Abstract #81: Osteoporosis Screening by Primary Care Physicians in an Inner City Teaching Hospital in Brooklyn

2004 ◽  
Vol 10 ◽  
pp. 27
Author(s):  
Vaidehi Kaza ◽  
Eric A. Jaffe ◽  
Gerald Posner ◽  
Maria Ferandez-Renedo ◽  
Zewge S. Deribe
Keyword(s):  
Primary Care ◽  
Inner City ◽  
Teaching Hospital ◽  
Primary Care Physicians ◽  
Osteoporosis Screening

scholarly journals UNDERSTANDING OSTEOPOROSIS SCREENING PRACTICES IN MEN: A NATIONWIDE PHYSICIAN SURVEY

2020 ◽  
Vol 26 (11) ◽  
pp. 1237-1243
Author(s):  
Palak Choksi ◽  
Brittany L. Gay ◽  
David Reyes-Gastelum ◽  
Megan R. Haymart ◽  
Maria Papaleontiou
Keyword(s):  
Primary Care ◽  
Confidence Interval ◽  
Primary Care Physicians ◽  
Menopausal Woman ◽  
Significant Past Medical History ◽  
Endocrine Society ◽  
Osteoporosis Screening ◽  
Screening Practices ◽  
Clinical Scenarios ◽  
History Of

Objective: To understand osteoporosis screening practices, particularly in men, by a diverse cohort of physicians, including primary care physicians, endocrinologists, and geriatricians. Methods: We surveyed randomly selected members of the American Academy of Family Practice, Endocrine Society, and American Geriatrics Society. Respondents were asked to rate how often they would screen for osteoporosis in four different clinical scenarios by ordering a bone density scan. Multivariable logistic regression analyses were conducted to determine factors associated with offering osteoporosis screening in men in each clinical scenario. Physicians were also asked to note factors that would lead to osteoporosis screening in men. Results: Response rate was 63% (359/566). While 90% respondents reported that they would always or frequently screen for osteoporosis in a 65-year-old post-menopausal woman, only 22% reported they would screen a 74-year-old man with no significant past medical history. Endocrinologists were more likely to screen a 74-year-old man compared to primary care physicians (odds ratio, 2.32; 95% confidence interval, 1.10 to 4.88). In addition to chronic steroid use (94%), history of nontraumatic fractures (88%), and androgen-deprivation therapy for prostate cancer (82%), more than half the physicians reported suppressive doses of thyroid hormone (64%) and history of falls (52%) as factors leading to screening for osteoporosis in men. Conclusion: Our survey results highlight heterogeneity in osteoporosis screening in men, with underscreening in some scenarios compared to women, and identify factors that lead to screening in men. These findings can help design interventions to improve osteoporosis screening in men. Abbreviation: CI = confidence interval

scholarly journals High-Users of Acute Care in a Teaching Hospital: A Retrospective Chart Review and Survey of Primary Care Physicians

2020 ◽  
Vol 15 (3) ◽  
pp. 28-42
Author(s):  
Arpita Gantayet ◽  
Pamela Mathura ◽  
Alexis Fong-Leboeuf ◽  
Natalie McMurtry ◽  
Julie Zhang ◽  
...  
Keyword(s):  
Primary Care ◽  
Acute Care ◽  
Teaching Hospital ◽  
Primary Care Physicians ◽  
Retrospective Chart Review ◽  
High User ◽  
Soins Intensifs ◽  
Soins À Domicile ◽  
Tertiary Teaching ◽  
Ed Visits

