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https://www.readbyqxmd.com/read/28814373/convenience-quality-and-choice-patient-and-service-provider-perspectives-for-treating-primary-care-complaints-in-urgent-care-settings
#1
David Sturgeon
AIM: To investigate why patients chose to attend two, nurse-led, minor injury units (MIUs) to access primary healthcare services rather than attend their GP practice. BACKGROUND: Since the 1980's, healthcare organisations in the UK and elsewhere have implemented an increasingly consumer-orientated model of healthcare provision. As a result, patients with non-urgent presentations are attending Emergency Departments (EDs) and other urgent care facilities in growing numbers...
August 14, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28808942/primary-care-providers-opening-of-time-sensitive-alerts-sent-to-commercial-electronic-health-record-inbaskets
#2
Sarah L Cutrona, Hassan Fouayzi, Laura Burns, Rajani S Sadasivam, Kathleen M Mazor, Jerry H Gurwitz, Lawrence Garber, Devi Sundaresan, Thomas K Houston, Terry S Field
BACKGROUND: Time-sensitive alerts are among the many types of clinical notifications delivered to physicians' secure InBaskets within commercial electronic health records (EHRs). A delayed alert review can impact patient safety and compromise care. OBJECTIVE: To characterize factors associated with opening of non-interruptive time-sensitive alerts delivered into primary care provider (PCP) InBaskets. DESIGN AND PARTICIPANTS: We analyzed data for 799 automated alerts...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28807973/prevention-of-delayed-referrals-through-the-champlain-base-econsult-service
#3
Clare Liddy, Paul Drosinis, Adam Fogel, Erin Keely
OBJECTIVE: To identify the proportion and evaluate the content of eConsults (electronic consultations) in which the Champlain BASE (Building Access to Specialists through eConsultation) eConsult process prompted a referral to a specialist that was not originally contemplated by the primary care provider (PCP). DESIGN: Cross-sectional study of all eConsults submitted between April 15, 2011, and January 31, 2015. SETTING: Champlain Local Health Integration Network, a large health region in eastern Ontario...
August 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28806373/patient-aligned-care-team-engagement-to-connect-veterans-experiencing-homelessness-with-appropriate-health-care
#4
Adi V Gundlapalli, Andrew Redd, Daniel Bolton, Megan E Vanneman, Marjorie E Carter, Erin Johnson, Matthew H Samore, Jamison D Fargo, Thomas P O'Toole
BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806324/comparison-of-the-quality-of-informal-care-of-community-dwelling-taiwanese-older-people
#5
Chia-Yi Chiao, Yen-Ju Lin, Chiu-Yueh Hsiao
BACKGROUND: With social structures changing and the average life-span of individuals increasing, Taiwan is experiencing a steady rise in its elderly population. Thus, caring for older parentsis an urgent problem. Many foreign caregivers have been hired tocare for older parents.However, measuring the quality ofinformal care has not yet been fully explored in Taiwan, particularly among older people who are cared for by foreign caregivers in home settings. PURPOSE: The purposes of this study were to understand the differences in quality of care for older Taiwanese and to explore the predictors of quality of care in two types of caregiving...
August 12, 2017: Journal of Nursing Research: JNR
https://www.readbyqxmd.com/read/28797381/the-urgent-need-for-robust-geriatric-patient-care-skills-in-primary-care
#6
EDITORIAL
Demetra Antimisiaris, Laura Morton
No abstract text is available yet for this article.
