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https://www.readbyqxmd.com/read/28701449/the-change-program-exercise-intervention-in-primary-care
#1
Doug Klein, Khursheed Jeejeebhoy, Angelo Tremblay, Matthew Kallio, Caroline Rheaume, Serena Humphries, Dawna Royall, Paula Brauer, Daren Heyland, Rupinder Dhaliwal, David M Mutch
PROBLEM ADDRESSED: Primary care settings require a feasible program for integrating lifestyle interventions, which can reverse metabolic abnormalities, for patients in practice. OBJECTIVE OF PROGRAM: To integrate a lifestyle intervention program into existing primary care clinics with an interprofessional approach that includes dietitians and kinesiologists. PROGRAM DESCRIPTION: Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) provides a personalized approach to nutrition and exercise modification focusing on patients with metabolic syndrome...
July 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28697527/-family-health-teams-in-ontario-ideas-for-germany-from-a-canadian-primary-care-model
#2
Lisa-R Ulrich, Thuy-Nga Tia Pham, Ferdinand M Gerlach, Antje Erler
The German healthcare system is struggling with fragmentation of care in the face of an increasing shortage of general practitioners and allied health professionals, and the time-demanding healthcare needs of an aging, multimorbid patient population. Innovative interprofessional, intersectoral models of care are required to ensure adequate access to primary care across a variety of rural and urban settings into the foreseeable future. A team approach to care of the complex multimorbid patient population appears particularly suitable in attracting and retaining the next generation of healthcare professionals, including general practitioners...
July 11, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28606105/credentialing-and-retention-of-visa-trainees-in-post-graduate-medical-education-programs-in-canada
#3
Maria Mathews, Rima Kandar, Steve Slade, Yanqing Yi, Sue Beardall, Ivy Bourgeault, Lynda Buske
BACKGROUND: Visa trainees are international medical graduates (IMG) who come to Canada to train in a post-graduate medical education (PGME) program under a student or employment visa and are expected to return to their country of origin after training. We examined the credentialing and retention of visa trainees who entered PGME programs between 2005 and 2011. METHODS: Using the Canadian Post-MD Education Registry's National IMG Database linked to Scott's Medical Database, we examined four outcomes: (1) passing the Medical Council of Canada Qualifying Examination Part 2 (MCCQE2), (2) obtaining a specialty designation (CCFP, FRCPC/SC), and (3) working in Canada after training and (4) in 2015...
June 12, 2017: Human Resources for Health
https://www.readbyqxmd.com/read/28578739/improving-team-based-care-for-children-shared-well-child-care-involving-family-practice-nurses
#4
Grace Warmels, Sharon Johnston, Jolanda Turley
INTRODUCTION: Well child care (WCC) is the provision of routine preventative care and vaccinations to infants and children. In Canada, physicians provide the majority of this type of care, whereas in other developed countries, nurses provide most WCC. New models of shared care between nurses and family physicians should be explored. OBJECTIVE: This pilot project aimed to evaluate the feasibility and acceptability of shared nurse-physician WCC for a cohort of healthy children...
June 5, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28500211/computer-use-in-primary-care-practices-in-canada
#5
Yvonne Anisimowicz, Andrea E Bowes, Ashley E Thompson, Baukje Miedema, William E Hogg, Sabrina T Wong, Alan Katz, Fred Burge, Kris Aubrey-Bassler, Gregory S Yelland, Walter P Wodchis
OBJECTIVE: To examine the use of computers in primary care practices. DESIGN: The international Quality and Cost of Primary Care study was conducted in Canada in 2013 and 2014 using a descriptive cross-sectional survey method to collect data from practices across Canada. Participating practices filled out several surveys, one of them being the Family Physician Survey, from which this study collected its data. SETTING: All 10 Canadian provinces...
