scholarly journals Interventions for improving outcomes in patients with multimorbidity in primary care and community settings

2016 ◽  
Author(s):  
Susan M Smith ◽  
Emma Wallace ◽  
Tom O'Dowd ◽  
Martin Fortin
Keyword(s):  
Primary Care ◽  
Community Settings

scholarly journals Development of a Cancer Risk Prediction Tool for Use in the UK Primary Care and Community Settings

2017 ◽  
Vol 10 (7) ◽  
pp. 421-430 ◽  
Author(s):  
Artitaya Lophatananon ◽  
Juliet Usher-Smith ◽  
Jackie Campbell ◽  
Joanne Warcaba ◽  
Barbora Silarova ◽  
...  
Keyword(s):  
Primary Care ◽  
Cancer Risk ◽  
Risk Prediction ◽  
Prediction Tool ◽  
Community Settings ◽  
The Uk

scholarly journals Improving risk factor management for patients with poorly controlled type 2 diabetes: a systematic review of healthcare interventions in primary care and community settings

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015135 ◽  
Author(s):  
Mark E Murphy ◽  
Molly Byrne ◽  
Rose Galvin ◽  
Fiona Boland ◽  
Tom Fahey ◽  
...  
Keyword(s):  
Primary Care ◽  
Glycaemic Control ◽  
Study Quality ◽  
Regression Analyses ◽  
Community Settings ◽  
Baseline Hba1c ◽  
Poor Glycaemic Control ◽  
Healthcare Interventions ◽  
Meta Analyses

ObjectivesPoorly controlled type 2 diabetes mellitus (T2DM) is a major international health problem. Our aim was to assess the effectiveness of healthcare interventions, specifically targeting patients with poorly controlled T2DM, which seek to improve glycaemic control and cardiovascular risk in primary care settings.DesignSystematic review.SettingPrimary care and community settings.Included studiesRandomised controlled trials (RCTs) targeting patients with poor glycaemic control were identified from Pubmed, Embase, Web of Science, Cochrane Library and SCOPUS. Poor glycaemic control was defined as HbA1c over 59 mmol/mol (7.5%).InterventionsInterventions were classified as organisational, patient-oriented, professional, financial or regulatory.OutcomesPrimary outcomes were HbA1c, blood pressure and lipid control. Two reviewers independently assessed studies for eligibility, extracted data and assessed study quality. Meta-analyses were undertaken where appropriate using random-effects models. Subgroup analysis explored the effects of intervention type, baseline HbA1c, study quality and study duration. Meta-regression analyses were undertaken to investigate identified heterogeneity.ResultsForty-two RCTs were identified, including 11 250 patients, with most undertaken in USA. In general, studies had low risk of bias. The main intervention types were patient-directed (48%) and organisational (48%). Overall, interventions reduced HbA1c by −0.34% (95% CI −0.46% to −0.22%), but meta-analyses had high statistical heterogeneity. Subgroup analyses suggested that organisational interventions and interventions on those with baseline HbA1c over 9.5% had better improvements in HbA1c. Meta-regression analyses suggested that only interventions on those with population HbA1c over 9.5% were more effective. Interventions had a modest improvement of blood pressure and lipids, although baseline levels of control were generally good.ConclusionsThis review suggests that interventions for T2DM, in primary care, are better targeted at individuals with very poor glycaemic control and that organisational interventions may be more effective.

Useful information

2020 ◽  
pp. 831-844
Keyword(s):  
Primary Care ◽  
Herbal Medicine ◽  
Educational Needs ◽  
Alternative Therapies ◽  
Assistive Technologies ◽  
Faith Healing ◽  
Community Settings ◽  
Special Educational Needs ◽  
Death Certification ◽  
Complex Equipment

This chapter provides other useful topics for nurses working in primary care or community settings. It defines telecare and telehealth, assistive technologies (ranging from special educational needs equipment to moving and handling systems) and home adaptations (including complex equipment, methods of hiring or buying disability equipment, and wheelchair services), and complementary and alternative therapies (including acupuncture, aromatherapy, faith healing, herbal medicine, homeopathy, hypnotherapy, osteopathy, chiropractic treatments, and reflexology). It also outlines processes for the verification of the fact of death, certification of death, and the registration of births, marriages, civil partnerships, and deaths.

Comparison of Outcomes of Glaucoma Screening in Primary Care and Community Settings

2019 ◽  
Vol 26 (5) ◽  
pp. 355-359
Author(s):  
Adam J. Schettler ◽  
Oliver R. Filutowski ◽  
Ira M. Helenius ◽  
Peter A. Netland
Keyword(s):  
Primary Care ◽  
Community Settings ◽  
Glaucoma Screening

scholarly journals Interventions to improve the management of diabetes mellitus in primary care, outpatient and community settings

2000 ◽  
Author(s):  
Carry Mira Renders ◽  
Gerlof D Valk ◽  
Simon J Griffin ◽  
Edward Wagner ◽  
Jacques ThM van Eijk ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Community Settings

scholarly journals Costing Methodology and Key Drivers of Health Care Costs Within Economic Analyses in Musculoskeletal Community and Primary Care Services: A Systematic Review of the Literature

