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https://www.readbyqxmd.com/read/28650916/morning-hypertension-is-more-common-in-elderly-hypertensive-patients-with-controlled-documented-office-blood-pressure-in-primary-care-clinics-the-minhang-study
#1
Yan Wang, Ling Chen, Yajuan Wang, Yuesheng Qain, Jin Zhang, Xiaofeng Tang, Yan Li, Dingliang Zhu
BACKGROUND: Increased morning blood pressure (BP) has been associated with fatal and nonfatal cardiovascular events, especially in Asians. METHOD: To detect the control status of home BP, we performed a home BP monitoring study, including elderly patients with hypertension who had controlled documented office BP in Chinese primary care clinics. In 707 participants from Xinzhuang County Hospital in Shanghai, the home BP was measured by a memory-equipped device three times daily for seven consecutive days...
June 24, 2017: Journal of Hypertension
https://www.readbyqxmd.com/read/28650873/perceptions-of-ambulatory-workflow-changes-in-an-academic-primary-care-setting
#2
Michael A Hanak, Colleen McDevitt, Daniel P Dunham
As health care moves to a value-based system, the need for team-based models of care becomes increasingly important to adequately address the growing number of clinical quality metrics required of health care providers. Finding ways to better engage certified medical assistants (CMAs) in the process allows providers to focus on more complex tasks while improving the efficiency of each office visit. Although the roles and responsibilities for CMAs across the specialties can vary widely, standardizing the work can be a helpful step in scaling best practices across an institution...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28648219/primary-care-collaboration-to-improve-diagnosis-and-screening-for-colorectal-cancer
#3
Gordon D Schiff, Trudy Bearden, Lindsay Swain Hunt, Jennifer Azzara, Jay Larmon, Russell S Phillips, Sara Singer, Brandon Bennett, Jonathan R Sugarman, Asaf Bitton, Andrew Ellner
BACKGROUND: Colorectal cancer (CRC) is a leading cause of cancer death, reducible by screening and early diagnosis, yet many patients fail to receive recommended screening. As part of an academic improvement collaborative, 25 primary care practices worked to improve CRC screening and diagnosis. METHODS: The project featured triannual learning sessions, monthly conference calls, practice coach support, and monthly reporting. The project phases included literature review and interviews with national leaders/organizations, development of driver diagrams to identify key factors and change ideas, project launch and practice team planning, and a practice improvement phase...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28645954/assessing-the-impact-of-colonoscopy-complications-on-use-of-colonoscopy-among-primary-care-physicians-and-other-connected-physicians-an-observational-study-of-older-americans
#4
Nancy L Keating, A James O'Malley, Jukka-Pekka Onnela, Bruce E Landon
OBJECTIVES: Psychological biases can distort treatment decision-making. The availability heuristic is one such bias, wherein events that are recent, vivid or easily imagined are readily 'available' to memory and are therefore judged more likely to occur than expected based on epidemiological data. We assessed if the occurrence of a serious colonoscopy complication for a primary care physician's patient influenced colonoscopy rates for the physician's other patients. DESIGN: Longitudinal study with time-varying exposure variables...
June 23, 2017: BMJ Open
https://www.readbyqxmd.com/read/28644835/physician-assessments-of-drug-seeking-behavior-a-mixed-methods-study
#5
Michael A Fischer, John B McKinlay, Jeffrey N Katz, Eric Gerstenberger, Felicia Trachtenberg, Lisa D Marceau, Lisa C Welch
BACKGROUND: Pain complaints are common, but clinicians are increasingly concerned about overuse of opioid pain medications. This may lead patients with actual pain to be stigmatized as "drug-seeking," or attempting to obtain medications they do not require medically. We assessed whether patient requests for specific opioid pain medication would lead physicians to classify them as drug-seeking and change management decisions. METHODS AND FINDINGS: Mixed-methods analysis of interviews with 192 office-based primary care physicians after viewing video vignettes depicting patients presenting with back pain...
