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Journal of the American Board of Family Medicine: JABFM

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https://read.qxmd.com/read/30850467/re-the-complex-interpretation-and-management-of-zika-virus-test-results
#1
LETTER
Sora Yasri, Viroj Wiwanitkit
No abstract text is available yet for this article.
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850466/re-family-medicine-and-obstetrics-let-s-stop-pretending
#2
LETTER
Daniel M Avery, Marion D Reed, Catherine A Skinner
No abstract text is available yet for this article.
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850465/screening-for-psychotherapeutic-medication-misuse-in-primary-care-patients-comparing-two-instruments
#3
Sebastian T Tong, Kathryn M Polak, Michael F Weaver, Gabriela C Villalobos, Wally R Smith, Dace S Svikis
INTRODUCTION: Prescription psychotherapeutic medication misuse is a growing problem in the United States, but no method exists to routinely screen for this in primary care. Our study sought to (1) describe the prevalence of prescription psychotherapeutic medication misuse in primary care and the characteristics of patients who misuse and (2) compare 2 screening instruments modified to identify prescription medication misuse in primary care. METHODS: Primary care patients from underserved, urban clinics within a health system completed anonymous computer-directed health screens that included standard questions about prescription medication misuse...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850464/reports-of-two-broken-nexplanon%C3%A2-rods
#4
Joanna Campodonico, Jeffrey Wolfrey, Jenna Buchanan
Damage to progestin containing contraceptive implants has been reported for Implanon® rods but there appear to be few reports of damage to Nexplanon® rods. This report describes 2 cases of Nexplanon® rod breakage in an 18-year-old female and a 25-year-old female. The literature regarding damaged progestin implants is reviewed. These reports often involve an alteration in menstrual bleeding pattern and patients frequently request removal of bent or broken implants. The overall incidence of rod breakage and impact of damaged implants on contraceptive efficacy is not clear...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850463/emergency-department-high-utilizers-among-family-medicine-patients
#5
Stacey Kirkpatrick, Denny Fe G Agana, Kim Lynch, Peter J Carek
BACKGROUND: Increases in emergency department (ED) use are contributing to inefficient health care spending and becoming a public health concern. Previous studies have identified characteristics of ED high utilizers aimed at designing interventions to improve efficiency. We aim to expand on these findings in a family medicine outpatient population. METHODS: We conducted a retrospective analysis on a population of ED high utilizers, defined as those who had been to the ED 6 or more times in 1 year, including medical and demographic characteristics from 2015 to 2017...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850462/relationship-of-training-in-acupuncture-to-physician-burnout
#6
Paul F Crawford, Jedda Rupert, Jeremy T Jackson, Stevan Walkowski, Christy J W Ledford
BACKGROUND: Physician burnout is an ongoing problem that affects both physician wellbeing and patient care. Burnout is characterized by emotional exhaustion and depersonalization. Studies have explored ways to prevent and alleviate burnout. Receiving training in acupuncture may reduce physician burnout. OBJECTIVE: The purpose of this study is to determine if acupuncture training is associated with less patient depersonalization and less emotional exhaustion among physicians...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850461/a-randomized-trial-to-train-vulnerable-primary-care-patients-to-use-a-patient-portal
#7
Courtney R Lyles, Lina Tieu, Urmimala Sarkar, Stephen Kiyoi, Shobha Sadasivaiah, Mekhala Hoskote, Neda Ratanawongsa, Dean Schillinger
BACKGROUND: Patient portals are becoming ubiquitous. Previous research has documented substantial barriers, especially among vulnerable patient subgroups such as those with lower socioeconomic status or limited health literacy (LHL). We tested the effectiveness of delivering online, video-based portal training to patients in a safety net setting. METHODS: We created an online video curriculum about accessing the San Francisco Health Network portal, and then randomized 93 English-speaking patients with 1+ chronic diseases to receive 1) an in-person tutorial with a research assistant, or 2) a link to view the videos on their own...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850460/signs-and-symptoms-that-rule-out-community-acquired-pneumonia-in-outpatient-adults-a-systematic-review-and-meta-analysis
#8
Christian S Marchello, Mark H Ebell, Ariella P Dale, Eric T Harvill, Ye Shen, Christopher C Whalen