May 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28490923/multigene-expression-profile-testing-in-breast-cancer-is-there-a-role-for-family-physicians
#6
M A O'Brien, J C Carroll, D P Manca, B Miedema, P A Groome, T Makuwaza, J Easley, N Sopcak, L Jiang, K Decker, M L McBride, R Moineddin, J A Permaul, R Heisey, E A Eisenhauer, M K Krzyzanowska, S Pruthi, C Sawka, N Schneider, J Sussman, R Urquhart, C Versaevel, E Grunfeld
BACKGROUND: Family physicians (fps) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of fps in supporting cancer patients who undergo tumour gene expression profile (gep) testing. METHODS: We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with fps and cancer specialists about the role of fps in breast cancer gep testing were obtained during studies conducted within the pan-Canadian canimpact research program...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28490920/the-role-of-family-physicians-in-cancer-care-perspectives-of-primary-and-specialty-care-providers
#7
J Easley, B Miedema, M A O'Brien, J Carroll, D Manca, F Webster, E Grunfeld
BACKGROUND: Currently, the specific role of family physicians (fps) in the care of people with cancer is not well defined. Our goal was to explore physician perspectives and contextual factors related to the coordination of cancer care and the role of fps. METHODS: Using a constructivist grounded theory approach, we conducted telephone interviews with 58 primary and cancer specialist health care providers from across Canada. RESULTS: The participants-21 fps, 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 general practitioners in oncology-were asked to describe both the role that fps currently play and the role that, in their opinion, fps should play in the future care of cancer patients across the cancer continuum...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28483888/alignment-of-canadian-primary-care-with-the-patient-medical-home-model-a-qualico-pc-study
#8
Alan Katz, Nicole Herpai, Glenys Smith, Kris Aubrey-Bassler, Mylaine Breton, Antoine Boivin, William Hogg, Baukje Miedema, Jocelyn Pang, Walter P Wodchis, Sabrina T Wong
PURPOSE: The patient medical home (PMH) model aims to improve patient satisfaction and health outcomes in Canada, but since its introduction in 2009, there has been no evaluation of the extent to which primary care conforms with PMH attributes. Our objective was to compare current primary care across Canada with the 10 goals of the PMH model. METHODS: A cross-sectional survey of primary care organization and delivery was conducted in Canadian provinces to evaluate the PMH-based attributes of primary care practices...
May 2017: Annals of Family Medicine
https://www.readbyqxmd.com/read/28464979/how-do-family-medicine-residents-choose-an-anticoagulation-regimen-for-patients-with-nonvalvular-atrial-fibrillation
#9
Payam Yazdan-Ashoori, Zardasht Oqab, William F McIntyre, Kieran L Quinn, Erik van Oosten, Wilma M Hopman, Adrian Baranchuk
Aim To examine the choices Canadian family medicine residents make for oral anticoagulation (OAC) for patients with nonvalvular atrial fibrillation (AF). BACKGROUND: AF increases the risk of strokes. An important consideration in AF management is risk stratification for stroke and prescription of appropriate OAC. Family physicians provide the vast majority of OAC prescriptions. METHODS: We administered a survey to residents in multiple Canadian family medicine training programmes...
May 3, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/28463015/effectiveness-of-group-cognitive-behavioral-therapy-for-insomnia-cbt-i-in-a-primary-care-setting
#10
Judith R Davidson, Samantha Dawson, Adrijana Krsmanovic
OBJECTIVE/BACKGROUND: Primary care is where many patients with insomnia first ask for professional help. Cognitive-behavioral therapy for insomnia (CBT-I) is the recommended treatment for chronic insomnia. Although CBT-I's efficacy is well established, its effectiveness in real-life primary care has seldom been investigated. We examined the effectiveness of CBT-I as routinely delivered in a Canadian primary care setting. PARTICIPANTS: The patients were 70 women and 11 men (mean age = 57...
