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https://www.readbyqxmd.com/read/28340086/real-world-massage-therapy-produces-meaningful-effectiveness-signal-for-primary-care-patients-with-chronic-low-back-pain-results-of-a-repeated-measures-cohort-study
#1
William G Elder, Niki Munk, Margaret M Love, Geza G Bruckner, Kathryn E Stewart, Kevin Pearce
Objective.:  While efficacy of massage and other nonpharmacological treatments for chronic low back pain is established, stakeholders have called for pragmatic studies of effectiveness in "real-world" primary health care. The Kentucky Pain Research and Outcomes Study evaluated massage impact on pain, disability, and health-related quality of life for primary care patients with chronic low back pain. We report effectiveness and feasibility results, and make comparisons with established minimal clinically important differences...
March 14, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339767/accounting-for-overdispersion-when-determining-primary-care-outliers-for-the-identification-of-chronic-kidney-disease-learning-from-the-national-chronic-kidney-disease-audit
#2
Lois G Kim, Ben Caplin, Faye Cleary, Sally A Hull, Kathryn Griffith, David C Wheeler, Dorothea Nitsch
Background.: Early diagnosis of chronic kidney disease (CKD) facilitates best management in primary care. Testing coverage of those at risk and translation into subsequent diagnostic coding will impact on observed CKD prevalence. Using initial data from 915 general practitioner (GP) practices taking part in a UK national audit, we seek to apply appropriate methods to identify outlying practices in terms of CKD stages 3-5 prevalence and diagnostic coding. Methods.: We estimate expected numbers of CKD stages 3-5 cases in each practice, adjusted for key practice characteristics, and further inflate the control limits to account for overdispersion related to unobserved factors (including unobserved risk factors for CKD, and between-practice differences in coding and testing)...
January 17, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28339752/testing-shoulder-pain-mapping
#3
Levent Bayam, Rajendra Arumilli, Ian Horsley, Fatma Bayam, Lee Herrington, Lennard Funk
Objective. : A previous study on shoulder pain mapping showed specific pain patterns for common shoulder disorders. This study aimed to test those patterns for accuracy, modify shoulder pain mapping as needed, and observe their reliability and validity. Methods. : This prospective study used a two-step process and was undertaken to determine its potential utility in daily practice. New shoulder pain patients marked their pain, its character and severity, on a custom-made mapping form...
February 22, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339689/genomic-decision-support-needs-in-pediatric-primary-care
#4
Jeffrey W Pennington, Dean J Karavite, Edward M Krause, Jeffrey Miller, Barbara A Bernhardt, Robert W Grundmeier
Clinical genome and exome sequencing can diagnose pediatric patients with complex conditions that often require follow-up care with multiple specialties. The American Academy of Pediatrics emphasizes the role of the medical home and the primary care pediatrician in coordinating care for patients who need multidisciplinary support. In addition, the electronic health record (EHR) with embedded clinical decision support is recognized as an important component in providing care in this setting. We interviewed 6 clinicians to assess their experience caring for patients with complex and rare genetic findings and hear their opinions about how the EHR currently supports this role...
February 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339460/evaluating-implementation-of-a-fire-prevention-injury-prevention-briefing-in-children-s-centres-cluster-randomised-controlled-trial
#5
Toity Deave, Adrian Hawkins, Arun Kumar, Mike Hayes, Nicola Cooper, Michael Watson, Joanne Ablewhite, Carol Coupland, Alex Sutton, Gosia Majsak-Newman, Lisa McDaid, Trudy Goodenough, Kate Beckett, Elaine McColl, Richard Reading, Denise Kendrick
BACKGROUND: Many developed countries have high mortality rates for fire-related deaths in children aged 0-14 years with steep social gradients. Evidence-based interventions to promote fire safety practices exist, but the impact of implementing a range of these interventions in children's services has not been assessed. We developed an Injury Prevention Briefing (IPB), which brought together evidence about effective fire safety interventions and good practice in delivering interventions; plus training and facilitation to support its use and evaluated its implementation...
2017: PloS One
https://www.readbyqxmd.com/read/28339427/a-critical-analysis-of-obamacare-affordable-care-or-insurance-for-many-and-coverage-for-few
#6
Laxmaiah Manchikanti, Standiford Helm Ii, Ramsin M Benyamin, Joshua A Hirsch
The Affordable Care Act (ACA), of 2010, or Obamacare, was the most monumental change in US health care policy since the passage of Medicaid and Medicare in 1965. Since its enactment, numerous claims have been made on both sides of the aisle regarding the ACA's success or failure; these views often colored by political persuasion. The ACA had 3 primary goals: increasing the number of the insured, improving the quality of care, and reducing the costs of health care. One point often lost in the discussion is the distinction between affordability and access...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28339418/survey-of-kinesiologists-functional-capacity-evaluation-practice-in-canada
#7
Kathryn E Sinden, Taya L McGillivary, Elizabeth Chapman, Steven L Fischer
BACKGROUND: In Canada, functional capacity evaluations (FCEs) are commonly administered by several health care professions including kinesiologists. Kinesiologists have been recently regulated as health care professionals in Ontario and we know little about their demographics, the frequency of FCE administration, or the types of FCEs used by this group. OBJECTIVE: The purposes of this study were to identify: 1) the demographic characteristics and FCE education of kinesiology FCE practitioners; 2) the FCE systems most used by these practitioners and 3) the constructs from assessments used to determine functional capacity...
