Primary Care Provider Encounter Cadence and HbA1c Control in Older Patients With Diabetes

2019 ◽  
Vol 57 (4) ◽  
pp. e95-e101
Author(s):  
Jessica M. Dobbins ◽  
Sarah Wixson Elliott ◽  
Tristan Cordier ◽  
Gil Haugh ◽  
Andrew Renda ◽  
...  
2003 ◽  
Vol 33 (3) ◽  
pp. 241-256 ◽  
Author(s):  
Patricia A. Arean ◽  
Jennifer Alvidrez ◽  
Mitchell Feldman ◽  
Lowell Tong ◽  
Rebecca Shermer

Objectives: The purpose of this study was to determine if primary care provider knowledge of late-life depression, attitudes about treatment of depression in late life, and experience treating late-life depression affect the likelihood internists would prescribe antidepressants to older patients. Methods: This study was a primary care provider survey study. From a pool of 456 eligible mailed surveys, 253 providers completed (55% response rate) a survey assessing provider self-reported knowledge about treating late-life depression with antidepressants, their attitudes about older patients' acceptance and response to antidepressant medications, their professional and personal experience with antidepressant medication, and their comfort with prescribing antidepressants to older patients was created for this study. Results: Univariate analyses indicated that 75% of primary care providers were knowledgeable about the use of antidepressant treatment in older people, and 86% said they felt comfortable treating depression in older patients. Multivariate analyses indicated that the decision to treat older patients with antidepressants was largely influenced by time to treat patients, provider belief that antidepressants could treat late-life depression, their comfort with treating late-life depression, and having had older patients respond to anti-depressant treatment in the past ( R2 = .52, p < .001). Conclusions: This study shows that attitudinal and experiential factors play an important role in the likelihood that a provider will treat an older, depressed patient with an antidepressant, more so than knowledge about how to prescribe an anti-depressant to older patients. Residency programs for primary care practitioners should include education about the efficacy of antidepressant treatment in older people and should involve hands-on experience in treating late-life depression.


2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Tarika Srinivasan ◽  
Erica J. Sutton ◽  
Annika T. Beck ◽  
Idali Cuellar ◽  
Valentina Hernandez ◽  
...  

Introduction: Minority communities have had limited access to advances in genomic medicine. Mayo Clinic and Mountain Park Health Center, a Federally Qualified Health Center in Phoenix, Arizona, partnered to assess the feasibility of offering genomic screening to Latino patients receiving care at a community-based health center. We examined primary care provider (PCP) experiences reporting genomic screening results and integrating those results into patient care. Methods: We conducted open-ended, semi-structured interviews with PCPs and other members of the health care team charged with supporting patients who received positive genomic screening results. Interviews were recorded, transcribed, and analyzed thematically. Results: Of the 500 patients who pursued genomic screening, 10 received results indicating a genetic variant that warranted clinical management. PCPs felt genomic screening was valuable to patients and their families, and that genomic research should strive to include underrepresented minorities. Providers identified multiple challenges integrating genomic sequencing into patient care, including difficulties maintaining patient contact over time; arranging follow-up medical care; and managing results in an environment with limited genetics expertise. Providers also reflected on the ethics of offering genomic sequencing to patients who may not be able to pursue diagnostic testing or follow-up care due to financial constraints. Conclusions: Our results highlight the potential benefits and challenges of bringing advances in precision medicine to community-based health centers serving under-resourced populations. By proactively considering patient support needs, and identifying financial assistance programs and patient-referral mechanisms to support patients who may need specialized medical care, PCPs and other health care providers can help to ensure that precision medicine lives up to its full potential as a tool for improving patient care.


2021 ◽  
Author(s):  
Emily A. Croce ◽  
Fabiana C. P. S. Lopes ◽  
Jennifer Ruth ◽  
Jonathan I. Silverberg

Author(s):  
Stephanie L. Mayne ◽  
Chloe Hannan ◽  
Jennifer Faerber ◽  
Rupreet Anand ◽  
Ella Labrusciano-Carris ◽  
...  

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 855
Author(s):  
Omar Farooq ◽  
Ameer Farooq ◽  
Sunita Ghosh ◽  
Raza Qadri ◽  
Tanner Steed ◽  
...  

Background: Digital rectal examination (DRE) is considered an important part of the physical examination. However, it is unclear how many patients have a DRE performed at the primary care level in the work-up of rectal cancer, and if the absence of a DRE causes a delay to consultation with a specialist. Methods: A retrospective patient questionnaire was sent to 1000 consecutive patients with stage II or stage III rectal cancer. The questionnaire asked patients to recall if they had a DRE performed by their general practitioner (GP) when they first presented with symptoms or a positive FIT test. Demographic data, staging data, and time to consultation with a specialist were also collected. Results: A thousand surveys were mailed out, and a total of 262 patients responded. Of the respondents, 46.2% did not recall undergoing a digital rectal examination by their primary care provider. Women were less likely to undergo a DRE than men (28.6% vs. 44.3%, p = 0.019). While there was a trend towards longer times to specialist consultation in patients who did not undergo a DRE (27.0 vs. 12.2 weeks), this was not statistically significant (p = 0.121). Conclusion: A significant proportion of patients who are FIT positive or have symptomatic rectal bleeding do not recall having a DRE by their primary care provider. Barriers may include lack of comfort with performing DRE or lack of time. Clearer guidelines and more support for GP’s may increase uptake of DRE.


2020 ◽  
Vol 15 (4) ◽  
pp. 175-180
Author(s):  
Margaret Nolan ◽  
Deejay Zwaga ◽  
Danielle McCarthy ◽  
Christian Kastman ◽  
Timothy Baker ◽  
...  

AbstractIntroductionMost tobacco treatment efforts target healthcare settings, because about 75% of smokers in the United States visit a primary care provider annually. Yet, 25% of patients may be missed by such targeting.AimsTo describe patients who smoke but infrequently visit primary care – their characteristics, rates of successful telephone contact, and acceptance of tobacco treatment.MethodsTobacco Cessation Outreach Specialists ‘cold-called’ those without a primary care visit in the past year, offering tobacco dependence treatment. Age, sex, insurance status, race, ethnicity, electronic health record (EHR) patient-portal status and outreach outcomes were reported.ResultsOf 3,407 patients identified as smokers in a health system registry, 565 (16.6%) had not seen any primary care provider in the past year. Among 271 of those called, 143 (53%) were successfully reached and 33 (23%) set a quit date. Those without visits tended to be younger, male, some-day versus every-day smokers (42 vs. 44 years, P = 0.004; 48% vs. 40% female, P = 0.0002, and 21% vs. 27% some-day, P = 0.003), and less active on the EHR patient portal (33% vs. 40%, P = 0.001).ConclusionsA substantial proportion of patients who smoke are missed by traditional tobacco treatment interventions that require a primary care visit, yet many are receptive to quit smoking treatment offers.


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