scholarly journals Barriers to Follow-up Eye Care After Preschool Vision Screening in the Primary Care Setting: Findings From a Pilot Study

2006 ◽  
Vol 10 (5) ◽  
pp. 476-478 ◽  
Author(s):  
Alex R. Kemper ◽  
Rebecca L. Uren ◽  
Sarah J. Clark
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Vision Screening ◽  
Eye Care

Identifying barriers to follow-up eye care for children after failed vision screening in a primary care setting

2013 ◽  
Vol 17 (4) ◽  
pp. 385-390 ◽  
Author(s):  
Zhuo Su ◽  
Elizabeth K. Marvin ◽  
Bing Q. Wang ◽  
Tavé van Zyl ◽  
Maxwell D. Elia ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Vision Screening ◽  
Eye Care

Efficacy of Using Physical Activity Mentors to Increase the Daily Steps of Older Adults in the Primary Care Setting: A Pilot Study

2014 ◽  
Vol 22 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Karen A. Croteau ◽  
Vijiayurani Suresh ◽  
Elanna Farnham
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Primary Care ◽  
Pilot Study ◽  
Repeated Measures ◽  
Care Setting ◽  
Primary Care Setting ◽  
Chronic Illnesses ◽  
Main Effects

The purpose of this pilot study was to determine if using physical activity (PA) mentors has any additional impact on daily steps of older adults participating in the Maine in Motion (MIM) program in the primary care setting. Participants were randomly assigned to a MIM-only group (n= 14) or a MIM+ mentor group (n= 14). The MIM intervention lasted 6 months with follow-up at 12 months. Average age of participants was 64 ± 8.8 years and most participants had multiple chronic illnesses. At baseline, mean body mass index (BMI) was 32.2 ± 5.1 and average daily steps were 4,236 ± 2,266. Repeated-measures ANOVA revealed significant main effects for steps,F(2.324, 59.104) = 4.168,p= .015, but no main effects for group,F(1, 25) = 2.988,p= .096, or time-by-group interaction,F(2.324, 59.104) = 0.905,p= .151. All participants significantly increased daily steps over the course of the intervention, with MIM+ participants maintaining increases at follow-up. No significant findings were found for BMI.

scholarly journals A Pilot Study on Using the Patient Health Questionnaire in the Primary Care Setting in Japan

2005 ◽  
Vol 6 (1) ◽  
pp. 9-16
Author(s):  
Kazuhiro Waza ◽  
Graham Antonnette ◽  
Zyzanski Stephen ◽  
Kazuo Inoue ◽  
Masato Sasaki ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health

Combined Hemimandibular Hyperplasia and Elongation: the Orthodontic-Surgical Management

2020 ◽  
Vol 13 (3) ◽  
pp. 134-140
Author(s):  
Ciarán Devine ◽  
Anna Sayan ◽  
Velupillai Ilankovan
Keyword(s):  
Primary Care ◽  
Surgical Treatment ◽  
Surgical Management ◽  
Clinical Relevance ◽  
Care Setting ◽  
Primary Care Setting ◽  
Diagnostic Techniques ◽  
Mandibular Asymmetry ◽  
Contemporary Management

Patients commonly present to orthodontists with complaints of facial and/or mandibular asymmetry. It is important that all asymmetry complaints are taken seriously and further investigated. Orthodontists play an important role in the diagnosis, management and follow-up of these conditions. For condylar hyperactivity, management is generally in a multidisciplinary setting. Clinicians who practice orthodontics in a primary care setting need to be aware of the correct terminology and the appropriate investigations required for diagnosis and the management of this condition. This paper aims to describe the contemporary management of condylar hyperactivity and presents a case of combined orthodontic-surgical treatment. CPD/Clinical Relevance: Condylar hyperactivity can lead to severe orofacial deformities and severe malocclusions. The orthodontist must understand the terminology, diagnostic techniques and treatment of this condition in order to offer the most appropriate management. The entire dental team may be involved in cases of condylar hyperactivity from diagnosis through to follow-up. Increased awareness may therefore improve diagnosis and ensure appropriate early referrals are made, thus potentially improving outcomes.

scholarly journals Impact of a diabetes disease management program on quality of care and costs: propensity score-matched real-world data from Switzerland.