PurposeTo characterize high-users (HUs) of inpatient units, obtain insights from their primary care physicians (PCPs) and identify factors that can be modified to reduce resource use. MethodThe study design included retrospective chart reviews of high-user patients and qualitative surveys of their PCPs. HUs were defined as adults with 3 or more admissions to an index tertiary teaching hospital in Edmonton as well as a cumulative length of stay (cLOS) greater than 30 days at any hospital in the province of Alberta, between September 1, 2015 and September 30, 2016. The charts of HUs were reviewed to assess demographics, admitting and consulting services, medical profile, social profile, community supports, and scores on pre-existing risk-stratification tools to identify patient factors that might be characteristic of HUs. Additionally, a survey comprising 12 multiple-choice and 8 short-answer questions was faxed to their PCPs to assess HU attitudes and behaviors and collect recommendations to prevent high use of acute care. ResultsOf 125 HUs (median 62 years old, 5 admissions, cLOS 49 days, 14 emergency department (ED) visits, 10 medications), 74% lived at home, 86% had a PCP, 56% received homecare pre-admission and 34% had at least one critical care admission. HUs accounted for 2474 admissions or ED visits (median 14, IQR 10-22) at all sites in the year studied; 41% of their 1605 ED visits and 21% of their 869 admissions were at other hospitals. Their most prevalent comorbidities were hypertension, depression, and diabetes. 49 responses were received to 114 faxed surveys (43% response rate). Only 14 of 49 responding PCPs suggested interventions to address ED revisits and readmissions; PCPs most frequently cited living conditions and lack of social supports as key causative factors.ConclusionsWe have characterized high-user patients and discussed PCP perspectives and strategies to optimize their healthcare use. Resume ObjetCaractériser les grands utilisateurs (HU) des unités d’hospitalisation, obtenir des informations de leurs médecins de soins primaires (PCP) et identifier les facteurs qui peuvent être modifiés pour réduire l’utilisation des ressources. MéthodeLa conception de l’étude comprenait des examens rétrospectifs de dossiers de patients très utilisateurs et des enquêtes qualitatives sur leurs PPC. Les UH ont été définis comme des adultes ayant été admis à trois reprises ou plus dans un hôpital universitaire tertiaire d’Edmonton et dont la durée de séjour cumulée (DSC) est supérieure à 30 jours dans n’importe quel hôpital de la province de l’Alberta, entre le 1er septembre 2015 et le 30 septembre 2016. Les tableaux des HU ont été examinés afin d’évaluer les données démographiques, les services d’admission et de consultation, le profil médical, le profil social, les soutiens communautaires et les scores des outils de stratification des risques préexistants afin d’identifier les facteurs des patients qui pourraient être caractéristiques des HU. En outre, une enquête comprenant 12 questions à choix multiple et 8 questions à réponse courte a été envoyée par fax à leurs PCP afin d’évaluer les attitudes et les comportements des HU et de recueillir des recommandations pour prévenir un recours élevé aux soins de courte durée. RésultatsSur 125 HU (âge médian 62 ans, 5 admissions, cLOS 49 jours, 14 visites aux urgences, 10 médicaments), 74 % vivaient à domicile, 86 % avaient un PCP, 56 % recevaient des soins à domicile avant leur admission et 34 % avaient au moins une admission en soins intensifs. Les HU ont représenté 2474 admissions ou visites aux urgences (médiane 14, IQR 10-22) dans tous les sites au cours de l’année étudiée ; 41% de leurs 1605 visites aux urgences et 21% de leurs 869 admissions se sont faites dans d’autres hôpitaux. Leurs comorbidités les plus fréquentes étaient l’hypertension, la dépression et le diabète. 49 réponses ont été reçues pour 114 enquêtes envoyées par fax (taux de réponse de 43 %). Seuls 14 des 49 PCP ayant répondu ont suggéré des interventions pour remédier aux problèmes des visites aux urgences et des réadmissions; les PCP ont le plus souvent cité les conditions de vie et le manque de soutien social comme principaux facteurs de causalité. ConclusionsNous avons caractérisé les patients grands utilisateurs et discuté des perspectives et des stratégies de la PCP pour optimiser leur utilisation des soins de santé.

scholarly journals Family violence among mothers seen at the University of Ilorin Teaching Hospital, Ilorin, Nigeria

2008 ◽  
Vol 14 (3) ◽  
pp. 7 ◽  
Author(s):  
B A Ayinmode ◽  
M F Tunde-Ayinmode
Keyword(s):  
Primary Care ◽  
Family Violence ◽  
Teaching Hospital ◽  
Primary Care Physicians ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Facility ◽  
Cross Sectional ◽  
The University ◽  
Self Reporting Questionnaire

