Primary care physicians struggle to balance harms and benefits of lung cancer screening in patients with multiple health issues, often relying on clinical judgment. Ultimately, the decision rests with the patient, who makes their own choice despite physician advice.
The EvidenceNOW initiative, launched by AHRQ in 2015, aimed to improve cardiovascular care in small and medium-sized primary care practices. The program provided external quality improvement support and funding to seven regions across the US, resulting in improved quality of care and heart health outcomes.
The COVID-19 pandemic significantly interrupted pediatric healthcare, resulting in foregone care, well-child visits, and vaccinations for vulnerable populations. Non-Hispanic White children were less likely to experience these gaps, while virtual school formats increased the risk of foregone care.
A mixed-methods study examines the challenges faced by independent family physicians in urban communities, who serve socially vulnerable patients with limited support from healthcare entities. The researchers propose that health equity-focused policies and new payment models could help these practices stay afloat.
A four-month department-wide EHR optimization project led to improved usability and reduced administrative burdens. The study demonstrates that successful EHR workflow optimization is possible at the departmental level through ongoing collaboration between EHR users and IT colleagues.
A recent study found that primary care physicians' electronic health record (EHR) workload has continued to grow, with PCPs spending nearly 30 minutes more on EHR tasks per clinic appointment between 2019 and 2023. This increased burden can lead to burnout and affect their ability to provide adequate care.
This study explores the perspectives of primary care physicians (PCPs) and urologists on active surveillance (AS) care for men with low-risk prostate cancer. Key findings include the importance of patient education and clear communication among care team members to prevent loss to follow-up.
A new screening tool helps identify primary care patients with precarious employment, associated with health insurance issues, lower incomes, and greater psychological stress. The tool assesses temporary contracts, job insecurity, and income variability.
The study found that patients had a positive experience obtaining TeleMAB through their primary care health system, citing ease of access, autonomy, and reduced anxiety. This normalizes abortion care within the context of comprehensive primary care, improving access for many people of reproductive age.
A recent meta-analysis of 20,000 patients with Alzheimer's disease found no clinically significant improvement in cognitive or functional abilities from monoclonal antibody treatment. The studies also revealed a high risk of serious harms, including cerebral edema and death, associated with the use of these expensive medications.
A quality improvement intervention linked high-risk prenatal patients with primary care, resulting in a significant increase in postpartum and primary care utilization. Despite challenges, FQHC participation improved patient outcomes, highlighting the need for greater resources to ensure sustainability.
Gabapentinoid usage has continued to rise in the US, increasing from 4.0% in 2015 to 4.7% in 2021, according to a recent report. The study found that users continue to take these medications despite FDA warnings against combining them with other sedating medications.
A study found that primary care physicians spent nearly 30 minutes more on EHR tasks between pre-pandemic and final year, with time spent outside of scheduled hours increasing significantly. This growth in EHR workload may contribute to burnout and affect decisions to cut back on clinic time or leave the profession.
This study explores how better communication with care teams can improve the birthing experience for Black people. Researchers found that addressing urgent procedures and fostering a welcoming environment to share birth experiences mitigated negative consequences of preterm births.
A recent study published in Annals of Family Medicine explores how technology is changing medical practice, including the use of AI-driven tools to effectively diagnose patients. The study also examines the interplay between fulfillment of basic psychological needs at work and technology use in maintaining clinician well-being.
A Canadian study examines how rapid shift to virtual care during COVID-19 pandemic impacts primary care doctors' well-being. The researchers found that basic psychological need satisfaction at work was associated with higher well-being, while controlled motivation towards using virtual care predicted lower well-being.
Researchers assessed Veterans Affairs participants' coping strategies over three timepoints, finding that stable coping styles are associated with lower levels of anxiety and depression. The majority of the sample (71%) changed their coping style at least once during the study period.
Researchers found that using doctor- and patient-oriented materials improved conversations about erectile dysfunction (ED) among Asian men with diabetes. The study suggests that these materials can encourage treatment of ED, particularly in cultures where sex is viewed as taboo.
Researchers found that practice interventions for improving integrated behavioral health (IBH) activities had a minimal impact on patient outcomes. However, practices that completed the intervention and those with higher IBH levels showed improved patient outcomes.
A new study found that an AI-aided home stethoscope can efficiently detect asthma exacerbation in patients of all ages, including children under 5 years old. The device records and analyzes respiratory sounds, providing valuable information for parents and caregivers to identify symptoms early on.
An international group of researchers developed a Consensus Reporting Items for Studies in Primary Care (CRISP) Checklist, outlining 24 items to improve the quality and consistency of primary care research. The checklist addresses various aspects of research, including study design, data collection, and implementation of findings.
Researchers developed a practice facilitation program to support family physicians in identifying unvaccinated patients and addressing vaccine hesitancy. The intervention provided resources such as scripts and medical student volunteers to work as physician-delegates, resulting in improved vaccination rates.
A new checklist, Consensus Reporting Items for Studies in Primary Care (CRISP), outlines key reporting items for primary care studies. The CRISP Checklist describes aspects of research, including teams, patients, and study implementation, to improve primary care research reporting worldwide.
Researchers from the Amsterdam University Medical Centre conducted a study on patients who choose to voluntarily stop eating and drinking (VSED) to hasten death. They identified three distinct groups: older patients seeking control over their lives, care-dependent patients with poor quality of life, and younger psychiatric patients. Th...
A study found that nearly one-third of US family medicine residents are training in states with abortion restrictions, highlighting the impact on reproductive health care. The analysis suggests that increased support for comprehensive reproductive health education is needed to mitigate this effect.
A qualitative study found that staff turnover, staffing shortages, and time constraints are major barriers to participation in quality improvement projects. The authors recommend policy makers provide direct support for primary care to alleviate burnout and address these challenges.
