scholarly journals Primary care providers’ cancer genetic testing-related knowledge, attitudes, and communication behaviors: A systematic review and research agenda

2016 ◽  
Vol 32 (3) ◽  
pp. 315-324 ◽  
Author(s):  
Jada G. Hamilton ◽  
Ekland Abdiwahab ◽  
Heather M. Edwards ◽  
Min-Lin Fang ◽  
Andrew Jdayani ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Genetic Testing ◽  
Research Agenda ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cancer Genetic ◽  
Communication Behaviors

Systematic review of barriers and enablers to the delivery of palliative care by primary care practitioners

2019 ◽  
Vol 33 (9) ◽  
pp. 1131-1145 ◽  
Author(s):  
Mariko L Carey ◽  
Alison C Zucca ◽  
Megan AG Freund ◽  
Jamie Bryant ◽  
Anne Herrmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Palliative Care ◽  
Care Delivery ◽  
Primary Care Providers ◽  
Healthcare Services ◽  
Care Providers ◽  
Eligibility Criteria ◽  
Barriers And Enablers ◽  
Primary Care Practitioners

Background: There is increasing demand for primary care practitioners to play a key role in palliative care delivery. Given this, it is important to understand their perceptions of the barriers and enablers to optimal palliative care, and how commonly these are experienced. Aim: To explore the type and prevalence of barriers and enablers to palliative care provision reported by primary care practitioners. Design: A systematic review of quantitative data-based articles was conducted. Data sources: Medline, Embase and PsychINFO databases were searched for articles published between January 2007 and March 2019. Data synthesis: Abstracts were assessed against the eligibility criteria by one reviewer and a random sample of 80 articles were blind coded by a second author. Data were extracted from eligible full-texts by one author and checked by a second. Given the heterogeneity in the included studies’ methods and outcomes, a narrative synthesis was undertaken. Results: Twenty-one studies met the inclusion criteria. The most common barriers related to bureaucratic procedures, communication between healthcare professionals, primary care practitioners’ personal commitments, and their skills or confidence. The most common enablers related to education, nurses and trained respite staff to assist with care delivery, better communication between professionals, and templates to facilitate referral to out-of-hours services. Conclusion: A holistic approach addressing the range of barriers reported in this review is needed to support primary care providers to deliver palliative care. This includes better training and addressing barriers related to the interface between healthcare services.

scholarly journals Primary Care Physician Experiences with Integrated Population-Scale Genetic Testing: A Mixed-Methods Assessment

2020 ◽  
Vol 10 (4) ◽  
pp. 165
Author(s):  
Amy A. Lemke ◽  
Laura M. Amendola ◽  
Kristine Kuchta ◽  
Henry M. Dunnenberger ◽  
Jennifer Thompson ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Genetic Testing ◽  
Data Privacy ◽  
Qualitative Interviews ◽  
Genomic Medicine ◽  
Primary Care Providers ◽  
The United States ◽  
Care Physician ◽  
Care Providers

The scalable delivery of genomic medicine requires collaboration between genetics and non-genetics providers. Thus, it is essential to investigate and address the perceived value of and barriers to incorporating genetic testing into the clinical practice of primary care providers (PCPs). We used a mixed-methods approach of qualitative interviews and surveys to explore the experience of PCPs involved in the pilot DNA-10K population genetic testing program. Similar to previous research, PCPs reported low confidence with tasks related to ordering, interpreting and managing the results of genetic tests, and identified the need for additional education. PCPs endorsed high levels of utility for patients and their families but noted logistical challenges to incorporating genetic testing into their practice. Overall PCPs were not familiar with the United States’ Genetic Information Nondiscrimination Act and they expressed high levels of concern for patient data privacy and potential insurance discrimination. This PCP feedback led to the development and implementation of several processes to improve the PCP experience with the DNA-10K program. These results contribute to the knowledge base regarding genomic implementation using a mixed provider model and may be beneficial for institutions developing similar clinical programs.

