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
Patient and provider prediabetes knowledge, attitudes, and behavior in a large urban family medicine practice.
Context: One-third of American adults have prediabetes. However, only 11% are aware of their condition, and they often do not receive prediabetes education or management. Prior studies have indicated knowledge gaps among primary care providers and patients on prediabetes management. ⋯ Over half (59%) of patients reported having been told they have prediabetes and 84% thought diet and lifestyle changes were effective treatment, but 65% were unaware of medication options and only 5% had been referred to DPP. In open-ended responses, providers requested more nutrition counseling and an improved DPP referral process; patients also requested nutrition counseling and classes. Conclusions: Providers and patients saw prediabetes as important but reported knowledge and management gaps, particularly for metformin and DPP, and requested additional practice resources.
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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
Intention for COVID-19 vaccination: predictors and sources of influence.
Context: General acceptance of COVID-19 vaccination is needed to end the pandemic, but vaccine hesitancy is a challenge. Identifying predictors of acceptance of COVID-19 vaccines and sources of positive influence on vaccine decisions could inform and guide the efforts to improve vaccination rates. Objective: 1) To determine the proportion and predictors of vaccine intentions among adults served by our mobile free clinic. 2) To determine the sources of positive influence on vaccine uptake. ⋯ Conclusions: Similar to national averages, 66% of our sample intended to accept a COVID-19 vaccine. Flu vaccination in the last year and worrying about health during the pandemic predicted intention to receive the vaccine. Health care providers were most frequently identified as a positive influence on vaccine uptake, underscoring the importance of their role in recommending COVID-19 vaccinations.
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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.