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Journal of Primary Care & Community Health

Yan Li, Foram Jasani, Dejun Su, Donglan Zhang, Lizheng Shi, Stella S Yi, José A Pagán
OBJECTIVE: Nearly one-third of adults in New York City (NYC) have high blood pressure and many social, economic, and behavioral factors may influence nonadherence to antihypertensive medication. The objective of this study is to identify profiles of adults who are not taking antihypertensive medications despite being advised to do so. METHODS: We used a machine learning-based population segmentation approach to identify population profiles related to nonadherence to antihypertensive medication...
January 2019: Journal of Primary Care & Community Health
Christopher R McParland, Mark A Cooper, Bridget Johnston
BACKGROUND: Differential Diagnosis Decision Support Systems (DDDSS) and other forms of clinical decision support systems may have a role in supporting clinicians and the public in making decisions about differential diagnosis and accessing health care services. The aim of this qualitative, focus group study was to explore the needs of out-of-hours and primary care clinicians, and members of the public in relation to DDDSS. METHODS: Twenty-nine participants (comprising 13 advanced nurse practitioners [ANPs], 7 general practitioners [GPs], 2 allied health professional advanced practitioners [AAPs], and 7 members of the public) took part in 1 of 6 focus groups...
January 2019: Journal of Primary Care & Community Health
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January 2019: Journal of Primary Care & Community Health
Kevin O Hwang, Aitebureme Aigbe, Hsiao-Hui Ju, Victoria C Jackson, Emily W Sedlock
BACKGROUND: Despite the high prevalence of blood pressure (BP) measurement errors in the outpatient setting, little is known about why primary care clinics struggle to achieve consistently accurate BP measurements in routine practice. We investigated barriers affecting measurement of BP for adult patients in primary care. METHODS: We conducted a qualitative evaluation in 6 adult primary care clinics. BP measurement was observed during 54 routine patient encounters...
January 2018: Journal of Primary Care & Community Health
Kyle Melin, Carlos E Rodríguez-Díaz
One year ago, Hurricane Maria passed over the archipelago of Puerto Rico, leaving widespread disruption of nearly all human services, including the health care sector. In the aftermath of the hurricane, limited access to medical care and prescription medications presented a serious challenge to maintaining control of preexisting chronic diseases. Many patients did not have access to refrigeration for heat-sensitive medications. Significant dietary changes due to the limited availability of shelf-stable foods further exacerbated chronic conditions such as heart failure and diabetes...
January 2018: Journal of Primary Care & Community Health
Tore Bonsaksen, Unni Sveen, Anne-Stine Dolva, Sissel Horghagen, Else Merete Thyness, Cathrine Hagby, Cathrine Arntzen
AIM: This study aimed to assess the perceived influence that community-working occupational therapists in Norway have on the service goals of their respective organizations. In addition, we aimed to assess sociodemographic and work-related factors associated with the perceived level of influence. METHODS: A cross-sectional survey was distributed to occupational therapists in community-based services in Norway (n = 1767), to which 561 (32%) responded. By multivariate regression analysis, factors associated with "self-perceived influence" were assessed...
January 2018: Journal of Primary Care & Community Health
Iman Mohammadi, Huanmei Wu, Ayten Turkcan, Tammy Toscos, Bradley N Doebbeling
OBJECTIVES: Using predictive modeling techniques, we developed and compared appointment no-show prediction models to better understand appointment adherence in underserved populations. METHODS AND MATERIALS: We collected electronic health record (EHR) data and appointment data including patient, provider and clinical visit characteristics over a 3-year period. All patient data came from an urban system of community health centers (CHCs) with 10 facilities. We sought to identify critical variables through logistic regression, artificial neural network, and naïve Bayes classifier models to predict missed appointments...
January 2018: Journal of Primary Care & Community Health
Yusuf Haji, Milion Teshome, Akalewold Alemayehu, Mekdes Mekonnen, Fistum W/Gebrieal, Achamyelesh G/Tsasdik
BACKGROUND: Globally, there has been progress in reducing maternal and under-5 child deaths in the past 2 decades; however, the progress in reducing newborn mortality has been slower with estimated 3 million neonatal deaths per year. In Ethiopia, unhealthy newborn care is common at home deliveries compared with institutional births that might be associated with neonatal deaths. The purpose of the current study was to assess the practices of immediate newborn care at home and institutional deliveries in rural Sidama Zone, 2017...
