The treatment of depression in older adults in the primary care setting: An evidence-based review.

Abstract Background The primary care setting offers an attractive opportunity for, not only the identification of pediatric eating disorders, but also the delivery of evidence-based treatment. However, constraints of this setting pose barriers for implementing treatment. For interventions to be successful, they need to take into consideration the perspectives of stakeholders. As such, the purpose of this study was to examine in-depth primary care providers’ perspective of challenges to identifying and managing eating disorders in the primary care setting. Methods This mixed methods study surveyed 60 Pediatric and Family Medicine providers across 6 primary care practices. Sixteen of these providers were further interviewed using a qualitative, semi-structured interview. Results Providers (n = 60, response rate of 45%) acknowledged the potential of primary care as a point of contact for early identification and treatment of pediatric eating disorders. They also expressed that this was an area of need in their practices. They identified numerous barriers to successful implementation of evidence-based treatment in this setting including scarcity of time, knowledge, and resources. Conclusions Investigations seeking to build capacities in primary care settings to address eating disorders must address these barriers.

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

Journal of Aging and Physical Activity ◽

10.1123/japa.2012-0120 ◽

2014 ◽

Vol 22 (1) ◽

pp. 16-24 ◽

Cited By ~ 5

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.

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A comprehensive framework and key guideline recommendations for the provision of evidence-based breast cancer survivorship care within the primary care setting

Family Practice ◽

10.1093/fampra/cmu082 ◽

2014 ◽

Vol 32 (2) ◽

pp. 129-140 ◽

Cited By ~ 7

Author(s):

M. Luctkar-Flude ◽

A. Aiken ◽

M. A. McColl ◽

J. Tranmer

Keyword(s):

Breast Cancer ◽

Primary Care ◽

Cancer Survivorship ◽

Care Setting ◽

Primary Care Setting ◽

Evidence Based ◽

Survivorship Care ◽

Breast Cancer Survivorship ◽

Comprehensive Framework

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A collaborative care management programme in a primary care setting was effective for older adults with late life depression

Evidence-Based Nursing ◽

10.1136/ebn.6.3.91 ◽

2003 ◽

Vol 6 (3) ◽

pp. 91-91 ◽

Cited By ~ 3

Author(s):

L. Slimmer

Keyword(s):

Older Adults ◽

Primary Care ◽

Collaborative Care ◽

Care Management ◽

Care Setting ◽

Primary Care Setting ◽

Late Life ◽

Management Programme ◽

Late Life Depression

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Physical fitness assessment of older adults in the primary care setting

Journal of the American Academy of Nurse Practitioners ◽

10.1111/j.1745-7599.2008.00391.x ◽

2009 ◽

Vol 21 (2) ◽

pp. 101-107 ◽

Cited By ~ 24

Author(s):

Janet Purath ◽

Susan W. Buchholz ◽

Deborah L. Kark

Keyword(s):

Older Adults ◽

Primary Care ◽

Physical Fitness ◽

Care Setting ◽

Primary Care Setting ◽

Fitness Assessment

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Prevalence of dementia and cognitive impairment with no dementia in a primary care setting in southern Brazil

Arquivos de Neuro-Psiquiatria ◽

10.1590/0004-282x-anp-2020-0410 ◽

2021 ◽

Vol 79 (7) ◽

pp. 565-570

Author(s):

Sérgio Ferreira de Ferreira-Filho ◽

Wyllians Vendramini Borelli ◽

Rodrigo Mantovani Sguario ◽

Gustavo Fiorentin Biscaia ◽

Vitória Schneider Müller ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Cognitive Impairment ◽