2020 ◽  
Author(s):  
Maria Carlander ◽  
Marc Hoeglinger ◽  
Maria Trottmann ◽  
Birgitta Rhomberg ◽  
Cornelia Caviglia ◽  
...  
Keyword(s):  
Primary Care ◽  
Disease Management ◽  
Propensity Score ◽  
Guideline Adherence ◽  
Care Setting ◽  
Primary Care Setting ◽  
Management Program ◽  
Control Group

Objectives Structured treatment programs have been recommended for management of patients with chronic conditions to overcome ill-coordinated care. We aimed to evaluate a disease management program (DMP) with for diabetes mellitus in Switzerland. Methods We performed a prospective observational study with a propensity score-matched usual care control group from a claims database. We included type-1 and type-2 diabetes patients from a primary care setting. The DMP (intervention) comprised a structured treatment approach with an individual treatment plan, treatment goals and an interprofessional team approach. Our outcome comprehensive measures included quality of life (QOL: EQ-5D-5L), pre-defined indicators for diabetes guideline adherence, number of used services and direct medical costs. We applied a difference-in-difference (DID) approach to compare DMP with usual care (follow-up 1 year). Costs were calculated with non-parametric bootstrapping (2017 Swiss Francs, CHF; conversion rate to Euros: 0.85) from a third-party payer perspective (Swiss health care insurance). Results QOL in a sub-sample of 80 patients did not change during follow-up (mean utility 0.89 at baseline and follow-up; p=0.94). Guideline adherence showed slight improvements for DMP. For example, non-adherence (baseline DMP: 19%) decreased in the DMP group by -3 %-points (DID; 95%-CI: -0.07 to 0.01) but not in the control group. A general trend emerged, though mostly not statistically significant, with less used services in the DMP group compared to the control group. Costs increased in both groups during follow-up, but the increase was higher in the control group (DID, mean total costs per patient per year: CHF -950.00 [95%-CI: -1959.53 to 59.56]). Such a negative difference-in-difference estimate in favor of DMP also emerged for cost sub-categories (e.g. costs for inpatient and outpatient care). Conclusions The structured treatment program under evaluation is a promising approach to improve diabetes care in a Swiss primary care setting but more follow-up data are needed.

scholarly journals Patients’ Utilization and Perception of an Artificial Intelligence–Based Symptom Assessment and Advice Technology in a British Primary Care Waiting Room: Exploratory Pilot Study

10.2196/19713 ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. e19713 ◽  
Author(s):  
Stephen Miller ◽  
Stephen Gilbert ◽  
Vishaal Virani ◽  
Paul Wicks
Keyword(s):  
Artificial Intelligence ◽  
Primary Care ◽  
Pilot Study ◽  
Health System ◽  
Care Setting ◽  
Primary Care Setting ◽  
Symptom Assessment ◽  
Medical Attention ◽  
Self Assessment ◽  
Care Clinic