scholarly journals Protocol for a Systematic Review of the Effectiveness of Provider-targeted Interventions to Improve Opioid Prescribing in Primary Care

2021 ◽  
Author(s):  
Pallavi Prathivadi ◽  
Natalie Connell ◽  
Louisa Picco ◽  
Karleen F Giannitrapani ◽  
Hong-nei Wong ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Primary Care Providers ◽  
Cochrane Library ◽  
Narrative Synthesis ◽  
Care Providers ◽  
Strict Adherence ◽  
Targeted Interventions ◽  
Opioid Prescribing ◽  
Wide Range

Abstract Background: Improving primary care opioid prescribing is a public health priority in many western nations. Governments, policymakers and key stakeholders are intervening on multiple levels to address patient, prescriber and systems factors contributing to opioid over-prescription in primary care. Many opioid prescribing interventions specifically target primary care providers (PCPs); however, the overall effectiveness of these interventions is not known. Identifying effective components of PCP-targeted behaviour change interventions may help inform scalability and translation of prescribing interventions across countries and varying primary healthcare settings. The aim of this systematic review is to assess the effectiveness of provider-targeted interventions to improve opioid prescribing in primary care. This protocol reports the methods of the proposed narrative synthesis review that will be guided by the Theoretical Domains Framework (TDF). Methods: The study will follow Cochrane methods for conducting a narrative synthesis. Reporting is compliant with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) protocols. The review will conduct searches in PubMed, EMBASE, PsychInfo, CINAHL, and the Cochrane Library databases for studies published in the English language from 2010 onwards. Reference lists of accepted articles will be also screened for additional studies meeting inclusion. Any opioid prescribing behaviour will be measured as an outcome. Intervention components will be mapped to domains of the TDF. No geographic limits will be applied. All stages of screening and data extraction will involve a dual review with gold standard adjudication. The Cochrane Risk of Bias tool will be used to evaluate quality and risk. Discussion: This review is being conducted in strict adherence to Cochrane principles. The protocol was submitted for registration to Prospero prior to publication for transparency and to avoid duplication of research. Formal ethics approval is not required for this research. The findings of this review will inform the delivery and implementation of PCP targeted opioid prescribing interventions. Findings will be disseminated to a wide range of stakeholders involved in quality improvement, prescribing interventions, education and training; professional groups, policymakers, researchers and PCPs.Systematic review registration: Submitted to Prospero 22 December 2020; pending registration

Patient satisfaction and provider use of electronic communication: A cross-sectional analysis

2017 ◽  
Vol 5 (4) ◽  
pp. 441 ◽  
Author(s):  
Joy L Lee ◽  
Sydney M. Dy ◽  
Steven J. Kravet ◽  
Bimal H. Ashar ◽  
Todd Nesson ◽  
...  
Keyword(s):  
Primary Care ◽  
Patient Satisfaction ◽  
Text Messaging ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cross Sectional ◽  
Communication Behaviors ◽  
Cross Sectional Analysis ◽  
Sectional Analysis ◽  
The Relationship

Background: The way patients and providers communicate with one another outside of the clinic is changing. However, little is known about primary care provider perspectives and experiences of these changes and whether these provider behaviors correlate with patient satisfaction. This study examines provider patterns of communication with patients outside of the clinic setting via cellphone, email and text messaging and the relationship between communication behaviors and patient satisfaction. Method: Cross-sectional analysis of the association between patient satisfaction scores and a 16-question community survey of 149 Mid-Atlantic primary care providers in community practice was conducted in the year prior to clinic implementation of a new electronic health record system with secure patient-messaging capabilities.Results: Providers who gave patients their email addresses were more likely to communicate with their patients electronically than those who did not. Providers who made their email addresses available to patients also had significantly higher overall satisfaction scores than those who did not, although there were no statistically significant differences in individual satisfaction domains. The use of these cellphone, email and text-messaging were also not found to be associated with patient satisfaction domains.    Conclusions: Provider provision of their email addresses may be an indicator of a stronger relationship with certain patients. This study elucidates the relationship between provider communication behaviors and patient satisfaction. A better understanding of the role of the patient-provider relationship and its role in patient satisfaction may help practices and providers improve their patients’ experience of primary care.  

