J Am Board Fam Med
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Practice-based research networks (PBRNs) are "experimental farms" for research that matters in clinical practice. One of the defining characteristics of PBRNs is their ability to operate across a wide range of the bidirectional "pipeline of research translation," from clinical trials to informing health care policy. ⋯ While the first decades of PBRN research generated a substantial body of evidence for improving individual practices (horizontal movement), PBRNs now find themselves at the multidimensional crossroads of patient-centeredness and community/population health (vertical movement). This practice-based research theme issue of the Journal of the American Board of Family Medicine provides a rich, cross-sectional synopsis of PBRN activities encompassing T2 translation, core practice-based research, implementation and dissemination research, community practice, and contributions to health care policy.
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Randomized Controlled Trial
Unrecognized heart failure and chronic obstructive pulmonary disease (COPD) in frail elderly detected through a near-home targeted screening strategy.
Reduced exercise tolerance and dyspnea are common in older people, and heart failure (HF) and chronic obstructive pulmonary disease (COPD) are the main causes. We want to determine the prevalence of previously unrecognized HF, COPD, and other chronic diseases in frail older people using a near-home targeted screening strategy. ⋯ Unrecognized chronic diseases might be detected in community-dwelling frail elderly using a near-home screening strategy that is simple to implement. It remains to be proven, however, whether optimizing treatment of the newly detected diagnoses in this fragile population with multimorbidities and polypharmacy improves quality of life and reduces morbidity and mortality.
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Practice-based research networks (PBRNs) have developed a grounded approach to conducting practice-relevant and translational research in community practice settings. Seismic shifts in the health care landscape are shaping PBRNs that work across organizational and institutional margins to address complex problems. ⋯ To facilitate co-learning and solution-building, these networks have a flexible architecture that allows pragmatic inclusion of stakeholders based on the demands of the problem and the needs of the network. Praxis-based research networks represent an evolving trend that combines the core values of PBRNs with new opportunities for relevance, rigor, and broad participation.
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The purpose of this study was to determine the prevalence of mobile health (mHealth) use among primary care patients and examine demographic and clinical correlates. ⋯ Use of mHealth technologies is lower among older adults but otherwise is common among primary care patients, including those with limited health literacy and those with chronic conditions. Findings support the potential role of mHealth in improving disease management among certain groups in need; however, greater involvement of health care providers may be important for realizing this potential.