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Journal of Primary Care & Community Health

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https://www.readbyqxmd.com/read/30226091/paraneoplastic-phenomena-in-a-patient-with-locally-destructive-and-metastatic-renal-cell-carcinoma
#1
Allen L Pimienta, Thomas A Billings, Robert G Fish
Renal cell carcinoma (RCC) accounts for approximately 80% of all primary renal neoplasms in United States causing approximately 65 000 new cases of RCC and 14 000 deaths each year. Symptoms of RCC typically include weight loss and night sweats but may also feature paraneoplastic phenomena in advanced stages as well as flank pain, gross hematuria, scrotal varicocele, inferior vena cava pathology, and a palpable abdominal mass. In this article, we present the course of a patient with advanced RCC, from initial presentation through workup and to eventual diagnosis...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/30168355/pulmonary-embolism-while-on-aspirin-for-venous-thromboembolism-prophylaxis-after-total-knee-arthroplasty
#2
Francisco Roman, Jay-Sheree Allen, Heather Catherine Wurm, Kathy MacLaughlin
A 62-year-old Caucasian man with past medical history significant for coronary artery disease, status post drug eluting stent to the left anterior descending artery 10 years prior, was admitted for elective total right knee arthroplasty. His intraoperative course was uneventful, and he was discharged on hospital day 2 on aspirin 325 mg twice daily for 6 weeks for venous thromboembolism (VTE) prophylaxis. Three weeks later the patient developed chest pain shortly after an approximately 1-hour flight and presented to a local emergency department where computed tomography angiogram showed pulmonary emboli involving segmental and subsegmental pulmonary arteries bilaterally...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/30129388/family-physicians-attaching-new-patients-from-centralized-waiting-lists-a-cross-sectional-study
#3
Mylaine Breton, Mélanie Ann Smithman, Nassera Touati, Antoine Boivin, Christine Loignon, Carl-Ardy Dubois, Kareen Nour, Catherine Lamoureux-Lamarche, Astrid Brousselle
PURPOSE: In response to more than 15% of Canadians not having a family physician, 7 provinces have implemented centralized waiting lists for unattached patients. The aim of this study is to analyze the association between family physicians' characteristics and their participation in centralized waiting lists. METHODS: Cross-sectional observational study using administrative data in 5 local health networks in Quebec, between 2013 and 2015. All physicians who had attached at least 1 patient were included (n = 580)...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/30084705/determinants-of-successful-weight-loss-in-low-income-african-american-women-a-positive-deviance-analysis
#4
Elaine Seaton Banerjee, Sharon J Herring, Katelyn Hurley, Katherine Puskarz, Kyle Yebernetsky, Marianna LaNoue
OBJECTIVE: We set out to investigate the behaviors of low-income African American women who successfully lost weight. METHODS: From an urban, academic, family medicine practice, we used a mixed methods positive deviance approach to evaluate 35 low-income African American women who were obese and lost at least 10% of their maximum weight, and maintained this loss for 6 months, comparing them with 36 demographically similar control participants who had not lost weight...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/30079790/introducing-primary-care-telephone-visits-an-urban-safety-net-community-clinic-experience
#5
Kelly Kyanko, Kathleen Hanley, Sondra Zabar, Jennifer Joseph, William Bateman, Antoinette Schoenthaler
BACKGROUND: Telephone consultation is widely used in primary care and can provide an effective and efficient alternative for the in-person visit. Gouverneur Health, a safety-net primary care practice in New York City serving a predominately immigrant population, evaluated the feasibility and physician and patient acceptability of a telephone visit initiative in 2015. MEASURES: Patient and physician surveys, and physician focus groups. RESULTS: Though only 85 of 270 scheduled telephone visits (31%) were completed, 84% of patients reported being highly satisfied with their telephone visit...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29785866/impact-of-personality-disorder-cluster-on-depression-outcomes-within-collaborative-care-management-model-of-care
#6
Merit P George, Gregory M Garrison, Zachary Merten, Dagoberto Heredia, Cesar Gonzales, Kurt B Angstman
BACKGROUND: Previous studies have suggested that having a comorbid personality disorder (PD) along with major depression is associated with poorer depression outcomes relative to those without comorbid PD. However, few studies have examined the influence of specific PD cluster types. The purpose of the current study is to compare depression outcomes between cluster A, cluster B, and cluster C PD patients treated within a collaborative care management (CCM), relative to CCM patients without a PD diagnosis...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29756524/chest-pain-atherosclerotic-cardiovascular-disease-risk-and-cardiology-referral-in-primary-care
