Annals of family medicine
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Annals of family medicine · Apr 2022
Patient engagement works: Patient and researcher experiences of patient partnership in primary healthcare research.
Context: Health researchers are increasingly engaging patients and their families as partners in the research process, from inception to knowledge translation. The trend toward 'patient-oriented' research is encouraged by a growing view that studies which integrate the patient perspective will make better use of resources to produce more relevant evidence that can be more easily translated to clinical settings. While there is an emerging literature on best practices, challenges, and learnings related to patient engagement (PE), few studies consider the experiences of patient partners (PP) and researchers in the same project. ⋯ PP make integral contributions to study and instrument design, data analysis, and knowledge translation. Clear expectations about the degree and nature of PE and team members' roles are critical. Conclusions: Meaningful PE requires patient-researcher partnership and clear expectation setting at the outset and throughout the research process, and ongoing flexibility to adapt.
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Annals of family medicine · Apr 2022
Black patient perceptions of COVID-19 vaccine, treatment, and testing.
Context: The Presence for Racial Justice project leverages the Stanford Presence 5 framework to present anti-racism communication practices that promote clinician trust-building for Black patients in primary care. With the racial/ethnic disparities in COVID-19 infection rates, an assessment of Black patients' perspectives around COVID-19 care is required to promote health equity in current and future health crises. Objective: To compile clinician communication strategies for promotion of patient understanding and agency concerning Black patients' perceptions of COVID-19 vaccine, treatment and testing. ⋯ They expressed a preference for receiving COVID-19 medical care in the comfort of their homes due to high costs and risks of maltreatment, death, and loneliness. Conclusion: Black patients hinged their vaccination decisions on having enough time to observe vaccine rollout and discussion with their clinicians. Relating new medical interventions (ie., COVID-19 vaccine) to accept medical approaches (ie., Flu vaccine) and being aware of historical distrust in medicine can inform clinician efforts to empower and provide excellent care for Black patients moving forward.
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Context: To aid prioritisation of funding for stroke research, a Stroke Priority Setting Partnership is being conducted in the UK by The Stroke Association using surveys and workshops with stroke survivors, stroke carers and health professionals. Another valuable source of information about topics that require research is the social media platform Twitter. Objective: To ascertain common topics of discussion in relation to stroke recovery on Twitter amongst stroke survivors, their carers, and the general public. ⋯ Amongst the most prominent aspects of recovery discussed was the psychological impact of stroke, with users expressing difficulty in addressing the emotional sequalae in comparison to the physical aspects. This may be addressed by targeted funding of mental health services, and recognition of the specialised needs of stroke survivors. It is hoped that the findings of this project will be useful in guiding the apportioning of funding, as well as complementing the findings of the James Lind Alliance's Priority Setting Partnership.
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Annals of family medicine · Apr 2022
The Virginia primary care workforce: Final results of a novel method of analysis.
Background: In order to evaluate the capacity of primary care to provide comprehensive, coordinated, continuous care, a description of the primary care workforce is necessary. There have been prior efforts to describe the distribution of primary care, however, an accurate and timely description of which clinicians are in what location has been lacking. Further, the scope of care provided has not been fully explored. ⋯ This will provide insight into the way care is provided across the state and establishes a foundation for evaluation of continuous care, comprehensive care and coordinated care in the future. As claims can be used to identify individuals over the course of time, it will be possible to identify scope, continuity and additional characteristics of clinicians. Additionally, we hope to identify advanced practice providers and their scope of care as well as clinicians migration and evolution during their career.
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Annals of family medicine · Apr 2022
Does de-implementation of low value care impact the patient-clinician relationship? A mixed methods study.
Context: In the U. S., provision of LVC is prevalent (up to 20% of total health services), costly ($350 billion annually), and associated with patient harm. Concern about a negative impact on the patient-clinician relationship has been cited by primary care clinicians as a barrier to reducing LVC. ⋯ However, most emphasized that negative impacts could be mitigated if the clinician listened to them, spent time with them, and offered understandable advice. Conclusions: Findings emphasize prioritization of the patient-clinician relationship in LVC de-implementation interventions and suggest minimal impact of such interventions on the patient-clinician relationship. Evidence of service-specific differences was observed.