2017: PloS One
https://www.readbyqxmd.com/read/28642642/access-to-and-payment-for-office-based-buprenorphine-treatment-in-ohio
#6
Theodore V Parran, Joseph Z Muller, Elina Chernyak, Chris Adelman, Christina M Delos Reyes, Douglas Rowland, Mykola Kolganov
IMPORTANCE: Office-based opiate agonist therapy has dramatically expanded access to medication-assisted treatment over the past decade but has also led to increased buprenorphine diversion. OBJECTIVE: Our study sought to characterize physicians who participate in office-based therapy (OBT) to assess patient access to OBT in Ohio 10 years after its introduction. DESIGN/SETTING/PARTICIPANTS: Cross-sectional telephone survey of Drug Addiction Treatment Act-waivered physicians in Ohio listed by the Center for Substance Abuse Treatment (CSAT)...
2017: Substance Abuse: Research and Treatment
https://www.readbyqxmd.com/read/28636442/the-national-ebola-training-and-education-center-preparing-the-united-states-for-ebola-and-other-special-pathogens
#7
Christopher J Kratochvil, Laura Evans, Bruce S Ribner, John J Lowe, Melissa Cole Harvey, Richard C Hunt, Abbigail J Tumpey, Ryan P Fagan, Michelle M Schwedhelm, Sonia Bell, John Maher, Colleen S Kraft, Nicholas V Cagliuso, Sharon Vanairsdale, Angela Vasa, Philip W Smith
The National Ebola Training and Education Center (NETEC) was established in 2015 in response to the 2014-2016 Ebola virus disease outbreak in West Africa. The US Department of Health and Human Services office of the Assistant Secretary for Preparedness and Response and the US Centers for Disease Control and Prevention sought to increase the competency of healthcare and public health workers, as well as the capability of healthcare facilities in the United States, to deliver safe, efficient, and effective care to patients infected with Ebola and other special pathogens nationwide...
May 2017: Health Security
https://www.readbyqxmd.com/read/28626503/does-a-free-office-visit-affect-primary-care-seeking-behavior-a-study-of-new-exchange-health-plan-enrollees-in-mississippi
#8
Bettina M Beech, Tristan Cordier, Laura E Happe, Laura Trunk, Gilbert S Haugh, Richard Kwong, Vipin Gopal, Roy A Beveridge
BACKGROUND: Given the positive association between primary care and overall health, several health plans are offering doctors' visits without patient copay, with the intent to increase primary care use. However, the effectiveness of these offers has not been established in the literature. OBJECTIVE: To evaluate the impact of a free primary care provider (PCP) office visit offered by a health plan on primary care-seeking behaviors. METHODS: This nonrandomized concurrent control study used event/trials logistic regression to compare the differences in primary care utilization between new exchange enrollees in Mississippi who were offered a free nonpreventive PCP visit and concurrent controls from Georgia and Tennessee who were not offered a free visit, between January 1, 2014, and December 31, 2014, which was the first year of the exchange plans...
April 2017: American Health & Drug Benefits
https://www.readbyqxmd.com/read/28623995/rationale-design-and-methodology-of-the-observational-insights-svt-study-on-the-current-state-of-care-and-outcomes-of-patients-with-superficial-vein-thrombosis
#9
Rupert Bauersachs, Horst Eberhard Gerlach, Andreas Heinken, Ulrich Hoffmann, Florian Langer, Thomas Noppeney, David Pittrow, Jens Klotsche, Eberhard Rabe
OBJECTIVE: Superficial vein thrombosis (SVT) is a common disease in clinical practice. In terms of pathophysiology and outcomes, the condition is related to venous thromboembolism, bearing a potential for severe thromboembolic complications if it is not treated adequately. A wide range of treatment approaches (including oral and injectable anticoagulants, pain medication, nondrug therapy including compression therapy, and no treatment at all) are applied in clinical practice, but there is sparse information about selection of patients for therapies, current treatment pathways, and drug use as well as outcomes...
July 2017: Journal of Vascular Surgery. Venous and Lymphatic Disorders
https://www.readbyqxmd.com/read/28621808/primary-care-interventions-to-reduce-childhood-obesity-and-sugar-sweetened-beverage-consumption-food-for-thought-for-oral-health-professionals
#10
Diane Dooley, Nicolette M Moultrie, Elsbeth Sites, Patricia B Crawford
OBJECTIVES: Childhood obesity remains a significant threat to America's children. Health care leaders have increasingly called upon oral health professionals to integrate healthy weight promotion and enhanced sugar-sweetened beverage counseling into their professional practices. The aim of this scoping review is to examine recent evidence regarding the effectiveness of primary care childhood obesity interventions that have potential for adoption by oral health professionals. METHODS: Medine, and PubMed were searched from 2010 to 2016 for review articles and studies reporting patient outcomes or policy outcomes relevant to primary care childhood obesity interventions for children ages 2-11 years...
