The National Commission on Prevention Priorities releases updated rankings of clinical preventive services, identifying high-impact services for improving population health. The top three services are immunizing children, tobacco-use screening and brief intervention, and alcohol misuse screening with brief intervention.
Greater primary care physician involvement at the end of life is associated with less costly and less intensive care. Regions with more primary care involvement have lower Medicare spending in the last two years of life and fewer ICU days in the last six months.
A study found that only 55% of breastfed infants received the recommended daily vitamin D supplementation. Mothers preferred to supplement themselves, citing safety as their top concern. Higher doses of vitamin D could be incorporated into maternal supplementation routines to enrich breast milk and improve intakes in breastfed infants.
A recent study by European researchers found that patients with acute bacterial lower respiratory tract infections (LRTIs) had only slightly worse symptoms and returned more often to their physician than those without bacterial LRTIs. The authors conclude that these infections are generally mild and self-limiting, allowing physicians t...
A randomized trial involving 1,302 asthmatic patients found no evidence to support the effectiveness of orally administered probiotics in reducing respiratory tract infections and antibiotic use. In contrast, a review of psychological interventions for postnatal depression found that community-based therapies were effective treatment o...
This study reveals a significant increase in prediabetes prevalence among healthy-weight adults over 18 years, highlighting the need for revised screening recommendations. Additionally, inadequate hydration is linked to higher BMI and obesity rates, suggesting drinking more water could be an effective tool against the obesity epidemic.
Researchers found that men with localized prostate cancer often underestimate their life expectancy without treatment and overestimate the benefits of surgery or radiation. This can lead to overtreatment, decisional regret, and decreased post-treatment quality of life. A recent study published in the Annals of Family Medicine suggests ...
A randomized controlled trial found that electronic consultations improved access to cardiac care, with nearly two-thirds of patients not requiring a face-to-face visit. Additionally, e-consultations were completed on average almost a month sooner than traditional consultations.
Research studies examine the viability of small, solo family practices in rural areas, finding they often provide vital care. Large independent primary care groups are also shown to be attractive options for physicians and patients, offering resources and autonomy while reducing costs.
Researchers tested intensive multifaceted interventions to reduce Potentially Inappropriate Prescribing (PIP) in older patients, finding significant reductions in PIP. A systematic review also found transitional care interventions for congestive heart failure patients reduced readmission and emergency department visits. Additionally, m...
Researchers find PCMH costs per physician FTE were $7,691 in Utah and $9,658 in Colorado. Family physicians with high HIV experience are more likely to adhere to antiretroviral therapy protocols. Adequate compensation is critical for practices to sustain medical home services.
Erectile dysfunction is linked to a higher risk of undiagnosed diabetes. Additionally, a study found that ACA Medicaid expansion increased demand for primary care services. Furthermore, sleep apnea may increase the risk of developing panic disorder, while changes in cervical cancer screening guidelines resulted in decreased chlamydia s...
Research finds that family physicians with a broader scope of practice have patients with 10-15% lower costs and fewer hospitalizations. The study suggests comprehensiveness in family medicine is both measurable and important for bending the cost curve and achieving the nation's Triple Aim.
Researchers predict a shortage of over 33,000 primary care physicians by 2035 due to demographic changes and insurance expansion. To eliminate this deficit, experts suggest increasing residency production by nearly 2,200 positions by 2020.
Only 2.2% of American physicians have DEA waivers for prescribing buprenorphine-naloxone, a treatment for opioid use disorder, with most practicing in urban counties. This scarcity limits treatment options in rural areas, leaving over 30 million persons without access to this life-saving medication.
Researchers develop two swallowing techniques to ease pill swallowing in patients with and without difficulties. Continuity of care is associated with reduced mortality, morbidity, and healthcare expenses in patients with chronic conditions.
The Illinois Medicaid primary care case management program, implemented in 2006, was associated with substantial savings, reductions in inpatient and emergency care, and improvements in quality measures. The programs promoted preventive care, reduced redundancy of services, and improved chronic disease management.
