scholarly journals 971. Online Medical Education Improves Knowledge of Data on Appropriate and Timely Use of Influenza Antiviral Medications to Patients at High Risk for Influenza-Related Complications and Morbidity

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S577-S578
Author(s):  
Allison Armagan ◽  
Roderick Smith
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Online Education ◽  
Primary Care Physicians ◽  
Statistical Tests ◽  
Influenza B ◽  
Video Lecture ◽  
Cohen’S D ◽  
Cohen's D ◽  
Antiviral Medications

Abstract Background Many patients are at a higher risk of influenza complications because of age and comorbidities. We sought to assess whether online education, focused on appropriate and timely use of influenza antiviral medications to patients at high risk for influenza-related complications and morbidity, could improve knowledge, competence, and confidence of clinicians. Methods Primary care physicians (PCPs) and pediatricians participated in a 30-minute video lecture with synchronized slides. Educational effect was assessed using a repeated-pairs design with pre-/post-assessment. Three multiple choice questions assessed knowledge/competence, and 1 question assessed confidence. Statistical tests to assess significance: Paired samples t-test for overall average number of correct responses and for confidence rating; McNemar’s test for individual questions (5% significance level, P < .05). Cohen’s d estimated the effect size impact on number of correct responses (< .20 modest, .20-.49 small, .59-.79 moderate, ≥.80 large). Data were collected from 10/28/20 to 12/23/20. Results Average knowledge/competence improved from 29% to 43% (N=430, P< .001, Cohen’s d = 0.46) among primary care physicians and from 31% to 43% (N=226, P< .001, Cohen’s d = 0.38) among pediatricians. Post participation, 12% more PCPs and pediatricians answered all questions correctly. Relative improvements post-participation in specific areas were as follows (P< .001): (i) 105% improvement among PCPs and 100% improvement among pediatricians in findings associated with the efficacy of treatment with antivirals for influenza in hospitalized patients. (ii) 117% improvement among PCPs and 104% improvement among pediatricians in identifying the antiviral with the greatest activity against influenza B viral strain as reported in a phase 3 clinical trial. (iii) 34% of PCPs and 46% of pediatricians had a measurable improvement in confidence after completing the program. Conclusion This study demonstrated the success of a video lecture with synchronized slides at improving PCPs and pediatricians knowledge, competence and confidence related to appropriate and timely use of influenza antiviral medications to patients at high risk for influenza-related complications and morbidity. Disclosures All Authors: No reported disclosures

scholarly journals Louisiana Geriatric Workforce Enhancement Program: Analysis of Learning Outcomes From Dementia Training

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 58-58
Author(s):  
Katherine Kirsch ◽  
Catherine Lemieux ◽  
Laura Ainsworth ◽  
Sarah Choate ◽  
Ashleigh Borgmeyer ◽  
...  
Keyword(s):  
Primary Care ◽  
Program Analysis ◽  
Training Session ◽  
Cohen’S D ◽  
Response Formats ◽  
Cohen's D ◽  
Item Knowledge ◽  
South Louisiana ◽  
Severe Shortage ◽  
Primary Care Professionals

Abstract A recent Alzheimer’s Association report noted that by year 2050, the number of Americans diagnosed with Alzheimer’s disease and related dementias (ADRD) will triple to over 15 million. The report referred to primary care as the front line for meeting this demand, yet the nation faces a severe shortage of ADRD trained, primary care professionals (PCPs). Louisiana Geriatric Workforce Enhancement Program (LA-GWEP) addresses this demand. The purpose of this study was to examine preliminary data respective to LA-GWEP effectiveness with interdisciplinary education and training seminars, primarily aimed at medical, nursing, and social work PCPs. Three seminars were conducted in south Louisiana: Seminars 1 and 2 addressed effective communication, verbal and nonverbal, among persons with ADRD and caregivers; Seminar 3 offered basic overview of dementia symptomology, stages, and behaviors. Pre- and post-training session data were collected on-site. Participants completed questionnaires that included a 10-item knowledge assessment and 20-item Dementia Attitudes Scale (DAS). These measures contained Likert response formats; higher scores indicating greater levels of ADRD knowledge, in patient and caregiver contexts. Paired sample t-tests were conducted to observe any significant pre-to-post improvement, Cohen’s d for effect size. Seminar 1 revealed no significant pre-to-post difference: t = -1.019, p = 0.320. Adjusting content from audience feedback, Seminar 2 revealed significant pre-to-post difference: t = -7.516, p < .001, Cohen’s d = 1.2. Seminar 3 yielded significant improvement on DAS scores: t = -2.96, p < .01, Cohen’s d = 0.34. Implications for seminars in future years of LA-GWEP are discussed.