June 16, 2017: Journal of Public Health Dentistry
https://www.readbyqxmd.com/read/28612689/evaluation-of-flood-preparedness-in-government-healthcare-facilities-in-eastern-province-sri-lanka
#11
Jessica M Farley, Inoka Suraweera, W L S P Perera, Jeremy Hess, Kristie L Ebi
BACKGROUND: Sri Lanka is vulnerable to floods and other hydro-meteorological disasters. Climate change is projected to increase the intensity of these events. OBJECTIVE: This study aimed to assess the flood preparedness in healthcare facilities in Eastern Province. DESIGN: This was a cross-sectional, descriptive, mixed methods study conducted in Trincomalee District. Surveys were conducted in 31 government healthcare facilities, using a pre-tested, structured questionnaire covering the last 5 years...
2017: Global Health Action
https://www.readbyqxmd.com/read/28609535/comparison-of-content-on-the-american-board-of-internal-medicine-maintenance-of-certification-examination-with-conditions-seen-in-practice-by-general-internists
#12
Bradley Gray, Jonathan Vandergrift, Rebecca S Lipner, Marianne M Green
Importance: Success on the internal medicine (IM) examination is a central requirement of the American Board of Internal Medicine's (ABIM's) Maintenance of Certification program (MOC). Therefore, it is important to understand the degree to which this examination reflects conditions seen in practice, one dimension of content validity, which focuses on the match between content in the discipline and the topics on the examination questions. Objective: To assess whether the frequency of questions on IM-MOC examinations were concordant with the frequency of conditions seen in practice...
June 13, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28607235/meeting-the-current-and-future-health-care-needs-of-sri-lanka-s-ageing-population
#13
Dilhar Samaraweera, Shiromi Maduwage
Sri Lanka is one of the fastest-ageing countries in the world. This rapid demographic transition is expected to result in one quarter of the population being elderly by the year 2041. Profound challenges face the country as a result, especially with respect to planning adequate elderly-oriented services in the social-care and health-care sectors. In response to this need, many initiatives have been put in place to promote and protect the welfare of older people, and these rights have been inscribed in law. Within the health sector, despite the wealth of policies and initiatives in recent years, it is clear that the existing health infrastructure and systems still require strengthening, reorientation and coordination, to meet the needs of the growing population of elderly individuals...
September 2016: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28603550/health-system-governance-to-support-scale-up-of-mental-health-care-in-ethiopia-a-qualitative-study
#14
Charlotte Hanlon, Tigist Eshetu, Daniel Alemayehu, Abebaw Fekadu, Maya Semrau, Graham Thornicroft, Fred Kigozi, Debra Leigh Marais, Inge Petersen, Atalay Alem
BACKGROUND: Ethiopia is embarking upon a ground-breaking plan to address the high levels of unmet need for mental health care by scaling up mental health care integrated within primary care. Health system governance is expected to impact critically upon the success or otherwise of this important initiative. The objective of the study was to explore the barriers, facilitators and potential strategies to promote good health system governance in relation to scale-up of mental health care in Ethiopia...
2017: International Journal of Mental Health Systems
https://www.readbyqxmd.com/read/28602556/attacks-against-health-care-in-syria-2015-16-results-from-a-real-time-reporting-tool
#15
Mohamed Elamein, Hilary Bower, Camilo Valderrama, Daher Zedan, Hazem Rihawi, Khaled Almilaji, Mohammed Abdelhafeez, Nabil Tabbal, Naser Almhawish, Sophie Maes, Alaa AbouZeid
BACKGROUND: Collecting credible data on violence against health services, health workers, and patients in war zones is a massive challenge, but crucial to understanding the extent to which international humanitarian law is being breached. We describe a new system used mainly in areas of Syria with a substantial presence of armed opposition groups since November, 2015, to detect and verify attacks on health-care services and describe their effect. METHODS: All Turkey health cluster organisations with a physical presence in Syria, either through deployed and locally employed staff, were asked to participate in the Monitoring Violence against Health Care (MVH) alert network...
