Annals of family medicine
-
Annals of family medicine · Apr 2022
Behavioral health treatment barriers and preferences of primary care patients with chronic pain and alcohol use.
Although chronic pain and high-risk alcohol use are prevalent in primary care and associated with more severe pain and functional impairment, current approaches address them separately and often neglect risky alcohol use among those with chronic pain. Treatments tailored to patient preferences increase utilization, yet little is known about patient treatment preferences for chronic pain and high-risk alcohol use. ⋯ Primary care patients with chronic musculoskeletal pain and alcohol use showed clear preferences for individual, face-to-face behavioral health treatment focused on chronic pain in a VA primary care clinic. Those with co-occurring high-risk alcohol use may experience differences in treatment barriers that may impede treatment engagement (i.e., stronger pain-alcohol beliefs), and in other cases, may facilitate treatment engagement (i.e., more readiness to change, more favorable treatment attitudes) compared to those with low- or no-risk alcohol use. Incorporating patient perspectives may help clinicians provide optimal behavioral health treatment for chronic pain and/or hazardous alcohol use in primary care.
-
Annals of family medicine · Apr 2022
Choosing active surveillance versus curative treatment in a population-based survey of men with low-risk prostate cancer.
Context: Active Surveillance (AS) is a preferred treatment option for low-risk prostate cancer (LPC) in current practice guidelines. Limited data as to factors influencing men's decision to choose AS. Objective: To identify determinants of initial treatment choice and whether race and geographical location influence the AS decision. ⋯ When "curing cancer" was highly influential, White men were less likely than Black men to choose AS (OR 0.5, 95%CI 0.2-0.9). Conclusions: In this population-based sample, more than half of patients with LPC chose AS. Many factors influenced patient's AS decision with Urologist's AS recommendation being the strongest predictor of patient's AS decision.
-
Annals of family medicine · Apr 2022
Effects of COVID-19 pandemic on anxiety and depression in primary care: A cohort study in Ontario, Canada.
Many people have experienced poorer mental health and increased distress during the COVID-19 pandemic. It is unclear to what extent this has resulted in increases in the number of patients presenting with anxiety and/or depression in primary care. ⋯ The COVID-19 pandemic has resulted in an increased demand for mental health services from family physicians. Increases in anxiety and depression were especially pronounced among younger female patients and increased throughout the pandemic. Our findings highlight the need for continued efforts to support and addresses mental health concerns in primary care.
-
Annals of family medicine · Apr 2022
Rapid adaptation of cancer screening practices during COVID-19: A multi-state qualitative study.
Context: The COVID-19 pandemic required primary care practices to rapidly adapt cancer screening procedures to comply with changing guidelines and policies. Objective: This study sought to: 1) identify cancer screening barriers and facilitators during the COVID-19 pandemic; 2) describe cancer screening adaptations; and 3) provide recommendations. Study design: A qualitative study was conducted (n= 42) with primary care staff. ⋯ Recommendations included more public health education about the importance of cancer screening during COVID-19, more mail-home testing, and expanded healthcare access (e.g., weekend clinic) to address patient backlogs for cancer screening. Conclusions: Primary care staff developed innovative strategies to adapt cancer screening during the COVID-19 pandemic. Unresolved challenges (e.g., patient backlogs) will require additional implementation stra.
-
Annals of family medicine · Apr 2022
People with type 2 diabetes experiences and needs of emotional support in Australian general practice: A qualitative study.
Context: Diabetes distress is the negative emotional response to the burden of living with and managing diabetes. It is associated with sub-optimal glycemia and diabetes self-management, with up to 40% of people with type 2 diabetes experiencing diabetes distress. Australian guidelines specifically recommend using Patient Reported Outcome Measures such as Problem Areas In Diabetes (PAID) scale to assess diabetes distress and discuss sources of distress with people with diabetes. ⋯ They believed that the PAID scale could promote an understanding from the GP about issues impacting their life beyond the biomedical aspects of diabetes. Conclusions: Our findings indicate people with type 2 diabetes have no experience of using the PAID scale during diabetes care but perceive the use of the PAID scale could improve communication with their GP due to pre-identification of emotional issues. The findings will be used to develop a tool to implement the PAID scale in general practices in Victoria, Australia.