Annals of family medicine
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Annals of family medicine · Jan 2023
ReviewReview of Patient Outcomes After Referral to OT Embedded Within a Primary Care Practice.
Context: Interprofessional teams can reduce workload of primary care providers (PCP). Currently, there is no standardization regarding which professionals should be on the team. We completed a 2 year pilot imbedding an occupational therapist (OT) within a family medicine team. ⋯ Learning Objectives: OT imbedded within a primary care team can result in efficient and successful treatment of a wide variety of patient complaints. OT services embedded within a primary care team are reimbursable by Medicare and commercial insurance plans. Research Category: Original research Study Design: Retrospective chart review.
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Annals of family medicine · Jan 2023
Randomized Controlled TrialFeasibility Study for Randomised Control Trial for Topical Treatment of Impetigo in Australian General Practice.
Context Impetigo affects millions of children worldwide. Most guidelines recommend antibiotics as first-line treatment however topical antiseptics present a potentially valuable, understudied, antibiotic-sparing treatment for mild impetigo. Objective We aimed to determine the feasibility of a randomized controlled trial (RCT) comparing efficacy of soft white paraffin (SWP), hydrogen peroxide (H2O2) and mupirocin for mild impetigo. ⋯ Conclusions Valuable insight was gained into the practicality of conducting a RCT of impetigo treatments in general practice. Future trials should consider recruiting outside of general practice clinics to capture patients at earlier, more mild stages of infection. Further investigation into the prevalence and impact of use of at-home expired antibiotics may be beneficial.
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Annals of family medicine · Jan 2023
Randomized Controlled Trial Pragmatic Clinical TrialRapid Detection of Influenza Outbreaks in Long Term Care Facilities Reduces Emergency Room Visits and Hospitalization.
Context: Influenza is a significant respiratory pathogen for residents of long-term care facilities (LTCFs). Rapid influenza detection tests (RIDT) may enable early outbreak detection allowing a timely response. Objective: We assessed whether RIDT for LTCF residents with acute respiratory infection is associated with increased antiviral use and decreased healthcare utilization. ⋯ There were significant reductions in the rates of all-cause ED visits (22% decline), hospitalizations (21% decline), and hospital length of stay (36% decline) across three combined influenza seasons. No significant differences were noted in respiratory-associated and all-cause deaths between intervention and control sites. This feasible, and low-cost intervention may provide significant benefit and should be further tested in other settings.
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Annals of family medicine · Jan 2023
Randomized Controlled TrialEvaluation of a Virtual Pre-Consultation Tool for Older Adults in Primary Care: Results from a Randomized Trial.
Context: Virtual pre-consultation screening of patient needs may offer opportunities to improve the care and health outcomes of older patients in primary care, especially those with multiple care needs. Objective: We sought to implement and evaluate the effectiveness of a multidimensional virtual pre-consultation tool in the primary care setting to support rapid and standardized needs assessment for older persons. Study Design and Analysis: Pragmatic, multi-center, 1:1 individually randomized trial design. ⋯ Final results of the intention-to-treat analysis will be presented overall and stratified by urban and rural sites. Conclusions: Intended consequences of this intervention include an increased responsiveness of consultations for providers resulting in improved care of older patients. Overall, we hope results will support the implementation of evidence-based, multidimensional and virtual pre-consultation tools for older persons in the primary care setting.
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Annals of family medicine · Jan 2023
Randomized Controlled TrialEvaluating the Feasibility of Enhanced Care Planning and Clinical-Community Linkages for Primary Care Teams to Better Address.
Context: Patients with MCC have a range of needs that extend beyond traditional medical care including behavioral, mental health, and social needs. While primary care does its best to address these needs, few practices can undertake a systematic approach without broader health system and coordinated community support. We are conducting a randomized controlled trial to compare a package of four tools (an online health risk assessment called My Own Health Report (MOHR), patient navigator, community health worker, and linkage to community programs) versus usual care to better address these root causes of poor health. ⋯ Conclusions: Helping patients create care plans and connecting them with a patient navigator for the short-term may have long-term benefits for patients and care teams. Yet, this model of team-based care is not currently feasible for many practices. Primary care will benefit from increased health system and community support to make this model more viable to better support the complex needs of patients with MCCs.