March 23, 2017: Work: a Journal of Prevention, Assessment, and Rehabilitation
https://www.readbyqxmd.com/read/28339327/raising-public-awareness-of-clinical-trials-development-of-messages-for-a-national-health-communication-campaign
#8
Holly A Massett, David M Dilts, Robert Bailey, Jennifer Berktold, Rebecca Ledsky, Nancy L Atkinson, Grace Mishkin, Andrea Denicoff, Rose Mary Padberg, Marin P Allen, Karen Silver, Kelli Carrington, Lenora E Johnson
Clinical trials are essential for developing new and effective treatments and improving patient quality of life; however, many trials cannot answer their primary research questions because they fall short of their recruitment goals. This article reports the results of formative research conducted in two populations, the public and primary care physicians, to identify messages that may raise awareness and increase interest in clinical trials and be used in a national communication campaign. Results suggested that participants were primarily motivated to participate in clinical trials out of a self-interest to help themselves first...
March 24, 2017: Journal of Health Communication
https://www.readbyqxmd.com/read/28334979/the-effectiveness-of-optimised-clinical-medication-reviews-for-geriatric-patients-opti-med-a-cluster-randomised-controlled-trial
#9
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background.: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective.: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28334936/satisfaction-with-general-practice-care-in-german-patients-with-multimorbidity-a-cross-sectional-study
#10
Achim Mortsiefer, Attila Altiner, Annette Ernst, Hanna Kadusziewicz, Alice Krahe, Christine Mellert, Ingmar Schäfer, Carl-Otto Stolzenbach, Birgitt Wiese, Christin Löffler
Background.: Little is known about the quality of general practice care received by patients suffering from multimorbidity. Objectives.: To assess how patients with multimorbidity evaluate their General Practitioners (GPs') performance and to identify factors associated with high patient satisfaction levels. Methods.: Cross-sectional study in Germany using the EUROPEP questionnaire consisting of 23 items with a five-point Likert scale and covering two dimensions: clinical performance of the GP and organisation of care...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28334908/adherence-and-persistence-of-patients-using-oral-bone-sparing-drugs-in-primary-care
#11
Babette C van der Zwaard, Wesley van Hout, Jacqueline G Hugtenburg, Henriëtte E van der Horst, Petra J M Elders
Aim.: Studies based on pharmacy medication records have shown suboptimal adherence and persistence of osteoporosis treatment with oral bone sparing drugs (OBSD). Little is known about adherence and persistence of OBSD treatment in primary care. We assessed adherence and persistence of OBSD use of patients in general practices and identified associated factors. Methods.: Using electronic medical records, adherence and persistence of newly prescribed treatment with OBSD in patients from 16 general practices was retrospectively assessed...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28334856/evaluating-the-effects-of-organizational-and-educational-interventions-on-adherence-to-clinical-practice-guidelines-in-a-low-resource-primary-care-setting-in-kenya
#12
Joseph R Egger, Kayla Stankevitz, Robert Korom, Philip Angwenyi, Brittney Sullivan, Jun Wang, Sonia Hatfield, Emma Smith, Karishma Popli, Jessica Gross
Background: Mid-level care providers serve as the backbone of primary care in many parts of sub-Saharan Africa. Despite this, research suggests that the quality and consistency of this care is uneven. This study assessed the degree to which a set of four simple, low-cost interventions could improve adherence to a set of clinical quality measures (CQMs) associated with four common health conditions seen in a resource-constrained primary care setting. Methods: A quasi-experimental, longitudinal study was carried out in three primary care clinics in Nairobi, Kenya from August 2014 to January, 2015...
March 15, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/28334812/understanding-collaboration-in-general-practice-a-qualitative-study
#13
Susan McInnes, Kath Peters, Andrew Bonney, Elizabeth Halcomb
Background.: An increased incidence of chronic and complex conditions in the community is placing pressure on human resources in general practice. Improving collaboration between GPs and registered nurses may help alleviate workforce stressors and enhance health outcomes. Objective.: To explore the facilitators and challenges of collaboration between GPs and registered nurses in Australian general practice. Methods.: Eight GPs and 14 registered nurses from general practices in New South Wales, Australia, participated in semi-structured face-to-face interviews...