September 2017: Primary Care
https://www.readbyqxmd.com/read/28793384/factors-that-influence-care-priority-for-chest-pain-patients-using-the-manchester-triage-system
#7
Carine Lais Nonnenmacher, Ananda Ughini Bertoldo Pires, Vitor Monteiro Moraes, Amália de Fátima Lucena
AIMS AND OBJECTIVES: Analyze crucial factors for determining care priority for patients with acute myocardial infarction based on the Manchester Triage System. BACKGROUND: Triage is the first potentially critical step in the care of myocardial infarction patients. However, there are still very few studies on the factors interfering in the lack of care priority for these patients, impacting their treatment and prognosis. DESIGN: Retrospective cohort study with 217 patients in the emergency department of a Brazilian hospital...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28792290/pearls-and-pitfalls-for-prescribing-opioids-in-a-climate-of-increased-provider-scrutiny
#8
Joanna Gedzior, Arlen Kwong
In August 2016, U.S. Surgeon General Vivek Murthy, MD, MBA, issued a letter to healthcare providers requesting aid in addressing "an urgent health crisis facing America: the opioid epidemic." In this article, we address some of the more poignant challenges that surface in treating patients with opiate addiction. We provide an outline of recommendations from the leading medical organizations to educate primary care providers on how to navigate patients to decreased or discontinued medication loads.
March 2017: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28791424/-to-stent-or-not-to-stent-immediate-emergency-surgery-with-laparoscopic-radical-colectomy-with-cme-and-primary-anastomosis-is-feasible-for-obstructing-left-colon-carcinoma
#9
Salomone Di Saverio, Arianna Birindelli, Edoardo Segalini, Matteo Novello, Anna Larocca, Francesco Ferrara, Gian Andrea Binda, Marco Bassi
Great debate exists in the initial acute management of large bowel obstruction from obstructing left colon carcinoma. While endoscopic stenting is well established as the first approach in the setting of palliative care of patients with advanced metastatic disease as well as a bridge to elective surgery in elderly patients who have an increased risk of postoperative mortality (age >70 years and/or ASA status ≥3), controversies exist regarding oncological safety and long-term outcomes of endoscopic colonic stenting in younger patients and ESGE Guidelines do not recommend SEMS placement in patients <70 and fit for curative surgery...
August 8, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28789637/perceptions-practices-and-health-seeking-behaviour-constrain-je-aes-interventions-in-high-endemic-district-of-north-india
#10
Sanjay Chaturvedi, Neha Sharma, Manish Kakkar
BACKGROUND: Acute Encephalitis Syndrome (AES) and Japanese Encephalitis (JE) stay as poorly understood phenomena in India. Multiple linkages to determinants such as poverty, socio-economic status, gender, environment, and population distribution, make it a greater developmental issue than just a zoonotic disease. METHODS: A qualitative study was conducted to map knowledge, perceptions and practices of community and health systems level stakeholders. Seventeen interviews with utilizers of AES care, care givers from human and veterinary sectors, Non-governmental Organizations (NGOs), and pig owners and 4 Focused Group Discussions (FGDs) with farmers, community leaders, and students were conducted in an endemic north Indian district-Kushinagar...
August 8, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28782080/awareness-of-stomach-and-colorectal-cancer-risk-factors-symptoms-and-time-taken-to-seek-medical-help-among-public-attending-primary-care-setting-in-muscat-governorate-oman
#11
Mohammed Al-Azri, Jamila Al-Kindi, Thuraiya Al-Harthi, Manal Al-Dahri, Sathiya Murthi Panchatcharam, Abdullah Al-Maniri
Colorectal and stomach cancers are the top ranking cancers in Oman. Most of the patients are diagnosed at advanced disease stages. The aim of this study is to explore the knowledge of risk factors, symptoms and the time needed to seek medical care for stomach cancer and colorectal cancer (CRC) among Omani participants attending 28 local health centres (LHCs) in the governorate of Muscat, the capital city of Oman. The Bowel Cancer/CRC Awareness Measure (CAM) questionnaire (translated into Arabic) was used to collect data from Omani adult participants (aged 18 years and above) who attended the LHCs during the study period...
