Annals of family medicine
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Annals of family medicine · Apr 2022
Patient survey superior to EMR extraction for eliciting positive symptoms at COVID-19 illness onset.
Context: COVID-19 has ravaged nations around the world, with New York City (NYC) and the NYC suburbs being particular epicenters of COVID-19 infection. Suffolk County, NY, has reported over 200,000 cases and 3,000 deaths to date. Most initial COVID-19 research concerned hospitalized patients. ⋯ Setting or Dataset: 107 patients with suspected and confirmed COVID-19 cases at the 3 primary care practices of Stony Brook University Hospital between March and December, 2020. Population Studied: adult, English speaking primary care patients with suspected or confirmed COVID-19 Intervention/Instrument: patient self report telephone survey, EMR data extraction survey Outcome Measures: symptom duration, symptom severity, persistence of symptoms at 3 month time point Significant Results: Patient self-report survey elicited nearly twice as many symptoms described at illness onset vs. those recorded in the EMR. Conclusions: Early in the setting of newly emerging infectious diseases, particularly those such as COVID-19 which involve multiple organ systems, patient self report of symptoms of illness rather than EMR extraction alone may be crucial both for identifying cases and in order to characterize pathophysiology of disease in real time.
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Annals of family medicine · Apr 2022
Recommendations for virtual care in primary care practices: a survey of patients across Ontario, Canada.
Context: The onset of COVID-19 has required the rapid adoption of virtual services in primary care (PC) practices, and virtual care delivery is likely to continue to some extent post-pandemic. Objective: To understand patient experience with synchronous virtual (telephone (Tel)/Video) appointments and elicit recommendations for its future use. Design: Mixed method, including patient survey co-developed with stakeholders and implemented online Feb-Mar 2021 with large promotional efforts through social media, patient and caregiver organizations, and other networks. ⋯ Conclusions: Patient experience was largely positive and is influenced by patient/provider factors. Patients and providers may benefit from support/training to optimize care experience. We are now evaluating whether the reasons for visits influences care experience.
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Annals of family medicine · Apr 2022
Cost of COVID-19: Using life course theory as a lens to understand the consequences of the pandemic.
The COVID-19 pandemic and associated countermeasures have had broad implications across society which will have implications for physical and mental health for years to come. Understanding these experiences through the lens of life course constructs may help communities, service providers including family doctors, and governments to recognize and respond more effectively to the lasting impacts. ⋯ Our data illustrate the pervasive impact of the COVID-19 pandemic on all aspects of the life course. While service providers and policy makers are attuned to the acute crises currently unfolding, the long term impacts of life course disruption will play out over years, or potentially over the entire lifespan of this cohort. Responses to the pandemic cannot limit themselves to crisis management in the next 12-18 months, but will need to integrate an understanding of life course theory to support long term healing of individuals and communities.
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Annals of family medicine · Apr 2022
Identifying value arguments and deployment avenues of primary care innovations using a deliberative multidimensional approach.
Context: The increasing pressure on primary care services calls for efficient approaches to assess the potential value of innovations and identify facilitators to their deployment in local contexts. Objective: To explore the value arguments of innovations in primary care identified as promising during Quebec College of Family Physicians' Symposia on Innovations and to propose avenues for their improvement and deployment. Methods: Ten innovations were selected using their ranking at the Symposia and pre-established criteria to ensure diversity. ⋯ Innovations to support clinical processes also received mixed appraisals; proposals for further development included keeping them up to date and integrating them with information systems. Conclusions: This study highlights the factors that influence the value of certain categories of primary care innovations as well as avenues for their improvement and implementation that can guide innovators. This work demonstrates that exploring complex innovations with a multidimensional deliberative approach including patients and citizens is useful to identify their value arguments from a comprehensive standpoint, which is essential to identify the best implementation avenues to optimize the creation of value in real life.
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Annals of family medicine · Apr 2022
Mental health needs assessment of individuals experiencing homelessness in Charleston, South Carolina.
More than 4,268 people were experiencing homelessness in South Carolina during the 2020 point in time count, with Charleston county ranked the 4th highest in the state for number of individuals experiencing homelessness. Mental health disorders often contribute to or result from housing insecurity. ⋯ PEH have significant mental health needs and experience barriers to accessing mental health services. Resources directed at addressing these barriers are essential to improve the mental health of this vulnerable population and ameliorate housing instability.