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https://www.readbyqxmd.com/read/29161171/at-the-expense-of-a-life-race-class-and-the-meaning-of-buprenorphine-in-pharmaceuticalized-care
#1
Alexandrea E Hatcher, Sonia Mendoza, Helena Hansen
BACKGROUND/OBJECTIVE: Office-based buprenorphine maintenance has been legalized and promoted as a treatment approach that not only expands access to care, but also reduces the stigma of addiction treatment by placing it in a mainstream clinical setting. At the same time, there are differences in buprenorphine treatment utilization by race, ethnicity, and socioeconomic status. METHODS: This article draws on qualitative data from interviews with 77 diverse patients receiving buprenorphine in a primary care clinic and two outpatient substance dependence clinics to examine differences in patients' experiences of stigma in relation their need for psychosocial supports and services...
November 21, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/29156186/treatment-of-obesity-in-primary-care
#2
REVIEW
Adam G Tsai, Jocelyn E Remmert, Meghan L Butryn, Thomas A Wadden
This article outlines some of the behavioral, pharmacologic, and surgical interventions available to primary care physicians (PCPs) to help their patients with weight management. Studies on lifestyle modification, commercial weight loss programs, and medical and surgical options are reviewed. Several clinical suggestions on obesity management that PCPs can take back and use immediately in office practice are offered.
January 2018: Medical Clinics of North America
https://www.readbyqxmd.com/read/29155688/characteristics-of-visits-to-primary-care-physicians-by-adults-diagnosed-with-hypertension
#3
Jill J Ashman, Pinyao Rui, Susan M Schappert, Alexander Strashny
Objective-This report describes the demographic, state, and regional differences in hypertension control and pharmaceutical treatment among visits to primary care physicians made by hypertensive adults during 2013-2014. Methods-Data are from the 2013-2014 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of visits to nonfederal, office-based physicians. The sample design for the 2013-2014 NAMCS included oversampling in selected states. Estimates are provided for the 18 states oversampled in both years...
September 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/29150147/clinic-and-home-based-behavioral-intervention-for-obesity-in-preschoolers-a-randomized-trial
#4
Lori J Stark, Stephanie Spear Filigno, Christopher Bolling, Megan B Ratcliff, Jessica C Kichler, Shannon M Robson, Stacey L Simon, Mary Beth McCullough, Lisa M Clifford, Cathleen Odar Stough, Cynthia Zion, Richard F Ittenbach
OBJECTIVE: To test the hypotheses that an innovative skills-based behavioral family clinic and home-based intervention (LAUNCH) would reduce body mass index z score (BMIz) compared with motivational interviewing and to standard care in preschool-aged children with obesity. STUDY DESIGN: Randomized controlled trial with children between the ages of 2 and 5 years above the 95(th) percentile for body mass index for age and sex recruited from 27 pediatrician offices across 10 recruitment cycles between March 12, 2012 and June 8, 2015...
November 14, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29148968/collecting-practice-level-data-in-a-changing-physician-office-based-ambulatory-care-environment-a-pilot-study-examining-the-physician-induction-interview-component-of-the-national-ambulatory-medical-care-survey
#5
Meghan C Halley, Katharine A Rendle, Brian Gugerty, Denys T Lau, Harold S Luft
Objective This report examines ways to improve National Ambulatory Medical Care Survey (NAMCS) data on practice and physician characteristics in multispecialty group practices. Methods From February to April 2013, the National Center for Health Statistics (NCHS) conducted a pilot study to observe the collection of the NAMCS physician interview information component in a large multispecialty group practice. Nine physicians were randomly sampled using standard NAMCS recruitment procedures; eight were eligible and agreed to participate...
November 2017: Vital and Health Statistics. Series 2, Data Evaluation and Methods Research
https://www.readbyqxmd.com/read/29148334/evidence-of-pent-up-demand-for-care-after-medicaid-expansion
#6
Angela R Fertig, Caroline S Carlin, Scott Ode, Sharon K Long
We compared new Medicaid enrollees with similar ongoing enrollees for evidence of pent-up demand using claims data following Minnesota's 2014 Medicaid expansion. We hypothesized that if new enrollees had pent-up demand, utilization would decline over time as testing and disease management plans are put in place. Consistent with pent-up demand among new enrollees, the probability of an office visit, a new patient office visit, and an emergency department visit declines over time for new enrollees relative to ongoing Medicaid enrollees...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#7
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29140858/computerized-cognitive-testing-in-primary-care-a-qualitative-study
#8
Geneva Millett, Gary Naglie, Ross Upshur, Liisa Jaakkimainen, Jocelyn Charles, Mary C Tierney
Computerized cognitive assessment tools may facilitate early identification of dementia in the primary care setting. We investigated primary care physicians' (PCPs') views on advantages and disadvantages of computerized testing based on their experience with the Computer Assessment of Mild Cognitive Impairment (CAMCI). Over a 2-month period, 259 patients, 65 years and older, from the family practice of 13 PCPs completed the CAMCI. Twelve PCPs participated in an individual interview. Generally, PCPs felt that the relationship between them and their patients helped facilitate cognitive testing; however, they thought available paper tests were time consuming and not sufficiently informative...