BACKGROUND: A systematic review of clinical decision rules to identify patients at low risk for community-acquired pneumonia (CAP) has not been previously presented in the literature. METHODS: A systematic review of MEDLINE for prospective studies that used at least 2 signs, symptoms, or point-of-care tests to determine the likelihood of CAP. We included studies that enrolled adults and adolescents in the outpatient setting where all or a random sample of patients received a chest radiograph as the reference standard...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850459/impact-of-a-rapid-point-of-care-test-for-influenza-on-guideline-consistent-care-and-antibiotic-use
#9
Ariella Perry Dale, Mark Ebell, Brian McKay, Andreas Handel, Ronald Forehand, Kevin Dobbin
BACKGROUND: Rapid influenza diagnostic tests that detect the presence of viral antigens are currently used throughout the United States but have poor sensitivity. The objective of this study was to identify if the use of a new highly accurate rapid point of care test would significantly increase the likelihood of guideline consistent care. METHODS: We prospectively recruited 300 students at a university health clinic who presented with cough and 1 influenza-like illness symptom between December 2016 and February 2017 to receive care guided by a rapid polymerase chain reaction (PCR) test...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850458/primary-care-physician-characteristics-associated-with-low-value-care-spending
#10
Tyler W Barreto, Yoonkyung Chung, Peter Wingrove, Richard A Young, Stephen Petterson, Andrew Bazemore, Winston Liaw
BACKGROUND: Previous work has shown that $210 billion may be spent annually on unnecessary medical services and has identified patient and hospital characteristics associated with low value care (LVC). However, little is known about the association between primary care physician (PCP) characteristics and LVC spending. The objective of this study was to assess this association. METHODS: We performed a retrospective analysis by using Medicare claims data to identify LVC and American Medical Association Masterfile data for PCP characteristics...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850457/patterns-of-diabetes-screening-and-prediabetes-treatment-during-office-visits-in-the-us
#11
Kayce M Shealy, Jun Wu, Jessica Waites, Nancy A Taylor, G Blair Sarbacker
INTRODUCTION: The American Diabetes Association recommends annual screenings for prediabetes if the patient meets the suggested requirements. The overall prevalence of prediabetes has decreased from an estimated 86 million adults in 2012 to 84.1 million adults in 2015 in the United States. Along with lifestyle modifications, the use of metformin as a treatment option or in combination has shown a decrease in weight and health care costs. This study was designed to review the prevalence of screening and treatment of prediabetes in the United States by using the National Ambulatory Medical Care Survey, as well as identify any factors associated with screenings and treatment...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850456/patient-characteristics-associated-with-making-requests-during-primary-care-visits
#12
Joshua J Fenton, Elizabeth M Magnan, Anthony Jerant, Richard L Kravitz, Peter Franks
BACKGROUND: Patient requests for tests, treatments, or referrals occur frequently during primary care visits and pose challenges for clinicians to address, but little is known about patient characteristics that may predict requests. OBJECTIVE: To identify patient characteristics associated with a higher rate of patient requests during primary care visits. DESIGN, SETTING, AND SAMPLE: Cross-sectional analyses of data from 1141 adult patients attending 1319 visits with 56 primary care physicians (including 45 resident and 11 faculty physicians) in an academic family medicine practice...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850455/the-burden-of-childhood-atopic-dermatitis-in-the-primary-care-setting-a-report-from-the-meta-larc-consortium
#13
Jinan Al-Naqeeb, Sankirtana Danner, Lyle J Fagnan, Katrina Ramsey, LeAnn Michaels, Julie Mitchell, Kelsey Branca, Cynthia Morris, Donald E Nease, Linda Zittleman, Barcey Levy, Jeanette Daly, David Hahn, Rowena J Dolor, Hywel C Williams, Joanne R Chalmers, Jon Hanifin, Susan Tofte, Katharine E Zuckerman, Karen Hansis, Mollie Gundersen, Julie Block, Francie Karr, Sandra Dunbrasky, Kathy Siebe, Kristen Dillon, Ricardo Cibotti, Jodi Lapidus, Eric L Simpson
BACKGROUND: Little is known about the burden of atopic dermatitis (AD) encountered in US primary care practices and the frequency and type of skin care practices routinely used in children. OBJECTIVE: To estimate the prevalence of AD in children 0 to 5 years attending primary care practices in the United States and to describe routine skin care practices used in this population. DESIGN: A cross-sectional survey study of a convenience sample of children under the age of 5 attending primary care practices for any reason...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850454/barriers-and-facilitators-of-colorectal-cancer-screening-in-a-federally-qualified-health-center-fqhc
