Annals of family medicine
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Annals of family medicine · Apr 2022
Impacts of the COVID-19 pandemic on gamblers in Canada: qualitative analysis of responses to an open-ended question.
draw up a portrait of the experience of gamblers regarding the impacts of the COVID-19 pandemic on their gambling practices. STUDY DESIGN: Qualitative analysis. SETTING: Content analysis of responses to a single open-ended question placed at the end of a cross-sectional survey which was online from February 16 to March 15 2021 in Quebec (Canada). Participants were recruited by a non-randomised online sampling. POPULATION STUDIED: 1529 individuals participated in the study, of whom 724 answered the open-ended question. Inclusion criteria were: (1) 18 years and older (2) living in the province of Quebec, Canada (3) has gambled at least once in the past year. ⋯ The pandemic has created space to fill into many individuals' lives as usual leisure activities, hobbies and spending habits became out of reach. It led to increased gambling for many participants. While many did not report deleterious effects of this increase, others expressed being at great risk and therefore need primary care professionals to be equipped to support them.
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Annals of family medicine · Apr 2022
Using chart reviews to evaluate a continuing medical education (CME) program.
Context Moore's Expanded Outcomes Framework is a 7 level framework commonly used to assess the outcomes of continuing medical education (CME) programs. Levels 1 to 5 are provider-level outcomes (participation, satisfaction, knowledge, competence, and performance) while levels 6 and 7 are patient- and community-level outcomes. Chart reviews are one method to assess level 5 (performance). ⋯ Trends in results showed marginal, but non-significant, improvements in PCP performance after ECHO as indicated by increased use of pain and opioid management strategies. Conclusions Conducting chart reviews was a challenging method to assess provider performance. Future work to assess provider performance should include a qualitative component (in-depth interviews or focus groups) in order to complement the quantitative data and provide context for care and management decisions.
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Annals of family medicine · Apr 2022
Applying QI-focused SPIDER approach to safer deprescribing for geriatric patients: Results of the Toronto Feasibility Study.
Context: More than 25% of Canadian seniors are prescribed 10+ different medications each year. There is a direct association between more medications and persistent high care needs/costs for seniors. Effective and appropriate deprescribing for seniors in primary care is needed. ⋯ Efficacy: reductions in PIP prevalence and prevalence of patients with at least one PIP were 3.6% (p=.4) and 1.4% (p=.5), respectively. Conclusions: The SPIDER approach appears to be feasible. Access to coaching support and pharmacist services may enhance sustainability.
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Annals of family medicine · Apr 2022
Continuous glucose monitoring for primary care patients with diabetes: Barriers, facilitators, & resources to support access.
Context: Continuous glucose monitoring (CGM) for patients with type 1 and type 2 diabetes is associated with improved patient health outcomes including reduced glycated hemoglobin (A1c) and hypoglycemia and is part of ADA Standards of Medical Care. CGM prescription often takes place in endocrinology practices. With limited access to endocrinologists, many patients could benefit from receiving CGM through primary care. ⋯ Conclusions: Increased understanding among primary care clinicians of the use and benefits of CGM can help with confidence in prescribing. CGM management in primary care could benefit patients with diabetes, especially those with access barriers to endocrinologists. Addressing cost and insurance barriers at a policy level can make CGM more attainable to underserved populations and reduce disparities in diabetes control.
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Annals of family medicine · Apr 2022
Observational StudyScreening patterns and identification of non-alcoholic fatty liver disease in obese children in canadian primary care.
Context. Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronic liver disease in children. There is no epidemiological data on rates of pediatric NAFLD in Canada. ⋯ Only 19.9% were referred to a specialist (pediatrician, gastroenterologist). Conclusions: This is the first study to estimate the screening patterns of pediatric NAFLD in primary care in Canada at a national level. The study revealed low screening rates in primary care, these results will help facilitate prioritization of care and future work that could evaluate successful implementation strategies while emphasizing the role of PCPs in screening and managing pediatric NAFLD in Canadian health care setting.