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Nurse practitioner as primary care provider

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https://www.readbyqxmd.com/read/28629510/screening-strategies-for-atrial-fibrillation-a-systematic-review-and-cost-effectiveness-analysis
#1
Nicky J Welton, Alexandra McAleenan, Howard Hz Thom, Philippa Davies, Will Hollingworth, Julian Pt Higgins, George Okoli, Jonathan Ac Sterne, Gene Feder, Diane Eaton, Aroon Hingorani, Christopher Fawsitt, Trudie Lobban, Peter Bryden, Alison Richards, Reecha Sofat
BACKGROUND: Atrial fibrillation (AF) is a common cardiac arrhythmia that increases the risk of thromboembolic events. Anticoagulation therapy to prevent AF-related stroke has been shown to be cost-effective. A national screening programme for AF may prevent AF-related events, but would involve a substantial investment of NHS resources. OBJECTIVES: To conduct a systematic review of the diagnostic test accuracy (DTA) of screening tests for AF, update a systematic review of comparative studies evaluating screening strategies for AF, develop an economic model to compare the cost-effectiveness of different screening strategies and review observational studies of AF screening to provide inputs to the model...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28627110/patient-preferences-for-healthcare-delivery-through-community-pharmacy-settings-in-the-usa-a-discrete-choice-study
#2
M Feehan, M Walsh, J Godin, D Sundwall, M A Munger
WHAT IS KNOWN AND OBJECTIVE: In order to improve public health, it is necessary to facilitate patients' easy access to affordable high-quality primary health care, and one enhanced approach to do so may be to provide primary healthcare services in the community pharmacy setting. Discrete choice experiments to evaluate patient demand for services in pharmacy are relatively limited and have been hampered by a focus on only a few service alternatives, most focusing on changes in more traditional pharmacy services...
June 18, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28617196/factors-associated-with-having-a-physician-nurse-practitioner-or-physician-assistant-as-primary-care-provider-for-veterans-with-diabetes-mellitus
#3
Perri Morgan, Christine M Everett, Valerie A Smith, Sandra Woolson, David Edelman, Cristina C Hendrix, Theodore S Z Berkowitz, Brandolyn White, George L Jackson
Expanded use of nurse practitioners (NPs) and physician assistants (PAs) is a potential solution to workforce issues, but little is known about how NPs and PAs can best be used. Our study examines whether medical and social complexity of patients is associated with whether their primary care provider (PCP) type is a physician, NP, or PA. In this national retrospective cohort study, we use 2012-2013 national Veterans Administration (VA) electronic health record data from 374 223 veterans to examine whether PCP type is associated with patient, clinic, and state-level factors representing medical and social complexity, adjusting for all variables simultaneously using a generalized logit model...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28614974/electronic-consultation-system-demonstrates-educational-benefit-for-primary-care-providers
#4
Jonas Kwok, J Nwando Olayiwola, Margae Knox, Elizabeth J Murphy, Delphine S Tuot
Background Electronic consultation systems allow primary care providers to receive timely speciality expertise via iterative electronic communication. The use of such systems is expanding across the USA with well-documented high levels of user satisfaction. We characterise the educational impact for primary care providers of a long-standing integrated electronic consultation and referral system. Methods Primary care providers' perceptions of the educational value inherent to electronic consultation system communication and the impact on their ability to manage common speciality clinical conditions and questions were examined by electronic survey using five-point Likert scales...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28607235/meeting-the-current-and-future-health-care-needs-of-sri-lanka-s-ageing-population
#5
Dilhar Samaraweera, Shiromi Maduwage
Sri Lanka is one of the fastest-ageing countries in the world. This rapid demographic transition is expected to result in one quarter of the population being elderly by the year 2041. Profound challenges face the country as a result, especially with respect to planning adequate elderly-oriented services in the social-care and health-care sectors. In response to this need, many initiatives have been put in place to promote and protect the welfare of older people, and these rights have been inscribed in law. Within the health sector, despite the wealth of policies and initiatives in recent years, it is clear that the existing health infrastructure and systems still require strengthening, reorientation and coordination, to meet the needs of the growing population of elderly individuals...
September 2016: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28606909/-treated-as-a-number-not-treated-as-a-person-a-qualitative-exploration-of-the-perceived-barriers-to-effective-pain-management-of-patients-with-chronic-pain
#6
Muhammad Abdul Hadi, David Phillip Alldred, Michelle Briggs, Kathryn Marczewski, S José Closs
OBJECTIVES: To identify barriers to effective pain management encountered by patients with chronic pain within the UK's National Health Service (NHS). DESIGN: Secondary analysis of face-to-face, semistructured qualitative interviews using thematic analysis. SETTING: A community-based chronic pain clinic jointly managed by a nurse and pharmacist located in the North of England. PARTICIPANTS: Nineteen adult (>18 years) patients with chronic pain discharged from a pain clinic, with the ability to understand and speak the English language...