May 2, 2017: Behavioral Sleep Medicine
https://www.readbyqxmd.com/read/28457296/the-role-of-occult-hypertension-in-retinal-vein-occlusions-and-diabetic-retinopathy
#11
Nataly Pesin, Efrem D Mandelcorn, Tina Felfeli, Richard I Ogilvie, Michael H Brent
OBJECTIVE: The aim of the study was to investigate whether individuals who develop retinal vein occlusion (RVO) or sudden-onset activity in otherwise quiescent diabetic retinopathy (DR) and those who have normal blood pressure (BP) or controlled hypertension according to their family physician show evidence of occult hypertension on 24-hour BP monitoring. METHODS: Patients with a new-onset RVO or DR that led to vitreous hemorrhage after a period of quiescence were identified...
April 2017: Canadian Journal of Ophthalmology. Journal Canadien D'ophtalmologie
https://www.readbyqxmd.com/read/28446522/improving-opioid-safety-practices-in-primary-care-protocol-for-the-development-and-evaluation-of-a-multifaceted-theory-informed-pilot-intervention-for-healthcare-providers
#12
Pamela Leece, Daniel Z Buchman, Michael Hamilton, Caitlyn Timmings, Yalnee Shantharam, Julia Moore, Andrea D Furlan
INTRODUCTION: In North America, drug overdose deaths are reaching unprecedented levels, largely driven by increasing prescription opioid-related deaths. Despite the development of several opioid guidelines, prescribing behaviours still contribute to poor patient outcomes and societal harm. Factors at the provider and system level may hinder or facilitate the application of evidence-based guidelines; interventions designed to address such factors are needed. METHODS AND ANALYSIS: Using implementation science and behaviour change theory, we have planned the development and evaluation of a comprehensive Opioid Self-Assessment Package, designed to increase adherence to the Canadian Opioid Guideline among family physicians...
April 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/28437370/ethics-guide-recommendations-for-organ-donation-focused-physicians-endorsed-by-the-canadian-medical-association
#13
Sam D Shemie, Christy Simpson, Jeff Blackmer, Shavaun MacDonald, Sonny Dhanani, Sylvia Torrance, Paul Byrne
Donation physicians are specialists with expertise in organ and tissue donation and have been recognized internationally as a key contributor to improving organ and tissue donation services. Subsequent to a 2011 Canadian Critical Care Society-Canadian Blood Services consultation, the donation physician role has been gradually implemented in Canada. These professionals are generally intensive care unit physicians with an enhanced focus and expertise in organ/tissue donation. They must manage the dual obligation of caring for dying patients and their families while providing and/or improving organ donation services...
May 2017: Transplantation
https://www.readbyqxmd.com/read/28436360/prostate-cancer-screening-practices-amongst-physicians-in-the-north-simcoe-muskoka-local-health-integration-network
#14
Thomas Burrows, A Andrew Ray, Cory Hartsburg
INTRODUCTION: The prostate-specific antigen (PSA) screening test is controversial and can result in both over-diagnosis and over-treatment. Recently, the Canadian Task Force on Preventive Health Care (CTFPHC) has recommended against routine screening for prostate cancer. We sought to determine how the CTFPHC has impacted the practice patterns among family physicians in the North Simcoe Muskoka (NSM) Local Health Integration Network (LHIN). MATERIALS AND METHODS: We surveyed all 439 family physicians within the NSM LHIN as well as 21 residents of the Family Medical Teaching Unit...
April 2017: Canadian Journal of Urology
https://www.readbyqxmd.com/read/28423861/a-digital-framework-to-support-providers-and-patients-in-diabetes-related-behavior-modification
#15
Samina Abidi, Michael Vallis, Helena Piccinini-Vallis, Syed Ali Imran, Syed Sibte Raza Abidi
We present Diabetes Web-Centric Information and Support Environment (D-WISE) that features: (a) Decision support tool to assist family physicians to administer Behavior Modification (BM) strategies to patients; and (b) Patient BM application that offers BM strategies and motivational interventions to engage patients. We take a knowledge management approach, using semantic web technologies, to model the social cognition theory constructs, Canadian diabetes guidelines and BM protocols used locally, in terms of a BM ontology that drives the BM decision support to physicians and BM strategy adherence monitoring and messaging to patients...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28404720/shared-canadian-curriculum-in-family-medicine-sharc-fm-creating-a-national-consensus-on-relevant-and-practical-training-for-medical-students
#16
David A Keegan, Ian Scott, Michael Sylvester, Amy Tan, Kathleen Horrey, W Wayne Weston
PROBLEM ADDRESSED: In 2006, leaders of undergraduate family medicine education programs faced a series of increasing curriculum mandates in the context of limited time and financial resources. Additionally, it became apparent that a hidden curriculum against family medicine as a career choice was active in medical schools. OBJECTIVE OF PROGRAM: The Shared Canadian Curriculum in Family Medicine was developed by the Canadian Undergraduate Family Medicine Education Directors and supported by the College of Family Physicians of Canada as a national collaborative project to support medical student training in family medicine clerkship...
