scholarly journals Who are we missing with EHR-based smoking cessation treatments? A descriptive study of patients who smoke and do not regularly visit primary care clinics

2020 ◽  
Vol 15 (4) ◽  
pp. 175-180
Author(s):  
Margaret Nolan ◽  
Deejay Zwaga ◽  
Danielle McCarthy ◽  
Christian Kastman ◽  
Timothy Baker ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Provider ◽  
Primary Care Provider ◽  
The United States ◽  
Primary Care Visit ◽  
Patient Portal ◽  
The Past ◽  
Healthcare Settings ◽  
Care Visit ◽  
Tobacco Treatment

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.

Public Expectations for Nonemergency Hospital Resources and Services During Disasters

2013 ◽  
Vol 7 (2) ◽  
pp. 167-174 ◽  
Author(s):  
Rachel L. Charney ◽  
Terri Rebmann ◽  
Cybill R. Esguerra ◽  
Charlene W. Lai ◽  
Preeti Dalawari
Keyword(s):  
Primary Care ◽  
Resource Utilization ◽  
Care Provider ◽  
Primary Care Provider ◽  
The Past ◽  
Public Expectations ◽  
Higher Ed ◽  
Public Risk ◽  
Hospital Resources ◽  
Ed Visits

AbstractObjectiveThe public's expectations of hospital services during disasters may not reflect current hospital disaster plans. The objective of this study was to determine the public's expected hospital service utilization during a pandemic, earthquake, and terrorist bombing.MethodsA survey was distributed to adult patients or family members at 3 emergency departments (EDs). Participants identified resources and services they expect to need during 3 disaster scenarios. Linear regression was used to describe factors associated with higher expected utilization scores for each scenario.ResultsOf the 961 people who participated in the study, 66.9% were women, 47.5% were white, and 44.6% were black. Determinants of higher pandemic resource utilization included persons who were younger (P < .01); non-white (P < .001); had higher ED visits (P < .01), hospitalization (P = .001), or fewer primary care provider visits (P = .001) in the past year; and did not having a reunification plan (P < .001). Determinants of higher earthquake resource utilization included persons who were non-white (P < .001); who were a patient or spouse (vs parent) participating in the study (P < .05 and P = .001); and had higher ED visits in the past year (P = .001). Determinants of higher bombing resource utilization included persons who were female (P = .001); non-white (P < .001); had higher ED (P = .001) or primary care provider (P < .01) visits in past year; and experienced the loss of home or property during a past disaster (P < .05).ConclusionsPublic expectations of hospitals during disasters are high, and some expectations are inappropriate. Better community disaster planning and public risk communication are needed. (Disaster Med Public Health Preparedness. 2013;0:1–8)

Back and Limb Pain

2018 ◽  
pp. 117-148
Author(s):  
Andrea C. Adams
Keyword(s):  
United States ◽  
Primary Care ◽  
Low Back Pain ◽  
Back Pain ◽  
Care Provider ◽  
Primary Care Provider ◽  
Diagnostic Tests ◽  
The United States ◽  
Spine Pain ◽  
Acute Back Pain

Back (spine) pain is a common problem. Low back pain is estimated to occur in up to 80% of adults and is the greatest cause of lost workdays in the United States. The cause of acute back pain is usually musculoskeletal. Most patients with back pain can be cared for by their primary care provider without the need for specialist consultation or diagnostic tests.

scholarly journals Integrating Genomic Screening into Primary Care: Provider Experiences Caring for Latino Patients at a Community-Based Health Center

2021 ◽  
Vol 12 ◽  
pp. 215013272110002
Author(s):  
Tarika Srinivasan ◽  
Erica J. Sutton ◽  
Annika T. Beck ◽  
Idali Cuellar ◽  
Valentina Hernandez ◽  
...  
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Patient Care ◽  
Health Center ◽  
Care Provider ◽  
Primary Care Provider ◽  
Genomic Sequencing ◽  
Community Based ◽  
Genomic Screening

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.

Interventions to improve primary care provider management of atopic dermatitis: A systematic review

2021 ◽  
Author(s):  
Emily A. Croce ◽  
Fabiana C. P. S. Lopes ◽  
Jennifer Ruth ◽  
Jonathan I. Silverberg
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Atopic Dermatitis ◽  
Care Provider ◽  
Primary Care Provider

Parent and Primary Care Provider Priorities for Wellness in Early Childhood: A Discrete Choice Experiment

2021 ◽  
Author(s):  
Stephanie L. Mayne ◽  
Chloe Hannan ◽  
Jennifer Faerber ◽  
Rupreet Anand ◽  
Ella Labrusciano-Carris ◽  
...  
Keyword(s):  
Primary Care ◽  
Early Childhood ◽  
Discrete Choice Experiment ◽  
Discrete Choice ◽  
Care Provider ◽  
Primary Care Provider ◽  
Choice Experiment

scholarly journals The Digital Divide: A Retrospective Survey of Digital Rectal Examinations during the Workup of Rectal Cancers

Healthcare ◽  
2021 ◽  
Vol 9 (7) ◽  
pp. 855
Author(s):  
Omar Farooq ◽  
Ameer Farooq ◽  
Sunita Ghosh ◽  
Raza Qadri ◽  
Tanner Steed ◽  
...  
Keyword(s):  
Primary Care ◽  
Rectal Cancer ◽  
Care Provider ◽  
Primary Care Provider ◽  
Demographic Data ◽  
Significant Proportion ◽  
Digital Rectal Examination ◽  
Patient Questionnaire ◽  
Rectal Examination ◽  
Rectal Cancers

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.

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