Abstract 3892: Brooklyn AWAReness of StrokE in Diabetes Mellitus

Stroke ◽  
2012 ◽  
Vol 43 (suppl_1) ◽  
Author(s):  
Kessarin Panichpisal ◽  
Benedict Tan ◽  
Yogesh Moradiya ◽  
Hasan Memon ◽  
Volodymyr Vulkanov ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Primary Care ◽  
Risk Factor ◽  
High Risk ◽  
Primary Care Physicians ◽  
Current Status ◽  
Medical Complications ◽  
High Risk Population ◽  
Diabetic Patients ◽  
Stroke Risk Factor

OBJECTIVE: Diabetes mellitus (DM) is a common risk factor for stroke. Hence stroke awareness is very critical in diabetic patients. In order to design effective educational strategies for stroke intervention and prevention in this high risk group, we assessed the current status of knowledge about stroke symptoms, risk factors and activation of emergency medical services in individuals with DM. METHOD: A hospital-based survey was conducted between February and August 2011. Subjects who have DM were interviewed at 2 sites by trained Internal medicine, Neurology residents and medical students using a structured, closed-ended questionnaire. RESULTS: Two hundred and thirty subjects were interviewed, 64% female and 71% Caribbean-American and African-American. Seventy five percent of subjects had hypertension. Only sixty percent of subjects knew that they were high risk of stroke and only 46% had been informed by their primary care physician about this risk. More than 75% did not know their hemoglobin a1c and cholesterol levels. Stroke and diabetic ketoacidosis were the least recognized medical complications of DM (29%) while diabetic foot ulcer and diabetic nephropathy were the most recognized complications (54%). Hypertension was the most identified stroke risk factor (66%). Eighty-nine percent of respondents identified two or more stroke symptoms. Only 58% of respondents would call 911 for a stroke scenario. Subjects having DM > 10 years (p=0.02) and graduating from high school (p=0.002) were more likely to call 911, while people who had a history of kidney disease were less likely to call 911 (p=0.024). The two most common sources of information about stroke that DM patients received were from their primary care physicians (43%) and family and friends (35%). CONCLUSION: Stroke is one of the least recognized medical complications in DM patients. Primary care physicians play a very important role of stroke education in this high risk population.

scholarly journals Assessment of and Interventions for Women at High Risk for Breast or Ovarian Cancer: A Survey of Primary Care Physicians

2020 ◽  
Author(s):  
Goli Samimi ◽  
Brandy M. Heckman-Stoddard ◽  
Christine Holmberg ◽  
Bethany Tennant ◽  
Bonny Bloodgood Sheppard ◽  
...  
Keyword(s):  
Ovarian Cancer ◽  
Primary Care ◽  
High Risk ◽  
Primary Care Physicians

scholarly journals Development of a prediction model to aid primary care physicians in early identification of women at high risk of developing endometriosis: cross-sectional study

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e030346
Author(s):  
Nina Julie Verket ◽  
Ragnhild Sørum Falk ◽  
Erik Qvigstad ◽  
Tom Gunnar Tanbo ◽  
Leiv Sandvik
Keyword(s):  
Primary Care ◽  
Family History ◽  
High Risk ◽  
Prediction Model ◽  
Early Identification ◽  
Primary Care Physicians ◽  
Lasso Regression ◽  
Cross Sectional ◽  
Predictive Values ◽  
History Of