2020 ◽  
Vol 11 ◽  
pp. 215013271989976
Author(s):  
Roanna Burgess ◽  
James Hall ◽  
Annette Bishop ◽  
Martyn Lewis ◽  
Jonathan Hill
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Health Care Costs ◽  
Community Settings ◽  
Outpatient Visits ◽  
Key Drivers ◽  
Gp Visits ◽  
Economic Analyses ◽  
Care Costs

Background: Identifying variation in musculoskeletal service costs requires the use of specific standardized metrics. There has been a large focus on costing, efficiency, and standardized metrics within the acute musculoskeletal setting, but far less attention in primary care and community settings. Objectives: To ( a) assess the quality of costing methods used within musculoskeletal economic analyses based primarily in primary and community settings and ( b) identify which cost variables are the key drivers of musculoskeletal health care costs within these settings. Methods: Medline, AMED, EMBASE, CINAHL, HMIC, BNI, and HBE electronic databases were searched for eligible studies. Two reviewers independently extracted data and assessed quality of costing methods using an established checklist. Results: Twenty-two studies met the review inclusion criteria. The majority of studies demonstrated moderate- to high-quality costing methods. Costing issues included studies failing to fully justify the economic perspective, and not distinguishing between short- and long-run costs. Highest unit costs were hospital admissions, outpatient visits, and imaging. Highest mean utilization were the following: general practitioner (GP) visits, outpatient visits, and physiotherapy visits. Highest mean costs per patient were GP visits, outpatient visits, and physiotherapy visits. Conclusion: This review identified a number of key resource use variables that are driving musculoskeletal health care costs in the community/primary care setting. High utilization of these resources (rather than high unit cost) appears to be the predominant factor increasing mean health care costs. There is, however, need for greater detail with capturing these key cost drivers, to further improve the accuracy of costing information.

scholarly journals Peer Support for Diabetes Management in Primary Care and Community Settings in Anhui Province, China

2015 ◽  
Vol 13 (Suppl_1) ◽  
pp. S50-S58 ◽  
Author(s):  
X. Zhong ◽  
Z. Wang ◽  
E. B. Fisher ◽  
C. Tanasugarn
Keyword(s):  
Primary Care ◽  
Peer Support ◽  
Diabetes Management ◽  
Anhui Province ◽  
Community Settings

scholarly journals Naturopathic Practice at North American Academic Institutions: Description of 300,483 Visits and Comparison to Conventional Primary Care

2014 ◽  
Vol 9 ◽  
pp. IMI.S14124 ◽  
Author(s):  
Steven R. Chamberlin ◽  
Erica Oberg ◽  
Douglas A. Hanes ◽  
Carlo Calabrese
Keyword(s):  
Primary Care ◽  
North American ◽  
Healthcare Services ◽  
Software Systems ◽  
Community Settings ◽  
Academic Institutions ◽  
Care Survey ◽  
Ambulatory Medical Care ◽  
Teaching Clinics ◽  
American Academic

This study collected patient visit data to explore similarities and differences between conventional and naturopathic primary care (PC). Administrative data from practice management software systems from the main teaching clinics of four of the eight accredited North American naturopathic academic institutions were abstracted into an integrated database containing five years (2006–2010) of visit, patient, laboratory, and prescribing data. Descriptive analyses of healthcare services were compared to the National Ambulatory Medical Care Survey (NAMCS). Over the five-year period, 300,483 patient visits to naturopathic doctors occurred at clinics, excluding visits at clinics operated by the schools in community settings. Patients were 69% female; mean age was 39 (SE 0.09). Older adults (>65) comprised 9% of the population and children (<16) comprised 8%. Comparing academic naturopathic clinics to national conventional PC (NAMCS), we found more patients paid out of pocket at naturopathic clinics (50 vs. 4%) and naturopathic clinics more frequently offered discounted care (26 vs. 0.3%). There was a 44% overlap in the most frequent 25 diagnoses for PC at conventional community clinics. Overall, these data suggest substantial similarities in care offered by academic naturopathic clinics, at which most Naturopathic Doctor (ND) students are trained, and by conventional PC practices.

Variation in Value-Based Outcome Measures Among Assisted Living Communities Served by a Home-Based Primary Care Practice During COVID-19

2020 ◽  
Vol 33 (1) ◽  
pp. 45-48
Author(s):  
William R. Mills ◽  
Janet M. Buccola ◽  
Jamie Roosa ◽  
Lisa Lemin ◽  
Lynn Cappelli ◽  
...  
Keyword(s):  
Primary Care ◽  
Assisted Living ◽  
Primary Care Practice ◽  
Hospitalization Rate ◽  
Care Practice ◽  
Community Settings ◽  
Home Based Primary Care ◽  
Home Based ◽  
The Mean ◽  
At Home

We aimed to determine the hospitalization rate and average days spent at home in a population of assisted living (AL) residents served by a home-based primary care (HBPC) practice during the COVID-19 pandemic. We provided on-site HBPC to 1,699 AL residents and calculated hospitalization rate and days spent at home. The AL population had a mean age of 84 ± 10 years and 73% were female. The mean hospitalization rate was 449 admissions per 1,000 per year, and there was wide variation among AL communities. AL residents spent a mean of 358 days at home per year, and the average days spent at home varied during the COVID-19 pandemic. Use of these measures may help AL articulate its value proposition by enabling seniors with complex health needs to live in community settings for as many days as possible.

Sign in / Sign up

Export Citation Format

Share Document