June 7, 2017: Lancet
https://www.readbyqxmd.com/read/28599674/cluster-randomized-trial-of-a-mhealth-intervention-imtecho-to-improve-delivery-of-proven-maternal-neonatal-and-child-care-interventions-through-community-based-accredited-social-health-activists-ashas-by-enhancing-their-motivation-and-strengthening-supervision
#16
Dhiren Modi, Shrey Desai, Kapilkumar Dave, Shobha Shah, Gayatri Desai, Nishith Dholakia, Ravi Gopalan, Pankaj Shah
BACKGROUND: To facilitate the delivery of proven maternal, neonatal, and child health (MNCH) services, a new cadre of village-based frontline workers, called the Accredited Social Health Activists (ASHAs), was created in 2005 under the aegis of the National Rural Health Mission in India. Evaluations have noted that coverage of selected MNCH services to be delivered by the ASHAs is low. Reasons for low coverage are inadequate supervision and support to ASHAs apart from insufficient skills, poor quality of training, and complexity of tasks to be performed...
June 9, 2017: Trials
https://www.readbyqxmd.com/read/28598752/association-between-continuity-of-care-in-swedish-primary-care-and-emergency-services-utilisation-a-population-based-cross-sectional-study
#17
Hannes Kohnke, Andrzej Zielinski
OBJECTIVE: The primary objective of this study was to determine the association between longitudinal continuity of care (CoC) in Swedish primary care (PC) and emergency services (ES) utilisation. STUDY DESIGN: A cross-sectional analysis of longitudinal population data. SETTING: PC centres, out-of-hours PC facilities and emergency departments (EDs) in Blekinge County in southern Sweden. SUBJECTS: People of all ages who lived in Blekinge County and who had made two or more visits per year to a general practitioner (GP) during office hours from 1 January 2012 to 31 December 2014...
June 9, 2017: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/28597854/decentralizing-provision-of-mental-health-care-in-sri-lanka
#18
Neil Fernando, Thirupathy Suveendran, Chithramalee de Silva
In the past, mental health services in Sri Lanka were limited to tertiary-care institutions, resulting in a large treatment gap. Starting in 2000, significant efforts have been made to reconfigure service provision and to integrate mental health services with primary health care. This approach was supported by significant political commitment to establishing island-wide decentralized mental health care in the wake of the 2004 tsunami. Various initiatives were consolidated in The mental health policy of Sri Lanka 2005-2015, which called for implementation of a comprehensive community-based, decentralized service structure...
April 2017: WHO South-East Asia Journal of Public Health
https://www.readbyqxmd.com/read/28594757/anesthetic-cream-use-during-office-pessary-removal-and-replacement-a-randomized-controlled-trial
#19
Susanne K Taege, William Adams, Elizabeth R Mueller, Linda Brubaker, Colleen M Fitzgerald, Cynthia Brincat
OBJECTIVE: To estimate the effect of lidocaine-prilocaine cream on patient pain at the time of office pessary removal and reinsertion. METHODS: In this double-blind, randomized placebo-controlled trial, participants undergoing routine pessary care in a urogynecology office at a tertiary referral center were randomized to application of 4 g of either lidocaine-prilocaine or placebo cream 5 minutes before pessary change. Visual analog scale pain scores were collected from the patient at baseline, after pessary removal, and after pessary reinsertion...
June 6, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28593925/intensive-educational-efforts-combined-with-external-quality-assessment-improve-the-preanalytical-phase-in-general-practitioner-offices-and-nursing-homes
#20
Una Ørvim Sølvik, Wenche Iren Bjelkarøy, Kari van den Berg, Anne Lise Saga, Helle Borgstrøm Hager, Sverre Sandberg
BACKGROUND: Errors in the preanalytical phase in clinical laboratories affect patient safety. The aim of this study was to evaluate the effect of intensive educational efforts together with external quality assessment (EQA) of the preanalytical phase from 2013 to 2015 to improve patient identification in primary health care in Norway. In addition, routines for venous and capillary blood sampling were investigated. METHODS: A preanalytical EQA was circulated in 2013 by the Norwegian Quality Improvement of Laboratory Examinations (Noklus) to general practitioner offices and nursing homes (n=2000) to obtain information about important issues to focus on before launching an intensive educational program with courses, posters and visits in 2013-2015...
May 5, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
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