Physicians' Attitudes toward Disclosure of Genetic Information to Third Parties

1993 ◽  
Vol 21 (2) ◽  
pp. 238-240 ◽  
Author(s):  
Gail Geller ◽  
Ellen S. Tambor ◽  
Barbara A. Bernhardt ◽  
Gary A. Chase ◽  
Karen J. Hofman ◽  
...  
Keyword(s):  
Primary Care ◽  
Genetic Testing ◽  
Genetic Information ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Third Parties ◽  
Care Providers ◽  
Physician Patient Relationship ◽  
Her Family ◽  
Physician Patient

Confidentiality is a cornerstone of the physician-patient relationship. Breaches of confidentiality in the context of genetic testing are of particular concern for a number of reasons. First, genetic testing reveals information not only about a particular patient, but also about his or her family members. Second,genetic testing can label healthy people as “at risk,” subjecting them to possible stigmatization or discrimination by third parties. Third, as genetic testing becomes more widespread and is incorporated into primary care, breaches of confidentiality might inadvertently occur more frequently because primary care providers may not be trained to understand the uniqueness of genetic information. Until now, genetic services have been provided primarily by medical geneticists and genetic counselors. However, with the proliferation of new genetic presymptomatic and carrier tests, primary care physicians are going to become increasingly involved in genetic testing. Currently, little is known about physicians’ attitudes (other than those of medical geneticists) toward disclosure of confidential genetic information to third parties.

scholarly journals When primary care providers and smokers meet: a systematic review and metasynthesis

2021 ◽  
Vol 31 (1) ◽  
Author(s):  
Emilie Manolios ◽  
Jordan Sibeoni ◽  
Maria Teixeira ◽  
Anne Révah-Levy ◽  
Laurence Verneuil ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Smoking Cessation ◽  
Clinical Practice ◽  
Smoking Status ◽  
Primary Care Providers ◽  
Care Providers ◽  
The Core ◽  
Primary Care Settings

AbstractPrimary Care Providers (PCPs) often deal with patients on daily clinical practice without knowing anything about their smoking status and willingness to quit. The aim of this metasynthesis is to explore the PCPs and patients who are smokers perspectives regarding the issue of smoking cessation within primary care settings. It relies on the model of meta-ethnography and follows thematic synthesis procedures. Twenty-two studies are included, reporting on the view of 580 participants. Three main themes emerge: (i) What lacks, (ii) Some expectations but no request, and (iii) How to address the issue and induce patients’ motivation. Our results reveal a global feeling of a lack of legitimacy among PCPs when it comes to addressing the issue of tobacco and smoking cessation with their patients, even though they have developed creative strategies based on what is at the core of their practice, that is proximity, continuity, long-term and trustworthy relationship.

Barriers to the practice of cancer genetic by primary care providers

2004 ◽  
Vol 22 (14_suppl) ◽  
pp. 6149-6149
Author(s):  
M. E. Wood ◽  
A. Stockdale ◽  
B. S. Flynn
Keyword(s):  
Primary Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Cancer Genetic

scholarly journals Chronic kidney disease care models in low- and middle-income countries: a systematic review

2018 ◽  
Vol 3 (2) ◽  
pp. e000728 ◽  
Author(s):  
John W Stanifer ◽  
Megan Von Isenburg ◽  
Glenn M Chertow ◽  
Shuchi Anand
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Chronic Kidney Disease ◽  
Clinical Care ◽  
Primary Care Providers ◽  
Care Providers ◽  
Middle Income ◽  
Middle Income Countries ◽  
Care Models ◽  
Kidney Function Decline

