Annals of family medicine
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Annals of family medicine · Apr 2022
The primary care COVID-19 integrated pathway: a quantitative study of rapid response to health and social impacts of COVID-19.
Context: The first wave of COVID-19 in Calgary, Alberta health zone accelerated Primary Care (PC) integration. Specifically, it connected Family Physicians (FPs) with their counterparts in the broader health system to deliver wraparound patient care through a COVID-19 Integrated Pathway (CIP). A key element of the CIP included a data sharing platform that facilitated the provision of test results directly to the FP identified by patients. ⋯ The majority of patients were referred to local PC networks where follow-up was conducted using the CIP: 3223 (43%) already had their own FP, 2448 (32%) were successfully attached to an FP, and 1899 (25%) of these patients were monitored by C4 physicians - these patients either did not have FP or their FP was not available to follow the patient. 8.6% of these patients visited ED and 3.1% were hospitalized. More than 80% of these patients had at least of 5 visits with their FP. Conclusion: Data suggest that the CIP facilitated primary care based management of patients with COVID-19.
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Annals of family medicine · Apr 2022
Utilizing primary care to engage patients on opioids in a psychological intervention for chronic pain.
Context: Chronic pain, one of the most prevalent issues encountered in primary care, is often treated with opioid prescriptions. Overuse of these medications can cause overdose and death, creating a dire need for alternative treatment methods. Psychological interventions are effective for improving pain and distress, yet are underutilized. ⋯ This suggests that engaging patients who are on opioids in a psychological treatment for chronic pain, specifically in a primary care setting, may increase utilization. However, this may be true for women, but not men. Further work needs to be done to identify methods to increase psychological intervention engagement among all patients receiving opioids, but especially men.
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Annals of family medicine · Apr 2022
Applying QI-focused SPIDER approach to safer deprescribing for geriatric patients: Results of the Toronto Feasibility Study.
Context: More than 25% of Canadian seniors are prescribed 10+ different medications each year. There is a direct association between more medications and persistent high care needs/costs for seniors. Effective and appropriate deprescribing for seniors in primary care is needed. ⋯ Efficacy: reductions in PIP prevalence and prevalence of patients with at least one PIP were 3.6% (p=.4) and 1.4% (p=.5), respectively. Conclusions: The SPIDER approach appears to be feasible. Access to coaching support and pharmacist services may enhance sustainability.
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Annals of family medicine · Apr 2022
COVID-19 vaccination hesitancy among southern rural veterans with cancer in the arkansas-louisiana-texas (ArkLATX) region.
Context: The COVID-19 pandemic continues to be a major socioeconomic disruptor in the U. S. and around the globe. The only intervention that has a far-reaching impact is the adoption of an efficient large-scale vaccination campaign with the highly effective COVID-19 vaccines. ⋯ Conclusions: This survey indicates that the majority of ArkLATX veterans with cancer are willing to be vaccinated against COVID-19. The major reasons behind vaccine hesitancy seem to be information problems consisting of questions about safety, inadequate information, and seeing no reason for the vaccine. Such barriers can be potentially circumvented by providing the appropriate information and counseling.
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Annals of family medicine · Apr 2022
General practitioner perspectives and experiences when screening for primary aldosteronism in hypertensive patients.
Context: Primary aldosteronism (PA) is a common form of hypertension caused by excess production of the adrenal hormone aldosterone. Screening hypertensive patients with a simple blood test enables early detection and targeted treatment of PA, leading to fewer cardiovascular complications. Australian family physicians (FPs) rarely screen for PA, and screening rates are equally low among North American FPs. ⋯ Knowledge and convenience of the screening process, the conceptualization of risk, and the perceived impacts of detecting PA were influencing factors that modified the FP screening experience. Conclusion: This study demonstrates that additional factors, other than limited awareness, influence a FP's decision to screen for PA. Our findings have the potential to inform future policy, practice, and training interventions to improve the detection of PA in family practice.