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General Practice, Family Medicine

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https://www.readbyqxmd.com/read/28346620/varied-rates-of-implementation-of-patient-centered-medical-home-features-and-residents-perceptions-of-their-importance-based-on-practice-experience
#1
M Patrice Eiff, Larry A Green, Geoff Jones, Alex Verdieck Devlaeminck, Elaine Waller, Eve Dexter, Miguel Marino, Patricia A Carney
BACKGROUND AND OBJECTIVES: Little is known about how the patient-centered medical home (PCMH) is being implemented in residency practices. We describe both the trends in implementation of PCMH features and the influence that working with PCMH features has on resident attitudes toward their importance in 14 family medicine residencies associated with the P4 Project. METHODS: We assessed 24 residency continuity clinics annually between 2007-2011 on presence or absence of PCMH features...
March 2017: Family Medicine
https://www.readbyqxmd.com/read/28342441/building-a-community-of-practice-in-rural-medical-education-growing-our-own-together
#2
Randall L Longenecker, David Schmitz
CONTEXT: This article chronicles the rise, decline, and recent resurgence of rural training track residency programs (RTTs) in the USA over the past 30 years and the emergence of a healthy community of practice in rural medical education. This has occurred during a time in the USA when federal and state funding of graduate medical education has been relatively stagnant and the rules around finance and accreditation of rural programs have been challenging. ISSUE: Many of the early family residency programs developed in the 1970s included a curricular focus on rural practice...
January 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/28292304/design-and-implementation-of-electronic-health-record-integrated-clinical-prediction-rules-icpr-a-randomized-trial-in-diverse-primary-care-settings
#3
David A Feldstein, Rachel Hess, Thomas McGinn, Rebecca G Mishuris, Lauren McCullagh, Paul D Smith, Michael Flynn, Joseph Palmisano, Gheorghe Doros, Devin Mann
BACKGROUND: Clinical prediction rules (CPRs) represent a method of determining individual patient risk to help providers make more accurate decisions at the point of care. Well-validated CPRs are underutilized but may decrease antibiotic overuse for acute respiratory infections. The integrated clinical prediction rules (iCPR) study builds on a previous single clinic study to integrate two CPRs into the electronic health record and assess their impact on practice. This article discusses study design and implementation of a multicenter cluster randomized control trial of the iCPR clinical decision support system, including the tool adaptation, usability testing, staff training, and implementation study to disseminate iCPR at multiple clinical sites across two health care systems...
March 14, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28289469/using-movies-in-family-medicine-teaching-a-reference-to-euract-educational-agenda
#4
Zalika Klemenc Ketiš, Igor Švab
INTRODUCTION: Cinemeducation is a teaching method where popular movies or movie clips are used. We aimed to determine whether family physicians' competencies as listed in the Educational Agenda produced by the European Academy of Teachers in General Practice/Family Medicine (EURACT) can be found in movies, and to propose a template for teaching by these movies. METHODS: A group of family medicine teachers provided a list of movies that they would use in cinemeducation...
June 1, 2017: Zdravstveno Varstvo
https://www.readbyqxmd.com/read/28250000/assessment-of-rapid-blood-culture-identification-results-interpretation-and-antibiotic-prescribing-practices
#5
Linsey M Donner, W Scott Campbell, Elizabeth Lyden, Trevor C Van Schooneveld
Background: Rapid pathogen identification can alter antibiotic prescribing if interpreted correctly. Microbiology reporting can be difficult to understand and new technology has made it more challenging. Nebraska Medicine recently implemented the Biofire FilmArray® Blood Culture Identification Panel (BCID) coupled with stewardship-based education on interpretation.Methods: Physician BCID result interpretation and prescribing was assessed via an electronic survey with a response rate of 40.8% (156/382). Seven questions required respondents to interpret BCID results and identify the most likely pathogen, then choose therapy based on the results...
March 1, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28219385/language-support-for-linguistic-minority-chronic-hepatitis-b-c-patients-an-exploratory-study-of-availability-and-clinicians-perceptions-of-language-barriers-in-six-european-countries
#6
Abby M Falla, Irene K Veldhuijzen, Amena A Ahmad, Miriam Levi, Jan Hendrik Richardus
BACKGROUND: Language support for linguistic minorities can improve patient safety, clinical outcomes and the quality of health care. Most chronic hepatitis B/C infections in Europe are detected among people born in endemic countries mostly in Africa, Asia and Central/Eastern Europe, groups that may experience language barriers when accessing health care services in their host countries. We investigated availability of interpreters and translated materials for linguistic minority hepatitis B/C patients...
