Assessment of Primary Care Appointment Times and Appropriate Prescribing of Statins for At-Risk Patients

In the UK, the National Institute for Clinical Excellence has recommended the use of neuraminidase inhibitors for elderly and at-risk patients who present with influenza-like illness within 36 hours of symptom onset. However, few data exist to enable primary care trusts to evaluate the logistics and costs of prescribing. We sought to determine, during a confirmed influenza outbreak, the proportion of eligible patients who currently present in time to benefit from treatment with a neuraminidase inhibitor, and to develop the findings into a model for evaluating potential prescribing costs. Within a single primary care group, demographic and co-morbidity data were collected on all patients consulting their general practitioner or attending an out-of-hours centre with influenza-like illness during the outbreak period. A typical primary care trust serving 100 000 patients might expect to prescribe a neuraminidase inhibitor to 140 eligible at-risk patients in a season of low influenza activity, rising to 300 in a large epidemic. At-risk patients were more likely than non-at-risk patients to consult within 36 hours of the onset of symptoms. However, only 20% of such patients, rising to 47% in out-of-hours centres, consulted in time to benefit from treatment. The low proportion of elderly and at-risk patients who consult their general practitioner in time to benefit from treatment with a neuraminidase inhibitor emphasizes the overriding importance of annual vaccination in these groups. If the full benefits of neuraminidase inhibitors are to be realized, access to treatment for eligible patients must be improved.

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Declining Medicaid Fees and Primary Care Appointment Availability for New Medicaid Patients

JAMA Internal Medicine ◽

10.1001/jamainternmed.2017.6302 ◽

2018 ◽

Vol 178 (1) ◽

pp. 145 ◽

Cited By ~ 8

Author(s):

Molly Candon ◽

Stephen Zuckerman ◽

Douglas Wissoker ◽

Brendan Saloner ◽

Genevieve M. Kenney ◽

...

Keyword(s):

Primary Care ◽

Care Appointment ◽

Appointment Availability ◽

Primary Care Appointment

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Su1523 Use of Hyperosmolar Bowel Preparations in At-Risk Patients: Results of a National Survey of Primary Care Physicians

Gastrointestinal Endoscopy ◽

10.1016/j.gie.2015.03.484 ◽

2015 ◽

Vol 81 (5) ◽

pp. AB314-AB315

Author(s):

Andrew J. Read ◽

Arlene Weissman ◽

Philip S. Schoenfeld ◽

Seema Saini ◽

Stacy B. Menees ◽

...

Keyword(s):

Primary Care ◽

At Risk ◽

National Survey ◽

Primary Care Physicians ◽

Risk Patients ◽

Bowel Preparations

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Hot Spotting Medically Complex At-Risk Patients in an Urban Primary Care Residency Clinic

Journal of Patient-Centered Research and Reviews ◽

10.17294/2330-0698.1667 ◽

2018 ◽

Vol 5 (4) ◽

pp. 319

Author(s):

Glenda Sundberg ◽

Chris Peters ◽

Catherine de Grandville ◽

Natalie Sorenson ◽

Rinal Patel ◽

...

Keyword(s):

Primary Care ◽

At Risk ◽

Primary Care Residency ◽

Risk Patients

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A carve-out model for primary care appointment scheduling with same-day requests and no-shows

Operations Research for Health Care ◽

10.1016/j.orhc.2018.01.003 ◽

2018 ◽

Vol 16 ◽

pp. 41-58 ◽

Cited By ~ 1

Author(s):

Babak Hoseini ◽

Wenbo Cai ◽

Layek Abdel-Malek

Keyword(s):

Primary Care ◽

Appointment Scheduling ◽

Care Appointment ◽

Primary Care Appointment

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HIV Primary Care Appointment Keeping by Homeless Veterans

PsycEXTRA Dataset ◽

10.1037/e663402011-001 ◽

2011 ◽

Author(s):

Stephen Randal Henry ◽

Matthew B. Goetz ◽

Sarah Longino ◽

Hemen Saifu ◽

Tuyen Hoang ◽

...

Keyword(s):

Primary Care ◽

Homeless Veterans ◽

Hiv Primary Care ◽

Care Appointment ◽

Appointment Keeping ◽

Primary Care Appointment

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Abstract P077: Missed Opportunities for Behavioral Counseling by Primary Care Providers

Circulation ◽

10.1161/circ.133.suppl_1.p077 ◽

2016 ◽

Vol 133 (suppl_1) ◽

Author(s):

John D Omura ◽

Susan A Carlson ◽

Prabasaj Paul ◽

Kathleen B Watson ◽

Fleetwood Loustalot ◽

...

