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https://www.readbyqxmd.com/read/29332263/creating-a-primary-care-workforce-strategies-for-leaders-clinicians-and-nurses
#1
Patricia Robinson, Julie Oyemaja, Bridget Beachy, Jeff Goodie, Lisa Sprague, Jennifer Bell, Mike Maples, Christy Ward
Many primary care clinics struggle with rapid implementation and systematic expansion of primary care behavioral health (PCBH) services. Often, an uneven course of program development is due to lack of attention to preparing clinic leadership, addressing operational factors, and training primary care providers (PCPs) and nurses. This article offers competency tools for clinic leaders, PCPs, and nurses to use in assessing their status and setting change targets. These tools were developed by researchers working to disseminate evidence-based interventions in primary care clinics that included fully integrated behavioral health consultants and were then used by early adaptors of the PCBH model...
January 13, 2018: Journal of Clinical Psychology in Medical Settings
https://www.readbyqxmd.com/read/29332213/survivorship-care-plan-outcomes-for-primary-care-physicians-cancer-survivors-and-systems-a-scoping-review
#2
REVIEW
Weston LaGrandeur, Julie Armin, Carol L Howe, Leila Ali-Akbarian
PURPOSE: With the focus on survivorship care-coordination between oncology and primary care providers (PCPs), there is a need to assess the research regarding the use of survivorship care plans (SCPs) and determine emerging research areas. We sought to find out how primary care physicians have been involved in the use of SCPs and determine SCP's effectiveness in improving care for cancer survivors. In this scoping review, we aimed to identify gaps in the current research and reveal opportunities for further research...
January 13, 2018: Journal of Cancer Survivorship: Research and Practice
https://www.readbyqxmd.com/read/29331971/a-study-protocol-for-a-non-randomised-comparison-trial-evaluating-the-feasibility-and-effectiveness-of-a-mobile-cognitive-behavioural-programme-with-integrated-coaching-for-anxious-adults-in-primary-care
#3
Eva Szigethy, Francis Solano, Meredith Wallace, Dina L Perry, Lauren Morrell, Kathryn Scott, Megan Jones Bell, Megan Oser
INTRODUCTION: Generalised anxiety disorder (GAD) and subclinical GAD are highly prevalent in primary care. Unmanaged anxiety worsens quality of life in patients seen in primary care practices and leads to increased medical utilisation and costs. Programmes that teach patients cognitive-behavioural therapy (CBT) techniques have been shown to improve anxiety and to prevent the evolution of anxiety symptoms to disorders, but access and engagement have hampered integration of CBT into medical settings...
January 13, 2018: BMJ Open
https://www.readbyqxmd.com/read/29331655/what-makes-it-so-difficult-for-nurses-to-coach-patients-in-shared-decision-making-a-process-evaluation
#4
Stephanie Anna Lenzen, Ramon Daniëls, Marloes Amantia van Bokhoven, Trudy van der Weijden, Anna Beurskens
BACKGROUND: Primary care nurses play a crucial role in coaching patients in shared decision making about goals and actions. This presents a challenge to practice nurses, who are frequently used to protocol-based working routines. Therefore, an approach was developed to support nurses to coach patients in shared decision making. OBJECTIVES: To investigate how the approach was implemented and experienced by practice nurses and patients. DESIGN: A process evaluation was conducted using quantitative and qualitative methods...
December 16, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29331504/a-systematic-review-of-health-care-provider-perceived-barriers-and-facilitators-to-routine-hiv-testing-in-primary-care-settings-in-the-southeastern-united-states
#5
Kelly Tan, Beth Perry Black
Despite efforts to improve HIV screening and testing, many primary care settings do not follow established guidelines. The purpose of our systematic review was to describe health care providers' perceived barriers and facilitators to testing for HIV at poorly used/novel testing sites in the southeastern United States. PubMed, CINAHL, and Embase databases were searched for peer-reviewed studies of providers' perceived barriers and facilitators to routine HIV testing from January 2016 to April 2017 according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement...
December 27, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/29331474/clinical-databases-for-chest-physicians
#6
REVIEW
Andrew M Courtwright, Peter E Gabriel
A clinical database is a repository of patient medical and sociodemographic information focused on one or more specific health condition or exposure. Although clinical databases may be used for research purposes, their primary goal is to collect and track patient data for quality improvement, quality assurance, and/or actual clinical management. This article aims to provide an introduction and practical advice on the development of small-scale clinical databases for Chest physicians and practice groups. Through example projects we discuss the pros and cons of available technical platforms, including Microsoft Excel and Access, relational database management systems such as Oracle and PostgreSQL, and REDCap...