February 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28207666/are-they-complying-physicians-knowledge-attitudes-and-readiness-to-change-regarding-low-back-pain-treatment-guideline-adherence
#7
Sheera Epstein-Sher, Dena H Jaffe, Amnon Lahad
STUDY DESIGN: Cross-sectional survey of 145 primary care practitioners (PCPs). OBJECTIVE: To examine low back pain (LBP) guideline knowledge, readiness to implement (RTI) these guidelines, and LBP attitudes and beliefs among Israeli PCPs and determine whether physician age, guideline familiarity, and medical specialty affect these variables. SUMMARY OF BACKGROUND DATA: LBP is a common condition managed primarily by PCPs. Little is known, however, about physician's LBP knowledge, attitudes, and beliefs and how these factors (knowledge, A&B) influence their practice behavior...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28166575/impact-of-potential-accreditation-and-certification-in-family-medicine-maternity-care
#8
Aimee R Eden, Lars E Peterson
BACKGROUND AND OBJECTIVES: Advanced maternity care training in family medicine is highly variable at both the residency and fellowship levels. Declining numbers of family physicians providing maternity care services may exacerbate disparities in access to maternal and child care, especially in rural and other underserved communities. Accreditation of maternity care fellowships and board certification may be one potential avenue to address this trend. This study sought to understand the perceptions and beliefs of key family medicine stakeholders in advanced maternity care regarding the formalization of maternity care training through fellowship accreditation and the creation of a certificate of added qualification (CAQ)...
January 2017: Family Medicine
https://www.readbyqxmd.com/read/28144194/the-effects-of-a-web-application-and-medical-monitoring-on-the-quality-of-medication-adverse-drug-events-and-adherence-in-the-elderly-living-at-home-a-protocol-of-the-study
#9
Polona Selic, Eva Cedilnik Gorup, Savin Gorup, Marija Petek Ster, Janez Rifel, Zalika Klemenc Ketis
BACKGROUND: In more than half of elderly chronically-ill family clinic attendees, drug prescribing deviates from the internationally acknowledged STOPP/START recommendations. Our study will determine whether it is possible to improve the quality of drug prescriptions in chronically-ill elderly people living at home by regularly monitoring the prescribed drugs according to STOPP/START criteria. METHODS: The project started in 2014 and will run until 2017. Forty general practitioners (GPs) are participating in a pragmatic randomized controlled trial...
December 2016: Materia Socio-medica
https://www.readbyqxmd.com/read/28129956/-medically-unexplained-symptoms-care-in-internal-medicine-a-paradigm-of-doctor-patient-relationship-in-situation-of-uncertainty
#10
B Ranque, O Nardon
Medically unexplained symptoms (MUS) are extremely common in general practice as in all medical specialties, but their designation is not unambiguous and the approaches to take care of the patients differ from conventional therapeutic approaches. The difficulty is not to confirm the diagnosis, which is rapidly obvious with some experience, but to establish a genuinely human therapeutic relationship, without any technical help, which pushes the doctor to the edge of his empathy and communication skills. The discomfort or even distress regularly encountered by physicians in front of a patient with MUS shows that the foundations of the doctor-patient relationship under uncertainty are poorly mastered...
January 24, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28068145/comparison-of-patient-health-history-questionnaires-used-in-general-internal-and-family-medicine-integrative-medicine-and-complementary-and-alternative-medicine-clinics
#11
Justin G R Laube, Martin F Shapiro
OBJECTIVES: Health history questionnaires (HHQs) are a set of self-administered questions completed by patients prior to a clinical encounter. Despite widespread use, minimal research has evaluated the content of HHQs used in general internal medicine and family medicine (GIM/FM), integrative medicine, and complementary and alternative medicine (CAM; chiropractic, naturopathic, and Traditional Chinese Medicine [TCM]) clinics. Integrative medicine and CAM claim greater emphasis on well-being than does GIM/FM...
January 9, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
https://www.readbyqxmd.com/read/28062808/practice-innovation-for-care-integration-opioid-management-and-quality-measurement-in-family-medicine
#12
EDITORIAL
Anne Victoria Neale, Marjorie A Bowman, Dean A Seehusen
Ringing in the new year 2017! This may finally be the year of real practice improvement after many false starts. Research into practice transformation has informed both local work and national policy. Human factors and payment structures are key. And payment structures depend on how quality is measured. Large gaps between practicing physician recommendations for the most important quality measures and those currently imposed externally are exposed in this issue. Also see information on in-practice social work consultations and their outcomes and recommendations from innovators in integrated care, and for chronic opioid therapy management based on visits to many family medicine offices...
January 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28003897/use-of-prescription-drugs-and-investigations-by-doctors-in-primary-care-settings-in-oman-and-the-uk
#13
Robin Davidson
OBJECTIVES: This audit aimed to investigate the use of prescription drugs and investigations by trainee doctors in primary care settings in Oman and the UK. METHODS: This audit took place between February and April 2015. The medical records of consecutive patients seen by five family medicine trainee doctors at a primary care setting in Oman were retrospectively reviewed. These data were compared to those gathered from two trainees at a general practice clinic in the UK as well as an experienced general practitioner (GP) who had practiced in both countries...
November 2016: Sultan Qaboos University Medical Journal
https://www.readbyqxmd.com/read/27997259/a-new-comprehensive-model-for-continuous-professional-development
#14
Niels Kristian Kjaer, Marianne Vedsted, James Høpner
BACKGROUND: It is generally agreed that continuing professional development (CPD) for GPs is important for quality of care. Internationally, however, different approaches to identify the learning objectives and the CPD content have been chosen. OBJECTIVES: To improve GPs' CPD in Denmark we explore how general practitioners' (GPs) self-experienced learning needs can be combined with learning needs experienced from a societal perspective and still make sense for GPs...