January 2018: Journal of Primary Care & Community Health
Rebecca Geiger, Jessica Steinert, Grant McElwee, Jennifer Carver, Robert Montanez, Julie Niewoehner, Cassandra Clark, Brigg Reilley
BACKGROUND: American Indian/Alaska Natives (AI/ANs) are disproportionately affected by hepatitis C virus (HCV), with more than double the national rate of HCV-related mortality as well as the highest rates of acute HCV. The "cascade of care" for HCV consists of screening, confirmation, treatment, and sustained virologic clearance (SVR)/cure. At each stage of this process, patients can be lost to follow-up. Federal health care facilities in an administrative area of the Indian Health Service conducted a review to identify and address gaps in HCV treatment...
January 2018: Journal of Primary Care & Community Health
Christine Louw, De Wet Swanepoel, Robert H Eikelboom
OBJECTIVE: To evaluate the performance of self-reported hearing loss alone and in combination with pure tone audiometry screening in primary health care clinics in South Africa. DESIGN: Nonprobability purposive sampling was used at 2 primary health care clinics. A total of 1084 participants (mean age 41.2 years; SD 15.5 years; range 16-97 years, 74.0% female) were screened using self-report and audiometry screening. Those failing audiometric screening and a sample of those who passed audiometric screening were also assessed by diagnostic pure time audiometry, to confirm or negate the finding of a hearing loss...
January 2018: Journal of Primary Care & Community Health
Ramya Walsan, Andrew Bonney, Darren J Mayne, Nagesh Pai, Xiaoqi Feng, Renin Toms
AIM OF THE STUDY: This review aims to systematically synthesize the body of literature examining the association between neighborhood socioeconomic disadvantage and serious mental illness (SMI)-type 2 diabetes (T2D) co-occurrence. METHODS: We conducted an electronic search of four databases: PubMed, Scopus, Medline, and Web of Science. Studies were considered eligible if they were published in English, peer reviewed, quantitative, and focused on the association between neighborhood disadvantage and SMI-T2D comorbidity...
January 2018: Journal of Primary Care & Community Health
Allen L Pimienta, Thomas A Billings, Robert G Fish
Renal cell carcinoma (RCC) accounts for approximately 80% of all primary renal neoplasms in United States causing approximately 65 000 new cases of RCC and 14 000 deaths each year. Symptoms of RCC typically include weight loss and night sweats but may also feature paraneoplastic phenomena in advanced stages as well as flank pain, gross hematuria, scrotal varicocele, inferior vena cava pathology, and a palpable abdominal mass. In this article, we present the course of a patient with advanced RCC, from initial presentation through workup and to eventual diagnosis...
January 2018: Journal of Primary Care & Community Health
Francisco Roman, Jay-Sheree Allen, Heather Catherine Wurm, Kathy MacLaughlin
A 62-year-old Caucasian man with past medical history significant for coronary artery disease, status post drug eluting stent to the left anterior descending artery 10 years prior, was admitted for elective total right knee arthroplasty. His intraoperative course was uneventful, and he was discharged on hospital day 2 on aspirin 325 mg twice daily for 6 weeks for venous thromboembolism (VTE) prophylaxis. Three weeks later the patient developed chest pain shortly after an approximately 1-hour flight and presented to a local emergency department where computed tomography angiogram showed pulmonary emboli involving segmental and subsegmental pulmonary arteries bilaterally...
January 2018: Journal of Primary Care & Community Health
Mylaine Breton, Mélanie Ann Smithman, Nassera Touati, Antoine Boivin, Christine Loignon, Carl-Ardy Dubois, Kareen Nour, Catherine Lamoureux-Lamarche, Astrid Brousselle
PURPOSE: In response to more than 15% of Canadians not having a family physician, 7 provinces have implemented centralized waiting lists for unattached patients. The aim of this study is to analyze the association between family physicians' characteristics and their participation in centralized waiting lists. METHODS: Cross-sectional observational study using administrative data in 5 local health networks in Quebec, between 2013 and 2015. All physicians who had attached at least 1 patient were included (n = 580)...
