The Latest General Practice & Family Medicine Articles

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  • Demographic Characteristics Associated With Utilization of Noninvasive Treatments for Chronic Low Back Pain and Related Clinical Outcomes During the COVID-19 Pandemic in the United States.
    This study was conducted to determine if limited access to health care during the COVID-19 pandemic impacted utilization of recommended nonpharmacological treatments, nonsteroidal anti-inflammatory drugs, and opioids by patients with chronic low back pain and affected clinical outcomes relating to pain intensity and disability.Participants within the Pain Registry for Epidemiological, Clinical, and Interventional Studies and […]
  • Using Virtual Visits to Care for Primary Care Patients With COVID-19 Symptoms.
    Examine use of office resources by primary care patients who were initially evaluated through telehealth, telephone, or in-person encounters.Retrospective electronic health record review on patients seen in March 2020 for evaluation of potential COVID-19 symptoms, to assess the total number of interactions with physicians and office staff.Of 202 patients, 89 (44%) had initial telehealth, 55 […]
  • Designing and Evaluating COVID-19 Protocols for an Office-Based Opioid Treatment Program in an Urban Underserved Setting.
    Despite changing federal regulations for providing telehealth services and provision of controlled substances during the COVID-19 pandemic, there is little guidance available for office-based opioid treatment (OBOT) programs integrated into primary care settings.(1) Develop disaster-preparedness protocols specific to the COVID-19 pandemic for an urban OBOT program, and (2) evaluate the impacts of the protocol and […]
  • Family Medicine With Refugee Newcomers During the COVID-19 Pandemic.
    Certain members of society are disproportionately affected by the COVID-19 crisis and the added strain being placed on already overextended health care systems. In this article, we focus on refugee newcomers. We outline vulnerabilities refugee newcomers face in the context of COVID-19, including barriers to accessing health care services, disproportionate rates of mental health concerns, […]
  • Key Factors Promoting Rapid Implementation of Virtual Screening Modalities for the COVID-19 Pandemic Response.
    The COVID-19 (C-19) pandemic required swift response from health care organizations to mitigate spread and impact. A large integrated health network rapidly deployed and operationalized multiple access channels to the community, allowing assessment and triage to occur virtually. These channels were characterized by swift implementation of virtual models, including asynchronous e-visits and video visits for […]
  • Launching a Statewide COVID-19 Primary Care Hotline and Telemedicine Service.
    To respond to the COVID-19 pandemic and recover from its aftermath, primary care teams will face waves of overwhelming demand for information and the need to significantly transform care delivery.Oregon Health & Science University’s primary care team envisioned and implemented the COVID-19 Connected Care Center, a statewide telephone “hotline” service.The hotline has taken more than […]
  • Lessons Learned During COVID-19 That Can Move Telehealth in Primary Care Forward.
    Our university hospital-based primary care practices transitioned a budding interest in telehealth to a largely telehealth-based approach in the face of the COVID-19 pandemic.Implementation of telehealth began in 2017. Health system barriers, provider and patient reluctance, and inadequate reimbursement prevented widespread adoption at the time. COVID-19 served as the catalyst to accelerate telehealth efforts.COVID-19 resulted […]
  • Localized Scarlatiniform Rash of the Ears and Antecubital Fossa in COVID-19.
    The worldwide spread of the novel coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has led to a global pandemic since its identification in Wuhan, China in December 2019.1 Few cases of COVID-19-associated dermatologic manifestations have been reported in the literature to date. This report describes the clinical features of […]
  • A Family Medicine Residency Program’s Response to an Impending COVID-19 Surge.
    The University of Colorado family medicine residency watched along with the rest of the nation as the first cases of COVID-19 were being reported in the United States in March 2020. Concern grew as epidemiological models began to predict alarming hospital bed shortages for the state. Massive scheduling adjustments were needed as faculty and residents […]
  • Not Telehealth: Which Primary Care Visits Need In-Person Care?