June 12, 2017: BMJ Open
https://www.readbyqxmd.com/read/28602803/patient-preference-in-primary-care-provider-type
#7
Brandi Leach, Margaret Gradison, Perri Morgan, Christine Everett, Michael J Dill, Justine Strand de Oliveira
BACKGROUND: Given the growing roles of nurse practitioners (NPs) and physician assistants (PAs), patients are increasingly able to choose their primary care provider type. Studies examining patient preferences among provider types are limited and ours is the first to examine reasons for patients' provider type preferences. METHODS: Using data from the 2014 Association of American Medical Colleges' (AAMC) Consumer Survey of Health Care Access, we used qualitative analysis to identify themes in open text responses of reasons for respondents' provider type preference (N = 4220)...
June 8, 2017: Healthcare
https://www.readbyqxmd.com/read/28577459/nurse-practitioners-as-primary-care-providers-with-their-own-patient-panels-and-organizational-structures-a-cross-sectional-study
#8
Lusine Poghosyan, Jianfang Liu, Allison A Norful
BACKGROUND: Health care systems globally are facing challenges of meeting the growing demand for primary care services due to a shortage of primary care physicians. Policy makers and administrators are searching for solutions to increase the primary care capacity. The effective utilization of nurse practitioners (NPs) has been proposed as a solution. However, organizations utilize NPs in variable capacities. In some settings, NPs serve as primary care providers delivering ongoing continuous care to their patients, referred to as patient panels, whereas in other settings they deliver episodic care...
May 25, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28576661/knowledge-and-practice-related-to-gestational-diabetes-among-primary-health-care-providers-in-morocco-potential-for-a-defragmentation-of-care
#9
Bettina Utz, Bouchra Assarag, Amina Essolbi, Amina Barkat, Alexandre Delamou, Vincent De Brouwere
INTRODUCTION: The objective of this study was to assess knowledge and practices of general practitioners, nurses and midwives working at primary health care facilities in Morocco regarding screening and management of gestational diabetes (GDM). METHODS: Structured interviews with 100 doctors, midwives and nurses at 44 randomly selected public health care centers were conducted in Marrakech and Al Haouz. All data were descriptively analyzed. Ethical approval for the study was granted by the institutional review boards in Belgium and Morocco...
May 30, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28545538/providing-online-weight-management-in-primary-care-a-mixed-methods-process-evaluation-of-healthcare-practitioners-experiences-of-using-and-supporting-patients-using-power
#10
Emily Smith, Katherine Bradbury, Lisa Scott, Mary Steele, Paul Little, Lucy Yardley
BACKGROUND: An online weight management intervention (POWeR+) combined with a small amount of primary care healthcare practitioner support is effective in helping patients to lose weight, but little is known about how practitioners interact with the POWeR+ intervention or their experiences of providing support for patients using POWeR+. The aim of this study was to explore practitioners' usage of POWeR+ and their experiences of providing support to patients using POWeR+. METHODS: Set within a randomised controlled trial of POWeR+, practitioners' usage of POWeR+ was automatically captured and a qualitative process analysis was conducted employing semi-structured telephone interviews with practitioners who provided support to patients using POWeR+...
May 25, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28544584/examining-differences-in-characteristics-between-patients-receiving-primary-care-from-nurse-practitioners-or-physicians-using-medicare-current-beneficiary-survey-data-and-medicare-claims-data
#11
Figaro L Loresto, Daniel Jupiter, Yong-Fang Kuo
BACKGROUND: Few studies have examined differences in functional, cognitive, and psychological factors between patients utilizing only nurse practitioners (NPs) and those utilizing only primary care medical doctors (PCMDs) for primary care. PURPOSE: Patients utilizing NP-only or PCMD-only models for primary care will be characterized and compared in terms of functional, cognitive, and psychological factors. METHODOLOGY: Cohorts were obtained from the Medicare Current Beneficiary Survey linked to Medicare claims data...
June 2017: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/28537777/palliative-care-office-hours-for-patients-with-hematologic-malignancies-an-innovative-model-for-symptom-management-and-education
#12
Anessa M Foxwell, Mary E Moyer, David J Casarett, Nina R O'Connor
BACKGROUND: Palliative care programs are experiencing rapid growth, with demand for consults surpassing staffing. Innovative models are needed to equip nonpalliative care providers to manage basic palliative care issues. OBJECTIVES: To develop a novel program of palliative care office hours for hematologic oncology advanced practice providers, and to evaluate its impact on palliative care consult volume and composition. METHODS: A palliative care nurse practitioner or pharmacist was available for weekday office hours to all inpatient hematologic oncology advanced practice providers at an academic medical center to offer advice on pain, nonpain symptoms, and psychosocial distress...
May 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28505559/a-two-phased-study-on-health-care-professionals-perceptions-of-single-or-multi-use-of-intermittent-catheters
#13
D McClurg, J Coyle, A Long, K Moore, A Cottenden, C May, M Fader
AIMS: This two phase study aimed to explore health care professionals' teaching and prescribing practice related to intermittent catheterisation and to identify their perceptions about the possible implementation of a mixed (single and multi-use) package for intermittent catheterization. INTRODUCTION: Single-use intermittent catheters are the norm in the UK although multi-use is common in some other countries. A recent Cochrane review found no difference in complications, including urinary tract infection rates, between those using single or multi-use catheters...