A recent study in Iowa found that nearly all adolescents aged 11-16 had ridden an ATV, with most engaging in risky behaviors like riding daily or weekly and not wearing helmets. The authors conclude that prevention efforts should be prioritized to reduce the risk of pediatric ATV crashes.
Researchers found an estimated 9 million people with diabetes and 5.6 million people with coronary artery disease are not receiving statins, highlighting a concerning trend driven by high cholesterol. Statin use is often associated with reduced cardiovascular risk, regardless of cholesterol levels.
Research found azithromycin and levofloxacin therapies associated with higher mortality risks compared to amoxicillin. Levofloxacin use also linked to increased serious arrhythmia risk. Only one quarter of primary care patients with mild cognitive impairment progress to dementia within three years, according to study.
Researchers found self-rated health to be a strong predictor of depression risk in patients with recent depressive symptoms. Family physicians can assess self-rated health using a simple question and integrate indirect methods to explore treatment expectations, promoting collaborative relationships and improved antibiotic prescribing.
Researchers found that patients surveyed at federally supported community health centers generally reported high-quality care, with excellent or very good ratings for overall quality of services, clinician care, and referrals. The study also found that higher patient ratings of access to care and patient-centered communication were ass...
A study found that one-third of Walgreens vaccinations are administered during off-clinic hours, particularly among younger, healthy adults. This shift in vaccination access could measurably increase immunization rates in the US. Additionally, a new study suggests that eligible Medicaid beneficiaries under the Patient Protection and Af...
Researchers found that most men report little shared decision making in PSA screening, with only 8% reporting full shared decision making. Coupling physician education with patient activation improves rates of shared decision making and influences physicians' attitudes about screening.
Research on practice transformation, cost estimates for primary care facilitation, and alternative payment reform options are presented. The median cost of practice facilitation to improve chronic illness care is estimated at $9,670 per year, with lower costs expected in subsequent years.
The AHRQ-funded journal supplement provides insights from 14 natural experiments on transforming primary care practice. Key findings highlight the importance of a strong foundation, visionary leadership, and contextual factors in achieving successful transformation towards the patient-centered medical home model.
A longitudinal cohort study of 1,310 women found that even three years after being declared free of cancer, women who had a false-positive result consistently reported greater negative psychosocial consequences compared to women with normal test findings. Researchers propose annual blood pressure screening instead of checking at every ...
The adoption of electronic health records by family physicians has doubled since 2005, reaching 68% nationally in 2011. Researchers found that family physicians are adopting EHRs at a higher rate than other office-based physicians and are likely to exceed 80% penetration by 2013 if the current trend continues. Meanwhile, patients' expe...
The US will need 52,000 additional primary care physicians by 2025 due to population growth and aging, with a projected 25% increase in the workforce. Researchers also examine the benefits of starting prostate cancer screening at age 40 versus 50 and argue that guidelines should be evidence-based to prioritize proven services.
Studies find extended office hours reduce health expenditures and improve breast cancer outcomes for Medicare beneficiaries. Additionally, research on adult cancer survivors reveals the need for primary care engagement in follow-up care, while a team-based model of primary care offers potential solutions to excessive patient panel sizes.
Chronic pain patients with depression are more likely to misuse opioids, and primary care physicians should take a leading role in setting opioid prescribing standards. Safer alternatives like physical therapy and cognitive behavioral therapy can be effective treatments for chronic pain.
The Folsom Group revitalizes the 1967 report's blueprint, updating 13 grand challenges to facilitate nationwide integrated patient-centered community health services. Intranasal corticosteroids show small therapeutic benefit for sinus infection sufferers, but with potential harms and cost implications.
Researchers project that the cost of family health insurance premiums will surpass household income by 2033, with a current estimate suggesting this could happen as early as 2021. The study highlights the challenges and opportunities facing the US healthcare environment following the passage of the Patient Protection and Affordable Car...