    The Coronavirus disease 2019 (COVID 19) pandemic has resulted in a rapid shift to telehealth and many services that need in-person care have been avoided. Yet, as practices and payment policies return to a new normal, there will be many questions about what proportion of visits should be done in-person vs telehealth. Using the 2016 […]
  • A Qualitative Study of Primary Care Physicians’ Experiences With Telemedicine During COVID-19.
    Primary care practices rapidly adopted telemedicine visits because of the COVID-19 pandemic, but information on physician perspectives about these visits is lacking.Fifteen semistructured interviews with practicing primary care physicians and physicians-in-training from a Southern California academic health system and group-model health maintenance organization were conducted to assess physician perspectives regarding the benefits and challenges of […]
  • Primary Care Relevant Risk Factors for Adverse Outcomes in Patients With COVID-19 Infection: A Systematic Review.
    The aim of this systematic review is to summarize the best available evidence regarding individual risk factors, simple risk scores, and multivariate models that use patient characteristics, vital signs, comorbidities, and laboratory tests relevant to outpatient and primary care settings.Medline, WHO COVID-19, and MedRxIV databases were searched; studies meeting inclusion criteria were reviewed in parallel, […]
  • A Stepwise Transition to Telemedicine in Response to COVID-19.
    With the emergence of COVID-19, many primary care offices closed their physical space to limit exposure. Despite decades of telemedicine in clinical practice, it is rare to find it used in small-metro and academic settings. Following the decision to limit face-to-face care, we tracked our practice’s transition to telemedicine.This was a prospective quality improvement project […]
  • Protecting Family Medicine by Changing the Reimbursement Model Post-COVID-19.
    The United States spends billions of dollars each year preparing for medical emergencies. Noticeably absent from that budget is an effective process to protect the frontline defenders delivering primary care. View the full article @ Journal of the American Board of Family Medicine : JABFM Get PDF with LibKey Authors: Guy L Culpepper
  • An Overview of Health Care Worker Reported Deaths During the COVID-19 Pandemic.
    As of May 13, 2020, 1004 health care worker (HCW) deaths due to coronavirus disease 2019 (COVID-19) have been reported globally. This study seeks to organize deaths by demographic group, including age, gender, country, and occupation.We collected data from a crowdsourced list of global HCW COVID-19 deaths published by Medscape, including age, gender, country, occupation, […]
  • Quantifying Worsened Glycemic Control During the COVID-19 Pandemic.
    We hypothesized that glycemic control in outpatients, measured by HbA1c, was worse during the early months of the COVID-19 pandemic than in 2019. We sought to quantify how much worse and to determine if social determinants of health were associated with these differences.Data were extracted from the electronic medical records of 2 cohorts of patients […]
  • Assessment of Patient and Provider Satisfaction With the Change to Telehealth From In-Person Visits at an Academic Safety Net Institution During the COVID-19 Pandemic.
    The 2019 novel coronavirus (COVID-19) caused a global pandemic that forced medical providers to rapidly alter methods of health care delivery. One month into this pandemic, we surveyed providers and patients to assess satisfaction or concerns with the change from in-person visits.We surveyed internal medicine (IM) and family medicine (FM) faculty and residents to ascertain […]
  • Site of Care for COVID-19-Like Respiratory Illnesses.
    COVID-19 is primarily a respiratory illness. Historically, upper and lower respiratory illness has been cared for at home or in the ambulatory primary care setting. It is likely that patients experiencing COVID-19-like symptoms may first contact their primary care provider. The Medical Expenditure Panel Survey (MEPS) is a representative sample of patients from the United […]
  • Association of COVID-19 With Race and Socioeconomic Factors in Family Medicine.
    Recent data demonstrated that socioeconomic, environmental, demographic, and health factors can contribute to vulnerability for coronavirus 2019 (COVID-19). The goal of this study was to assess association between severe acute respiratory syndrome coronavirus (SARS CoV-2) infection and demographic and socioeconomic factors in patients from a large academic family medicine practice to support practice operations.Patients referred […]
  • Teachings After COVID-19 Outbreak From a Survey of Family Physicians.
