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Primary care in internal medicine

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https://www.readbyqxmd.com/read/29164037/guidelines-for-the-management-of-degenerative-cervical-myelopathy-and-acute-spinal-cord-injury-development-process-and-methodology
#1
Lindsay A Tetreault, Andrea C Skelly, Joseph R Dettori, Jefferson R Wilson, Allan R Martin, Michael G Fehlings
The Institute of Medicine defines clinical practice guidelines as "statements that include recommendations intended to optimize patient care that are informed by a systematic review of evidence and an assessment of the benefits and harms of alternative care options." Guidelines help clinicians implement best evidence into practice and encourage informed shared decision making with patients. Guidelines are intended to enhance the quality of patient care by discouraging ineffective and potentially harmful interventions and standardizing practice...
September 2017: Global Spine Journal
https://www.readbyqxmd.com/read/29163729/prevalence-comorbidity-and-investigation-of-anemia-in-the-primary-care-office
#2
Shivani Jatin Gandhi, Iris Hagans, Karim Nathan, Krystal Hunter, Satyajeet Roy
Background: Anemia has a myriad of causes and its prevalence is growing. Anemia is associated with increased all-cause hospitalization and mortality in community-dwelling individuals above age 65 years. Our aim was to determine the prevalence and severity of anemia in adult patients in our primary care office and to determine the relationship between anemia and medical comorbidities. Methods: Electronic medical records of 499 adult patients in our suburban internal medicine office were reviewed who had had at least one hemoglobin value and did not undergo moderate to high-risk surgery in the preceding 30 days...
December 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29153354/the-choosing-wisely-initiative-a-critical-analysis-with-a-special-focus-on-primary-care
#3
Karl Horvath, Andrea Siebenhofer
The Choosing Wisely initiative (CWI), a campaign led by the American Board of Internal Medicine (ABIM) Foundation, promotes doctor-patient communication and reducing waste in healthcare. At present, many of the top 5 lists from the Choosing Wisely Initiative appear to be primarily eminence-based and influenced by self-interest. The implementation of recommendations from these lists may mean taking a step backwards to the time before evidence-based medicine. On the other hand, despite all the challenges that the Choosing Wisely initiatives are currently facing, it is difficult to deny that they also hold great potential in terms of making healthcare systems more efficient and beneficial to patients...
November 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/29117934/uses-of-mobile-device-digital-photography-of-dermatologic-conditions-in-primary-care
#4
Jennifer L Pecina, Kirk D Wyatt, Nneka I Comfere, Matthew E Bernard, Frederick North
BACKGROUND: PhotoExam is a mobile app that incorporates digital photographs into the electronic health record (EHR) using iPhone operating system (iOS, Apple Inc)-based mobile devices. OBJECTIVE: The aim of this study was to describe usage patterns of PhotoExam in primary care and to assess clinician-level factors that influence the use of the PhotoExam app for teledermatology (TD) purposes. METHODS: Retrospective record review of primary care patients who had one or more photos taken with the PhotoExam app between February 16, 2015 to February 29, 2016 were reviewed for 30-day outcomes for rates of dermatology consult request, mode of dermatology consultation (curbside phone consult, eConsult, and in-person consult), specialty and training level of clinician using the app, performance of skin biopsy, and final pathological diagnosis (benign vs malignant)...
November 8, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29116901/use-of-ics-in-copd-from-blockbuster-medicine-to-precision-medicine
#5
Marco Contoli, Angelo G Corsico, Pierachille Santus, Fabiano Di Marco, Fulvio Braido, Paola Rogliani, Luigi Calzetta, Nicola Scichilone
Chronic obstructive pulmonary disease (COPD) is a major cause of mortality worldwide, whose burden is expected to increase in the next decades, because of numerous risk factors, including the aging of the population. COPD is both preventable and treatable by an effective management including risk factor reduction, prevention, assessment, and treatment of acute exacerbations and co-morbidities. The available agents approved for COPD treatment are long-acting or ultra-long-acting β2-agonists (LABAs) and long-acting muscarinic antagonists (LAMAs) bronchodilators, as well as inhaled corticosteroids (ICS) in combination with LABAs...
