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Primary care in internal medicine

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https://www.readbyqxmd.com/read/28821597/a-randomised-controlled-trial-assessing-the-efficacy-of-an-electronic-discharge-communication-tool-for-preventing-death-or-hospital-readmission
#1
Maria J Santana, Jayna Holroyd-Leduc, Danielle A Southern, Ward W Flemons, Maeve O'Beirne, Michael D Hill, Alan J Forster, Deborah E White, William A Ghali
OBJECTIVE: To assess the efficacy of an electronic discharge communication tool (e-DCT) for preventing death or hospital readmission, as well as reducing patient-reported adverse events after hospital discharge. The e-DCT assessed has already been shown to yield high-quality discharge summaries with high levels of patient and physician satisfaction. METHODS: This two-arm randomised controlled trial was conducted in a Canadian tertiary care centre's internal medicine medical teaching units...
August 18, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28817394/drivers-of-continuing-education-learning-preferences-for-veterans-affairs-women-s-health-primary-care-providers
#2
Jessica L Zuchowski, Alison B Hamilton, Donna L Washington, Arthur G Gomez, Laure Veet, Kristina M Cordasco
INTRODUCTION: Documented gaps in health professionals' training in women's health are a special concern for continuing education (CE). In the Veterans Affairs (VA) health care system, women veterans are a numerical minority, preferably assigned to designated women's health primary care providers (DWHPs). DWHPs need to maintain their knowledge and skills in women's health topics, in addition to general internal medicine topics. We explored drivers of VA DWHPs' learning preferences for women's health topics-ie, factors which influence greater and lesser learning interest...
August 16, 2017: Journal of Continuing Education in the Health Professions
https://www.readbyqxmd.com/read/28813762/the-impact-of-a-rural-training-track-on-medical-students-specialty-choice
#3
Brooke Jensen, Susan M Anderson, Edward Simanton
BACKGROUND: Compare the expectations and outcomes of students involved in rural medical training versus those of urban trainees. METHODS: Survey items relating to primary care interest were added to program evaluation surveys already being sent at the beginning and end of the primary clinical year. Students from the graduating class of 2016 and the class of 2017 responded to the surveys (N=115). Responses from students trained in rural sites were compared with students trained in medium or large communities...
June 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28810112/patient-and-physician-perceptions-of-genetic-testing-in-primary-care
#4
Samuel A Evenson, H Eugene Hoyme, Jan E Haugen-Rogers, Eric A Larson, Susan E Puumala
INTRODUCTION: The convergence of biomedical informatics and translational genomics is changing the way we practice. Primary care will play a pivotal role in this transformation. We therefore sought to assess general knowledge about genetic testing among outpatient internal medicine providers, and the patients that they serve across a five state region in the Midwest. METHODS: One thousand take-home paper surveys were created and distributed to internal medicine patients at 13 Midwestern clinics...
November 2016: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28808486/the-saudi-thoracic-society-guidelines-for-diagnosis-and-management-of-noncystic-fibrosis-bronchiectasis
#5
Hamdan Al-Jahdali, Abdullah Alshimemeri, Abdullah Mobeireek, Amr S Albanna, Nehad N Al Shirawi, Siraj Wali, Khaled Alkattan, Abdulrahman A Alrajhi, Khalid Mobaireek, Hassan S Alorainy, Mohamed S Al-Hajjaj, Anne B Chang, Stefano Aliberti
This is the first guideline developed by the Saudi Thoracic Society for the diagnosis and management of noncystic fibrosis bronchiectasis. Local experts including pulmonologists, infectious disease specialists, thoracic surgeons, respiratory therapists, and others from adult and pediatric departments provided the best practice evidence recommendations based on the available international and local literature. The main objective of this guideline is to utilize the current published evidence to develop recommendations about management of bronchiectasis suitable to our local health-care system and available resources...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28807953/developing-family-practice-to-respond-to-global-health-challenges-the-besrour-papers-a-series-on-the-state-of-family-medicine-in-the-world
#6
REVIEW
Neil Arya, Bruce Dahlman, Christine Gibson, David Ponka, Cynthia Haq, Katherine Rouleau, Stephanie Hansel
OBJECTIVE: To assess family medicine's role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally. COMPOSITION OF THE COMMITTEE: A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird's eye view of family medicine internationally...
August 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28798013/an-electronic-health-record-based-strategy-to-systematically-assess-medication-use-among-primary-care-patients-with-multidrug-regimens-feasibility-study
#7
Stacy Cooper Bailey, Christine U Oramasionwu, Alexandra C Infanzon, Emily R Pfaff, Izabela E Annis, Daniel S Reuland
BACKGROUND: Medication nonadherence and misuse are public health and patient safety concerns. With the increased adoption of electronic health records (EHRs), greater opportunities exist to communicate directly with, and collect data from, patients through secure portals linked to EHRs. OBJECTIVE: The study objectives were to develop and pilot test a method of monitoring patient medication use in outpatient settings and determine the feasibility and acceptability of this approach...
