Patient’s experience with comorbidity management in primary care: a qualitative study of comorbid pain and obesity

2015 ◽  
Vol 17 (01) ◽  
pp. 33-41 ◽  
Author(s):  
E. Amy Janke ◽  
Michelle L. Ramirez ◽  
Brittany Haltzman ◽  
Megan Fritz ◽  
Andrea T. Kozak
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Comparative Method ◽  
Holistic Approach ◽  
Structured Interviews ◽  
Primary Care Settings ◽  
Lack Of Information ◽  
Motivation Enhancement ◽  
Primary Care Patients ◽  
Clinical Interactions

AimThe aim of this research is to examine perceptions of those with comorbid chronic pain and obesity regarding their experience of comorbidity management in primary care settings.BackgroundChronic pain and obesity are common comorbidities frequently managed in primary care settings. Evidence suggests individuals with this comorbidity may be at risk for suboptimal clinical interactions; however, treatment experiences and preferences of those with comorbid chronic pain and obesity have received little attention.MethodsSemi-structured interviews conducted with 30 primary care patients with mean body mass index=36.8 and comorbid persistent pain. The constant comparative method was used to analyze data.FindingsParticipants discussed frustration with a perceived lack of information tailored to their needs and a desire for a personalized treatment experience. Participants found available medical approaches unsatisfying and sought a more holistic approach to management. Discussions also focused around the need for providers to initiate efforts at education and motivation enhancement and to show concern for and understanding of the unique difficulties associated with comorbidity. Findings suggest providers should engage in integrated communication regarding weight and pain, targeting this multimorbidity using methods aligned with priorities discussed by patients.

scholarly journals Medication and treatment use in primary care patients with chronic pain of predominantly neuropathic origin

2007 ◽  
Vol 24 (5) ◽  
pp. 481-485 ◽  
Author(s):  
N. Torrance ◽  
B. H Smith ◽  
M. C Watson ◽  
M. I Bennett
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Primary Care Patients ◽  
Treatment Use

Facilitators and barriers for promoting healthy eating among primary care patients: results of a qualitative study among practice nurses

2021 ◽  
Author(s):  
Geertruida J Groenendijk-van Woudenbergh ◽  
Marlies C van Hell-Cromwijk ◽  
Ytje J J van der Veen ◽  
Hylkje F Algra ◽  
Willemieke Kroeze
Keyword(s):  
Primary Care ◽  
Communication Skills ◽  
Healthy Eating ◽  
Patient Encounter ◽  
Structured Interviews ◽  
Good Communication ◽  
Practice Nurses ◽  
Professional Characteristics ◽  
Primary Care Patients ◽  
Facilitators And Barriers

Abstract Background Practice nurses have an important role in promoting healthy eating to prevent or delay long-term complications from chronic lifestyle-related diseases. Objective To identify the facilitators and barriers encountered by practice nurses at a professional level when promoting healthy eating among patients. Methods Face-to-face semi-structured interviews were conducted with 21 Dutch practice nurses. Data were recorded, transcribed and analysed using inductive thematic analysis. Results Two main themes were determined: professional characteristics and professional–patient encounter. Professional characteristics included good communication skills and experience facilitated the successful promotion of healthy eating, while a lack of communication skills and lack of knowledge about diet were perceived as barriers. The most frequently identified facilitators for professional–patient encounter included ensuring a personal connection with patients, creating food awareness, focussing on small changes, adopting a tailored approach, motivating and arranging extra consultations. Barriers included lack of skills to raise the topic, lack of persistence, inability to find a common understanding, lack of competence in handling patients’ own choices and underuse of existing educational materials. Conclusions Further research using the identified facilitators and barriers for promoting healthy eating in primary care patients with chronic diseases could assist in the development of future training programmes for practice nurses.

scholarly journals The Impact of a Primary Care, Pharmacist-Driven Intervention in Patients with Chronic Non-Cancer Pain—A Pilot Study

Pharmacy ◽  
2020 ◽  
Vol 8 (3) ◽  
pp. 113
Author(s):  
Mo Chen ◽  
Tejal Patel ◽  
Feng Chang
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Chronic Pain ◽  
Cancer Pain ◽  
Family Health ◽  
Primary Care Settings ◽  
Pain Intervention ◽  
Family Health Team ◽  
The Impact