    Since December 2019, the dramatic escalation in coronavirus (COVID-19) cases worldwide has had a significant impact on health care systems. Family physicians (FPs) have played a critical role in the coordination of care.In April 2020, we performed an online prospective survey to assess the impact of the pandemic on FPs’ practices.Three hundred FPs were included. […]
  • Building Bridges Between Community Health Centers and Academic Medical Centers in a COVID-19 Pandemic.
    The threat to the public health of the United States from the COVID-19 pandemic is causing rapid, unprecedented shifts in the health care landscape. Community health centers serve the patient populations most vulnerable to the disease yet often have inadequate resources to combat it. Academic medical centers do not always have the community connections needed […]
  • The Pharmacist as Part of the Primary Care Team During the COVID-19 Pandemic.
    Pharmacists’ roles and training have evolved to prepare pharmacists to provide clinical patient care services as part of interdisciplinary teams in primary care settings. Especially now, amidst a global health crisis such as COVID-19, patients may become more aware of their health status and be exposed to increased medical information in the media. Additionally, some […]
  • Capacity of Primary Care to Deliver Telehealth in the United States.
    Because of the Coronavirus disease 2019 (COVID 19) pandemic, many primary care practices have transitioned to telehealth visits to keep patients at home and decrease the transmission of the disease. Yet, little is known about the nationwide capacity for delivering primary care services via telehealth.Using the 2016 National Ambulatory Medical Survey we estimated the number […]
  • The Virtual Patient and Family Advisory Council in the COVID-19 Era.
    In 2016, we launched our first Patient and Family Advisory Council (PFAC) as a means of collaborating with our patients and families to improve care. Using an Internet-based remote meeting technology, we transitioned to a virtual platform in April.We have conducted 12 PFAC meetings across 4 sites to date. Virtual PFAC meeting topics over the […]
  • Could Telehealth Improve Equity During the COVID-19 Pandemic?
    In response to the COVID-19 pandemic, many physicians and health care systems have shifted to providing care via telehealth as much as possible. Although necessary to control spread of the virus and preserve personal protective equipment, this shift highlights existing disparities in access and care. Patients without the skills and tools to access telehealth services […]
  • Uniting Public Health and Primary Care for Healthy Communities in the COVID-19 Era and Beyond.
    The Coronavirus disease 2019 (COVID-19) pandemic has laid bare the dis-integrated health care system in the United States. Decades of inattention and dwindling support for public health, coupled with declining access to primary care medical services have left many vulnerable communities without adequate COVID-19 response and recovery capacity. “Health is a Community Affair” is a […]
  • Factors Associated with a Career in Primary Care Medicine: Continuity Clinic Experience Matters.
    Due to concerns of inadequate primary care access, national agencies like the Health Resources and Services Administration (HRSA) support primary care (PC) residencies. Recent research demonstrates that up to 35% of PC alumni lost interest in PC during residency. These alumni who lost interest noted that their continuity clinic experience influenced their career choice. The […]
  • Guidance impact on primary care prescribing rates of simple analgesia: an interrupted time series analysis in England.
    In March 2018, NHS England published guidance for clinical commissioning groups (CCGs) to encourage implementation of policy to reduce primary care prescriptions of over-the-counter medications, including simple analgesia.To investigate the impact of guidance publication on prescribing rates of simple analgesia (oral paracetamol, oral ibuprofen, and topical non-steroidal anti-inflammatory drugs) in primary care; CCG guidance implementation […]
  • Inequalities in health-related quality of life: repeated cross-sectional study of trends in general practice survey data.
    After decades of steady progress, life expectancy at birth has stalled in England. Inequalities are also rising, and life expectancy has fallen for females living in the most deprived areas. However, less attention has been given to trends in other measures of population health, particularly health-related quality of life (HRQoL).To examine trends and inequalities in […]
  • Trends in diabetes medication use in Australia, Canada, England, and Scotland: a repeated cross-sectional analysis in primary care.
