Annals of family medicine
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Annals of family medicine · Apr 2022
Understanding culturally tailored approaches in males of punjabi ancestry with alcohol use disorder at roshni clinic.
1. Identify and describe factors that are important to the care of patients of Punjabi ancestry suffering from AUD. 2. Explain the importance of culturally tailored approaches to primary care in the context of AUD. ⋯ Culturally tailored approaches and providers fluent in the Punjabi language proved to be the most beneficial factors to patients at Roshni Clinic. There are limited culturally tailored, primary care addictions centers such as Roshni Clinic serving Punjabi males with AUD in BC’s Lower Mainland. Thus, this study stresses the importance of investment in research and development of patient informed culturally tailored care centers.
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Annals of family medicine · Apr 2022
Randomized Controlled TrialRandomized controlled trial of an audit and feedback cycle to improve adherence to Choosing Wisely Canada recommendations.
Context: Choosing Wisely Canada (CWC) aims to engage healthcare providers to reduce unnecessary care. Reducing overuse of antimicrobials and antipsychotics in patients with dementia in primary care settings remains an ongoing challenge. Audit and Feedback (A&F) interventions can facilitate practice change but can be improved by understanding factors affecting the likelihood of uptake of the feedback. ⋯ There were no statistically significant provider characteristics when considering all providers with improved prescribing, but male, rural and fee for service providers were more likely to decrease prescribing greater than the mean. Conclusion: Both practice specific and generic A&F information sent directly to primary care providers by a trusted source reduced potentially unnecessary prescriptions. This supports ongoing engagement with primary care providers in practice-based research networks to improve care and promote sustained practice changes.
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Annals of family medicine · Apr 2022
Characterizing posttraumatic stress disorder in primary care using electronic medical records: a retrospective cohort study.
Posttraumatic stress disorder (PTSD) is a chronic mental health disorder associated with significant morbidity and economic cost. Primary care providers are frequently involved in the ongoing management of patients experiencing PTSD, as well as related comorbid conditions. Despite recognized need to enhance PTSD management in primary care settings, knowledge regarding its prevalence in these settings is limited. ⋯ This is the first study to describe PTSD prevalence in a large Canadian sample of primary care patients using an EMR-based case definition. Characterizing patients with PTSD in primary care may improve disease surveillance and inform the interdisciplinary care required to manage PTSD symptoms.
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Annals of family medicine · Apr 2022
Group-based nutrition interventions for community-dwelling older adults: a systematic review to inform community co-design.
Context: Many older adults fail to meet dietary recommendations for food quality and quantity, which is important to prevent disability and disease. Group and community-based nutrition interventions may help overcome psychosocial, environmental, and behavioural barriers to healthy eating. The EMBOLDEN project uses community co-design, integrating the best available evidence with local knowledge to develop a novel, group-based physical activity, system navigation, and nutrition intervention for older adults. ⋯ Results were shared with EMBOLDEN's Guiding Council of older adults and local health/social service providers to co-design the intervention. Conclusions: Although group-based interventions demonstrate promise in promoting healthier eating among community-dwelling older adults, the available evidence is relatively low quality. Our analysis highlights an opportunity for primary care researchers to advance the science of health promotion and disease prevention nutrition initiatives for older adults.
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Annals of family medicine · Apr 2022
Relationship of primary care clinician characteristics with continuous glucose monitoring use and confidence.
Context: Continuous glucose monitoring (CGM) provides clearer readings of blood glucose levels than traditional finger-stick glucose tests and is associated with improved diabetes outcomes such as reduced HbA1c. CGM can inform insulin dosing and diet decisions, and alert patients to hypoglycemia. A lack of endocrinologists in the majority of U. ⋯ Clinician type, percentage of time spent practicing, portion of time delivering primary care, and distance from endocrinologist are related to likelihood to prescribe CGM. Previous experience prescribing CGM may improve confidence and likelihood of future prescribing. Consultation, education and training on CGM for primary care clinicians may increase access to CGM.