Annals of Family Medicine

Katy Rooney
No abstract text is available yet for this article.
May 2020: Annals of Family Medicine
Mary Theobald, Traci Brazelton
No abstract text is available yet for this article.
May 2020: Annals of Family Medicine
Susan Latta
No abstract text is available yet for this article.
May 2020: Annals of Family Medicine
David Mitchell
No abstract text is available yet for this article.
May 2020: Annals of Family Medicine
Elizabeth G Baxley, Deborah S Clements, Warren P Newton, Aimee Eden, Kathy Botner
No abstract text is available yet for this article.
May 2020: Annals of Family Medicine
Christopher P Morley, Winston Liaw
No abstract text is available yet for this article.
May 2020: Annals of Family Medicine
Kurt Hager, Alexandra De Kesel Lofthus, Betty Balan, Diana Cutts
No abstract text is available yet for this article.
May 2020: Annals of Family Medicine
David Bergman, Christina Bethell, Narangerel Gombojav, Sandra Hassink, Kurt C Stange
In light of concerns over the potential detrimental effects of declining care continuity, and the need for connection between patients and health care providers, our multidisciplinary group considered the possible ways that relationships might be developed in different kinds of health care encounters.We were surprised to discover many avenues to invest in relationships, even in non-continuity consultations, and how meaningful human connections might be developed even in telehealth visits. Opportunities range from the quality of attention or the structure of the time during the visit, to supporting relationship development in how care is organized at the local or system level and in the use of digital encounters...
May 2020: Annals of Family Medicine
David Bittleman
A few years into my practice at the Veterans Affairs (VA) clinic, I was threatened by an angry patient when I had to discontinue his opioids. I placed a civil restraining order against him and when we met in court he admitted to the judge that stopping opioids improved his behavior. I discovered that the legal system could support the medical system's care of threatening patients but found the process stressful. My story outlines my journey and suggests that safety-net institutions such as the Veterans Affairs clinics might consider creating "patients of concern" panels where patients who have made threats meet with clinicians and administrators as part of ongoing treatment and, as a result, perhaps avoid courtroom visits...
May 2020: Annals of Family Medicine
Evan V Goldstein, Laura C Prater, Seuli Bose-Brill, Thomas M Wickizer
Firearm suicide receives relatively little public attention in the United States, however, the United States is in the midst of a firearm suicide crisis. Most suicides are completed using a firearm. The age-adjusted firearm suicide rate increased 22.6% from 2005 to 2017, and globally the US firearm suicide rate is 8 times higher than the average firearm suicide rate of 22 other developed countries. The debate over how to solve the firearm suicide epidemic tends to focus on reducing the firearm supply or increasing access to behavioral health treatment...
May 2020: Annals of Family Medicine
Nicholas Darshan Tolat, Bindi Jayendra Naik-Mathuria, Amy Lynn McGuire
Firearm-related deaths are on the rise in the United States, especially among our youth. Tragically, proper firearm storage and safety could have prevented a great number of these deaths. Professional and public health organizations have thus encouraged physicians to provide direct patient counseling on firearm safety. Yet, even with these recommendations, the majority of physicians are still not talking to their patients about this issue. There may be many reasons for this, including concerns about liability, feeling unprepared, patient discomfort, and lack of time during office visits...
May 2020: Annals of Family Medicine
Wei Han Lim, Wei Mon Wong
Coronavirus disease 2019 (COVID-19) is a rapidly progressing global pandemic against which nations are struggling for containment. Singapore is known to have promptly instituted aggressive public health and containment measures. A key pillar sustaining this is the response of its primary health care network. It is important for health care systems worldwide to recognize the value of a strong coordinated response to this crisis from a primary health perspective. There are best practices for early isolation and containment of suspect cases while protecting health care workers and limiting cross infections that are transferable across nations...
May 2020: Annals of Family Medicine
Jacqueline K Kueper, Amanda L Terry, Merrick Zwarenstein, Daniel J Lizotte
PURPOSE: Rapid increases in technology and data motivate the application of artificial intelligence (AI) to primary care, but no comprehensive review exists to guide these efforts. Our objective was to assess the nature and extent of the body of research on AI for primary care. METHODS: We performed a scoping review, searching 11 published or gray literature databases with terms pertaining to AI (eg, machine learning, bayes* network) and primary care (eg, general pract*, nurse)...