January 2018: Journal of Primary Care & Community Health
Elaine Seaton Banerjee, Sharon J Herring, Katelyn Hurley, Katherine Puskarz, Kyle Yebernetsky, Marianna LaNoue
OBJECTIVE: We set out to investigate the behaviors of low-income African American women who successfully lost weight. METHODS: From an urban, academic, family medicine practice, we used a mixed methods positive deviance approach to evaluate 35 low-income African American women who were obese and lost at least 10% of their maximum weight, and maintained this loss for 6 months, comparing them with 36 demographically similar control participants who had not lost weight...
January 2018: Journal of Primary Care & Community Health
Kelly Kyanko, Kathleen Hanley, Sondra Zabar, Jennifer Joseph, William Bateman, Antoinette Schoenthaler
BACKGROUND: Telephone consultation is widely used in primary care and can provide an effective and efficient alternative for the in-person visit. Gouverneur Health, a safety-net primary care practice in New York City serving a predominately immigrant population, evaluated the feasibility and physician and patient acceptability of a telephone visit initiative in 2015. MEASURES: Patient and physician surveys, and physician focus groups. RESULTS: Though only 85 of 270 scheduled telephone visits (31%) were completed, 84% of patients reported being highly satisfied with their telephone visit...
January 2018: Journal of Primary Care & Community Health
Merit P George, Gregory M Garrison, Zachary Merten, Dagoberto Heredia, Cesar Gonzales, Kurt B Angstman
BACKGROUND: Previous studies have suggested that having a comorbid personality disorder (PD) along with major depression is associated with poorer depression outcomes relative to those without comorbid PD. However, few studies have examined the influence of specific PD cluster types. The purpose of the current study is to compare depression outcomes between cluster A, cluster B, and cluster C PD patients treated within a collaborative care management (CCM), relative to CCM patients without a PD diagnosis...
January 2018: Journal of Primary Care & Community Health
Vishaal Buch, Hayley Ralph, Joanne Salas, Paul J Hauptman, Dawn Davis, Jeffrey F Scherrer
BACKGROUND: The atherosclerotic cardiovascular disease (ASCVD) 10-year risk estimate is recommended by cardiologists for determining risk of a cardiac event. However, the majority of patients presenting to primary care with chest pain have noncardiac etiologies. Therefore, we determined if high versus low ASCVD risk was associated with primary care physicians' referral to cardiology in patients with and without chest pain. METHODS: Deidentified electronic health record (EHR) data was obtained from 5795 patients treated in academic primary care clinics from 2008 to 2015...
January 2018: Journal of Primary Care & Community Health
Rita Suhadi, Dita Maria Virginia, Christianus Heru Setiawan
BACKGROUND: Evidence from previous studies demonstrates that lifestyle modification reduces the incidence and complications of atherosclerotic cardiovascular disease. The study aimed to investigate the effect of a lifestyle intervention provided by pharmacists on the 10-year atherosclerotic cardiovascular disease (ASCVD) risk and quality of life (QoL) in a low socioeconomic status Javanese population. METHODS: This research was a cluster-randomized controlled study of 1-year duration, conducted in a lower social economic community in the Sleman District of Yogyakarta, Indonesia...
January 2018: Journal of Primary Care & Community Health
Jeremy J Solberg, Mark E Deyo-Svendsen, Kelsey R Nylander, Elliot J Bruhl, Dagoberto Heredia, Kurt B Angstman
BACKGROUND: The use of a collaborative care management (CCM) model can dramatically improve short- and long-term treatment outcomes for patients with major depressive disorder (MDD). Patients with comorbid personality disorder (PD) may experience poorer treatment outcomes for MDD. Our study seeks to examine the differences in MDD treatment outcomes for patients with comorbid PD when using a CCM approach rather than usual care (UC). METHODS: In our retrospective cohort study, we reviewed the records of 9614 adult patients enrolled in our depression registry with the clinical diagnosis MDD and the diagnosis of PD (Yes/No)...
January 2018: Journal of Primary Care & Community Health
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