Cognitive Decline ◽

Medical Records ◽

Care Setting ◽

Primary Care Setting ◽

Cognitive Screening ◽

Southern Brazil ◽

Symptoms Of Depression

ABSTRACT Background: Cognitive decline is a common condition, but is still underrepresented in studies conducted in developing countries. Objective: To calculate the prevalence of cognitive decline and depression in an elderly community-dwelling population in a city in southern Brazil. Methods: We calculated the prevalences of dementia, cognitive impairment with no dementia (CIND) and symptoms of depression in an elderly population relying on the public healthcare system. This epidemiological study in Pelotas, Brazil, was conducted within the primary care setting. It included 299 older adults (mean age = 69.75 ± 7.6 years) who presented low levels of education (mean = 4.16 ± 3.17 years of education). They underwent cognitive screening and their medical records were analyzed. Results: Among these older adults, 142 (47.5%) presented cognitive decline: 104 (34.8%) matching the cognitive criteria for CIND and 38 (12.7%) matching the cognitive criteria for dementia. Among all the individuals who completed the cognitive screening, 141 (48.4%) were positive for symptoms of depression, of whom 99 (34%) did not have any previous diagnosis in their medical records. Conclusion: There was high prevalence of cognitive impairment among these older adults in a primary care setting. A large number of older adults were found to have symptoms of depression without any diagnosis.

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A pilot feasibility randomized controlled trial on combining mind-body physical exercise, cognitive training, and nurse-led risk factor modification to reduce cognitive decline among older adults with mild cognitive impairment in primary care

PeerJ ◽

10.7717/peerj.9845 ◽

2020 ◽

Vol 8 ◽

pp. e9845

Author(s):

Zijun Xu ◽

Dexing Zhang ◽

Allen T.C. Lee ◽

Regina W.S. Sit ◽

Carmen Wong ◽

...

Keyword(s):

Older Adults ◽

Primary Care ◽

Risk Factor ◽

Hong Kong ◽

Care Setting ◽

Primary Care Setting ◽

Controlled Trial ◽

Risk Factor Modification ◽

Randomized Controlled ◽

Factor Modification

Objectives To examine the feasibility and preliminary effectiveness of (1) combining cognitive training, mind-body physical exercise, and nurse-led risk factor modification (CPR), (2) nurse-led risk factor modification (RFM), and (3) health advice (HA) on reducing cognitive decline among older adults with mild cognitive impairment (MCI). Methods It was a 3-arm open-labeled pilot randomized controlled trial in the primary care setting in Hong Kong. Nineteen older adults with MCI were randomized to either CPR (n = 6), RFM (n = 7), or HA (n = 6) for 6 months. The primary outcome was the feasibility of the study. Secondary outcomes included the Alzheimer’s Disease Assessment Scale-Cognitive Subscale (ADAS-Cog), the Montreal Cognitive Assessment Hong Kong version (HK-MoCA), the Clinical Dementia Rating (CDR), the Disability Assessment for Dementia (DAD), quality of life, depression, anxiety, physical activity, health service utilization, and diet. Results Nineteen out the 98 potential patients were recruited, with a recruitment rate of 19% (95% CI [12–29]%, P = 0.243). The adherence rate of risk factor modification was 89% (95% CI [65–98]%, P = 0.139) for CPR group and 86% (95% CI [63–96]%, P = 0.182) for RFM group. In the CPR group, 53% (95% CI [36–70]%, P = 0.038) of the Tai Chi exercise sessions and 54% (95% CI [37–71]%, P = 0.051) of cognitive sessions were completed. The overall dropout rate was 11% (95% CI [2–34]%, P = 0.456). Significant within group changes were observed in HK-MoCA in RFM (4.50 ± 2.59, P = 0.008), cost of health service utilization in CPR (−4000, quartiles: −6800 to −200, P = 0.043), fish and seafood in HA (−1.10 ± 1.02, P = 0.047), and sugar in HA (2.69 ± 1.80, P = 0.015). Group × time interactions were noted on HK-MoCA favoring the RFM group (P = 0.000), DAD score favoring CPR group (P = 0.027), GAS-20 favoring CPR group (P = 0.026), number of servings of fish and seafood (P = 0.004), and sugar (P < 0.001) ate per day. Conclusions In this pilot study, RFM and the multi-domain approach CPR were feasible and had preliminary beneficial effects in older adults with MCI in primary care setting in Hong Kong. Trial registration Chinese Clinical Trial Registry (ChiCTR1800015324).

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