Background: Chronic pain is a prevalent condition, experienced by 15.3% to 55% of Canadians, that is difficult to manage. With their broad accessibility and expertise on drugs, primary care pharmacists can help patients optimize their pain management. Methods: The objective of this study is to examine the effectiveness of a primary care, pharmacist-driven chronic pain intervention on pain and quality of life in patients with chronic non-cancer pain. A three-month naturalistic prospective study was conducted in primary care settings (five community pharmacies and one Family Health Team) across Ontario, Canada with a total of six pharmacists and 19 study participants. The primary care, pharmacist-driven chronic pain intervention consisted of patient assessments, medication reviews, care plan recommendations, and patient education. In order to evaluate the effectiveness of the intervention, pain intensity, pain interference, and quality of life were evaluated at baseline and at follow up (week 2 and month 3). Results: Trends towards improvement in pain and quality of life were found, however, these improvements were not statistically significant at follow up (month 3). Conclusions: This study provides the foundational research required to better understand the impact of Ontario pharmacists’ extended role in pain management in non-cancer patients within multiple primary care settings (e.g., Family Health Team, etc.) and has illustrated the importance of modifying and customizing care plans in patients with chronic pain. A larger sample size with tailored outcome measures may be necessary to better highlight significant improvements in pain and quality of life in patients with chronic non-cancer pain using a primary care, pharmacist-driven intervention.

scholarly journals A sociological study of children with albinism at a special school in the Limpopo province

Curationis ◽  
2002 ◽  
Vol 25 (4) ◽  
Author(s):  
R.J. Gaigher ◽  
P.M. Lund ◽  
E. Makuya
Keyword(s):  
Holistic Approach ◽  
Medical Intervention ◽  
Limpopo Province ◽  
Special School ◽  
Structured Interviews ◽  
Sociological Study ◽  
Social Construct ◽  
Lack Of Information ◽  
Physical Environments ◽  
The Social

This article maintains that it is the social context, as much as, and sometimes more than the physical condition, that largely structures and limits the lives of people with albinism. It deals with albinism from a sociological, rather than a medical perspective. Viewed as such the problems experiencing by affected people stem primarily not from their physical differences but from the way others respond to those differences and from the social and physical environments they have to cope with. The article is based on a study of 32 children with albinism from a special school in the Limpopo province. Educational, health and social problems, attitudes and perceptions about albinism were tested by way of structured interviews. The data reveal an acute lack of information about the causes and consequences of albinism. It projects it as a condition still deeply immersed in myths and superstition resulting in the stigmatising and rejection of affected people. It also discloses a physical environment which is preventing rather than supporting people with albinism from reaching their potential. It calls for a reorientation in dealing with albinism -away from just medical intervention to treating it as a social construct requiring a holistic approach.

scholarly journals GPs’ experiences of children with anxiety disorders in primary care: a qualitative study

2017 ◽  
Vol 67 (665) ◽  
pp. e888-e898 ◽  
Author(s):  
Doireann O’Brien ◽  
Kate Harvey ◽  
Bridget Young ◽  
Tessa Reardon ◽  
Cathy Creswell
Keyword(s):  
Primary Care ◽  
Anxiety Disorders ◽  
Emotional Disorders ◽  
Medical Training ◽  
Comparative Method ◽  
Significant Proportion ◽  
Childhood Anxiety ◽  
Care Process ◽  
Structured Interviews ◽  
Specialist Services

BackgroundAnxiety disorders have a median age of onset of 11 years and are the most common emotional disorders in childhood; however, a significant proportion of those affected do not access professional support. In the UK, GPs are often the first medical professional that families see so are in a prime position to support children with anxiety disorders; however, currently there is little research available on GPs’ perspectives on and experiences of supporting children with these disorders.AimTo explore the experiences of GPs in relation to identification, management, and access to specialist services for children (<12 years) with anxiety disorders.Design and settingTwenty semi-structured interviews were conducted with GPs in primary care throughout England.MethodGPs reflected a diverse group in relation to the ethnic and socioeconomic profile of registered patients, GP age, sex, professional status, previous engagement with research, and practice size and location. Purposive sampling was used to recruit GPs until theoretical saturation was reached. Data were analysed using a constant comparative method of thematic analysis.ResultsData from 20 semi-structured interviews were organised into three themes: decision making, responsibility, and emotional response, with an overarching theme of GPs feeling ill equipped. These themes were retrospectively analysed to illustrate their role at different stages in the primary care process (identification, management, and access to specialist services).ConclusionGPs feel ill equipped to manage and support childhood anxiety disorders, demonstrating a need for medical training to include greater emphasis on children’s mental health, as well as potential for greater collaboration between primary and specialist services.