November 8, 2017: COPD
https://www.readbyqxmd.com/read/29114346/enhanced-skills-in-global-health-and-health-equity-guidelines-for-curriculum-development
#6
Russell Dawe, Andrea Pike, Monica Kidd, Praseedha Janakiram, Eileen Nicolle, Jill Allison
Introduction: Global health addresses health inequities in the care of underserved populations, both domestic and international. Given that health systems with a strong primary care foundation are the most equitable, effective and efficient, family medicine is uniquely positioned to engage in global health. However, there are no nationally recognized standards in Canada for postgraduate family medicine training in global health. Objective: To generate consensus on the essential components of a Global Health/Health Equity Enhanced Skills Program in family medicine...
April 2017: Canadian Medical Education Journal
https://www.readbyqxmd.com/read/29113636/evaluation-of-interventions-in-clinical-pharmacist-led-annual-medicare-wellness-visits-compared-with-usual-care
#7
Regine C Beliard, Jessica W Merrey
OBJECTIVE: Evaluate and compare the number and types of medication and non-medication-related interventions by clinical pharmacists and nonpharmacists conducting an Annual Medicare Wellness Visit (MWV). DESIGN: Multi-center, retrospective case-control study. SETTING: Two community primary care internal medicine clinics in urban Maryland. PARTICIPANTS: Patients who had a MWV performed January 2014 through October 2015...
November 1, 2017: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29110803/sexual-dysfunction-in-primary-care-an-exploratory-descriptive-analysis-of-medical-record-diagnoses
#8
Katie M Heiden-Rootes, Joanne Salas, Sarah Gebauer, Matthew Witthaus, Jeffrey Scherrer, Kristin McDaniel, Dasha Carver
BACKGROUND: The prevalence of sexual dysfunction (SDx) diagnoses in primary care settings is not well known, which is a concern because of the high prevalence of comorbid chronic health conditions in patients diagnosed with SDx. AIM: To explore the relation of SDx diagnosis, chronic health conditions, and prescription medications commonly associated with SDx for men and women in primary care using medical records diagnoses. METHODS: Exploratory descriptive analyses were used to interpret secondary data from a primary care patient database...
November 2017: Journal of Sexual Medicine
https://www.readbyqxmd.com/read/29096701/assessment-of-utilization-pattern-of-fixed-dose-drug-combinations-in-primary-secondary-and-tertiary-healthcare-centers-in-nepal-a-cross-sectional-study
#9
Arjun Poudel, Mohamed Izham Mohamed Ibrahim, Pranaya Mishra, Subish Palaian
BACKGROUND: Prescription practices, especially in South Asian countries, have come under investigation for quality. Although there have been no studies in Nepal that have analyzed the prescription pattern of FDCs for different levels of health care centers, several studies from Nepal and other countries in the region have revealed poor medicine use practices, including irrational use of fixed-dose drug combinations (FDCs). This research aimed at assessing the utilization pattern of FDCs among primary (PHC), secondary (SHC) and tertiary health care (THC) centers in Western region of Nepal...
November 2, 2017: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/29084312/effect-of-patient-navigation-and-financial-incentives-on-smoking-cessation-among-primary-care-patients-at-an-urban-safety-net-hospital-a-randomized-clinical-trial
#10
Karen E Lasser, Lisa M Quintiliani, Ve Truong, Ziming Xuan, Jennifer Murillo, Cheryl Jean, Lori Pbert
Importance: While the proportion of adults who smoke cigarettes has declined substantially in the past decade, socioeconomic disparities in cigarette smoking remain. Few interventions have targeted low socioeconomic status (SES) and minority smokers in primary care settings. Objective: To evaluate a multicomponent intervention to promote smoking cessation among low-SES and minority smokers. Design, Setting, and Participants: For this prospective, unblinded, randomized clinical trial conducted between May 1, 2015, and September 4, 2017, adults 18 years and older who spoke English, smoked 10 or more cigarettes per day in the past week, were contemplating or preparing to quit smoking, and had a primary care clinician were recruited from general internal medicine and family medicine practices at 1 large safety-net hospital in Boston, Massachusetts...