March 8, 2017: Family Practice
https://www.readbyqxmd.com/read/28334801/a-systematic-review-of-the-physical-activity-assessment-tools-used-in-primary-care
#14
Toby O Smith, Máire C McKenna, Charlotte Salter, Wendy Hardeman, Kathryn Richardson, Melvyn Hillsdon, Carly A Hughes, Nicholas Steel, Andy P Jones
Background.: Primary care is an ideal setting for physical activity interventions to prevent and manage common long-term conditions. To identify those who can benefit from such interventions and to deliver tailored support, primary care professionals (e.g. GPs, practice nurses, physiotherapists, health care assistants) need reliable and valid tools to assess physical activity. However, there is uncertainty about the best-performing tool. Objective.: To identify the tools used in the literature to assess the physical activity in primary care and describe their psychometric properties...
February 21, 2017: Family Practice
https://www.readbyqxmd.com/read/28334728/does-emergency-presentation-of-cancer-represent-poor-performance-in-primary-care-insights-from-a-novel-analysis-of-linked-primary-and-secondary-care-data
#15
Peter Murchie, Sarah M Smith, Michael S Yule, Rosalind Adam, Melanie E Turner, Amanda J Lee, Shona Fielding
BACKGROUND: People diagnosed with cancer following emergency presentation have poorer short-term survival. To what extent this signifies a missed opportunity for earlier diagnosis in primary care remains unclear as little detailed data exist on the patient/general practitioner interaction beforehand. METHODS: Analysis of primary care and regional data for 1802 cancer patients from Northeast Scotland. Adjusted odds ratios (OR) and 95% confidence intervals (CIs) for patient and GP practice predictors of emergency presentation...
March 23, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28334593/pediatric-postoperative-pulse-oximetry-monitoring-during-transport-to-the-postanesthesia-care-unit-reduces-frequency-of-hypoxemia
#16
Thomas J Caruso, Tara E Mokhtari, Monica J Coughlan, Diane S Wu, Juan L Marquez, Melissa Duan, Heather Freeman, Andrew Giustini, Mary Tweedy, Paul J Sharek
BACKGROUND: The standard use of pulse oximetry during the transport of postoperative patients from the operating room (OR) to the postanesthesia care unit (PACU) is not routinely practiced. A study was conducted to determine if the frequency of hypoxemia on admission to the PACU decreased after implementation of routine use of transport pulse oximeters for postoperative patients being transferred to the PACU. METHODS: In this prospective cohort study, which was conducted at an academic pediatric hospital, the primary outcome measure was the frequency of hypoxemic events on arrival to the PACU...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334591/crossing-the-communication-chasm-challenges-and-opportunities-in-transitions-of-care-from-the-hospital-to-the-primary-care-clinic
#17
Nicholas A Rattray, Jason J Sico, LeeAnn M Cox, Alissa L Russ, Marianne S Matthias, Richard M Frankel
BACKGROUND: Transitions of care from specialty and acute settings to primary care abound. Compared to the continuity in end-of-shift handoffs, care transitions involve provider communication between practices and facilities with their own cultures and bureaucracies. Using the transition from acute care to outpatient primary care for stroke/transient ischemic attack (TIA) patients as a case study, this qualitative research explored communication practices and institutional arrangements among clinical providers responsible for longitudinal management of hypertension...
March 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334584/delayed-workup-of-rectal-bleeding-in-adult-primary-care-examining-process-of-care-failures
#18
Saul N Weingart, Elena M Stoffel, Daniel C Chung, Thomas D Sequist, Ruth I Lederman, Stephen R Pelletier, Helen M Shields
BACKGROUND: Although delayed colorectal cancer diagnoses figure prominently in medical malpractice claims, little is known about the quality of primary care clinicians' workup of rectal bleeding. METHODS: In this study, 438 patients were identified using International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes for rectal bleeding, hemorrhoids, and blood in the stool at 10 Boston adult primary care practices. Following nurse chart abstraction, physician reviewers assessed the overall quality of care and key care processes...
January 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334561/determining-current-insulin-pen-use-practices-and-errors-in-the-inpatient-setting
#19
Katelyn E Brown, John B Hertig
BACKGROUND: The use of insulin pens in the inpatient setting has continued to be a controversial decision. Insulin pens provide several advantages, but given significant reports of medication errors, several organizations have issued alerts to caution users about safety concerns. A survey was conducted to assess the prevalence of insulin pen use and current utilization trends in the inpatient setting. METHODS: The 31-question guided-logic survey was developed based on review of primary literature regarding insulin pen utilization and evaluated by a panel of medication safety experts from a variety of health care settings...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334559/design-and-hospitalwide-implementation-of-a-standardized-discharge-summary-in-an-electronic-health-record
#20
Shannon M Dean, Andrea Gilmore-Bykovskyi, Joel Buchanan, Brad Ehlenfeldt, Amy J H Kind
BACKGROUND: The hospital discharge summary is the primary method used to communicate a patient's plan of care to the next provider(s). Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to posthospital care, incomplete discharge summaries remain a common problem that may contribute to poor posthospital outcomes. Electronic health records (EHRs) are regularly used as a platform on which standardization of content and format can be implemented...
December 2016: Joint Commission Journal on Quality and Patient Safety
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