Background When someone needs to know whether and when to seek medical attention, there are a range of options to consider. Each will have consequences for the individual (primarily considering trust, convenience, usefulness, and opportunity costs) and for the wider health system (affecting clinical throughput, cost, and system efficiency). Digital symptom assessment technologies that leverage artificial intelligence may help patients navigate to the right type of care with the correct degree of urgency. However, a recent review highlighted a gap in the literature on the real-world usability of these technologies. Objective We sought to explore the usability, acceptability, and utility of one such symptom assessment technology, Ada, in a primary care setting. Methods Patients with a new complaint attending a primary care clinic in South London were invited to use a custom version of the Ada symptom assessment mobile app. This exploratory pilot study was conducted between November 2017 and January 2018 in a practice with 20,000 registered patients. Participants were asked to complete an Ada self-assessment about their presenting complaint on a study smartphone, with assistance provided if required. Perceptions on the app and its utility were collected through a self-completed study questionnaire following completion of the Ada self-assessment. Results Over a 3-month period, 523 patients participated. Most were female (n=325, 62.1%), mean age 39.79 years (SD 17.7 years), with a larger proportion (413/506, 81.6%) of working-age individuals (aged 15-64) than the general population (66.0%). Participants rated Ada’s ease of use highly, with most (511/522, 97.8%) reporting it was very or quite easy. Most would use Ada again (443/503, 88.1%) and agreed they would recommend it to a friend or relative (444/520, 85.3%). We identified a number of age-related trends among respondents, with a directional trend for more young respondents to report Ada had provided helpful advice (50/54, 93%, 18-24-year olds reported helpful) than older respondents (19/32, 59%, adults aged 70+ reported helpful). We found no sex differences on any of the usability questions fielded. While most respondents reported that using the symptom checker would not have made a difference in their care-seeking behavior (425/494, 86.0%), a sizable minority (63/494, 12.8%) reported they would have used lower-intensity care such as self-care, pharmacy, or delaying their appointment. The proportion was higher for patients aged 18-24 (11/50, 22%) than aged 70+ (0/28, 0%). Conclusions In this exploratory pilot study, the digital symptom checker was rated as highly usable and acceptable by patients in a primary care setting. Further research is needed to confirm whether the app might appropriately direct patients to timely care, and understand how this might save resources for the health system. More work is also needed to ensure the benefits accrue equally to older age groups.

scholarly journals Reduction of corticosteroid use in outpatient treatment of exacerbated COPD – Study protocol for a randomized, double-blind, non-inferiority study (The “RECUT”-Trial)

2019 ◽  
Author(s):  
Pascal Urwyler ◽  
Maria Boesing ◽  
Kristin Abig ◽  
Marco Cattaneo ◽  
Thomas Dieterle ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Day Treatment ◽  
Corticosteroid Treatment ◽  
Double Blind ◽  
Corticosteroid Dose ◽  
Copd Exacerbations ◽  
Copd Patients

Abstract Background Chronic obstructive pulmonary disease (COPD) is a major public health issue affecting approximately four to seven percent of the Swiss population. According to current inpatient guidelines, systemic corticosteroids are important in the treatment of acute COPD exacerbations and should be given for five to seven days. Several studies suggest that corticosteroids accelerate the recovery of the FEV1 (forced expiratory volume in one second), enhance oxygenation, decrease duration of hospitalization and improve clinical outcome. However, the additional therapeutic benefit on FEV1 recovery appears to be most apparent in the first three to five days. No data are available on the minimal necessary corticosteroid dose and treatment duration in primary care patients with acute COPD exacerbations. Given that many COPD patients are treated on an outpatient basis, there is an urgent need to improve evidence about COPD management in this setting. The aim of this study is to investigate whether a three-day treatment with orally administered corticosteroids is non-inferior to a five-day treatment in acute exacerbations of COPD in a primary care setting. Methods The proposed study is a prospective, double-blind, randomized controlled trial conducted in a primary care setting, including an anticipated number of 470 patients with acutely exacerbated COPD. Participants are randomised to receive systemic corticosteroid treatment of 40 mg prednisone daily for five days (conventional arm, n = 235), or for three days, followed by two days of placebo (experimental arm, n = 235). Antibiotic treatment for seven days is given to all patients with CRP ≥ 50 mg/l, known diagnosis of bronchiectasis, or presenting with Anthonisen Type-I exacerbation. Additional treatment after inclusion is left at the discretion of the treating general practitioner. Follow-up visits are performed on days three and seven by the treating general practitioners, followed by telephone interviews on days 30, 90 and 180 after inclusion into the study. Primary endpoint is the time to next exacerbation during a six-months follow-up period, which includes re-exacerbation during index exacerbation. Discussion This study is designed to assess whether a three-day course of corticosteroid treatment is not inferior to the current conventional five-day treatment course in outpatients with exacerbated COPD regarding time to next exacerbation. Depending on the results, this trial might lead to a further reduction of cumulative corticosteroid dose in COPD patients.

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