November 14, 2017: Alzheimer Disease and Associated Disorders
https://www.readbyqxmd.com/read/29138182/disparities-in-the-quality-of-cardiovascular-care-between-hiv-infected-versus-hiv-uninfected-adults-in-the-united-states-a-cross-sectional-study
#9
Joseph A Ladapo, Adam K Richards, Cassandra M DeWitt, Nina T Harawa, Steven Shoptaw, William E Cunningham, John N Mafi
BACKGROUND: Cardiovascular disease is emerging as a major cause of morbidity and mortality among patients with HIV. We compared use of national guideline-recommended cardiovascular care during office visits among HIV-infected versus HIV-uninfected adults. METHODS AND RESULTS: We analyzed data from a nationally representative sample of HIV-infected and HIV-uninfected patients aged 40 to 79 years in the National Ambulatory Medical Care Survey/National Hospital Ambulatory Medical Care Survey, 2006 to 2013...
November 14, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29137869/morbidity-and-mortality-in-homeless-individuals-prisoners-sex-workers-and-individuals-with-substance-use-disorders-in-high-income-countries-a-systematic-review-and-meta-analysis
#10
Robert W Aldridge, Alistair Story, Stephen W Hwang, Merete Nordentoft, Serena A Luchenski, Greg Hartwell, Emily J Tweed, Dan Lewer, Srinivasa Vittal Katikireddi, Andrew C Hayward
BACKGROUND: Inclusion health focuses on people in extremely poor health due to poverty, marginalisation, and multimorbidity. We aimed to review morbidity and mortality data on four overlapping populations who experience considerable social exclusion: homeless populations, individuals with substance use disorders, sex workers, and imprisoned individuals. METHODS: For this systematic review and meta-analysis, we searched MEDLINE, Embase, and the Cochrane Library for studies published between Jan 1, 2005, and Oct 1, 2015...
November 10, 2017: Lancet
https://www.readbyqxmd.com/read/29135747/experiences-of-hiv-infected-adults-and-healthcare-providers-with-healthcare-delivery-practices-influencing-engagement-in-primary-healthcare-settings-a-qualitative-systematic-review-protocol
#11
Andrea Norberg, John Nelson, Cheryl Holly, Sarah T Jewell, Susan Salmond
The objective of this qualitative systematic review is to examine the experience and impact of health care delivery on health care engagement for adults infected with the human immunodeficiency virus receiving primary care. This review will identify and synthesize the best available evidence on health care structures, processes and practices that promote patient engagement in primary health care.The review question to be addressed is: What are the experiences of people living with human immunodeficiency virus (PLWH) and their health care providers with health care delivery processes and practices that impact engagement in primary health care settings (clinics, physician offices, and other community-based health care settings)? Specifically this review will compile evidence to illuminate health care system structures, provider practices, care delivery and programmatic processes that impact engagement in primary health care, as perceived by PLWH and their providers...
November 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29131917/a-pediatrician-s-take-on-a-few-common-infant-urologic-and-gynecologic-issues
#12
Sabrina Fernandez
Urologic and gynecologic issues are common in a pediatric primary care office. This article focuses on the evaluation and management of a few common diagnoses in infants and young children: fetal hydronephrosis, labial adhesions, physiologic phimosis, and hydrocele. This article can help pediatricians decide when these common issues can be managed in the primary care office and when they need subspecialty guidance. [Pediatr Ann. 2017;46(11):e397-e399.].
November 1, 2017: Pediatric Annals
https://www.readbyqxmd.com/read/29131289/negative-predictors-of-treatment-success-in-outpatient-therapy-of-arterial-hypertension-in-poland-results-of-the-control-nt-observational-registry
#13
Krzysztof J Filipiak, Mariusz Tomaniak, Anna E Płatek, Filip M Szymański, Andrzej Tykarski
BACKGROUND: Identification of factors interfering with adequate control of arterial hypertension in the course of antihypertensive therapy is necessary to plan the strategy or reducing the incidence of cardiovascular disorders and optimize clinical practice guidelines. There have only been limited reliable studies describing the current status of hypertension treatment. AIM: The study objective was to conduct a screening assessment of the rate of uncontrolled hypertension among hypertensive patients coming to a routine follow-up visit, and to characterize patients with inadequate control of arterial hypertension in the aspect of their cardiovascular risk profile and therapeutic strategies used...
November 13, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/29129193/experiences-of-three-states-implementing-the-medicaid-health-home-model-to-address-opioid-use-disorder-case-studies-in-maryland-rhode-island-and-vermont
#14
Lisa Clemans-Cope, Jane B Wishner, Eva H Allen, Nicole Lallemand, Marni Epstein, Brenda C Spillman
PURPOSE: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health...