August 10, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28793236/prostate-specific-antigen-screening-an-update-of-physician-beliefs-and-practices
#8
Ingrid J Hall, Sun Hee Rim, Greta M Massetti, Cheryll C Thomas, Jun Li, Lisa C Richardson
PSA testing for early detection of prostate cancer decreased dramatically following the 2012 PSA screening recommendation against routine screening of asymptomatic men. In an assessment of the screening behaviors of primary care providers, the majority (61%) of family medicine and internal medicine practitioners who responded to a 2016 DocStyles online survey (608 of 1003) recommended prostate-specific antigen (PSA) testing based on individual risk or other factors, rather than routinely screening all men for prostate cancer...
August 6, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28790344/morbidity-pattern-of-traditional-chinese-medicine-primary-care-in-the-hong-kong-population
#9
Wendy Wong, Cindy Lo Kuen Lam, Xiang Zhao Bian, Zhang Jin Zhang, Sze Tuen Ng, Shong Tung
Primary care manages >90% of illnesses requiring medical services in Hong Kong, in which 9,513 registered Chinese medicine practitioners (CMPs) provide 8.2% of the consultations. This is the first study aimed to determine the morbidity pattern in different Traditional Chinese Medicine (TCM) primary care settings in Chinese population. 55,312 patients' encounters were classified by the International Classification of Primary Care-2 (ICPC-2) from 260 of CMPs. Mean patient age was 50.5 years, with more females than males (67...
August 8, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28790075/implementation-of-a-pharmacist-managed-clinic-for-patients-with-chronic-nonmalignant-pain
#10
Jessica L Norman, Miranda E Kroehl, Huong Mindy Lam, Carmen L Lewis, Chelsea N Mitchell, Cindy L O'Bryant, Katy E Trinkley
PURPOSE: A pharmacist-managed chronic pain clinic (PMCPC) in a primary care setting is described. SUMMARY: As primary care providers (PCPs) may be unprepared or lack time to manage high-risk patients receiving opioids for chronic nonmalignant pain, alternative models of care are needed. The University of Colorado PMCPC is integrated into an internal medicine outpatient clinic. The PMCPC is staffed by 1 clinical pharmacist, with pharmacy students and residents also performing clinic duties...
August 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28761219/hypertension-control-in-the-university-of-chicago-primary-care-group
#11
Kathryn E Gunter, George W Weyer, Lisa M Vinci, Marshall H Chin, Monica E Peek
In Brief "Quality Improvement Success Stories" are published by the American Diabetes Association in collaboration with the American College of Physicians, Inc., and the National Diabetes Education Program. This series is intended to highlight best practices and strategies from programs and clinics that have successfully improved the quality of care for people with diabetes or related conditions. Each article in the series is reviewed and follows a standard format developed by the editors of Clinical Diabetes...
July 2017: Clinical Diabetes: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/28751837/anmco-sic-consensus-document-cardiology-networks-for-outpatient-heart-failure-care
#12
Nadia Aspromonte, Michele Massimo Gulizia, Andrea Di Lenarda, Andrea Mortara, Ilaria Battistoni, Renata De Maria, Michele Gabriele, Massimo Iacoviello, Alessandro Navazio, Daniela Pini, Giuseppe Di Tano, Marco Marini, Renato Pietro Ricci, Gianfranco Alunni, Donatella Radini, Marco Metra, Francesco Romeo
Changing demographics and an increasing burden of multiple chronic comorbidities in Western countries dictate refocusing of heart failure (HF) services from acute in-hospital care to better support the long inter-critical out-of- hospital phases of HF. In Italy, as well as in other countries, needs of the HF population are not adequately addressed by current HF outpatient services, as documented by differences in age, gender, comorbidities and recommended therapies between patients discharged for acute hospitalized HF and those followed-up at HF clinics...
May 2017: European Heart Journal Supplements: Journal of the European Society of Cardiology
https://www.readbyqxmd.com/read/28750905/automated-problem-list-generation-and-physicians-perspective-from-a-pilot-study
#13
Murthy V Devarakonda, Neil Mehta, Ching-Huei Tsou, Jennifer J Liang, Amy S Nowacki, John Eric Jelovsek
OBJECTIVE: An accurate, comprehensive and up-to-date problem list can help clinicians provide patient-centered care. Unfortunately, problem lists created and maintained in electronic health records by providers tend to be inaccurate, duplicative and out of date. With advances in machine learning and natural language processing, it is possible to automatically generate a problem list from the data in the EHR and keep it current. In this paper, we describe an automated problem list generation method and report on insights from a pilot study of physicians' assessment of the generated problem lists compared to existing providers-curated problem lists in an institution's EHR system...
