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Primary care in internal medicine

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https://www.readbyqxmd.com/read/29338539/primary-care-provider-experience-with-breast-density-legislation-in-massachusetts
#1
Christine M Gunn, Nancy R Kressin, Kristina Cooper, Cinthya Marturano, Karen M Freund, Tracy A Battaglia
BACKGROUND: Dense breasts on mammography independently increases breast cancer risk and decreases mammography sensitivity. Thirty-two states have adopted notification laws to raise awareness among women with dense breasts about supplemental screening. Little is known about these policies' impact on clinical practice among primary care providers (PCPs). MATERIALS AND METHODS: This study explores PCP attitudes, knowledge, and the impact of the Massachusetts dense breast notification legislation on clinical practice after its enactment in 2015...
January 17, 2018: Journal of Women's Health
https://www.readbyqxmd.com/read/29330235/primary-care-physician-perspectives-about-antipsychotics-and-other-medications-for-symptoms-of-dementia
#2
J William Kerns, Jonathan D Winter, Katherine M Winter, Terry Boyd, Rebecca S Etz
BACKGROUND: Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these efforts. However, antipsychotics are still prescribed "off label" to hundreds of thousands of seniors residing in nursing homes and communities. Our objective was to evaluate how and why primary-care physicians (PCPs) employ nonpharmacologic strategies and drugs for BPSD...
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
#3
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/29322473/pharmaceutical-care-and-health-related-quality-of-life-outcomes-over-the-past-25%C3%A2-years-have-we-measured-dimensions-that-really-matter
#4
REVIEW
Mohammed A Mohammed, Rebekah J Moles, Timothy F Chen
Background Several measures of Health-Related Quality of Life (HRQoL) have been used to evaluate Pharmaceutical Care (PC) interventions in the past decades. However, their suitability for evaluation of PC services has not been comprehensively evaluated. Aim of the review The aim of this review was to perform content analysis of HRQoL measures used in PC studies to gain an insight into their suitability for evaluation of PC services. Method PC studies evaluating HRQoL as a primary or secondary outcomes were retrieved based on a literature search of articles published from 1990 to 2015, on Medline, Embase, International Pharmaceutical Abstracts, Global Health, PsycInfo, Web of Science, Cinahl, HealthStar, Cochrane Library, AUSThealth, Australian Medical Index, and Current content...
January 10, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29306971/trauma-care-in-german-speaking-countries-have-changes-in-the-curricula-led-to-changes-in-practice-after-10%C3%A2-years
#5
Sarah Kuhn-Régnier, Michael Stickel, Björn-Christian Link, Henning Fischer, Reto Babst, Frank J P Beeres
PURPOSE: Traditionally, in the German-speaking countries, trauma patients are treated by general surgeons specialized in trauma surgery known as the Unfallchirurg. Over the last decade, a trend towards a lower influence of surgeons and a higher influence of subspecialties in the emergency department has been noted. With additional transformations in the health care system towards highly specialized medicine and the arising of new (sub-) specialties, diversification in the management of the trauma patient appears to occur...
January 6, 2018: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
https://www.readbyqxmd.com/read/29301735/integrating-patient-centered-electronic-health-record-communication-training-into-resident-onboarding-curriculum-development-and-post-implementation-survey-among-housestaff
#6
Maria Alcocer Alkureishi, Wei Wei Lee, Sandra Webb, Vineet Arora
BACKGROUND: Electronic health record (EHR) use can enhance or undermine the ability of providers to deliver effective, humanistic patient-centered care. Given patient-centered care has been found to positively impact patient health outcomes, it is critical to provide formal education on patient-centered EHR communication skills. Unfortunately, despite increasing worldwide EHR adoption, few institutions educate trainees on EHR communication best practices. OBJECTIVE: The goal of this research was to develop and deliver mandatory patient-centered EHR training to all incoming housestaff at the University of Chicago...
January 4, 2018: JMIR Medical Education
https://www.readbyqxmd.com/read/29299817/two-novel-urban-health-primary-care-residency-tracks-that-focus-on-community-level-structural-vulnerabilities
#7
Benjamin J Oldfield, Bennett W Clark, Monica C Mix, Katherine C Shaw, Janet R Serwint, Sanjay V Desai, Rachel M Kruzan, Rosalyn W Stewart, Sebastian Ruhs, Leonard S Feldman
BACKGROUND: Although residency programs are well situated for developing a physician workforce with knowledge, skills, and attitudes that incorporate the strengths and reflect the priorities of community organizations, few curricula explicitly do so. AIM: To develop urban health primary care tracks for internal medicine and combined internal medicine-pediatrics residents. SETTING: Academic hospital, community health center, and community-based organizations...