April 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/28401139/family-physician-led-team-based-lifestyle-intervention-in-patients-with-metabolic-syndrome-results-of-a-multicentre-feasibility-project
#17
Khursheed Jeejeebhoy, Rupinder Dhaliwal, Daren K Heyland, Roger Leung, Andrew G Day, Paula Brauer, Dawna Royall, Angelo Tremblay, David M Mutch, Lew Pliamm, Caroline Rhéaume, Doug Klein
BACKGROUND: Metabolic syndrome (MetS) is a medical condition with major complications and health care costs. Previous research has shown that diet and exercise can improve and reverse this condition. The goal of this study was to test the feasibility and effectiveness of implementing the Canadian Health Advanced by Nutrition and Graded Exercise (CHANGE) program into diverse family medicine practices to improve MetS. METHODS: In this longitudinal before-after study, 305 adult patients with MetS were recruited from 3 diverse family medicine team-based organizations to the CHANGE personalized diet and exercise program...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28401122/quality-indicators-for-the-detection-and-management-of-chronic-kidney-disease-in-primary-care-in-canada-derived-from-a-modified-delphi-panel-approach
#18
Karen Tu, Lindsay Bevan, Katie Hunter, Jess Rogers, Jacqueline Young, Gihad Nesrallah
BACKGROUND: The detection and management of chronic kidney disease lies within primary care; however, performance measures applicable in the Canadian context are lacking. We sought to develop a set of primary care quality indicators for chronic kidney disease in the Canadian setting and to assess the current state of the disease's detection and management in primary care. METHODS: We used a modified Delphi panel approach, involving 20 panel members from across Canada (10 family physicians, 7 nephrologists, 1 patient, 1 primary care nurse and 1 pharmacist)...
January 2017: CMAJ Open
https://www.readbyqxmd.com/read/28364118/enablers-and-determinants-of-the-provision-of-written-action-plans-to-patients-with-asthma-a-stratified-survey-of-canadian-physicians
#19
Fabienne Djandji, Alexandrine J Lamontagne, Lucie Blais, Simon L Bacon, Pierre Ernst, Roland Grad, Kim L Lavoie, Martha L McKinney, Eve Desplats, Francine M Ducharme
Despite national recommendations, most patients with asthma are not given a written action plan . The objectives were to ascertain physicians' endorsement of potential enablers to providing a written action plan, and the determinants and proportion, of physician-reported use of a written action plan. We surveyed 838 family physicians, paediatricians, and emergency physicians in Quebec. The mailed questionnaire comprised 102 questions on asthma management, 11 of which pertained to written action plan and promising enablers...
March 31, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28344695/are-we-adequately-preparing-the-next-generation-of-physicians-to-prescribe-exercise-as-prevention-and-treatment-residents-express-the-desire-for-more-training-in-exercise-prescription
#20
Kara Solmundson, Michael Koehle, Donald McKenzie
BACKGROUND: Physical activity (PA) is a key intervention for chronic disease, yet few physicians provide exercise prescription (EP). EP is an important component in larger strategies of reducing non-communicable disease (NCD). Our objective was to assess Family Medicine Residents (FMR) knowledge, competence, and perspectives of EP to help inform future curriculum development. METHODS: A 49-item cross-sectional survey was administered to 396 University of British Columbia FMR...
October 2016: Canadian Medical Education Journal
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