January 10, 2018: Chest
https://www.readbyqxmd.com/read/29331282/development-testing-and-implementation-of-a-training-curriculum-for-nonphysician-health-workers-to-reduce-cardiovascular-disease
#7
Maheer Khan, Pablo Lamelas, Hadi Musa, Jared Paty, Tara McCready, Robby Nieuwlaat, Eleonor Ng, Patricio Lopez-Jaramillo, Jose Lopez-Lopez, Khalid Yusoff, Fadhlina A Majid, Kien Keat Ng, Len Garis, Oyere Onuma, Salim Yusuf, Jon-David Schwalm
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide. The need to address CVD is greatest in low- and middle-income countries where there is a shortage of trained health workers in CVD detection, prevention, and control. OBJECTIVES: Based on the growing evidence that many elements of chronic disease management can be shifted to nonphysician health care workers (NPHW), the HOPE-4 (Heart Outcomes Prevention and Evaluation Program) aimed to develop, test, and implement a training curriculum on CVD prevention and control in Colombia, Malaysia, and low-resource settings in Canada...
January 10, 2018: Global Heart
https://www.readbyqxmd.com/read/29331046/prevalence-severity-and-risk-factors-for-acute-exacerbations-of-nasal-and-sinus-symptoms-by-chronic-rhinosinusitis-status
#8
Jordan R Kuiper, Annemarie G Hirsch, Karen Bandeen-Roche, Agnes S Sundaresan, Bruce K Tan, Robert P Schleimer, Robert C Kern, Walter F Stewart, Brian S Schwartz
BACKGROUND: Nasal and sinus symptoms (NSS) are common to many health conditions, including chronic rhinosinusitis (CRS). Few studies have investigated the occurrence and severity of, and risk factors for, acute exacerbations of NSS (AENSS) by CRS status (current, past, or never met European Position Paper on Rhinosinusitis [EPOS] criteria for CRS). METHODS: Four seasonal questionnaires were mailed to a stratified random sample of Geisinger primary care patients...
January 13, 2018: Allergy
https://www.readbyqxmd.com/read/29330643/antihypertensive-medication-and-dementia-risk-in-older-adult-african-americans-with-hypertension-a-prospective-cohort-study
#9
Michael D Murray, Hugh C Hendrie, Kathleen A Lane, Mengjie Zheng, Roberta Ambuehl, Shanshan Li, Frederick W Unverzagt, Christopher M Callahan, Sujuan Gao
BACKGROUND: African Americans are especially at risk of hypertension and dementia. Antihypertensive medications reduce the risk of cardiovascular events, but may also reduce the risk of dementia. OBJECTIVE: To assess the longitudinal effects of antihypertensive medications and blood pressure on the onset of incident dementia in a cohort of African Americans. DESIGN: Prospective cohort. PARTICIPANTS: 1236 community-dwelling patients from an inner-city public health care system, aged 65 years and older, with a history of hypertension but no history of dementia, and who had at least three primary care visits and a prescription filled for any medication...
January 12, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29330250/the-intersection-of-national-immigration-and-healthcare-policy
#10
Jeffrey Douaiher, Douglas J Inciarte, Edibaldo Silva
Immigration policy and health care policy remain principal undertakings of the federal government. The two have recently been pursued independently in the judicial and legislative arenas. Unbeknownst to many policymakers, however, national immigration policy and health care policy are linked in ways that, if unattended, could undermine the well-being of a significant portion of the US population, specifically medically underserved rural and urban populations. Using current data from a workforce report of the Association of American Colleges and the published literature, we demonstrate the significant impact that contemporary immigration policy directives may have on the number and distribution of international medical graduates who currently provide-and by the year 2025 will provide-a significant portion of primary health care in the United States, especially in underserved small urban and rural communities...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330248/the-effectiveness-of-problem-solving-therapy-for-primary-care-patients-depressive-and-or-anxiety-disorders-a-systematic-review-and-meta-analysis
#11
REVIEW
Anao Zhang, Sunyoung Park, John E Sullivan, Shijie Jing
BACKGROUND: There is increasing demand for managing depressive and/or anxiety disorders among primary care patients. Problem-solving therapy (PST) is a brief evidence- and strength-based psychotherapy that has received increasing support for its effectiveness in managing depression and anxiety among primary care patients. METHODS: We conducted a systematic review and meta-analysis of clinical trials examining PST for patients with depression and/or anxiety in primary care as identified by searches for published literature across 6 databases and manual searching...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330246/the-accuracy-of-trigger-tools-to-detect-preventable-adverse-events-in-primary-care-a-systematic-review
#12
Joshua Davis, Nicole Harrington, Heather Bittner Fagan, Barbara Henry, Margot Savoy
PURPOSE: To understand the ability of trigger tools to detect preventable adverse events (pAEs) in the primary care outpatient setting using the Institute for Healthcare Improvement's (IHI) Outpatient Adverse Event Trigger Tool (IHI Tool). METHODS: The OVID MEDLINE and OVID MEDLINE In-process and non-Indexed citations databases were queried using controlled vocabulary and Medical Subject Headings related to the concepts "primary care" and "adverse events." Included articles were conducted in the outpatient setting, used at least 1 of the triggers identified in the IHI Tool, and identified pAEs of any type...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330242/patient-perspectives-on-discussions-of-electronic-cigarettes-in-primary-care