December 20, 2016: European Journal of General Practice
https://www.readbyqxmd.com/read/27987572/-changing-to-a-career-in-general-practice-a-qualitative-study-reveals-motives-of-specialists
#15
Simon Schwill, Julia Magez, Cornelia Jäger, Wolfgang Cg von Meißner, Joachim Szecsenyi, Elisabeth Flum
BACKGROUND: In 2011, the national German Medical Association (Bundesärztekammer) published guidelines for a slim-lined training program in general practice (Quereinstieg) for qualified medical specialists in other fields (e. g., surgeons, internists or anesthesiologists). This step is part of a strategy to prevent further shortages of general practitioners in Germany. In the state of Baden-Wuerttemberg, qualified medical specialists are allowed to complete their general practice training in approximately two years instead of five...
December 2016: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/27977290/implementation-of-an-acceptance-and-mindfulness-based-group-for-depression-and-anxiety-in-primary-care-initial-outcomes
#16
Cara H Fuchs, Natasha Haradhvala, Daniel R Evans, Justin M Nash, Risa B Weisberg, Lisa A Uebelacker
INTRODUCTION: Depression and anxiety disorders are highly prevalent among primary care patients. Group visits provide a way of delivering interventions to multiple patients at the same time. Group visits for depression and anxiety present an opportunity to expand the reach of behavioral health services for primary care patients. The goal of the current study was to evaluate the implementation of an acceptance and mindfulness-based group for primary care patients with depression and anxiety...
December 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/27919245/one-day-workshop-based-training-improves-physical-activity-prescription-knowledge-in-latin-american-physicians-a-pre-test-post-test-study
#17
Maria C Arciniegas Calle, Felipe Lobelo, Mario A Jiménez, Diana C Páez, Sebastian Cortés, Andrés de Lima, John Duperly
BACKGROUND: The physical inactivity pandemic and related non-communicable diseases have made it imperative for medical doctors (MDs) to effectively provide lifestyle counseling as part of prevention and treatment plans for patients. A one-day certification workshop was designed to improve MDs PA prescription knowledge, as part of the Exercise is Medicine® (EIM®) global health initiative. The objective was to determine knowledge gain of MDs participating in a standardized, one-day PA prescription workshop performed throughout Latin America (LA)...
December 5, 2016: BMC Public Health
https://www.readbyqxmd.com/read/27913563/-you-can-t-be-a-person-and-a-doctor-the-work-life-balance-of-doctors-in-training-a-qualitative-study
#18
Antonia Rich, Rowena Viney, Sarah Needleman, Ann Griffin, Katherine Woolf
OBJECTIVES: Investigate the work-life balance of doctors in training in the UK from the perspectives of trainers and trainees. DESIGN: Qualitative semistructured focus groups and interviews with trainees and trainers. SETTING: Postgraduate medical training in London, Yorkshire and Humber, Kent, Surrey and Sussex, and Wales during the junior doctor contract dispute at the end of 2015. Part of a larger General Medical Council study about the fairness of postgraduate medical training...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27888178/perceived-causes-of-differential-attainment-in-uk-postgraduate-medical-training-a-national-qualitative-study
#19
Katherine Woolf, Antonia Rich, Rowena Viney, Sarah Needleman, Ann Griffin
OBJECTIVES: Explore trainee doctors' experiences of postgraduate training and perceptions of fairness in relation to ethnicity and country of primary medical qualification. DESIGN: Qualitative semistructured focus group and interview study. SETTING: Postgraduate training in England (London, Yorkshire and Humber, Kent Surrey and Sussex) and Wales. PARTICIPANTS: 137 participants (96 trainees, 41 trainers) were purposively sampled from a framework comprising: doctors from all stages of training in general practice, medicine, obstetrics and gynaecology, psychiatry, radiology, surgery or foundation, in 4 geographical areas, from white and black and minority ethnic (BME) backgrounds, who qualified in the UK and abroad...
November 25, 2016: BMJ Open
https://www.readbyqxmd.com/read/27887795/clinician-knowledge-clinician-barriers-and-perceived-parental-barriers-regarding-human-papillomavirus-vaccination-association-with-initiation-and-completion-rates
#20
Lila J Finney Rutten, Jennifer L St Sauver, Timothy J Beebe, Patrick M Wilson, Debra J Jacobson, Chun Fan, Carmen Radecki Breitkopf, Susan T Vadaparampil, Robert M Jacobson
PURPOSE: We tested the hypothesis that clinician knowledge, clinician barriers, and perceived parental barriers relevant to the human papillomavirus (HPV) vaccination account for the variation in vaccine delivery at the practice-site level. METHODS: We conducted a survey from October 2015 through January 2016 among primary care clinicians (n=280) in a 27-county geographic region to assess clinician knowledge, clinician barriers, and perceived parental barriers regarding HPV vaccination...
January 3, 2017: Vaccine
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