Annals of family medicine
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Annals of family medicine · Jan 2020
Observational StudyCancer Screening Among Women Prescribed Opioids: A National Study.
Prior work suggests that there are competing demands between addressing pain and other issues in primary care, potentially lessening delivery of evidence-based cancer screening. We assessed the association between opioid therapy and cancer screening among women in a nationally representative US sample. ⋯ In a nationally representative sample, receipt of opioid prescriptions was not associated with less recommended cancer screenings. Rather, women receiving opioids had greater adjusted odds of receiving breast, cervical, and colorectal cancer screening, although the associations were attenuated by adjusting for their more frequent office visits relative to women not receiving opioids.
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Annals of family medicine · Jan 2020
Multicenter StudyPatients Assess an eConsult Model's Acceptability at 5 US Academic Medical Centers.
Electronic consultation (eConsult), involving asynchronous primary care clinician-to-specialist consultation, is being adopted at a growing number of health systems. Most evaluations of eConsult programs have assessed clinical and financial impacts and clinician acceptability. Less attention has been focused on patients' opinions. We set out to understand patient perspectives and preferences for hypothetical eConsult use at 5 US academic medical centers in the process of adopting an eConsult model. ⋯ Primary care patients expressed strong support for eConsult, particularly when used by a trusted primary care clinician, in addition to voicing several concerns. Patient involvement in eConsult outreach and education efforts could help to enhance the model's effectiveness and acceptability.
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Annals of family medicine · Jan 2020
Observational StudyDifferences in Diabetes Care With and Without Certification as a Medical Home.
The purpose of this study was to assess whether primary care practices certified as medical homes differ in having the practice systems required for that designation and in attaining favorable outcomes for their patients with diabetes, and whether those systems are associated with better diabetes outcomes. ⋯ Practices certified as medical homes have more practice systems and higher performance on diabetes care than uncertified practices, but there is extensive overlap, and any differences may reflect self-selection for certification.
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In a previous story ("On Blindness and Blind Spots")1 I sought to understand the psychological causes of a long-time patient's myriad of seemingly inexplicable symptoms. Since then, I learned more of her story, which helped me understand my patient with a new perspective. Dana shared with me, and now with the readers, short poetic pieces she has written to describe her traumatic experiences as a child-and the efforts she makes as a grown woman to heal, like the phoenix rises from its ashes. The value of belief in one's patient, alongside patience and the opportunity to build a trusting relationship over many years-as the truth has a pace of its own-are underscored.