October 30, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29083974/patient-satisfaction-with-medicare-annual-wellness-visits-administered-by-a-clinical-pharmacist-practitioner
#11
Christina H Sherrill, Jamie Cavanaugh, Betsy Bryant Shilliday
BACKGROUND: In accordance with the Patient Protection and Affordable Care Act, Medicare provides coverage for annual wellness visits (AWVs) to eligible beneficiaries, which focus on preventative services, furnish personalized preventative health plans, and direct appropriate referrals. These visits may be conducted by a physician or another licensed practitioner working under the direct supervision of a physician. In North Carolina, pharmacists licensed as clinical pharmacist practitioners (CPPs) may perform and bill for AWVs, but there are limited data on patient satisfaction with pharmacists serving in this advanced role...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29069119/do-combined-pharmacist-and-prescriber-efforts-on-medication-reconciliation-reduce-postdischarge-patient-emergency-department-visits-and-hospital-readmissions
#12
Michelle Baker, Chaim M Bell, Wei Xiong, Edward Etchells, Peter G Rossos, Kaveh G Shojania, Kelly Lane, Tim Tripp, Mary Lam, Kimindra Tiwana, Derek Leong, Gary Wong, Jin-Hyeun Huh Huh, Emily Musing, Olavo Fernandes
BACKGROUND: Although medication reconciliation (Med Rec) has demonstrated a reduction in potential adverse drug events, its effect on hospital readmissions remains inconclusive. OBJECTIVE: To evaluate the impact of an interprofessional Med Rec bundle from admission to discharge on patient emergency department visits and hospital readmissions (hospital visits). METHODS: The design was a retrospective, cohort study. Patients discharged from general internal medicine over a 57-month interval were identified through administrative databases...
October 4, 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29061762/descriptive-analysis-of-the-medical-care-performed-in-the-spanish-military-role-1-medical-treatment-facility-deployed-in-operation-inherent-resolve-iraq-2015-2016
#13
Rafael García Cañas, R Navarro Suay
INTRODUCTION: Operation 'Inherent Resolve' was approved by the United Nations in August 2014 with the objective of suppressing the Islamic State in Iraq and the Levant and increasing the region's stability. The mission of the Spanish military forces within this was to direct training missions for the Iraqi Army. The aim of this study is to analyse the medical care provided in the Spanish Role 1 deployed medical treatment facility during Operation 'Apoyo a Irak'. METHODS: A cross-sectional, descriptive and retrospective study was conducted between 15 December 2015 and 18 November 2016...
October 23, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/29045985/entry-of-medical-school-graduates-into-family-medicine-residencies-2016-2017
#14
Stanley M Kozakowski, Alexandra Travis, Julie P Marcinek, Ashley Bentley, Gerald T Fetter
This annual report is an expansion on previous reports in this series that provides further evidence that the current medical school system is failing, collectively, to produce the primary care workforce that is needed to achieve optimal health in the United States. Inclusion of data on the performance of DO-granting and international medical schools, creates a more complete and complex picture of the contribution of all medical school types to the primary care workforce that should allow stakeholders to set goals, identify institutions with models from which to learn, and develop strategies for continuous improvement...
October 2017: Family Medicine
https://www.readbyqxmd.com/read/29045984/results-of-the-2017-national-resident-matching-program%C3%A2-and-the-american-osteopathic-association-intern-resident-registration-program
#15
Stanley M Kozakowski, Alexandra Travis, Julie P Marcinek, Ashley Bentley, Gerald T Fetter
The purpose of medicine as a profession is to meet the health needs of people and communities. Despite empirical evidence worldwide that an appropriate foundation of primary care in a health care system leads to improved health outcomes, improved experience of health care, a reduction in health disparities, and lower overall cost of care, publicly available data from National Resident Matching Program® (NRMP) and the American Osteopathic Association (AOA) Intern/Resident Registration Program show that PGY-1 family medicine and primary care positions offered in the NRMP Match continue to grow, but are losing ground in comparison to the growth of non-primary care specialties...