ObjectivesTo identify predictors of disease among a few factors commonly associated with endometriosis and if successful, to combine these to develop a prediction model to aid primary care physicians in early identification of women at high risk of developing endometriosis.DesignCross-sectional anonymous postal questionnaire study.SettingWomen aged 18–45 years recruited from the Norwegian Endometriosis Association and a random sample of women residing in Oslo, Norway.Participants157 women with and 156 women without endometriosis.Main outcome measuresLogistic and least absolute shrinkage and selection operator (LASSO) regression analyses were performed with endometriosis as dependent variable. Predictors were identified and combined to develop a prediction model. The predictive ability of the model was evaluated by calculating the area under the receiver operating characteristic curve (AUC) and positive predictive values (PPVs) and negative predictive values (NPVs). To take into account the likelihood of skewed representativeness of the patient sample towards high symptom burden, we considered the hypothetical prevalences of endometriosis in the general population 0.1%, 0.5%, 1% and 2%.ResultsThe predictors absenteeism from school due to dysmenorrhea and family history of endometriosis demonstrated the strongest association with disease. The model based on logistic regression (AUC 0.83) included these two predictors only, while the model based on LASSO regression (AUC 0.85) included two more: severe dysmenorrhea in adolescence and use of painkillers due to dysmenorrhea in adolescence. For the prevalences 0.1%, 0.5%, 1% and 2%, both models ascertained endometriosis with PPV equal to 2.0%, 9.4%, 17.2% and 29.6%, respectively. NPV was at least 98% for all values considered.ConclusionsExternal validation is needed before model implementation. Meanwhile, endometriosis should be considered a differential diagnosis in women with frequent absenteeism from school or work due to painful menstruations and positive family history of endometriosis.

Potentially modifiable influences on cancer family history-taking among primary care physicians in Vermont and Massachusetts

2006 ◽  
Vol 24 (18_suppl) ◽  
pp. 6067-6067
Author(s):  
B. S. Flynn ◽  
M. E. Wood ◽  
G. S. Dana ◽  
T. Ashikaga
Keyword(s):  
Primary Care ◽  
Family History ◽  
High Risk ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
Outcome Variable ◽  
History Taking ◽  
Cancer Family ◽  
Cancer Family History

6067 Background. Taking a complete family history is key in identifying individuals at increased risk for cancer. The objectives of this study were to test hypothesized relationships between potentially modifiable factors and family history-taking by primary care physicians. Methods. Primary care physicians (family medicine, internal medicine, gynecology) were surveyed by mail in Vermont, urban and suburban Boston (n=880) using comprehensive rosters from employers or state-wide networks, with a response rate of 70%. Measures of family history-taking quality and factors that may influence this behavior were developed systematically and validated using factor analysis methods. The primary outcome variable was either extent of history-taking or age of cancer diagnoses. These dependent variables were regressed on scales measuring physician perceptions of the advantages and disadvantages of history-taking, confidence in taking cancer family histories, supportive resources, and knowledge of management for patients at high risk for breast and colon cancer; relevant factors controlled in these multiple regressions included type and location of practice. Results. Most physician perception factors hypothesized to influence quality of history taking were found to be significantly associated in the analysis. The strongest predictor of extent of family history-taking was perceived disadvantages of taking a cancer family history (p<.001). Reports of supportive resources ((p<.01); perceived advantages (p=.02); and confidence (p=.02) were also associated with this behavior. Gathering age of cancer diagnoses was significantly associated with perceived advantages, supportive resources and confidence (all p<.0001). Knowledge of high risk management was not associated with quality of family history-taking in either analysis. Conclusions. Potentially modifiable resource and perception factors were significantly associated with quality of family history in a large and diverse sample of primary care physicians. Improving family history quality for identification of high risk individuals among primary care providers will need to address multiple factors. No significant financial relationships to disclose.

Identification of differentially expressed genes to predict radioresistant prostate carcinomas.

2019 ◽  
Vol 37 (7_suppl) ◽  
pp. 57-57
Author(s):  
Tim Nestler ◽  
Maike Wittersheim ◽  
Martin Hellmich ◽  
David J. K. P. Pfister ◽  
Margarete Odenthal ◽  
...  
Keyword(s):  
High Risk ◽  
Protein Expression ◽  
Risk Group ◽  
Expression Profiles ◽  
Gleason Pattern ◽  
Cohen’S D ◽  
Bonferroni Test ◽  
Protein Expression Profiles ◽  
Cohen's D