#7
Vishaal Buch, Hayley Ralph, Joanne Salas, Paul J Hauptman, Dawn Davis, Jeffrey F Scherrer
BACKGROUND: The atherosclerotic cardiovascular disease (ASCVD) 10-year risk estimate is recommended by cardiologists for determining risk of a cardiac event. However, the majority of patients presenting to primary care with chest pain have noncardiac etiologies. Therefore, we determined if high versus low ASCVD risk was associated with primary care physicians' referral to cardiology in patients with and without chest pain. METHODS: Deidentified electronic health record (EHR) data was obtained from 5795 patients treated in academic primary care clinics from 2008 to 2015...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29756523/the-effect-of-health-education-by-pharmacists-on-10-year-atherosclerotic-cardiovascular-disease-risk-a-cluster-randomized-control-study-in-a-low-socioeconomic-status-javanese-population
#8
Rita Suhadi, Dita Maria Virginia, Christianus Heru Setiawan
BACKGROUND: Evidence from previous studies demonstrates that lifestyle modification reduces the incidence and complications of atherosclerotic cardiovascular disease. The study aimed to investigate the effect of a lifestyle intervention provided by pharmacists on the 10-year atherosclerotic cardiovascular disease (ASCVD) risk and quality of life (QoL) in a low socioeconomic status Javanese population. METHODS: This research was a cluster-randomized controlled study of 1-year duration, conducted in a lower social economic community in the Sleman District of Yogyakarta, Indonesia...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29739287/collaborative-care-management-associated-with-improved-depression-outcomes-in-patients-with-personality-disorders-compared-to-usual-primary-care
#9
Jeremy J Solberg, Mark E Deyo-Svendsen, Kelsey R Nylander, Elliot J Bruhl, Dagoberto Heredia, Kurt B Angstman
BACKGROUND: The use of a collaborative care management (CCM) model can dramatically improve short- and long-term treatment outcomes for patients with major depressive disorder (MDD). Patients with comorbid personality disorder (PD) may experience poorer treatment outcomes for MDD. Our study seeks to examine the differences in MDD treatment outcomes for patients with comorbid PD when using a CCM approach rather than usual care (UC). METHODS: In our retrospective cohort study, we reviewed the records of 9614 adult patients enrolled in our depression registry with the clinical diagnosis MDD and the diagnosis of PD (Yes/No)...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29468934/impact-of-a-pharmacist-provided-spirometry-service-on-access-to-results-in-a-primary-care-setting
#10
Lisa A Mueller, Alexa Sevin Valentino, Aaron D Clark, Junan Li
OBJECTIVES: The primary objective of this study was to determine the effect of a pharmacist-provided spirometry service within a federally qualified health center on the percentage of spirometry referrals completed with results reviewed by the ordering provider. Secondary objectives evaluated differences between internal and external referrals, medication recommendations made by the pharmacist, and revenue brought in by the service. METHODS: Chart reviews were completed to determine the referral completion rates between patients who received a spirometry referral before (December 2014-September 2015) and after (January 2016-October 2016) the implementation of the pharmacy-provided spirometry service...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29357748/nursing-practice-in-primary-care-and-patients-experience-of-care
#11
Roxane Borgès Da Silva, Isabelle Brault, Raynald Pineault, Maud-Christine Chouinard, Alexandre Prud'homme, Danielle D'Amour
PURPOSE: Nurses are identified as a key provider in the management of patients in primary care. The objective of this study was to evaluate patients' experience of care in primary care as it pertained to the nursing role. The aim was to test the hypothesis that, in primary health care organizations (PHCOs) where patients are systematically followed by a nurse, and where nursing competencies are therefore optimally used, patients' experience of care is better. METHOD: Based on a cross-sectional analysis combining organizational and experience of care surveys, we built 2 groups of PHCOs...
January 2018: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29216790/dual-therapy-appears-superior-to-monotherapy-for-low-income-individuals-with-newly-diagnosed-type-2-diabetes
#12
Elizabeth M Vaughan, Craig A Johnston, David J Hyman, Daphne C Hernandez, Vagish Hemmige, John P Foreyt
BACKGROUND: There are variable recommendations regarding initiating monotherapy or dual therapy in patients with newly diagnosed type 2 diabetes (T2D). Clear initial strategies are of particular importance in underserved settings where access to care and financial burdens are significant barriers. OBJECTIVES: To provide descriptive data of metabolic outcomes to therapy regimens for low-income individuals with newly diagnosed T2D placed on oral hypoglycemic agents (OAs)...
