J Am Board Fam Med
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Retrospective review of prospectively collected data on 8960 consecutive patients at a safety net institution from June 1, 2006 to December 31, 2020. Data on patient reported mastalgia and diagnosis of breast cancer were collected. ⋯ Mastalgia is rarely associated with breast cancer. In the absence of other findings, imaging of patients less than age 40 is not recommended. Any workup beyond routine screening mammography in age-appropriate patients, to identify the "cause" of breast pain, does not seem warranted.
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COVID-19 policies such as quarantining, social isolation, and lockdowns are an essential public health measure to reduce the spread of disease but may lead to reduced physical activity. Little is known if these changes are associated with changes in physical or mental health. ⋯ These findings demonstrate the importance of walking during the COVID-19 pandemic. Promotion of physical activity should be taken into consideration when mandating restrictions to slow the spread of disease. Primary care providers can assess patient's walking patterns and implement brief interventions to help patients improve their physical and mental health through walking.
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This was a cross-sectional study of primary care physicians (PCPs) using data from the 2018 and 2019 National Electronic Health Records Survey administrations. After descriptively analyzing the prevalence of staff support for documentation, we used multivariable logistic regression to identify the adjusted relationship of staff support for documentation with gender. ⋯ Given positive effects of documentation support and known gender differences in burnout and EHR use times, the differences identified have important implications for the physician workforce. Future research should focus on identifying underlying reasons and potential solutions for the gender differences described.
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Seven regional Cooperatives delivered external support interventions (practice facilitation, health information technology support to assist with audit and feedback, performance benchmarking, learning collaboratives, and establishing community linkages) to 1278 smaller primary care practices. Outcomes included proportion of eligible patients meeting Centers for Medicaid and Medicare Services-specified ABCS metrics, that is, Aspirin for those at risk of ischemic vascular disease; achieving target Blood pressure among hypertensives; prescribing statin for those with elevated Cholesterol, diabetes, or increased cardiovascular disease risk; and screening for Smoking and providing cessation counseling. An event study compared prepost changes in outcomes among intervention practices and a difference-in-differences design compared intervention practices to 688 external comparison practices. ⋯ EvidenceNOW Cooperatives improved cardiovascular prevention quality metrics among small and medium sized primary care practices across the US. While estimated improvements were small, they reflected average changes across a large and diverse sample of practices.
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The 2017-2019 Medical Expenditure Panel Survey (MEPS) was used to investigate rates and associations of psychotherapy and psychiatry visits by age/sex and antidepressant/antipsychotic use. ⋯ Psychotherapy and psychiatry utilization have differences in population level patterns with use being highest among females between 15 to 30 years of age and higher among younger (compared with older) individuals who reported antidepressants or antipsychotics.