Primary care physicians' practice patterns and diabetic retinopathy. Current levels of care

1997 ◽  
Vol 6 (1) ◽  
pp. 29-37 ◽  
Author(s):  
S. K. Kraft
Keyword(s):  
Primary Care ◽  
Diabetic Retinopathy ◽  
Primary Care Physicians ◽  
Practice Patterns ◽  
Levels Of Care

scholarly journals Current practice patterns of primary care physicians in the management of patients with hepatitis C

Hepatology ◽  
1999 ◽  
Vol 30 (3) ◽  
pp. 794-800 ◽  
Author(s):  
Thomas M. Shehab ◽  
Seema S. Sonnad ◽  
Mark Jeffries ◽  
Naresh Gunaratnum ◽  
Anna S. Lok
Keyword(s):  
Primary Care ◽  
Hepatitis C ◽  
Primary Care Physicians ◽  
Current Practice ◽  
Practice Patterns

scholarly journals Monitoring Thyroid Function Tests in Patients With Type 1 Diabetes Mellitus: Adherence to Recommended Guidelines and Comparison of Practice Patterns in a Health Care System

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A852-A852
Author(s):  
Ling Cui ◽  
Madeleine Walsh ◽  
Sai Deepika Potluri ◽  
Nawar Suleman ◽  
Pamela Schroeder
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Type 1 Diabetes ◽  
Type 1 Diabetes Mellitus ◽  
Thyroid Function ◽  
Primary Care Physicians ◽  
Practice Patterns ◽  
Care Physician ◽  
Screening Rate

Abstract Approximately 1.7 million people in the U.S. have type 1 diabetes mellitus. Autoimmune thyroid disease occurs in 17 to 30% of patients with type 1 diabetes. The American Diabetes Association recommends that thyroid function be assessed at diagnosis of type 1 diabetes and repeated every 1 to 2 years thereafter or sooner if clinically indicated. With Centricity, our former electronic medical records (EMR) system, an EMR aid automatically imported key diabetes metrics including the TSH test. Our new EMR system, MedConnect, does not have an EMR aid that imports these metrics. We hypothesized that the screening rate for thyroid dysfunction in type 1 diabetic patients would be higher with the previous EMR system than with the new EMR system. We also hypothesized that the screening rate in patients followed by an endocrinologist would be higher than in those followed by a primary care physician. Methods: We compared practice patterns with Centricity (from June 1, 2013, to May 30, 2016) versus MedConnect (from January 1, 2017, to December 31, 2019) in both primary care and endocrinology clinics. A total of 502 patients (271 Centricity, 231 MedConnect) were identified by chart review with age ≥18 years and ICD 9/10 codes for type 1 diabetes mellitus in outpatient clinics in our multicenter system. Results: Baseline TSH was done in 253 of 271 (93.4%) Centricity patients and in 181 of 231 (78.4%) MedConnect patients. The odds of baseline TSH with Centricity was 3.88 times higher compared to MedConnect (OR = 3.88, 95% CI=2.19,6.88). Of the 214 patients with normal baseline TSH, 135 (63.1%) had repeat TSH done in 1-2 years; and of the 136 MedConnect patients with normal baseline TSH, 86 (63.2%) had repeat TSH done in 1-2 years. Of 434 patients with baseline TSH, 81 (18.6%) had abnormal TSH. Of these patients, 67 (82.7%) had hypothyroidism, 1 (1.2%) had hyperthyroidism, 8 (9.8%) had subclinical hypothyroidism, and 5 (6.1%) had subclinical hyperthyroidism. Of the total 502 patients, 380 (75.7%) were followed by an endocrinologist and 122 (24.3%) were followed by a primary care provider. Among patients followed by an endocrinologist, 348 (91.6%) had a baseline TSH result. Only 86 of 122 (70.5 %) patients followed by a primary care physician had a baseline TSH. Endocrinologists had 4.6 times higher odds of TSH screening at baseline compared with primary care physicians (p <0.0001). Conclusion: Thyroid function was not assessed at baseline in all patients with type 1 diabetes mellitus and was not followed at the recommended intervals per the guidelines. Higher screening rates were seen with an EMR aid. Endocrinologists screened significantly more patients than primary care physicians. Education of providers regarding the guidelines is needed, and addition of an EMR aid may help to improve detecting thyroid dysfunction in patients with type 1 diabetes mellitus.