October 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29161972/impacts-of-initial-transformation-to-a-patient-centered-medical-home-on-diabetes-outcomes-in-federally-qualified-health-centers-in-florida
#13
Heidi S Kinsell, Allyson G Hall, Jeffrey S Harman, Sweta Tewary, Andrew Brickman
OBJECTIVE: Federally qualified health centers (FQHCs) in Florida see large numbers of vulnerable patients with diabetes. Patient-centered medical home (PCMH) models can lead to improvements in health for patients with chronic conditions and cost savings for providers. Therefore, FQHCs are increasingly moving to PCMH models of care. The study objective was to examine the effects of initial transformation to a level 3 National Committee for Quality Assurance (NCQA) certified PCMH in 2011, on clinical diabetes outcomes among 27 clinic sites from a network of FQHCs in Florida...
October 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29161946/the-uptake-of-human-papillomavirus-vaccination-and-its-associated-factors-among-adolescents-a-systematic-review
#14
REVIEW
Alice Yuen Loke, Miu Ling Kwan, Yuen-Ting Wong, Alice Kar Yan Wong
BACKGROUND: The purpose of this review was to explore the uptake of the human papillomavirus (HPV) vaccination, its associated factors, and the facilitators of and barriers to HPV vaccination among adolescents. METHODS: A comprehensive literature search was conducted through 5 electronic databases, including PubMed, CINAHL, Cochrane Library, Medline, and PsycInfo from January 2006 to March 2015 for studies examining the uptake, awareness, knowledge, acceptability, and intention of adolescents with regard to HPV vaccination...
October 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29144194/an-integrative-behavioral-health-care-model-using-automated-sbirt-and-care-coordination-in-community-health-care
#15
Ronald Dwinnells, Lauren Misik
Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99...
October 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29082793/the-effectiveness-of-medicare-wellness-visits-in-accessing-preventive-screening
#16
Fabian Camacho, Nengliang Aaron Yao, Roger Anderson
INTRODUCTION: Under the American Affordable Care Act, Medicare insurance beneficiaries receive free Annual Wellness Visits (AWV); there is a need to examine the effectiveness of these visits. The purpose of this study is to examine their impact on subsequent screening rates. METHODS: Using 2011-2014 Medicare FFS (fee-for-service) claims data, seven preventive care services, including vaccinations and cancer screenings were compared among beneficiaries who received and did not receive AWVs...
October 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29047322/trends-in-primary-care-provision-to-medicare-beneficiaries-by-physicians-nurse-practitioners-or-physician-assistants-2008-2014
#17
Ying Xue, James S Goodwin, Deepak Adhikari, Mukaila A Raji, Yong-Fang Kuo
OBJECTIVES: To document the temporal trends in alternative primary care models in which physicians, nurse practitioners (NPs), or physician assistants (PAs) engaged in care provision to the elderly, and examine the role of these models in serving elders with multiple chronic conditions and those residing in rural and health professional shortage areas (HPSAs). DESIGN: Serial cross-sectional analysis of Medicare claims data for years 2008, 2011, and 2014. SETTING: Primary care outpatient setting...
October 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29034793/patient-s-utilization-of-primary-care-a-profile-of-clinical-and-administrative-reasons-for-visits-in-israel
#18
Tamar Adar, Inbar Levkovich, Orit Cohen Castel, Khaled Karkabi
BACKGROUND: Data on patients' utilization of health services in primary care is relevant to planning healthcare. Data may be collected by numerous methods, but obtaining a true picture of content of care has practical difficulties. OBJECTIVES: To describe patient's reasons for visits to primary care physicians (PCPs) as presented by the patient; and to examine the effect of patient-, doctor- and clinic-related variables on the reasons for the visit. METHODS: Visits to PCPs were observed by peer doctors during 2014, at primary care clinics in Israel...
October 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28929860/adolescent-perspectives-on-patient-provider-sexual-health-communication-a-qualitative-study
#19
Andrea J Hoopes, Samantha K Benson, Heather B Howard, Diane M Morrison, Linda K Ko, Taraneh Shafii
BACKGROUND: Adolescents in the United States are disproportionately affected by sexually transmitted infections and unintended pregnancy. Adolescent-centered health services may reduce barriers to health care; yet, limited research has focused on adolescents' own perspectives on patient-provider communication during a sexual health visit. METHODS: Twenty-four adolescents (14-19 years old) seeking care in a public health clinic in Washington State participated in one-on-one qualitative interviews...
October 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28911251/patient-enablement-after-a-single-appointment-with-a-gp-analysis-of-finnish-qualicopc-data
#20
Elina Tolvanen, Tuomas H Koskela, Mika Helminen, Elise Kosunen
BACKGROUND: Patient enablement is described as patient's ability to understand and cope with illness after a consultation. The purpose of this study was to analyze factors associated with enablement in Finnish primary health care. An additional aim was to evaluate whether a single question could be used to measure enablement. METHODS: A questionnaire survey was addressed to Finnish general practitioners (GPs) within the Quality and Costs of Primary Care in Europe (QUALICOPC) study framework...
October 2017: Journal of Primary Care & Community Health
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