Annals of family medicine
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Annals of family medicine · Apr 2022
Implementation analysis of case management interventions for frequent users of healthcare services: A multiple-case study.
Context. Case management interventions (CMIs) are recognized to improve patients' experience of integrated care, to promote better utilization of healthcare resources, and to reduce emergency department visits, hospitalizations and health care costs. However, contextual factors influencing implementation of CMIs in primary care settings in Canada still need to be studied. ⋯ On the other hand, a culture of patient-centredness and collaboration; managerial and clinical leadership and support; and a positive perception of the CMI alongside provider engagement helps to overcome these barriers. Conclusions. This study may help researchers, decision-makers and clinicians plan the implementation of CMIs in primary care settings for frequent users of healthcare services with chronic diseases and complex care needs.
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Annals of family medicine · Apr 2022
Research prioritization in migrant health in Ireland: toward a participatory arts-based paradigm for academic primary care.
Context: People are experts in their own health and need to be involved in health-related decisions, including decisions about what issues should be researched. Underserved communities, such as refugees and migrants, are often excluded from having a voice in relation to their priorities for health research. To avoid tokenistic participation, it is important to develop and test innovative methodologies that are culturally attuned and that can offer 'whole person' (affective, creative and cognitive) engagement. ⋯ Results: Analysis is underway and will describe participants' shared and differential experiences of (i) the research prioritisation sessions with particular attention to their experience of using music and other artistic practices (ii) cultural attunement and whole person engagement and (iii) generating identified research priorities. Conclusions: Findings will inform the evidence base about music as an arts-based method to support a new, inclusive participatory arts-based paradigm for migrants' involvement in research prioritisation. The work will be disseminated in Ireland and in the 53 Member States of the WHO Euro region.
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Annals of family medicine · Apr 2022
Cancer specialist perspectives on implementing an online communication system with primary care providers.
Context: The Canadian Team to Improve Community-Based Cancer Care along the Continuum (CanIMPACT) is a group of researchers, primary care providers (PCPs), cancer specialists, patients and caregivers working to improve cancer care coordination between PCPs and cancer specialists. Previous research by CanIMPACT and others has identified problems related to communication, coordination, and continuity of care. Objective: Describe findings from qualitative interviews with cancer specialists on implementation of an online communication system with PCPs. ⋯ Patients and caregivers play a critical role in coordinating cancer care, helping to facilitate coordination. Lack of access to the same electronic medical record (EMR) among healthcare providers poses a barrier to cancer care coordination. eOncoNote had the potential to be useful tool but it was not used extensively. Conclusions: Accessing eOncoNote as a separate system was challenging to incorporate into the workflow, and cancer specialists highlighted the need for integration with their EMR. eOncoNote did not affect information sharing with PCPs, as there was limited uptake within primary care.
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Annals of family medicine · Apr 2022
A qualitative study of adolescent perspectives on COVID-19 pandemic: considerations in the provision of primary virtual care.
Context: Amidst school shutdowns, sheltering in place, and social distancing, the COVID-19 pandemic uniquely affected adolescents. Understanding the experiences of adolescents with respect to social distancing, health changes, information sources and virtual care can inform effective health care for adolescents both during and after the pandemic. Objective: An exploration into their health care experiences during the beginning stage of the pandemic was undertaken to increase knowledge among family physicians to enable adjustments to the provision of care, primarily done virtually. ⋯ Parents were described as the most trusted source of information about the pandemic. Conclusions: Adolescents primarily look to parents for guidance and the increased family time promoted well-being. Physicians that are able to help adolescents negotiate privacy and mitigate communication challenges are able to provide effective virtual care.
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Annals of family medicine · Apr 2022
Achievement of glycemic control and antidepressant medication use in comorbid depression and type II diabetes.
Limited previous work has suggested that treatment of co-morbid patients with anti-depressant medication (ADM) is associated with improved glycemic control. ⋯ Receipt of adequate ADM therapy is associated with achieving glycemic control in the first 3 years after a T2DM diagnoses with uncontrolled A1c.