Keyword(s):

Physical Activity ◽

Primary Care ◽

At Risk ◽

Primary Care Providers ◽

Care Providers ◽

Behavioral Counseling ◽

The Metabolic Syndrome ◽

Patients At Risk ◽

Risk Patients ◽

Counseling Practices

Background: In 2014, the US Preventive Services Task Force recommended adults who are overweight or obese and have additional cardiovascular disease (CVD) risk factors be offered or referred to intensive behavioral counseling interventions to promote a healthful diet and physical activity for CVD prevention. Hypothesis: We hypothesized that primary care providers (PCPs) who discussed physical activity with most of their at risk patients would have a higher prevalence of offering select components than PCPs who discussed physical activity less frequently. Methods: DocStyles 2015, a Web-based panel survey of 1251 PCPs (response rate=76.8%), assessed physical activity counseling practices with patients at risk for CVD (overweight or obese and with hypertension, dyslipidemia, impaired fasting glucose, or the metabolic syndrome). Results: Overall, 55.9% (SE=1.4) of PCPs discussed physical activity with most of their patients at risk for CVD. Among respondents who discussed physical activity with any at risk patients (N=1244), the prevalence of components offered when they counseled ranged from 92.6% encouraging increased physical activity to 15.8% referring to intensive behavioral counseling (Table). PCPs who discussed physical activity with most at risk patients had a higher prevalence of offering all counseling components assessed than PCPs who discussed physical activity less frequently, except for referring to intensive behavioral counseling where no difference was found. Of all PCPs, 8.4% both discussed physical activity with most of their at risk patients and referred them to intensive behavioral counseling. Conclusion: Just over half of PCPs surveyed discussed physical activity with most patients at risk for CVD. These PCPs more frequently offered select components when they counseled with the exception of referral to intensive behavioral counseling. Both the low levels of counseling and referral to intensive behavioral counseling present important opportunities for improving counseling practices.

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Abstract P379: Features to Increase Primary Care Provider Referrals to Intensive Behavioral Counseling for Cardiovascular Disease Prevention

Circulation ◽

10.1161/circ.141.suppl_1.p379 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

John D Omura ◽

Kathleen B Watson ◽

Fleetwood V Loustalot ◽

Janet E Fulton ◽

Susan A Carlson

Keyword(s):

Physical Activity ◽

Cardiovascular Disease ◽

Primary Care ◽

At Risk ◽

Task Force ◽

Primary Care Providers ◽

Care Providers ◽

Behavioral Counseling ◽

Patients At Risk ◽

Risk Patients

Background: The US Preventive Services Task Force recommends adults with certain cardiovascular disease (CVD) risk factors be offered or referred to intensive behavioral counseling to promote a healthful diet and physical activity for CVD prevention. However, only 1 in 12 primary care providers (PCPs) currently follow this recommendation. This study assessed system and programmatic features PCPs reported would increase their likelihood of referring patients at risk for CVD to intensive behavioral counseling and whether this varied by the percentage of at-risk patients with whom they discuss physical activity. Methods: DocStyles 2018, a web-based panel survey of PCPs, assessed the percentage of at-risk patients with whom PCPs discuss physical activity and the degree to which select features would increase their likelihood of referring to intensive behavioral counseling. Results: Overall, 60.8% of PCPs discussed physical activity with most of their at-risk patients; 21.8% did so with many and 17.4% with few or some. The proportion of PCPs identifying features as increasing their likelihood of referring to intensive behavioral counseling by a great extent ranged from 24.1% for an automated referral in electronic health records, 35.3% for patient progress reports, 41.5% for the program being accredited or evidence-based, to 67.2% for the program having no cost to the patient (Table). These proportions increased for each feature as the percentage of at-risk patients with whom they discuss physical activity increased. Conclusion: PCPs identified programmatic features (i.e. being accredited and of no cost) as having the greatest influence on their likelihood of referring patients at risk for CVD to intensive behavioral counseling, although this varied by the percentage of at-risk patients with whom they discuss physical activity. Findings suggest that the effectiveness of strategies to improve behavioral counseling referrals by PCPs may depend on their current physical activity counseling practices.

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