As the US healthcare system faces significant challenges with multimorbidity, research articles and policy briefs offer solutions to improve care for patients with multiple chronic conditions. A study found that primary care attributes like comprehensiveness and patient-centeredness are associated with lower mortality rates.
Researchers found that uninsured patients had significantly shorter hospital stays for preventable and non-preventable conditions compared to insured patients. The study highlights the need for equal treatment of all patients regardless of insurance status.
The tip sheet highlights common barriers to depression disclosure among patients, including concerns about antidepressant prescriptions and confidentiality. It also explores the widespread use of NSAIDs by patients with chronic kidney disease, despite warnings against their use. Additionally, the article critiques long-established coro...
Researchers from Dartmouth used waist-mounted wireless mobile devices to track elderly patients' physical activity and social interactions, finding strong correlations with established questionnaires. The study suggests that automated inference of behavior using mobile devices could be a valid and feasible tool for older populations.
A meta-analysis of proton pump inhibitor use found a 29% increase in fracture risk, particularly hip and vertebral fractures. Clinicians should carefully consider PPI prescription, especially for patients with elevated fracture risk.
Patient-centered medical homes in Ontario's Family Health Team Model show high patient satisfaction and improved income for primary care physicians. Additionally, a novel approach to detecting white-coat hypertension using automated serial blood pressure measurements is found to be valid and useful.
Researchers found that Medicare covers only one out of 15 USPSTF-recommended interventions for adults aged 65 years and older. Meanwhile, they reimburse clinicians partially or fully for services not recommended by the task force, potentially increasing medical costs. Additionally, the authors suggest that tailored preventive messages ...
A study of adolescents found that less than 2% met annual preventive care visit recommendations, highlighting the need for better access to care. Meanwhile, a survey of family physicians revealed that many refer patients elsewhere for vaccines due to inadequate payment and lack of participation in federally-funded programs.
Research reveals nearly half of patients who initiated biennial fecal occult blood test screening did not adhere to subsequent colorectal screening. In contrast, depression management programs delivered promising long-term results for chronically depressed primary care patients. The study also found modest reductions in branded drug us...
The American Academy of Family Physicians accepted a large donation from Coca-Cola to fund obesity prevention materials, raising concerns about conflict of interest and loyalty to public health. In contrast, the organization's actions were seen as an effort to serve physicians and patients by addressing unmet public health needs.
Researchers analyzed data from 93,676 women aged 50-79 years and found that those exposed to verbal and physical abuse had lower scores on mental health assessments and greater depressive symptoms. Social visiting was also shown to be effective in improving mood and quality of life for depressed elderly individuals.
Researchers found that wait time is the most important factor in patients' care-seeking decisions, while high-touch aspects of the patient-centered medical home are more highly correlated with preventive services delivery. Additionally, in-office C-reactive protein testing can help physicians more appropriately prescribe antibiotics fo...
Research suggests that low vitamin D levels are an independent risk factor for cardiovascular disease and may contribute to higher cardiovascular risk among blacks. The study found that accounting for vitamin D levels reduced the race-based risk of cardiovascular mortality by 60 percent.
New studies reveal the high costs of implementing performance-reporting requirements for primary care practices, which can range from $1,000 to $11,100 per practitioner. Researchers also warn that undisclosed changes made to clinical trial outcomes threaten the integrity of scientific research. In contrast, early abortion care in famil...
Researchers found that universal health insurance reduces income inequities in healthcare access, but education-related disparities persist. Insured children with uninsured parents are more likely to experience unmet healthcare needs and lack preventive services.
The July/August issue of Annals of Family Medicine explores the paradox of primary care, where primary care is associated with poorer quality care for individual diseases yet higher value health care at the level of the whole person. Chronic disease management was found to be superior in community health centers and practices with nurs...
The American Academy of Family Physicians highlights the US healthcare system's fragmentation as a major cause of the current crisis. Dr. Kurt Stange's seven-part series proposes solutions by focusing on primary care and integrative services to promote healing and efficiency.