IntroductionThe number of persons with chronic kidney disease (CKD) living in low- and middle-income countries (LMIC) is increasing rapidly; yet systems built to care for them have received little attention. In order to inform the development of scalable CKD care models, we conducted a systematic review to characterise existing CKD care models in LMICs.MethodsWe searched PubMed, Embase and WHO Global Health Library databases for published reports of CKD care models from LMICs between January 2000 and 31 October 2017. We used a combination of database-specific medical subject headings and keywords for care models, CKD and LMICs as defined by the World Bank.ResultsOf 3367 retrieved articles, we reviewed the full text of 104 and identified 17 articles describing 16 programmes from 10 countries for inclusion. National efforts (n=4) focused on the prevention of end-stage renal disease through enhanced screening, public awareness campaigns and education for primary care providers. Of the 12 clinical care models, nine focused on persons with CKD and the remaining on persons at risk for CKD; a majority in the first category implemented a multidisciplinary clinic with allied health professionals or primary care providers (rather than nephrologists) in lead roles. Four clinical care models used a randomised control design allowing for assessment of programme effectiveness, but only one was assessed as having low risk for bias; all four showed significant attenuation of kidney function decline in the intervention arms.ConclusionsOverall, very few rigorous CKD care models have been reported from LMICs. While preliminary data indicate that national efforts or clinical CKD care models bolstering primary care are successful in slowing kidney function decline, limited data on regional causes of CKD to inform national campaigns, and on effectiveness and affordability of local programmes represent important challenges to scalability.

scholarly journals Genetic Referral Patterns and Responses to Clinical Scenarios: A Survey of Primary Care Providers and Clinical Geneticists

2021 ◽  
Vol 12 ◽  
pp. 215013272110467
Author(s):  
Tina K. Truong ◽  
Aileen Kenneson ◽  
Ami R. Rosen ◽  
Rani H. Singh
Keyword(s):  
Primary Care ◽  
Genetic Testing ◽  
Primary Care Providers ◽  
The United States ◽  
Genetic Services ◽  
Care Providers ◽  
Referral Patterns ◽  
Practice Characteristics ◽  
Clinical Scenarios ◽  
Genetics Services

Introduction: Primary care physicians (PCPs) are considered the gatekeepers of genetic services, but they often underutilize or inappropriately utilize such services, leading to lack of early treatment, incorrect diagnoses, and unnecessary procedures. This study aims to delineate PCP referral patterns, including the frequency of, motivators for, and barriers to genetic referrals and testing in the present landscape of genomics. Methods: A 34-item online survey was distributed to PCPs in the United States (US). PCP demographics, practice characteristics, and referral patterns, motivators, and barriers were analyzed. Six hypothetical clinical scenarios included in the survey also were presented to a cohort of clinical geneticists. We calculated PCPs’ rates of ordering genetic tests and of referral to genetics services in the past year. Rates and responses to clinical scenarios were compared based on respondents’ personal and practice characteristics. Results: A total of 95 PCPs and 25 clinical geneticists participated. Among the PCPs, 79% reported referring and 50% reported ordering genetic testing in the last year. PCPs with genetic counselors (GCs) in their clinic referred at significantly higher rates than those without ( P = .008). White PCPs referred at significantly higher rates compared to Black or African American PCPs ( P = .009). The most commonly reported motivators for referring patients to genetic services were preference for specialist coordination, lack of knowledge, and family’s desire for risk information. The most commonly reported barriers were patient refusal, provider concerns about costs to patients, and uncertainty of when a genetic referral is appropriate. In response to clinical scenarios, clinical geneticists were in agreement about the need for genetic testing or referral for 2 of the scenarios. For these 2 scenarios, only 48% and 71% of PCPs indicated that they would offer genetic testing or referral, respectively. Conclusions: Responses to clinical scenarios suggest that it is not clear to PCPs when referrals or testing are needed. Collaboration with GCs is one approach to reducing barriers to and improving PCPs’ utilization of genetic services. Clear guidelines from clinical geneticists may help facilitate appropriate use of genetics services by PCPs. Additional research is needed to further describe barriers that PCPs face in genetic testing/referrals.

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