A qualitative study found that transgender individuals often perceive clinician questions as stigmatizing or voyeuristic, leading to pathologization and substandard care. To improve care, medical systems must adopt inclusive policies, procedures, and data collection tools, prioritizing the safety and well-being of transgender patients.
A retrospective analysis of EHR data found that repetitive screening questions may compromise accuracy, especially in high-risk populations. The study suggests that prioritizing repetition for performance metrics can lead to administrative burden and low-value care, diverting clinical capacity from other essential services.
The North American Primary Care Research Group (NAPCRG) has made foundational contributions to primary care research, including practice-based networks and community-based participatory research. The organization's future depends on strengthening primary care and primary care research with stronger support, infrastructure, training, an...
A cross-sectional survey of 294 primary care patients found leg cramps are a common symptom (51.7%) associated with age-related decline and poor sleep quality. Clinicians should review resting leg cramps as a marker for impaired health and aging, and address the issue to optimize healthy aging.
A study found that severe erythrocytosis, where hematocrit is over 54%, is a rare outcome of testosterone therapy in adults. Researchers recommend reevaluating the need for frequent lab screenings to minimize unnecessary draws among patients who prefer not to undergo regular checks.
A learning collaborative enhanced educational and training support services for primary care doctors to use mifepristone for miscarriage management and abortion provision. Clinics increased knowledge of mifepristone and stockpiled the medication, despite existing financial barriers.
A scoping review identified four key themes: everyday language, thorough information, adequate discussion time, and a trusting relationship. The study also highlighted the impact of racism on Black men's medical interactions. Researchers suggest strategies to support men's communication preferences.
Clinical researchers developed a single prescriber account to centralize ordering and distribution of mifepristone, reducing barriers to providing abortion care. The new process mirrors other health system procedures and sets the stage for rapid expansion of medication abortion access in a post- Roe environment.
Primary care teams struggle to implement quality improvement efforts due to staff turnover, staffing shortages, and time constraints exacerbated by the COVID-19 pandemic. Researchers recommend direct support for primary care to alleviate burnout and improve participation in quality improvement projects.
Clinician staff perspectives on implementing Adverse Childhood Experience (ACE) screening in Los Angeles County Pediatric Clinics revealed that screening can elicit important patient information and build trust. However, challenges arise from insufficient time for screening, inadequate training, and limited referral resources.
A mixed methods study of 53,246 patients and 56 clinicians found that gay and lesbian patients, cisgender women, and doctors' sociodemographics are linked to higher odds of documented sexual history. Conversely, older patients, long-term relationships, and non-English primary languages are associated with lower odds.
High-performing primary care practices use similar strategies to manage change and improve diabetes care, including standardizing the care process, enhancing care teams, and engaging staff and clinicians. These practices also focus on proactive care, pre-visit planning, and improving patient relationships.
Researchers found that parents who felt misunderstood or not listened to by their doctors were more likely to request out-of-hours consultations. Greater awareness and understanding on the part of GPs about parental feelings and expectations could improve satisfaction with primary health care and reduce after-hours care requests.
A qualitative study explores the challenges transgender people face when sharing health information with clinicians, including risk of substandard care. The authors argue that improving medical culture, policies, and data collection tools are necessary to enhance quality and safety of clinical care for transgender individuals.
A new paper describes clinical experiences of transgender people and identifies four themes: voyeuristic questions, pathologization, stigma, and ineffective care. Researchers recommend strategies to improve safety and quality of care for this patient population.
The CARE program, a rapid risk assessment tool, gathered data on immunization status, general health risk, and support needs of people experiencing homelessness. Automated dashboards provide secure, real-time information on resident needs, enabling health professionals to mitigate risks associated with homelessness.
Researchers surveyed primary care clinicians on telemedicine use during the pandemic, noting initial challenges but increasingly positive attitudes towards its value. Clinicians recognized video- and phone-based care as a valuable tool, but also identified obstacles such as infrastructure and reimbursement issues.
Researchers identified key strategies contributing to significant reductions in Medicare acute hospitalization rates at high-performing Comprehensive Primary Care Plus (CPC+) sites. These clinics implemented effective strategies such as improving timely access to primary care, identifying high-risk patients with enhanced care managemen...
Researchers found that service-based loan repayment programs like NHSC promote more diverse scope of practice, rural practice, and serving medically underserved populations. In contrast, PSLF may be less effective in supporting underrepresented backgrounds and directing physicians to these areas.
A Dutch study found that higher levels of personal continuity among older patients are associated with reduced potentially inappropriate prescriptions and prescribing omissions. The researchers analyzed routine care data from over 25,000 patients and discovered that increased personal continuity led to a significant decrease in PIPs, p...
Researchers developed a step-by-step approach for creating joint displays of integrated data collection, facilitating comprehensive connections between qualitative and quantitative data. This method tackles the challenge of integrating qualitative and quantitative information in clinical studies, enabling robust mixed methods analysis.
A Canadian study found that patients were very satisfied with care from their family physicians (90%) and allied health teams (89%), comparable to traditional in-person models. Another pilot program successfully engaged hard-to-reach adolescents in preventive care, demonstrating a 40% increase in show rates for well visits.
A simulated study found that patients face challenges registering with primary care physicians, even when they have a nearby doctor. The research revealed that doctors are less likely to accept new patients requiring time-consuming procedures or working in areas with low PCP density.
A meta-analysis of 221 randomized controlled trials reveals oral isotretinoin as the most effective treatment for acne, followed by triple therapies containing antibiotics and retinoids. The study also found that monotherapies like antibiotics and retinoids have comparable efficacy for inflammatory lesions.