May 4, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28500631/exploring-the-value-of-mental-health-nurses-working-in-primary-care-in-england-a-qualitative-study
#14
Kristina McLeod, Alan Simpson
BACKGROUND: General practice is typically the first point of access to healthcare. However, emerging models of providing mental health services in primary care are poorly understood. AIMS: To explore what value a Primary Care Liaison Nurse (PCLN) service, established in 2011, can bring to people with mental health problems in primary care. PARTICIPANTS: Ten interviews with seven general practitioners and three senior practitioners working in primary care mental health services...
May 13, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/28490411/is-the-counterweight-program-a-feasible-and-acceptable-option-for-structured-weight-management-delivered-by-practice-nurses-in-australia-a-mixed-methods-study
#15
Jodi Gray, Elizabeth A Hoon, Hossein Haji Ali Afzali, Catherine Spooner, Mark F Harris, Jonathan Karnon
Nurse-led weight management programs, like the Counterweight Program in the United Kingdom, may offer a way for Australian general practices to provide weight management support to adults who are overweight or obese. During Counterweight, nurses provide patients with six fortnightly education sessions and three follow-up sessions to support weight maintenance. This study examined the feasibility, acceptability and perceived value of the Counterweight Program in the Australian primary care setting using a mixed-methods approach...
May 11, 2017: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/28483889/bridging-the-gaps-between-patients-and-primary-care-in-china-a-nationwide-representative-survey
#16
William C W Wong, Sunfang Jiang, Jason J Ong, Minghui Peng, Eric Wan, Shanzhu Zhu, Cindy L K Lam, Michael R Kidd, Martin Roland
PURPOSE: China introduced a national policy of developing primary care in 2009, establishing 8,669 community health centers (CHCs) by 2014 that employed more than 300,000 staff. These facilities have been underused, however, because of public mistrust of physicians and overreliance on specialist care. METHODS: We selected a stratified random sample of CHCs throughout China based on geographic distribution and urban-suburban ratios between September and December 2015...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28483137/expanded-roles-of-registered-nurses-in-primary-care-delivery-of-the-future
#17
Laurie Bauer, Thomas Bodenheimer
BACKGROUND: Primary care in the United States is changing: practice size is increasing, there is a growing shortage of primary care practitioners, and there is a heightened prevalence of chronic disease. Given these trends, it is likely that registered nurses will become important members of the primary care team. PURPOSE: This paper explores the challenges and opportunities in primary care delivery in the 21st century and examines the likelihood of expanded roles for RNs to improve quality and add capacity to the primary care workforce...
April 7, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28468642/the-ciprus-study-a-nurse-led-psychological-treatment-for-patients-with-undifferentiated-somatoform-disorder-in-primary-care-study-protocol-for-a-randomised-controlled-trial
#18
Kate Sitnikova, Stephanie S Leone, Lyonne N L Zonneveld, Harm W J van Marwijk, Judith E Bosmans, Johannes C van der Wouden, Henriëtte E van der Horst
BACKGROUND: Up to a third of patients presenting medically unexplained physical symptoms in primary care may have a somatoform disorder, of which undifferentiated somatoform disorder (USD) is the most common type. Psychological interventions can reduce symptoms associated with USD and improve functioning. Previous research has either been conducted in secondary care or interventions have been provided by general practitioners (GPs) or psychologists in primary care. As efficiency and cost-effectiveness are imperative in primary care, it is important to investigate whether nurse-led interventions are effective as well...
May 3, 2017: Trials
https://www.readbyqxmd.com/read/28456614/healthcare-provider-perceptions-of-accessible-exam-tables-in-primary-care-implementation-and-benefits-to-patients-with-and-without-disabilities
#19
Allysha C Maragh-Bass, Joan M Griffin, Sean Phelan, Lila J Finney Rutten, Megan A Morris
BACKGROUND: Recent healthcare mandates require availability of accessible medical exam equipment, which may reduce barriers to care for patients with disabilities (PWD). However, more research is needed to explore healthcare provider views on implementation and routine use of accessible equipment. OBJECTIVE: This study qualitatively explored healthcare provider perceptions of: (1) daily use of accessible medical examination tables with PWD; and (2) recommendations for addressing challenges to using this equipment...
April 12, 2017: Disability and Health Journal
https://www.readbyqxmd.com/read/28448226/the-role-of-social-support-for-patients-with-mental-disorders-in-primary-care-in-brazil
#20
Jacqueline de Souza, Raisa Chaves Magalhães, Denise M Saint Arnault, Jaqueline Lemos de Oliveira, Sara Pinto Barbosa, Francine Baltazar Assad, Toyoko Saeki, Luciane Sá de Andrade
The aim of this article was to identify the health care providers and other agencies in a given region where psychiatric patients included in the study reside. In addition, we evaluated how these patients perceive social support for specific needs related to mental health. This study was carried out using fieldwork and face-to-face semistructured interviews with 25 patients who were receiving psychiatric treatment through primary health care. We performed structural analysis of the data focusing on relationship structure...
May 2017: Issues in Mental Health Nursing
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