December 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29118679/an-electronic-health-record-data-driven-model-for-identifying-older-adults-at-risk-of-unintentional-falls
#15
Adam Baus, Jeffrey Coben, Keith Zullig, Cecil Pollard, Charles Mullett, Henry Taylor, Jill Cochran, Traci Jarrett, Dustin Long
Screening for risk of unintentional falls remains low in the primary care setting because of the time constraints of brief office visits. National studies suggest that physicians caring for older adults provide recommended fall risk screening only 30 to 37 percent of the time. Given prior success in developing methods for repurposing electronic health record data for the identification of fall risk, this study involves building a model in which electronic health record data could be applied for use in clinical decision support to bolster screening by proactively identifying patients for whom screening would be beneficial and targeting efforts specifically to those patients...
2017: Perspectives in Health Information Management
https://www.readbyqxmd.com/read/29116022/enhancing-mental-and-physical-health-of-women-through-engagement-and-retention-empower-a-protocol-for-a-program-of-research
#16
Alison B Hamilton, Melissa M Farmer, Tannaz Moin, Erin P Finley, Ariel J Lang, Sabine M Oishi, Alexis K Huynh, Jessica Zuchowski, Sally G Haskell, Bevanne Bean-Mayberry
BACKGROUND: The Enhancing Mental and Physical health of Women through Engagement and Retention or EMPOWER program represents a partnership with the US Department of Veterans Health Administration (VA) Health Service Research and Development investigators and the VA Office of Women's Health, National Center for Disease Prevention and Health Promotion, Primary Care-Mental Health Integration Program Office, Women's Mental Health Services, and the Office of Patient Centered Care and Cultural Transformation...
November 7, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29110523/access-to-primary-care-child-weight-management-programs-urban-parent-barriers-and-facilitators-to-participation
#17
Noel L Kulik, Erica M Thomas, Samantha Iovan, Margaret McKeough, Stephanie Kendzierski, Stacy Leatherwood
The prevalence and comorbidities of childhood obesity among low-income urban children are a significant health issue in the United States. Programs designed to assist families are underutilized. The aim of this study is to describe barriers and facilitators relevant to intervention program participation from the perspective of parents who have children who are overweight or obese. Systematic thematic analysis of focus groups and semi-structured interviews with parents from multiple urban pediatrics and family medicine practices were used to gather data...
January 1, 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29100717/primary-care-physician-perspectives-on-basal-insulin-initiation-and-maintenance-in-patients-with-type-2-diabetes-mellitus
#18
Samaneh Kalirai, Judith Stephenson, Magaly Perez-Nieves, Michael Grabner, Irene Hadjiyianni, Caroline Geremakis, Roy Daniel Pollom, Beverly Reed, Lawrence Fisher
AIMS: To describe primary care physicians' (PCPs) perceptions of patient reactions and concerns about insulin initiation and identify opportunities for increased support. METHODS: Cross-sectional, online survey of PCPs prescribing basal insulin to adults with type 2 diabetes mellitus (T2DM). PCPs were identified from administrative claims of a large commercial health plan and descriptive results of PCP responses were reported. RESULTS: PCPs (N=100) treated an average of 17 patients receiving insulin during a typical week...
October 31, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/29100217/nontraumatic-emergency-laparotomy-surgical-principles-similar-to-trauma-need-to-be-adopted
#19
Deepak Singh-Ranger, Edmund Leung, Mei-Ling Lau-Robinson, Sean Ramcharan, James Francombe
OBJECTIVES: In 2011, the Royal College of Surgeons published Emergency Surgery: Standards for Unscheduled Care in response to variable clinical outcomes for emergency surgery. The purpose of this study was to examine whether different treatment modalities would alter survival. METHODS: All patients who underwent emergency laparotomy between April 2011 and December 2012 at Warwick Hospital (Warwick, UK) were included retrospectively. Information relating to their demographics; preoperative score; primary pathology; timing of surgery; intraoperative details; and postoperative outcome, including 30-day mortality, were collated for statistical analysis...
November 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/29095849/multimorbid-outpatients-a-high-frequency-of-fp-appointments-and-or-family-difficulties-should-alert-fps-to-the-possibility-of-death-or-acute-hospitalization-occurring-within-six-months-a-primary-care-feasibility-study
#20
Jean Yves Le Reste, Patrice Nabbe, Alice Billot Grasset, Bernard Le Floch, Pauline Grall, Jeremy Derriennic, Michele Odorico, Sophie Lalande, Delphine le Goff, Marie Barais, Benoit Chiron, Heidrun Lingner, Morgane Guillou, Pierre Barraine
BACKGROUND: The European General Practitioners Research Network (EGPRN) designed and validated a comprehensive definition of multimorbidity using a systematic literature review and qualitative research throughout Europe. This definition was tested as a model to assess death or acute hospitalization in multimorbid outpatients. OBJECTIVE: To assess which criteria in the EGPRN concept of multimorbidity could detect outpatients at risk of death or acute hospitalization in a primary care cohort at a 6-month follow-up and to assess whether a large scale cohort with FPs would be feasible...
2017: PloS One
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