January 3, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29298366/getting-it-rite-impact-of-a-dedicated-hospital-medicine-curriculum-for-residents
#8
Doris Lin, Chirayu Shah, Steffanie Campbell, Jeffrey T Bates, Erica Lescinskas
OBJECTIVE: The goal of this study was to improve resident confidence in inpatient care and knowledge in hospital medicine topics with a newly developed rotation and curriculum called the Resident Inpatient Training Experience. METHODS: This study was a prospective observational study completed by postgraduate year-2 (PGY-2) internal medicine residents in two affiliated hospitals. Forty-six PGY-2 residents each rotated on the Resident Inpatient Training Experience service for 1 month and completed a pre- and postrotation confidential online survey...
January 2018: Southern Medical Journal
https://www.readbyqxmd.com/read/29297035/travel-medicine
#9
Daniel T Leung, Regina C LaRocque, Edward T Ryan
International travel can result in new illness or exacerbate existing conditions, and primary care clinicians have the opportunity to provide both pre- and posttravel health care. Providers should be familiar with destination-specific disease risks, be knowledgeable about travel and routine vaccines, be prepared to prescribe chemoprophylaxis and self-treatment regimens, and be aware of travel medicine resources.
January 2, 2018: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29291171/a-comprehensive-framework-for-international-medical-programs-a-2017-consensus-statement-from-the-american-college-of-academic-international-medicine
#10
Manish Garg, Gregory L Peck, Bonnie Arquilla, Andrew C Miller, Sari E Soghoian, Harry L Anderson Iii, Christina Bloem, Michael S Firstenberg, Sagar C Galwankar, Weidun Alan Guo, Ricardo Izurieta, Elizabeth Krebs, Bhakti Hansoti, Sudip Nanda, Chinenye O Nwachuku, Benedict Nwomeh, Lorenzo Paladino, Thomas J Papadimos, Richard P Sharpe, Mamta Swaroop, Stanislaw P Stawicki
The American College of Academic International Medicine (ACAIM) represents a group of clinicians who seek to promote clinical, educational, and scientific collaboration in the area of Academic International Medicine (AIM) to address health care disparities and improve patient care and outcomes globally. Significant health care delivery and quality gaps persist between high-income countries (HICs) and low-and-middle-income countries (LMICs). International Medical Programs (IMPs) are an important mechanism for addressing these inequalities...
October 2017: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/29286534/fitness-training-for-cardiorespiratory-conditioning-after-traumatic-brain-injury
#11
REVIEW
Leanne Hassett, Anne M Moseley, Alison R Harmer
BACKGROUND: Reduced cardiorespiratory fitness (cardiorespiratory deconditioning) is a common consequence of traumatic brain injury (TBI). Fitness training may be implemented to address this impairment. OBJECTIVES: The primary objective of this updated review was to evaluate whether fitness training improves cardiorespiratory fitness in people who have sustained a TBI. The secondary objectives were to evaluate whether fitness training improves body function and structure (physical and cognitive impairments, psychological responses resulting from the injury), activity limitations and participation restrictions in people who have sustained a TBI as well as to evaluate its safety, acceptance, feasibility and suitability...
December 29, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29279721/recent-surgical-options-for-vestibular-vertigo
#12
REVIEW
Stefan Volkenstein, Stefan Dazert
Vertigo is not a well-defined disease but a symptom that can occur in heterogeneous entities diagnosed and treated mainly by otolaryngologists, neurologists, internal medicine, and primary care physicians. Most vertigo syndromes have a good prognosis and management is predominantly conservative, whereas the need for surgical therapy is rare, but for a subset of patients often the only remaining option. In this paper, we describe and discuss different surgical therapy options for hydropic inner ear diseases, Menière's disease, dehiscence syndromes, perilymph fistulas, and benign paroxysmal positional vertigo...
2017: GMS Current Topics in Otorhinolaryngology, Head and Neck Surgery
https://www.readbyqxmd.com/read/29277629/patterns-and-correlates-of-cervical-cancer-screening-initiation-in-a-large-integrated-healthcare-system
#13
Tracy A Becerra-Culqui, Neal M Lonky, Qiaoling Chen, Chun R Chao
BACKGROUND: The latest 2012 United States Preventive Services Task Force cervical cancer screening guidelines recommended screening initiation at age 21 years. Little is known about the cervical cancer screening initiation practices in the community, and whether there are critical gaps with respect to adherence to current clinical guidelines. Despite an overall decline in cervical cancer incidence across women of all ages, the incidence rate has not declined among 24-25 year-olds between 2000 (2...
December 22, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29277495/clinical-pharmacist-understanding-of-the-2013-american-college-of-cardiology-american-heart-association-cholesterol-guideline
#14
John D Bucheit, Haleigh Helsing, Pramit Nadpara, Salim S Virani, Dave L Dixon
BACKGROUND: Clinical pharmacists are frequently involved in the management of dyslipidemia, yet clinical pharmacists' knowledge, awareness, and the level of agreement with the 2013 American College of Cardiology (ACC)/American Heart Association (AHA) cholesterol guideline are unknown. OBJECTIVE: The objective of the study was to examine clinical pharmacists' knowledge, awareness, and the level of agreement with the 2013 ACC/AHA cholesterol guideline. METHODS: We administered a validated questionnaire via an online survey that was electronically mailed to clinical pharmacists...
