-medicine
#19
EDITORIAL
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue presents research on the types of decisions that are required daily in family medicine. Patients often make these health decisions, and family physicians help patients with these decisions daily. Patients and their family physicians discuss when to quit screening for colon cancer, which treatment to choose for localized prostate cancer, when to test for pertussis when a cough is present, whether to take prescribed medications, how to complete more preventive services, and how to understand the "new genetics", and family physician use of telehealth...
May 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28379836/re-presenting-signs-of-multiple-myeloma-and-the-effect-of-diagnostic-delay-on-the-prognosis
#20
LETTER
Gurmukh Singh
No abstract text is available yet for this article.
March 2017: Journal of the American Board of Family Medicine: JABFM
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