scholarly journals Knowledge, Attitudes, and Practices towards Diabetic Retinopathy among Primary Care Physicians of Saudi Arabia: A Multicenter Cross-Sectional Study

Healthcare ◽  
2021 ◽  
Vol 9 (12) ◽  
pp. 1697
Author(s):  
Ashokkumar Thirunavukkarasu ◽  
Abdulmohsen Khaled Almulhim ◽  
Faisal Ahmed Albalawi ◽  
Ziyad Muharib Alruwaili ◽  
Ola Ali Almajed ◽  
...  
Keyword(s):  
Primary Care ◽  
Saudi Arabia ◽  
Diabetic Retinopathy ◽  
Work Experience ◽  
Primary Care Physicians ◽  
Cross Sectional Study ◽  
Age Group ◽  
Sectional Study ◽  
Cross Sectional ◽  
Attitudes And Practices

Primary care physicians play a vital role in preventing the progression of diabetic retinopathy (DR) from the initial stages to the late stages. This questionnaire-based analytical cross-sectional study was carried out to assess the knowledge, attitude, practices, and their correlation among 274 randomly selected primary care physicians in Saudi Arabia. Among the studied population, high knowledge, attitudes, and practice scores were observed in 21.5%, 15%, and 29.2% of the physicians, respectively. The mean knowledge score was significantly higher among the age group of less than 30 years (p = 0.031) and the female gender (p = 0.012). The attitude scores were significantly higher among the Saudi physicians (p = 0.027) and those with PHC work experience of less than five years (p < 0.001). Regarding the practices, a significant association was found among the age group of less than 30 years (p = 0.019) and Saudi physicians (p = 0.003). There was a significant positive correlation between knowledge (correlation coefficient (r) = 0.739, p < 0.001) and attitude (r = 0.479, p = 0.007) with the practice scores. It is recommended that targeted continuous medical education, workshops, and seminars are conducted on the prevention and care of DR among primary care physicians. Furthermore, an exploratory multicenter study that involves primary care physicians belonging to all ministries and private sectors is warranted.

scholarly journals Communication between health professionals and their influence on the coordination of care

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
M F M Mendes ◽  
I C Samico ◽  
Z M A Hartz
Keyword(s):  
Primary Care ◽  
Primary Care Physician ◽  
Primary Care Physicians ◽  
Diagnostic Errors ◽  
Care Physician ◽  
Primary Role ◽  
Coordination Of Care ◽  
Levels Of Care ◽  
Specialized Care

Abstract Background Problems linked to the coordination of care may represent a lack of communication between levels of care and reflect diagnostic errors, duplication of tests and unnecessary hospitalizations. This study aims to understand the role of communicational relationships between professionals and their influence on coordination between levels of care. Methods An evaluative and qualitative nature research. 24 interviews were carried out, with primary care physicians and specialists, institutional supporters and managers of a public health network in Pernambuco, Brazil. The content thematic analysis worked out sought to identify synergies and contradictions in the relationships between the actors. Results Knowledge about the role of primary care was incomplete, not being understood its primary role as a care provider. The primary care physician was not recognized as the responsible physician by most professionals. The specialists considered the references poorly filled out and showed a lack of confidence in the primary care physician, who in turn revealed that he did not receive any counter-reference and difficulty in contacting a specialist. Few articulation mechanisms have been reported between levels and the use of informal communication mechanisms. The managers acknowledged the existence of problems, but highlighted the commitment of management in the actions for organizing the network. The “goodwill” of the professionals was considered an articulation facilitator, but not a sufficient practice. Conclusions The results allowed to deepen the look at the complexity of the relationships between the actors and how they can influence coordination. Since is perceived the communicational tensions and weaknesses, it is urgent to think of strategies that establish institutionalized spaces for meetings and dialogues that allow articulation among professionals. Key messages The study analyzes communicational relationships between primary and specialized care professionals and their influence on the coordination of care. Strategies for mutual collaboration are mandatory.

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