scholarly journals Randomized Trial of Chronic Pain Self-Management Program in the Community or Clinic for Low-Income Primary Care Patients

2018 ◽  
Vol 33 (5) ◽  
pp. 668-677 ◽  
Author(s):  
Barbara J. Turner ◽  
Yuanyuan Liang ◽  
Maureen J. Simmonds ◽  
Natalia Rodriguez ◽  
Raudel Bobadilla ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Randomized Trial ◽  
Low Income ◽  
Management Program ◽  
Self Management ◽  
Community Or ◽  
Primary Care Patients

scholarly journals Tele-ECG consulting and outcomes on primary care patients in a low-to-middle income population: the first experience from Makassar telemedicine program, Indonesia

2020 ◽  
Vol 21 (1) ◽  
Author(s):  
Idar Mappangara ◽  
Andriany Qanitha ◽  
Cuno S. P. M. Uiterwaal ◽  
Jose P. S. Henriques ◽  
Bastianus A. J. M. de Mol
Keyword(s):  
Primary Care ◽  
Female Gender ◽  
Middle Income ◽  
Healthcare Facilities ◽  
Primary Care Settings ◽  
Lower Blood ◽  
History Of ◽  
Primary Care Patients ◽  
Male Patients

Abstract Background Telemedicine has been a popular tool to overcome the lack of access to healthcare facilities, primarily in underprivileged populations. We aimed to describe and assess the implementation of a tele-electrocardiography (ECG) program in primary care settings in Indonesia, and subsequently examine the short- and mid-term outcomes of patients who have received tele-ECG consultations. Methods ECG recordings from thirty primary care centers were transmitted to Makassar Cardiac Center, Indonesia from January to July 2017. We cross-sectionally measured the performance of this tele-ECG program, and prospectively sent a detailed questionnaire to general practitioners (GPs) at the primary care centers. We performed follow-up at 30 days and at the end of the study period to assess the patient outcomes. Results Of 505 recordings, all (100%) ECGs were qualified for analysis, and about half showed normal findings. The mean age of participants was 53.3 ± 13.6 years, and 40.2% were male. Most (373, 73.9%) of these primary care patients exhibited manifested CVD symptom with at least one risk factor. Male patients had more ischemic ECGs compared to women (p < 0.01), while older age (> 55 years) was associated with ischemic or arrhythmic ECGs (p < 0.05). Factors significantly associated with a normal ECG were younger age, female gender, lower blood pressure and heart rate, and no history of previous cardiovascular disease (CVD) or medication. More patients with an abnormal ECG had a history of hypertension, known diabetes, and were current smokers (p < 0.05). Of all tele-consultations, GPs reported 95% of satisfaction rate, and 296 (58.6%) used tele-ECG for an expert opinion. Over the total follow-up (14 ± 6.6 months), seven (1.4%) patients died and 96 (19.0%) were hospitalized for CVD. Of 88 patients for whom hospital admission was advised, 72 (81.8%) were immediately referred within 48 h following the tele-ECG consultation. Conclusions Tele-ECG can be implemented in Indonesian primary care settings with limited resources and may assist GPs in immediate triage, resulting in a higher rate of early hospitalization for indicated patients.

scholarly journals Clinical Factors Associated With Prescription Drug Use Disorder in Urban Primary Care Patients with Chronic Pain

2010 ◽  
Vol 11 (11) ◽  
pp. 1047-1055 ◽  
Author(s):  
Jane M. Liebschutz ◽  
Richard Saitz ◽  
Roger D. Weiss ◽  
Tali Averbuch ◽  
Sonia Schwartz ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Drug Use ◽  
Prescription Drug ◽  
Clinical Factors ◽  
Factors Associated ◽  
Prescription Drug Use ◽  
Primary Care Patients ◽  
Drug Use Disorder
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