#14
Kelly R Ylitalo, Brendan G Camp, M Renée Umstattd Meyer, Lauren A Barron, Gabriel Benavidez, Burritt Hess, Ryan Laschober, Jackson O Griggs
INTRODUCTION: Colorectal cancer is a leading cause of cancer-related mortality in the United States. Current screening recommendations for individuals aged 50 to 75 years include colonoscopy every 10 years, flexible sigmoidoscopy every 5 years, or annual stool-based testing. Stool-based testing, including fecal immunochemical tests (FITs), are cost effective, easy to perform at home, and noninvasive, yet many patients fail to return testing kits and go unscreened. The purpose of the study was to identify patient characteristics and perceived barriers and facilitators of FIT return...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850453/improving-the-adoption-of-advance-directives-in-primary-care-practices
#15
Elizabeth Wickersham, Mary Gowin, Munim H Deen, Zsolt Nagykaldi
BACKGROUND: Oklahoma's Advance Directive completion rate is less than 10%. We compared the implementation performance of 2 advance directive forms to determine which form could be more successfully disseminated. METHODS: The implementation of the Oklahoma Advance Directive (OKAD) and the Five Wishes form were compared in an 8-month pair-matched cluster randomized study in 6 primary care practices. The outcomes measured during the 22-week implementation included form offering rate, acceptance/completion rate by patients, and documentation in the chart...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850452/canadian-hiv-care-settings-as-patient-centered-medical-homes-pcmhs
#16
Claire E Kendall, Esther S Shoemaker, Janessa E Porter, Lisa M Boucher, Lois Crowe, Ron Rosenes, Christine Bibeau, Philip Lundrigan, Marissa L Becker, Shabnam Asghari, Sean B Rourke, Clare Liddy
PURPOSE: For people living with HIV (PLWH) using continuous antiretroviral therapy, HIV is now a complex chronic condition often managed in primary care settings. The patient-centered medical home (PCMH) is a model to deliver comprehensive, coordinated, and integrated primary care that promotes collaboration between primary and specialist care and allied services. The study assessed how both Canadian primary and specialist HIV care settings align with the PCMH. METHODS: Mixed-methods surveys and interviews with providers in Canadian HIV care settings...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850451/assessment-of-the-generalizability-of-an-econsult-service-through-implementation-in-a-new-health-region
#17
Clare Liddy, Isabella Moroz, Ariana Mihan, Erin Keely
INTRODUCTION: Excessive wait times for specialist care are a significant issue in many countries. Electronic consultation (eConsult) services have demonstrated the ability to improve access to specialist care. In this article, we evaluated the implementation of a successful eConsult service in a new jurisdiction to test its generalizability. METHODS: We used a multimethod approach to evaluate the Champlain Building Access to Specialists through eConsultation eConsult service's implementation in the South East Local Health Integration Network of Ontario, Canada...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850450/implementation-and-evaluation-of-a-laboratory-safety-process-improvement-toolkit
#18
Bethany M Kwan, Douglas Fernald, Peter Ferrarone, Natalia Loskutova, Jodi Summers Holtrop, Elizabeth W Staton, John M Westfall
PURPOSE: The purpose of this project was to evaluate the real-world usability and usefulness of a revised version of the published Agency for Healthcare Research and Quality "Improving Your Office Testing Process" toolkit, designed to help primary care practices standardize and systematize laboratory testing processes. METHOD: We used a multiple case study approach to evaluate toolkit implementation in 2 primary care practices with existing quality improvement (QI) infrastructure...
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850449/practice-intentions-of-family-physicians-trained-in-teaching-health-centers-the-value-of-community-based-training
#19
Zachary Levin, Peter Meyers, Lars Peterson, Andy Habib, Andrew Bazemore
Family medicine residents who graduate from Federally Qualified Health Center-aligned Teaching Health Center (THC) training residencies are nearly twice as likely to pursue employment in safety-net settings compared with non-THC graduates. This trend has been consistent over the past few years, suggesting that the program is fulfilling its mission to strengthen primary care in underserved settings.
March 2019: Journal of the American Board of Family Medicine: JABFM
https://read.qxmd.com/read/30850448/stuck-in-graduate-medical-education-traffic-teaching-health-centers-are-family-medicine-s-high-occupancy-vehicle-lane
#20
Joseph W Gravel
No abstract text is available yet for this article.
March 2019: Journal of the American Board of Family Medicine: JABFM
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