    Several new classes of glucose-lowering medications have been introduced in the past two decades. Some, such as sodium-glucose cotransporter 2 inhibitors (SGLT2s), have evidence of improved cardiovascular outcomes, while others, such as dipeptidyl peptidase-4 inhibitors (DPP4s), do not. It is therefore important to identify their uptake in order to find ways to support the use […]
  • How do contraindications to non-opioid analgesics and opioids affect the likelihood that patients with back pain diagnoses in the primary care setting receive an opioid prescription? An observational cross-sectional study.
    Given the risks of opioids, clinicians are under growing pressure to treat pain with non-opioid medications. Yet non-opioid analgesics such as non-steroidal anti-inflammatory drugs (NSAIDs) have their own risks: patients with kidney disease or gastrointestinal diseases can experience serious adverse events. We examined the likelihood that patients with back pain diagnoses and contraindications to NSAIDs […]
  • How many general practice consultations occur in Ireland annually? Cross-sectional data from a survey of general practices.
    General practice plays a central role in the Irish health system. This study aimed to determine a baseline estimate of the number of consultations completed in general practice in Ireland annually to facilitate evidence-based healthcare planning.A survey was emailed to all 3378 individual members of the Irish College of General Practitioners in February 2020 asking […]
  • Which patients miss appointments with general practice and why? A systematic review.
    Missed GP appointments have considerable time and cost implications for healthcare services.This systematic review aims to explore the rate of missed primary care appointments, what the reported reasons are for appointments being missed, and which patients are more likely to miss appointments.This study reports the findings of a systematic review.Included studies report the rate or […]
  • Evaluation of clinical and antidiabetic treatment characteristics of different sub-groups of patients with type 2 diabetes: Data from a Mediterranean population database.
    To describe the characteristics and antidiabetic treatment among type 2 diabetes patients according to the clinical conditions prioritized in the Spanish 2020 RedGDPS (Primary Care Diabetes Study Groups Network) therapeutic algorithm: obesity, older than 75 years, chronic kidney disease, cardiovascular disease, and heart failure.Retrospective, cross-sectional study. Clinical characteristics, the use of antidiabetic drugs and the […]
  • Evaluation of the metformin initiation rate in veterans with newly identified type 2 diabetes.
    An estimated 35 million individuals in the United States have diabetes. The American Diabetes Association recommends metformin as first-line pharmacologic treatment. The primary objective of this study was to evaluate the metformin initiation rate in veterans with recently identified type 2 diabetes.Veterans with new onset type 2 diabetes were identified using National Veterans Health Administration […]
  • Prevalence and Predictors of Potentially Inappropriate Prescribing in Middle-Aged Adults: Repeated Cross-Sectional Study.
    Potentially inappropriate prescribing (PIP) is common in older adults and known to be associated with polypharmacy and multimorbidity. Less is known about the prevalence and causes of PIP in middle-aged adults.To determine the prevalence and predictors of PIP in middle-aged adults.A repeated cross-sectional study was conducted using primary care data in London.PIP was defined using […]
  • Atopic dermatitis: More than just a rash.
    Atopic dermatitis’ association with allergic rhinitis and asthma is well known, but there is also increased risk of food allergies, ADHD, depression, and anxiety. View the full article @ The Journal of family practice Get PDF with LibKey Authors: Franklin Berkey, Joseph Wiedemer
  • Breaking the cycle of medication overuse headache.
    Care of this disorder can be complex-from ruling out another secondary cause of headache to supervising detox from abortives, providing preventives, and educating often-fearful patients. View the full article @ The Journal of family practice Get PDF with LibKey Authors: Allison Crain
  • Family medicine residents’ skill levels in emergency chest X-ray interpretation.
    Family medicine physicians may encounter a wide variety of conditions, including acute and urgent cases. Considering the limited access to diagnostic investigations in primary care practice, chest X-ray remains the imaging modality of choice. The current study assessed the competency of family medicine residents in the interpretation of chest X-rays for emergency conditions and to […]
  • Generalized pruritic blisters and bullous lesions.
    In a patient with no history of skin disease, a recent change provided a clue to his condition. View the full article @ The Journal of family practice Get PDF with LibKey Authors: Zeeshan Afzal, Richard P Usatine
  • No pain, if you’ve got game.