August 7, 2017: Journal of Cancer Education: the Official Journal of the American Association for Cancer Education
https://www.readbyqxmd.com/read/28775192/seeking-ambulance-treatment-for-primary-care-problems-a-qualitative-systematic-review-of-patient-carer-and-professional-perspectives
#12
Matthew J Booker, Sarah Purdy, Alison R G Shaw
OBJECTIVES: To understand the reasons behind, and experience of, seeking and receiving emergency ambulance treatment for a 'primary care sensitive' condition. DESIGN: A comprehensive, qualitative systematic review. Medline, Embase, PsychInfo, Cumulative Index of Nursing and Allied Health, Health Management Information Systems, Healthcare Management Information Consortium, OpenSigle, EThOS and Digital Archive of Research Theses databases were systematically searched for studies exploring patient, carer or healthcare professional interactions with ambulance services for 'primary care sensitive' problems...
August 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28770596/high-rates-of-viral-suppression-in-adults-and-children-with-high-cd4-counts-using-a-streamlined-art-delivery-model-in-the-search-trial-in-rural-uganda-and-kenya
#13
Dalsone Kwarisiima, Moses R Kamya, Asiphas Owaraganise, Florence Mwangwa, Dathan M Byonanebye, James Ayieko, Albert Plenty, Doug Black, Tamara D Clark, Bridget Nzarubara, Katherine Snyman, Lillian Brown, Elizabeth Bukusi, Craig R Cohen, Elvin H Geng, Edwin D Charlebois, Theodore D Ruel, Maya L Petersen, Diane Havlir, Vivek Jain
INTRODUCTION: The 2015 WHO recommendation of antiretroviral therapy (ART) for all HIV-positive persons calls for treatment initiation in millions of persons newly eligible with high CD4+ counts. Efficient and effective care models are urgently needed for this population. We evaluated clinical outcomes of asymptomatic HIV-positive adults and children starting ART with high CD4+ counts using a novel streamlined care model in rural Uganda and Kenya. METHODS: In the 16 intervention communities of the HIV test-and-treat Sustainable East Africa Research for Community Health Study (NCT01864603), all HIV-positive individuals irrespective of CD4 were offered ART (efavirenz [EFV]/tenofovir disoproxil fumarate + emtricitabine (FTC) or lamivudine (3TC)...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28770593/differentiated-models-of-care-for-postpartum-women-on-antiretroviral-therapy-in-cape-town-south-africa-a-cohort-study
#14
REVIEW
Landon Myer, Victoria Iyun, Allison Zerbe, Tamsin K Phillips, Kirsty Brittain, Elton Mukonda, Joanna Allerton, Cathy D Kalombo, Andile Nofemela, Elaine J Abrams
BACKGROUND: The numbers of women initiating lifelong antiretroviral therapy (ART) during pregnancy and postpartum is increasing rapidly, presenting a burden on health systems and an urgent need for scalable models of care for this population. In a pilot project, we referred postpartum women who initiated ART during pregnancy to a community-based model of differentiated ART services. METHODS: Eligible women (on ART for at least 3 months with viral load (VL)<1000 copies/mL) were offered a choice of two ART models of care: (i) referral to an existing system of community-based 'adherence clubs', operated by lay counsellors with medication collection every 2-4 months; or (ii) referral to local primary healthcare clinics (PHC) with services provided by clinicians and medication collection every 1-2 months (local standard of care for postpartum ART)...
July 21, 2017: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/28766377/stigma-towards-mental-illness-and-substance-use-issues-in-primary-health-care-challenges-and-opportunities-for-latin-america
#15
Jaime C Sapag, Brena F Sena, Inés V Bustamante, Sireesha J Bobbili, Paola R Velasco, Franco Mascayano, Rubén Alvarado, Akwatu Khenti
Stigma towards mental illness and addictive disorders is a global problem and one of the main obstacles in tackling this issue remains the effective integration of mental health services into primary health care (PHC). In Latin America, information has significantly increased on the existence of stigma; however, little is known about effective interventions to prevent stigma and promote recovery-oriented practices in PHC. The aim of this study is to understand the existing evidence regarding mental health stigma in PHC with a special focus on the Latin American region...