December 6, 2017: Journal of Clinical Lipidology
https://www.readbyqxmd.com/read/29273289/inpatient-consults-and-complications-during-primary-total-joint-arthroplasty-in-a-bundled-care-model
#15
Billy T Baumgartner, Vasili Karas, Beau J Kildow, Daniel J Cunningham, Mitchell R Klement, Cindy L Green, David E Attarian, Thorsten M Seyler
BACKGROUND: The Centers for Medicare and Medicaid Services (CMS) are implementing changes in hospital reimbursement models for total joint arthroplasty (TJA), moving to value-based bundled payments from the fee-for-service model. The purpose of this study is to identify consults and complications during the perioperative period that increase financial burden. METHODS: We combined CMS payment data for inpatient, professional, and postoperative with retrospective review of patients undergoing primary TJA and developed profiles of patients included in the Comprehensive Care for Joint Replacement bundle undergoing TJA...
November 29, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29273028/implementation-of-a-novel-population-panel-management-curriculum-among-interprofessional-health-care-trainees
#16
Catherine P Kaminetzky, Lauren A Beste, Anne P Poppe, Daniel B Doan, Howard K Mun, Nancy Fugate Woods, Joyce E Wipf
BACKGROUND: Gaps in chronic disease management have led to calls for novel methods of interprofessional, team-based care. Population panel management (PPM), the process of continuous quality improvement across groups of patients, is rarely included in health professions training for physicians, nurses, or pharmacists. The feasibility and acceptance of such training across different healthcare professions is unknown. We developed and implemented a novel, interprofessional PPM curriculum targeted to diverse health professions trainees...
December 22, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29248393/primary-care-physicians-decision-making-regarding-initial-oncology-referral-for-adolescents-and-young-adults-with-cancer
#17
Lynne M Gordon, Rebecca H Johnson, Margaret A Au, Shelby L Langer, Karen H Albritton
PURPOSE: The objectives of this study were to determine whether pediatricians are more likely than other primary care physicians (PCPs) to refer newly diagnosed adolescent and young adult patients with cancer to pediatric oncological specialists, and to assess the physician and patient characteristics that affect patterns of referral. METHODS: A cross-sectional vignette survey was mailed to PCPs to examine hypothetical referral decisions as a function of physician characteristics and patient characteristics, including diagnosis, age, gender, race/ethnicity, family support, transportation, insurance, and patient preference for site of care...
December 13, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/29247110/prospective-economic-evaluation-of-an-electronic-discharge-communication-tool-analysis-of-a-randomised-controlled-trial
#18
Laura K Sevick, Maria-Jose Santana, William A Ghali, Fiona Clement
OBJECTIVE: To complete an economic evaluation within a randomised controlled trial (RCT) comparing the use of an electronic discharge communication tool (eDCT) compared with usual care. SETTING: Patients being discharged from a single tertiary care centre's internal medicine Medical Teaching Units. PARTICIPANTS: Between January 2012 and December 2013, 1399 patients were randomised to a discharge mechanism. Forty-five patients were excluded from the economic evaluation as they did not have data for the index hospitalisation cost; 1354 patients contributed to the economic evaluation...
December 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/29246247/intervention-to-improve-the-appropriate-use-of-polypharmacy-for-older-patients-with-hip-fractures-an-observational-study
#19
Junpei Komagamine, Kazuhiko Hagane
BACKGROUND: Polypharmacy is frequently observed in hip fracture patients. Although it is associated with an increased risk of hip fracture, polypharmacy often continues after hip fracture recovery. This study aimed to evaluate the effectiveness of an intervention to improve appropriate polypharmacy for elderly patients admitted to the hospital for hip fractures. METHODS: We conducted a retrospective observational study to compare the outcomes of patients receiving the intervention (n = 32) with those of patients who received usual care (n = 132)...
December 16, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29243572/development-dissemination-and-applications-of-a-new-terminological-resource-the-q-code-taxonomy-for-professional-aspects-of-general-practice-family-medicine
#20
Marc Jamoulle, Melissa Resnick, Julien Grosjean, Ashwin Ittoo, Elena Cardillo, Robert Vander Stichele, Stefan Darmoni, Marc Vanmeerbeek
BACKGROUND: While documentation of clinical aspects of General Practice/Family Medicine (GP/FM) is assured by the International Classification of Primary Care (ICPC), there is no taxonomy for the professional aspects (context and management) of GP/FM. OBJECTIVES: To present the development, dissemination, applications, and resulting face validity of the Q-Codes taxonomy specifically designed to describe contextual features of GP/FM, proposed as an extension to the ICPC...
December 15, 2017: European Journal of General Practice
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