    Allowing children to engage in “active” distraction techniques-such as playing a video game-during venipuncture can lead to reduced pain and anxiety. View the full article @ The Journal of family practice Get PDF with LibKey Authors: Benjamin McCollum, Stephen J Conner, J Scott Earwood
  • Pelvic pain.
    When a complete metabolic panel offered no clues, we turned to imaging. And that’s when we had our diagnosis. View the full article @ The Journal of family practice Get PDF with LibKey Authors: William Terrill, Cassie Tran, Don Nguyen
  • Prevalence and associated factors of the career plateau of primary care providers in Heilongjiang, China: a cross-sectional study.
    Primary care providers are pillars of China’s medical and health sectors. However, due to the gap between career expectations and reality, they enter a career plateau phase through excessive pressure. This study aims to examine the prevalence and associated factors of the career plateau of primary care providers in Heilongjiang Province, China, and proposes strategies […]
  • PURL: Can viscous fiber lower glycemic markers in type 2 diabetes?
    The first meta-analysis to focus on viscous dietary fiber in T2D suggests a potential role for this supplement in improving glycemic control. View the full article @ The Journal of family practice Get PDF with LibKey Authors: Erica S Meisenheimer, Bob Marshall, Samuel M Tiglao, Tyler S Rogers, David C Bury, Michael M Dickman, Robert […]
  • Recognizing and intervening in child sex trafficking.
    Know the risk factors, choose from among 3 validated screening tools, and use a trauma-informed approach with those likely involved in trafficking. View the full article @ The Journal of family practice Get PDF with LibKey Authors: Piali Basu, Vidhi Doshi, Ana Malinow, John Huang, Coleen Kivlahan, Lindsay Mann
  • Tactics to prevent or slow progression of CKD in patients with diabetes.
    Annual screening of urinary parameters, ongoing clinical vigilance, and proper medical therapy can help to keep declining renal function at bay. View the full article @ The Journal of family practice Get PDF with LibKey Authors: Faraz Ahmad, Matthew J Goldman
  • Individual and Community Factors Associated with Naloxone Co-prescribing Among Long-term Opioid Patients: a Retrospective Analysis.
    Naloxone co-prescribing to individuals at increased opioid overdose risk is a key component of opioid overdose prevention efforts.Examine naloxone co-prescribing in the general population and assess how co-prescribing varies by individual and community characteristics.Retrospective cross-sectional study. We conducted a multivariable logistic regression of 2017-2018 de-identified pharmacy claims representing 90% of all prescriptions filled at retail […]
  • NHS Health Checks: Equity and outcomes 2009-17: An observational study.
    The NHS Health Check cardiovascular prevention programme is now 10 years old.We describe NHS Heath Check attendance, new diagnoses and treatment in relation to equity indicators.Using a national general practice database 2009-17, we compared NHS Health Check attendance and new diagnoses and treatments, by age, gender, ethnic group and deprivation.In 2013-17, 590,218 eligible people age […]
  • A pharmacist health coaching trial evaluating behavioural changes in participants with poorly controlled hypertension.
    To investigate whether pharmacist health coaching improves progression through the stages of change (SOC) for three modifiable health behaviours; diet, exercise, and medication management in participants with poorly controlled hypertension.In this four-month controlled group study two community-based pharmacists provided three health coaching sessions to 20 participants with poorly controlled hypertension at monthly intervals. Changes in […]
  • Family medicine practitioners’ stress during the COVID-19 pandemic: a cross-sectional survey.
    The COVID-19 pandemic has shaken the world in early 2020. In France, General Practitioners (GPs) were not involved in the care organization’s decision-making process before and during the first wave of the COVID-19 pandemic. This omission could have generated stress for GPs. We aimed first to estimate the self-perception of stress as defined by the […]
  • Body size perception, knowledge about obesity and factors associated with lifestyle change among patients, health care professionals and public health experts.