August 2, 2017: Global Public Health
https://www.readbyqxmd.com/read/28753678/coughing-sneezing-and-aching-online-twitter-and-the-volume-of-influenza-like-illness-in-a-pediatric-hospital
#16
David M Hartley, Courtney M Giannini, Stephanie Wilson, Ophir Frieder, Peter A Margolis, Uma R Kotagal, Denise L White, Beverly L Connelly, Derek S Wheeler, Dawit G Tadesse, Maurizio Macaluso
This study investigates the relation of the incidence of georeferenced tweets related to respiratory illness to the incidence of influenza-like illness (ILI) in the emergency department (ED) and urgent care clinics (UCCs) of a large pediatric hospital. We collected (1) tweets in English originating in our hospital's primary service area between 11/1/2014 and 5/1/2015 and containing one or more specific terms related to respiratory illness and (2) the daily number of patients presenting to our hospital's EDs and UCCs with ILI, as captured by ICD-9 codes...
2017: PloS One
https://www.readbyqxmd.com/read/28740586/mechanical-valve-thrombosis-on-rivaroxaban-are-novel-anticoagulants-really-an-option
#17
Vishesh Kumar, Shawn Kelly, Amol Raizada, Jimmy Yee, Amornpol Anuwatworn, Adam Stys, Maria Stys
This is a case of a 54-year-old female with a history of mechanical aortic valve replacement who presented in cardiogenic shock. Her primary care provider started her on rivaroxaban for anticoagulation therapy. An urgent transesophageal echocardiogram revealed a significant gradient and thrombosis on one leaflet of the valve that was immobile. Given that she was not a surgical candidate, she underwent thrombolysis. However, she later died due to complications from the thrombotic valve. The utility of target-specific oral anticoagulants has yet to be established in clinical practice...
April 2017: Methodist DeBakey Cardiovascular Journal
https://www.readbyqxmd.com/read/28738685/assessing-the-effect-of-the-vha-pcmh-model-on-utilization-patterns-among-veterans-with-ptsd
#18
Ian Randall, Charles Maynard, Gary Chan, Beth Devine, Chris Johnson
OBJECTIVES: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH)-based Patient Aligned Care Teams (PACT) model in 2010. We examined its effects on the utilization of health services among US veterans with posttraumatic stress disorder (PTSD). STUDY DESIGN: We analyzed VHA clinical and administrative data to conduct an interrupted time series study. Encounter-level data were obtained for the period of April 1, 2005, through March 31, 2014...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28733686/comparison-of-the-proportion-and-healthcare-utilisation-of-adult-patients-with-uncontrolled-severe-asthma-versus-non-severe-asthma-seen-in-a-southeast-asian-hospital-based-respiratory-specialist-clinic
#19
Tunn Ren Tay, Hang Siang Wong, Rosna Ihsan, Hsiao Peng Toh, Xuening Choo, Augustine Kh Tee
INTRODUCTION: Understanding the burden of uncontrolled severe asthma is essential for disease-targeted healthcare planning. There is a scarcity of data regarding the proportion, healthcare utilisation and costs of patients with uncontrolled severe asthma in Asia. This study aimed to plug the knowledge gap in this area. MATERIALS AND METHODS: Consecutive patients with asthma managed in our respiratory specialist clinic were evaluated prospectively. Healthcare utilisation comprising unscheduled asthma-related primary care visits, emergency department (ED) visits and hospital admissions were obtained from the national health records system...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28731848/usability-acceptability-and-impact-of-a-pediatric-teledermatology-mobile-health-application
#20
Alexander G Fiks, Linda Fleisher, Lindsay Berrigan, Emily Sykes, Stephanie L Mayne, Rachel Gruver, Katherine Halkyard, Olivia S Jew, Patrick FitzGerald, Flaura Winston, Patrick McMahon
OBJECTIVE: Pediatric dermatology appointment wait times often exceed several months. We evaluated the usability, acceptability, and clinical impact of a store-and-forward teledermatology mobile application (app) linking families with pediatric dermatologists. METHODS: Parents of children age 6 weeks to 17 years or individuals 18-21 years old were invited (by e-mail or referral) to participate in this single group, prospective study. Within the app, users photographed the skin condition, answered questions, and submitted their case for review...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
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