57 Background: Although relapses after radiotherapy are common in prostate cancer (PCa) patients, there are no clinical models or markers to identify patients at high risk for radioresistance. So far, only in vitro studies and xenograft models have been performed to identify gene expression patterns associated with radioresistance. However, studies which address the protein pattern to predict radioresistance in humans are completely missing. In order to determine potential biomarkers for radioresistance, we compared protein expression profiles of radioresistant PCa patients with PCa of primary prostatectomized patients. Methods: Two study groups consisting of: I) 30 patients who were treated by salvage prostatectomy and II) 94 patients treated by primary prostatectomy were formed. Tissue microarrays were constructed and immunostained for 15 proteins which are suggested to be associated with radioresistance by in vitro findings. Kruskal-Wallis test was used for multiple group comparison and followed by Dunn-Bonferroni-Test to detect intergroup differences. Cohen’s d was used to calculate the intergroup effect size. Results: Most proteins studied did not show any relevant differences between radioresistant PCa and primary PCa, except for two (AR and AKR1C3). On comparing immunostaining patterns between radioresistant PCa and primary PCa separated by Gleason risk groups, we observed only AR (androgen receptor) to be most expressed in radioresistant PCa (89.7%) and, in 87.8% of primary PCa of the high-risk group ( > 7a) (p = 0.851, Cohen’s d = 0.05), while only 67.3% PCa of the low-risk group (≤7a) (p = 0.017, Cohen’s d = 0.55) were positive. Considering the highest Gleason pattern per patient, only AKR1C3 (Aldo-Keto Reductase Family 1 Member C3) was seen to be similarly expressed in radiation-resistant PCa and patients with Gleason patterns 4 and 5 (p = 0.827, Cohen’s d = 0.05 and p = 0.893, Cohen’s d = 0.10) as compared to Gleason pattern 3 (p = 0.20, Cohen’s d = 0.69) in primary PCa. Conclusions: This is the first study evaluating protein expression profiles to predict radioresistance in PCa, where AR and AKR1C3 were identified to be the most promising protein markers.

Prevalence, specialized ambulatory care and guideline-recommended therapy of peripheral vascular diseases in Germany

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
C Rammos ◽  
O Petrikhovich ◽  
A Mahabadi ◽  
M Steinmetz ◽  
J Lortz ◽  
...  
Keyword(s):  
Primary Care ◽  
High Risk ◽  
Ambulatory Care ◽  
Primary Care Physicians ◽  
Lipid Lowering ◽  
Age Group ◽  
Age And Gender ◽  
And Gender ◽  
Gender Specific ◽  
Recommended Therapy

Abstract Background Cardiovascular diseases are the leading causes of death in the industrialized world. In addition to coronary heart disease, PAD defines morbidity and is associated with increased mortality. Guideline-recommended therapy and specialized ambulatory care is essential for optimal treatment. Knowledge of the treatment structures, contact with dedicated specialists and pharmacotherapy in the outpatient area are essential for improving treatment, reducing symptoms and finally improve mortality in this high-risk population. Methods The study is based on the ambulatory claims data of the panel doctors services according to § 295 SGB V and drug prescription data according to § 300 SGB V. The prevalence of PAD in Germany (medical diagnoses of PAD ICD I70.2–9) was analyzed by age and gender-specific characteristics with a timeframe of 10 years (2009–2018). In addition, the current ambulatory care structure was examined subdivided by vascular specialist (vascular surgeons or angiologists) and primary care physicians (internal medicine or general practitioners). Additionally, the prescription of guideline-recommended pharmacotherapy like statins and antiplatelet inhibitors was analyzed for the years 2009–2016. Results An increase of PAD diagnosis was observed with a maximum in 2018 with 2.280.000 patients in Germany. The rise of PAD patients strongly correlates with increased age (age group 50–59: 243.000, age group 60–69: 533.000, age group 70–79: 735.000, age group 75–79: 438.000, age group 80–89: 710.000) and more commonly affects males (55%) than females (45%). Access to vascular specialist was low for all age groups with only 11% of patients receiving care from vascular surgeons and only 9% from angiologists. However, 99% received care by a primary care physician. The prescription of lipid-lowering drugs and platelet aggregation inhibitors in the current analysis period from 2009–2016 is insufficient, with only 46% receiving statins and 29% receiving antiplatelets and 15% oral anticoagulation, Conclusion There are relevant differences in age and gender-specific prevalence of PAD in Germany. In addition to the regular care provided by primary care physicians, PAD patients are in need for specialized vascular care. Guideline recommended prescriptions are alarmingly low in PAD patients. There is a clear need to improve the treatment algorithms in the high-risk PAD population. Funding Acknowledgement Type of funding source: None

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