#13
Mark P Doescher, Ming Wu, Elizabeth Rainwater, Ali S Khan, Dorothy A Rhoades
PURPOSE: Patient preferences regarding the role of the primary care provider (PCP) in discussing electronic cigarette (e-cigarette) use are unknown. METHODS: We administered a cross-sectional survey to 568 adult patients in a family medicine clinic to explore e-cigarette use, sources of information on e-cigarettes, perceived knowledge about e-cigarette health effects, views regarding PCP knowledge of e-cigarettes, interest in discussing e-cigarettes with PCPs and preferred format for e-cigarette information...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330238/changing-patterns-of-mental-health-care-use-the-role-of-integrated-mental-health-services-in-veteran-affairs-primary-care
#14
Lucinda B Leung, Jean Yoon, Lisa V Rubenstein, Edward P Post, Maureen E Metzger, Kenneth B Wells, Catherine A Sugar, José J Escarce
OBJECTIVE: Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated with changes in patient health care utilization and costs...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330237/-the-hand-on-the-doorknob-visit-agenda-setting-by-complex-patients-and-their-primary-care-physicians
#15
Christine P Kowalski, Deanna B McQuillan, Neetu Chawla, Courtney Lyles, Andrea Altschuler, Connie S Uratsu, Elizabeth A Bayliss, Michele Heisler, Richard W Grant
BACKGROUND: Choosing which issues to discuss in the limited time available during primary care visits is an important task for complex patients with chronic conditions. DESIGN, SETTING, AND PARTICIPANTS: We conducted sequential interviews with complex patients (n = 40) and their primary care physicians (n = 17) from 3 different health systems to investigate how patients and physicians prepare for visits, how visit agendas are determined, and how discussion priorities are established during time-limited visits...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330232/interventions-must-be-realistic-to-be-useful-and-completed-in-family-medicine
#16
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330165/survival-in-relation-to-multimorbidity-patterns-in-older-adults-in-primary-care-in-barcelona-spain-2010-2014-a-longitudinal-study-based-on-electronic-health-records
#17
Carolina Ibarra-Castillo, Marina Guisado-Clavero, Concepció Violan-Fors, Mariona Pons-Vigués, Tomàs López-Jiménez, Albert Roso-Llorach
BACKGROUND: Several studies have analysed the characteristics of multimorbidity patterns but none have evaluated the relationship with survival. The purpose of this study was to compare survival across older adults with different chronic multimorbidity patterns (CMPs). METHODS: Prospective longitudinal observational study using electronic health records for 190 108 people aged ≥65 years in Barcelona, Spain (2009-2014). CMPs were identified by cluster analysis...
January 12, 2018: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/29330083/rationale-and-design-of-the-clinic-and-community-approaches-to-healthy-weight-randomized-trial
#18
Lauren Fiechtner, Meghan Perkins, Vincent Biggs, Nancy Langhans, Mona Sharifi, Giselle O'Connor, Sarah Price, Joseph Locascio, Karen Kuhlthau, Jo-Ann Kwass, Candace Nelson, Thomas Land, Matt Longjohn, Valerie Lawson, Katherine Hohman, Elsie M Taveras
BACKGROUND: Recent studies have demonstrated the effectiveness of family-centered, pediatric weight management programs in reducing childhood obesity. Yet, programs to optimize the care of low-income children with obesity are needed. We sought to examine the comparative effectiveness of two, potentially scalable pediatric weight management programs delivered to low-income children in a clinical or community setting. MATERIALS AND METHODS: The Clinic and Community Approaches to Healthy Weight trial is a randomized trial in two communities in Massachusetts that serve a large population of low-income children and families...
January 9, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29330009/the-almanach-project-preliminary-results-and-potentiality-from-afghanistan
#19
A Bernasconi, F Crabbé, R Rossi, I Qani, A Vanobberghen, M Raab, S Du Mortier
INTRODUCTION: ALMANACH (ALgorithms for the MANagement of Acute CHildhood illnesses) is an electronic version of IMCI (Integrated Management of Childhood Illness) running on tablets. ALMANACH enhances its concept, it integrates well into health staff's daily consultation work and facilitates diagnosis and treatment. ALMANACH informs when to refer a child or to perform a rapid diagnostic test (RDT), recommends the right treatment dosage and synchronizes collected data real time with a Health Management Information System (DHIS2) for epidemiological evaluation and decision making...
December 28, 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29329975/risk-of-suicide-and-non-fatal-self-harm-after-bariatric-surgery-results-from-two-matched-cohort-studies
#20
Martin Neovius, Gustaf Bruze, Peter Jacobson, Kajsa Sjöholm, Kari Johansson, Fredrik Granath, Johan Sundström, Ingmar Näslund, Claude Marcus, Johan Ottosson, Markku Peltonen, Lena M S Carlsson
BACKGROUND: Bariatric surgery reduces mortality, but might have adverse effects on mental health. We assessed the risk of suicide and self-harm after bariatric surgery compared with non-surgical obesity treatment. METHODS: Suicide and non-fatal self-harm events retrieved from nationwide Swedish registers were examined in two cohorts. The non-randomised, prospective Swedish Obese Subjects (SOS) study compared bariatric surgery (n=2010; 1369 vertical-banded gastroplasty, 376 gastric banding, and 265 gastric bypass) with usual care (n=2037; recruitment 1987-2001)...
January 9, 2018: Lancet Diabetes & Endocrinology
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