J Am Board Fam Med
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Imaging tests are a widely used tool in primary care with many known benefits. Without an understanding of which outcomes matter the most to patients, clinicians are challenged to balance the benefits and harms of imaging tests. This study aimed to explore the perceived impacts imaging tests have on patients from the perspective of the primary care providers (PCPs) and determine PCPs' understanding of patient-centered outcomes (PCOs) from imaging tests. ⋯ PCPs recognize different outcomes of imaging tests that they consider important for patients. While providers are perceptive to patient outcomes there remains a challenge to how patient outcomes are used to improve care. Communication with patients and improving provider knowledge are needed to incorporate identified PCOs.
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Although people with severe mental illness (SMI) have high rates of diabetes and other metabolic disorders, adherence to recommended screening guidelines is low. This study aimed to compare primary care clinicians' and psychiatrists' attitudes toward metabolic monitoring and treatment of patients with SMI. ⋯ Systemic problems with care coordination and these varying expectations likely contribute to poor cardiometabolic outcomes in this vulnerable population.
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Comparative Study
Does Ownership Make a Difference in Primary Care Practice?
We assessed differences in structural characteristics, quality improvement processes, and cardiovascular preventive care by ownership type among 989 small to medium primary care practices. ⋯ Primary care practice ownership was associated with differences in quality improvement process measures, with FQHCs reporting the highest use of such quality-improvement strategies. ABCS were mostly unrelated to ownership, suggesting a complex path between quality improvement strategies and outcomes.
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Routine HIV testing is not adequately occurring in primary care. One reason is that physicians perceive that patients do not want to discuss HIV testing and would prefer that patients initiate the discussion. A patient-centered text message campaign may prompt patients to discuss HIV testing with their physicians, thereby increasing HIV testing. ⋯ Our proof-of-concept study suggests an HIV text message campaign may increase HIV testing by encouraging patients to initiate discussion with their physicians. This intervention may increase HIV testing among low-income populations. A larger study is needed to confirm these findings.
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Screening and referral for Social and Behavioral Determinants of Health (SDOH) are increasingly recommended in clinical guidelines and consensus statements. It is important to understand barriers and facilitators to implementation of standardized SDOH screening and referral practices, as well as the scope of current existing SDOH screening. ⋯ This study highlights the various SDOH screening methods currently used in Boston CHCs, and the need for workflow and process individualization of SDOH screening and referral. Providers and clinical staff should be part of the discussion when implementing SDOH screening and referral procedures to ensure appropriate work flow, staff buy-in, and to maximize resources available.