May 2020: Annals of Family Medicine
John R Handy, Michael Skokan, Erika Rauch, Steven Zinck, Rachel E Sanborn, Svetlana Kotova, Mansen Wang
PURPOSE: To address doubts regarding National Lung Screening Trial (NLST) generalizability, we analyzed over 6,000 lung cancer screenings (LCSs) within a community health system. METHODS: Our LCS program included 10 sites, 7 hospitals (2 non-university tertiary care, 5 community) and 3 free-standing imaging centers. Primary care clinicians referred patients. Standard criteria determined eligibility. Dedicated radiologists interpreted all LCSs, assigning Lung Imaging Reporting and Data System (Lung-RADS) categories...
May 2020: Annals of Family Medicine
Regina Wing Shan Sit, Ricky Wing Keung Wu, David Rabago, Kenneth Dean Reeves, Dicken Cheong Chun Chan, Benjamin Hon Kei Yip, Vincent Chi Ho Chung, Samuel Yeung Shan Wong
PURPOSE: To test the efficacy of intra-articular hypertonic dextrose prolotherapy (DPT) vs normal saline (NS) injection for knee osteoarthritis (KOA). METHODS: A single-center, parallel-group, blinded, randomized controlled trial was conducted at a university primary care clinic in Hong Kong. Patients with KOA (n = 76) were randomly allocated (1:1) to DPT or NS groups for injections at weeks 0, 4, 8, and 16. The primary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 0-100 points) pain score...
May 2020: Annals of Family Medicine
Kaylyn E Swankoski, Deborah N Peikes, Maya Palakal, Nancy Duda, Timothy J Day
PURPOSE: Practices in the 4-year Comprehensive Primary Care (CPC) initiative changed staffing patterns during 2012-2016 to improve care delivery. We sought to characterize these changes and to compare practice patterns with those in similar non-CPC practices in 2016. METHODS: We conducted an online survey among selected US primary care practices. We statistically tested 2012-2016 changes in practice-reported staff composition among 461 CPC practices using 2-tailed t tests...
May 2020: Annals of Family Medicine
Catherine Hudon, Maud-Christine Chouinard, Kris Aubrey-Bassler, Nazeem Muhajarine, Fred Burge, Paula Louise Bush, Alya Danish, Vivian R Ramsden, France Légaré, Line Guénette, Paul Morin, Mireille Lambert, Fiona Fick, Olivia Cleary, Véronique Sabourin, Mike Warren, Pierre Pluye
PURPOSE: Case management (CM) is a promising intervention for frequent users of health care services. Our research question was how and under what circumstances does CM in primary care work to improve outcomes among frequent users with chronic conditions? METHODS: We conducted a realist synthesis, searching MEDLINE, CINAHL, Embase, and PsycINFO (1996 to September 2017) for articles meeting the following criteria: (1) population: adult frequent users with chronic disease, (2) intervention: CM in a primary care setting with a postintervention evaluation, and (3) primary outcomes: integration of services, health care system use, cost, and patient outcome measures...
May 2020: Annals of Family Medicine
Joy Melnikow, Ethan Evans, Guibo Xing, Shauna Durbin, Dominique Ritley, Brock Daniels, Lindsey Woodworth
PURPOSE: We undertook a study to evaluate variation in the availability of primary care new patient appointments for Medi-Cal (California Medicaid) enrollees in Northern California, and its relationship to emergency department (ED) use after Medicaid expansion. METHODS: We placed simulated calls by purported Medi-Cal enrollees to 581 primary care clinicians (PCCs) listed as accepting new patients in online directories of Medi-Cal managed care plans. Data from the California Health Interview Survey, Medi-Cal enrollment reports, and California hospital discharge records were used in analyses...
May 2020: Annals of Family Medicine
Benjamin F Crabtree, William L Miller, Jenna Howard, Ellen B Rubinstein, Jennifer Tsui, Shawna V Hudson, Denalee O'Malley, Jeanne M Ferrante, Kurt C Stange
PURPOSE: Despite a burgeoning population of cancer survivors and pending shortages of oncology services, clear definitions and systematic approaches for engaging primary care in cancer survivorship are lacking. We sought to understand how primary care clinicians perceive their role in delivering care to cancer survivors. METHODS: We conducted digitally recorded interviews with 38 clinicians in 14 primary care practices that had national reputations as workforce innovators...
May 2020: Annals of Family Medicine
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No abstract text is available yet for this article.
May 2020: Annals of Family Medicine
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