October 2017: Family Medicine
https://www.readbyqxmd.com/read/29045622/international-exchanges-in-primary-care-learning-from-thy-neighbour
#16
Bernadeta Bridgwood, John Park, Claire Hawcroft, Natasha Kay, Eugene Tang
This systematic review describes how international exchange programmes in primary care have been received and evaluated. Electronic databases (MEDLINE, Embase, PsycINFO, EBM reviews, CAB abstracts and PubMED) were searched to identify articles where the main focus of the study was exchanges undertaken in primary care/family medicine until March 2016. Articles were included if they (i) discussed participant exchanges in primary care; (ii) presented associated outcome data-this included (a) individual/group experience of exchange; (b) mechanism of exchange and (c) observations during the exchange...
October 14, 2017: Family Practice
https://www.readbyqxmd.com/read/29042808/first-visit-patients-without-a-referral-to-the-department-of-internal-medicine-at-a-medium-sized-acute-care-hospital-in-japan-an-observational-study
#17
Nobuyuki Kajiwara, Kazuyuki Hayashi, Masahiro Misago, Shinichiro Murakami, Takato Ueoka
PURPOSE: We sought to profile first-time patients without a referral who sought medical care at the Department of Internal Medicine at a medium-sized acute care hospital in Japan. We anticipated that the analysis would highlight the demand for medical care needs from acute care hospitals and help confirm one of the problems associated with primary care in Japan. PATIENTS AND METHODS: The study population comprised 765 patients who sought outpatient consultation without a referral at "the Department of General Internal Medicine" at the Ikeda City Hospital on Fridays over 4 years...
2017: International Journal of General Medicine
https://www.readbyqxmd.com/read/29041794/the-views-of-key-stakeholders-in-zimbabwe-on-the-introduction-of-postgraduate-family-medicine-training-a-qualitative-study
#18
Cherifa Sururu, Robert Mash
BACKGROUND: Strengthening primary health care (PHC) is a priority for all effective health systems, and family physicians are seen as a key member of the PHC team. Zimbabwe has joined a number of African countries that are seriously considering the introduction of postgraduate family medicine training. Implementation of training, however, has not yet happened. AIM: To explore the views of key stakeholders on the introduction of postgraduate family medicine training...
September 12, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29036749/-paediatrics-in-light-of-the-convention-on-the-rights-of-the-child
#19
Christoph Klein
The United Nations Convention on the Rights of the Child not only grants comprehensive rights to children via international law, it also constitutes a legally binding framework under German federal law. With respect to health care, the convention establishes the "right of the child to the enjoyment of the highest attainable standard of health" and the principle that "the best interests of the child shall be a primary consideration" in all actions undertaken by public or private institutions. Here, some fundamental aspects of the convention and the monitoring of its implementation are summarized and current challenges in paediatric medicine in Germany are discussed in light of the convention...
October 16, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28992143/a-qualitative-study-of-sign-out-processes-between-primary-and-on-call-residents-relationships-in-information-exchange-responsibility-and-accountability
#20
Soo-Hoon Lee, Dale A Fisher, Heidi Mah, Wei-Ping Goh, Phillip H Phan
Objective: To review a quality improvement event on the process of sign-outs between the primary and on-call residents. Design: A retrospective qualitative study using semi-structured interviews. Setting: A tertiary academic medical center in Singapore with 283 inpatient Medicine beds served by 28 consultants, 29 registrars, 45 residents and 30 interns during the day but 5 residents and 3 interns at night. Participants: Residents, registrars and consultants...
October 1, 2017: International Journal for Quality in Health Care
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