    The attitudes towards obesity may have an important role on healthier behavior. The goal of the present study was to explore the attitudes towards obesity and to investigate how these attitudes were associated with lifestyle-changing behavior among the patients attending primary care centers, health care professionals and public health experts.This cross-sectional survey study was performed […]
  • Association of health literacy and other risk factors with glycemic control among patients with type 2 diabetes in Kuwait: A cross-sectional study.
    Poor health literacy (HL) has received much attention recently as a risk factor for poor health outcomes especially among patients with chronic diseases. The degree to which HL affects health outcomes is unknown among patients with type 2 diabetes mellitus (T2DM) in Kuwait. This study aimed to investigate the association between HL and glycated hemoglobin […]
  • Nortriptyline for pain in knee osteoarthritis in general practice: a double blind randomised controlled trial.
    Osteoarthritis (OA) of the knee is a common cause of chronic pain. The currently available analgesics have limited efficacy and may be poorly tolerated.To investigate the analgesic efficacy of nortriptyline in people with knee OA.A two-arm parallel-group 1:1 double blind randomised placebo-controlled trial. Participants were recruited from orthopaedic outpatient clinics, primary care, and by public […]
  • The impact of severe mental illness on healthcare use and health outcomes for people with type 2 diabetes.
    People with severe mental illnesses (SMI) have reduced life expectancy compared with the general population. Diabetes is a major contributor to this disparity with higher prevalence and poorer outcomes in people with SMI.To determine the impact of SMI on healthcare processes and outcomes for diabetes.Retrospective observational matched nested case-control study using patient records from the […]
  • Fidelity evaluation of the compared procedures for conducting the PVS-PREDIAPS implementation strategy to optimize diabetes prevention in primary care.
    Assessing the fidelity of an implementation strategy is important to understand why and how the strategy influences the uptake of evidence-based interventions. The present study aims to assess the fidelity of the two procedures for engaging primary care (PC) professionals and for the deployment of an implementation strategy for optimizing type 2 diabetes prevention in […]
  • Specialist respiratory outreach: a case-finding initiative for identifying undiagnosed COPD in primary care.
    COPD remains largely undiagnosed or is diagnosed late in the course of disease. We report findings of a specialist outreach programme to identify undiagnosed COPD in primary care. An electronic case-finding algorithm identified 1602 at-risk patients from 12 practices who were invited to attend the clinic. Three hundred and eighty-three (23.9%) responded and 288 were […]
  • Where Do International Medical Graduates Matriculate for Internal Medicine Training? A National Longitudinal Study.
    In 2020, roughly 25% of applicants who matched into internal medicine (IM) residencies were international medical graduates (IMGs). We examine 12-year trends in distribution of IMGs among IM training programs and explore differences in program perceptions towards IMG recruitment.Since 2007, Association of Program Directors in Internal Medicine Annual Surveys have collected data about trainees by […]
  • Discovering Common Elements of Empirically Supported Self-Help Interventions for Depression in Primary Care: a Systematic Review.
    Although the efficacy of self-help cognitive-behavioral therapy (CBT) for depression has been well established, its feasibility in primary care settings is limited because of time and resource constraints. The goal of this study was to identify common elements of empirically supported (i.e., proven effective in controlled research) self-help CBTs and frameworks for effective use in […]
  • Prevalence and Medication Treatment of Opioid Use Disorder Among Primary Care Patients with Hepatitis C and HIV.
    Hepatitis C and HIV are associated with opioid use disorders (OUD) and injection drug use. Medications for OUD can prevent the spread of HCV and HIV.To describe the prevalence of documented OUD, as well as receipt of office-based medication treatment, among primary care patients with HCV or HIV.Retrospective observational cohort study using electronic health record […]
  • Domestic abuse among female doctors: thematic analysis of qualitative interviews in the UK.
    Doctors can be victim-survivors of domestic abuse (DA), but how this impacts their work and wellbeing, and whether they face barriers to seeking help is not well understood.To understand single doctor mothers’ lived experience of DA, barriers to seeking help, and impact on their work.Individual qualitative interviews with female doctors in the UK who had […]