<p><strong>Objective.</strong> The attention given to family violence (FV) in primary medical care in Nigeria is still very insufficient in relation to its known adverse medical and psychosocial implications for women’s health. The objective of this preliminary study was to assess the prevalence rate, correlates and effects of FV among mothers attending a primary care facility in Nigeria, with the aim of gaining an understanding of whether screening for FV in the primary care setting in Nigeria would be beneficial.</p><p><strong>Methodology</strong> . A cross-sectional study of FV among 250 mothers attending the General Outpatient Department of the University of Ilorin Teaching Hospital was undertaken over a 5-month period. Data on the mothers’ sociodemographic characteristics, and experience of FV and its psychosocial correlates and effects were collected using a semi-structured questionnaire and a 20-item Self- Reporting Questionnaire (SRQ) as instruments. <strong></strong></p><p><strong>Data analysis</strong> . EPI Info version 6 was used to analyse the data.<strong> </strong></p><p><strong>Results</strong>. Sixty-nine mothers (28%) had experienced FV at the hands of their husbands. Of these women, 49 (71%) indicated occurrences within the preceding 2 years; in 17 (25%), the violence was severe enough to warrant a hospital visit or treatment. Mothers who experienced FV were significantly more likely to have had previous experiences of violence by an in-law; to have reported child cruelty by a husband; to have children with difficult behaviour; and to have reported that they were neglected by their husbands and not enjoying their marriages. They were also significantly more likely to have a high score on the SRQ and be identified as probable cases with psychological problems (SRQ score ≥ 5). <strong></strong></p><p><strong>Conclusion.</strong> In view of these findings, screening for FV in the primary care setting would be beneficial. Primary care physicians should therefore increase their interest, improve their skill, and carry out more research in the identification and management of FV.</p>

A Preliminary Retrospective Treatment and Pharmacoeconomic Analysis of Asthma Care Provided by Allergists, Immunologists, and Primary Care Physicians in a Teaching Hospital

2002 ◽  
Vol 39 (5) ◽  
pp. 405-412 ◽  
Author(s):  
Marianne Frieri ◽  
Jaya Therattil ◽  
Deborah Dellavecchia ◽  
Susan Rockitter ◽  
Jeff Pettit ◽  
...  
Keyword(s):  
Primary Care ◽  
Teaching Hospital ◽  
Primary Care Physicians ◽  
Pharmacoeconomic Analysis ◽  
Asthma Care

Fool’s Gold: Psychologists Using Disingenuous Reasoning to Mislead Legislatures into Granting Psychologists Prescriptive Authority

2003 ◽  
Vol 29 (4) ◽  
pp. 489-524
Author(s):  
Brent Pollitt
Keyword(s):  
Primary Care ◽  
Mental Illness ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
American Psychological Association ◽  
The United States ◽  
Psychotropic Medications ◽  
American Psychological ◽  
Training Requirements ◽  
Prescriptive Authority

Mental illness is a serious problem in the United States. Based on “current epidemiological estimates, at least one in five people has a diagnosable mental disorder during the course of a year.” Fortunately, many of these disorders respond positively to psychotropic medications. While psychiatrists write some of the prescriptions for psychotropic medications, primary care physicians write more of them. State legislatures, seeking to expand patient access to pharmacological treatment, granted physician assistants and nurse practitioners prescriptive authority for psychotropic medications. Over the past decade other groups have gained some form of prescriptive authority. Currently, psychologists comprise the primary group seeking prescriptive authority for psychotropic medications.The American Society for the Advancement of Pharmacotherapy (“ASAP”), a division of the American Psychological Association (“APA”), spearheads the drive for psychologists to gain prescriptive authority. The American Psychological Association offers five main reasons why legislatures should grant psychologists this privilege: 1) psychologists’ education and clinical training better qualify them to diagnose and treat mental illness in comparison with primary care physicians; 2) the Department of Defense Psychopharmacology Demonstration Project (“PDP”) demonstrated non-physician psychologists can prescribe psychotropic medications safely; 3) the recommended post-doctoral training requirements adequately prepare psychologists to prescribe safely psychotropic medications; 4) this privilege will increase availability of mental healthcare services, especially in rural areas; and 5) this privilege will result in an overall reduction in medical expenses, because patients will visit only one healthcare provider instead of two–one for psychotherapy and one for medication.

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