September 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28737648/who-is-responsible-for-what-happens-before-during-and-after-colonoscopy-results-of-a-national-survey-of-primary-care-physicians
#14
Andrew J Read, Arlene Weissman, Philip S Schoenfeld, Seema Saini, Stacy B Menees, Sameer D Saini
BACKGROUND AND AIMS: Primary care providers (PCPs) play a critical role in colon cancer screening by initiating referrals to gastroenterologists for colonoscopy, but little is known about their role in pre-colonoscopy bowel preparation selection and pre-colonoscopy follow-up care. This study aimed to better understand coordination of care between PCPs and gastroenterologists as well as the current availability of "open-access" screening colonoscopy. METHODS: A multiple-choice survey was developed to assess PCPs' experiences with open-access colonoscopy, their involvement in the pre-colonoscopy process, and follow-up after colonoscopy...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28724505/readmission-to-hospital-of-medical-patients-a-cohort-study
#15
Mette Gothardt Rasmussen, Pernille Ravn, Stig Molsted, Lise Tarnow, Susanne Rosthøj
INTRODUCTION: The incidence of acute readmissions is higher among elderly medical patients than in the general population. Risk factor identification is needed in order to prevent readmissions. OBJECTIVE: To estimate the incidence of acute readmissions among medical patients ≥65years discharged from departments of internal medicine and to identify risk factors associated with readmissions. MATERIAL AND METHODS: We included patients discharged between 1st of January 2011 and 1st of December 2014 and collected data regarding primary diagnosis and comorbidities...
July 16, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28724408/learning-intraprofessional-collaboration-by-participating-in-a-consultation-programme-what-and-how-did-primary-and-secondary-care-trainees-learn
#16
Marijn Janssen, Margaretha H Sagasser, Elisabeth A M Laro, Jacqueline de Graaf, Nynke D Scherpbier-de Haan
BACKGROUND: A growing number of patients require overview and management in both primary and secondary care. This situation requires that primary and secondary care professionals have well developed collaborative skills. While knowledge about interprofessional collaboration and education is rising, little is known about intraprofessional collaboration and education between physicians of various disciplines. This study examines a newly developed consultation programme for trainees in general practice and internal medicine to acquire intraprofessional collaboration skills...
July 19, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28724150/pregnancy-options-counseling-and-abortion-referrals-among-us-primary-care-physicians-results-from-a-national-survey
#17
Kelsey Holt, Elizabeth Janiak, Marie C McCormick, Ellice Lieberman, Christine Dehlendorf, Sandhya Kajeepeta, Jacquelyn M Caglia, Ana Langer
BACKGROUND AND OBJECTIVES: Primary care physicians (PCPs) can play a critical role in addressing unintended pregnancy through high-quality options counseling and referrals. METHODS: We surveyed a nationally representative sample of 3,000 PCPs in general, family, and internal medicine on practices and opinions related to options counseling for unintended pregnancy. We assessed predictors of physician practices using multivariable logistic regression weighted for sampling design and differential non-response...
July 2017: Family Medicine
https://www.readbyqxmd.com/read/28722078/true-prevalence-of-copd-and-its-association-with-peripheral-arterial-disease-in-the-internal-medicine-ward-of-a-tertiary-care-hospital
#18
Jonathan Tschopp, Philippe Dumont, Daniel Hayoz
OBJECTIVES: The primary objective was to determine the prevalence of confirmed chronic obstructive pulmonary disease (COPD) in patients aged 45 years or more who were admitted to the internal medicine ward of our tertiary care hospital (HFR Fribourg, Switzerland), and were either "tagged" as having COPD or at risk for COPD. The secondary objective was to determine the prevalence of the association of COPD with peripheral artery disease (PAD) in this population. METHODOLOGY: We evaluated all consecutive patients aged 45 years, admitted to our internal medicine ward between November 2013 and March 2014...
July 19, 2017: Swiss Medical Weekly
https://www.readbyqxmd.com/read/28721899/gaps-in-radiation-therapy-awareness-results-from-an-educational-multi-institutional-survey-of-us-internal-medicine-residents
#19
MULTICENTER STUDY
Narek Shaverdian, Sun Mi Yoo, Ryan Cook, Eric M Chang, Naomi Jiang, Ye Yuan, Kiri Sandler, Michael Steinberg, Percy Lee
PURPOSE: Internists and primary care providers play a growing role in cancer care. We therefore evaluated the awareness of radiation therapy in general and specifically the clinical utility of stereotactic body radiation therapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) among current US internal medicine residents. METHODS AND MATERIALS: A web-based institutional review board-approved multi-institutional survey was distributed to US internal medicine residency programs...
August 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28720635/increased-public-accountability-for-hospital-nonprofit-status-potential-impacts-on-residency-positions
#20
Melanie C Raffoul, Robert L Phillips
BACKGROUND: The Institute of Medicine recently called for greater graduate medical education (GME) accountability for meeting the workforce needs of the nation. The Affordable Care Act expanded community health needs assessment (CHNA) requirements for nonprofit and tax-exempt hospitals to include community assessment, intervention, and evaluation every 3 years but did not specify details about workforce. Texas receives relatively little federal GME funding but has used Medicaid waivers to support GME expansion...
July 2017: Journal of the American Board of Family Medicine: JABFM
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