The Contribution of Office-Based EMR Systems to the Performance of Family Physicians and Primary Care Medical Practices

(1) Background: Integrated models of primary care deliver the comprehensive and preventative approach needed to identify and manage frailty in older people. Seniors’ Community Hub (SCH) was developed to deliver person-centered, evidence-informed, coordinated, and integrated care services to older community dwelling adults living with frailty. This paper aims to describe the SCH model, and to present patient-oriented results of the pilot. (2) Methods: SCH was piloted in an academic clinic with six family physicians. Eligible patients were community dwelling, 65 years of age and older, and considered to be at risk of frailty (eFI > 0.12). Health professionals within the clinic received training in geriatrics and interprofessional teamwork to form the SCH team working with family physicians, patients and caregivers. The SCH intervention consisted of a team-based multi-domain assessment with person-centered care planning and follow-up. Patient-oriented outcomes (EQ-5D-5L and EQ-VAS) and 4-metre gait speed were measured at initial visit and 12 months later. (3) Results: 88 patients were enrolled in the pilot from April 2016–December 2018. No statistically significant differences in EQ-5D-5L/VAS or the 4-metre gait speed were detected in 38 patients completing the 12-month assessment. (4) Conclusions: Future larger scale studies of longer duration are needed to demonstrate impacts of integrated models of primary care on patient-oriented outcomes for older adults living with frailty.

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Family Physician’s and Primary Care Team’s Perspectives on Supporting Family Caregivers in Primary Care Networks

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18063293 ◽

2021 ◽

Vol 18 (6) ◽

pp. 3293

Author(s):

Jasneet Parmar ◽

Sharon Anderson ◽

Marjan Abbasi ◽

Saeed Ahmadinejad ◽

Karenn Chan ◽

...

Keyword(s):

Primary Care ◽

Family Caregivers ◽

Healthcare Providers ◽

Family Physicians ◽

Care Team ◽

Primary Care Team ◽

Caregiver Support ◽

Team Members ◽

Primary Care Teams ◽

Support Family

Background. Research, practice, and policy have focused on educating family caregivers to sustain care but failed to equip healthcare providers to effectively support family caregivers. Family physicians are well-positioned to care for family caregivers. Methods. We adopted an interpretive description design to explore family physicians and primary care team members’ perceptions of their current and recommended practices for supporting family caregivers. We conducted focus groups with family physicians and their primary care team members. Results. Ten physicians and 42 team members participated. We identified three major themes. “Family physicians and primary care teams can be a valuable source of support for family caregivers” highlighted these primary care team members’ broad recognition of the need to support family caregiver’s health. “What stands in the way” spoke to the barriers in current practices that precluded supporting family caregivers. Primary care teams recommended, “A structured approach may be a way forward.” Conclusion. A plethora of research and policy documents recommend proactive, consistent support for family caregivers, yet comprehensive caregiver support policy remains elusive. The continuity of care makes primary care an ideal setting to support family caregivers. Now policy-makers must develop consistent protocols to assess, and care for family caregivers in primary care.

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Teaching Normal and Abnormal Behavior to Primary Care Physicians

The International Journal of Psychiatry in Medicine ◽

10.2190/t6xy-qlqd-e6bx-m0g3 ◽

1994 ◽

Vol 24 (2) ◽

pp. 115-120 ◽

Cited By ~ 2

Author(s):

Uriel Halbreich

Keyword(s):

Primary Care ◽

Differential Diagnosis ◽

Human Behavior ◽

Primary Care Physicians ◽

Family Physicians ◽

Abnormal Behavior ◽

General Internists ◽

Education Committee ◽

Personal Skills

Objective: This article delineates the framework for a curriculum on psychiatry, normal and abnormal human behavior for primary care physicians (PCPs). Methods: Curricula have been surveyed. Members of the Education Committee of the Association of Medicine and Psychiatry, as well as Family Physicians and General Internists involved in education have been consulted. Their recommendations are integrated. Results and Conclusions: The curriculum should be developed according to the needs of PCPs and from their perspective. Patient and problem-oriented, its content can be divided into: a) personal skills that should be developed; and b) knowledge of symptoms, their differential diagnosis (DDX) and management within the PCP's, facilities and abilities.

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The PUFFinCA scale: development of an instrument for evaluating the primary care functions of family physicians in childhood asthma

Primary Health Care Research & Development ◽

10.1017/s1463423618000609 ◽

2018 ◽

Vol 20 ◽

Author(s):

Ayşe Nur Usturali Mut ◽

Zeliha Aslı Öcek ◽

Meltem Çiçeklioğlu ◽

Şafak Taner ◽

Esen Demir

Keyword(s):

Primary Care ◽

Childhood Asthma ◽

Assessment Tool ◽

Asthma Management ◽

Correlation Coefficients ◽

Family Physicians ◽

Principal Component ◽

Care Assessment ◽

Provision Of Services ◽

Children With Asthma

AbstractAimTo develop the Primary care fUnctions oF Family physicians in Childhood Asthma (PUFFinCA) scale for evaluating the cardinal process functions of primary care services (accessibility, comprehensiveness, continuity and coordination) provided by family physicians (FPs) in the management of childhood asthma.BackgroundIn the literature on the functions of primary care, there is no assessment tool focusing on children with asthma. Primary care assessment scales adapted to various languages are not suitable to adequately address the needs of special patient groups, such as children with asthma.MethodsIn this methodological study, the instrument development process was completed in four stages: establishing the pool of items, evaluating the content validity, applying the scale and statistical analysis. The scale was applied to 320 children who had asthma and received care in the clinic of the Department of Pediatrics, Division of Allergy and Pulmonology at Ege University School of Medicine, Turkey. The Cronbach’s α and Spearman–Brown coefficient were calculated to determine the reliability of the scale. Principal component analysis was used to determine the construct validity of the scale.FindingsThe PUFFinCA scale was found to have four-factor structure and 25 items. Cronbach’s α coefficient was 0.93. It has been determined that the reliability was excellent and the item-total correlation coefficients were >0.30 each. The factors were titled FP’s ‘functions of accessibility, first contact and continuity’, ‘functions of coordination and comprehensiveness of health services related to asthma management’, ‘provision of preventive care related to asthma’ and ‘provision of services for paid vaccinations’.

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Primary Care Practise in Turkey and Training of Contracted Family Physicians

Turkish Journal of Family Medicine & Primary Care ◽

10.5455/tjfmpc.207946 ◽

2016 ◽

pp. 1

Author(s):

Yildiz Yardimci ◽

Derya Akbiyik ◽

Cenk Aypak ◽

Hulya Yikilkan ◽

Suleyman Gorpelioglu

Keyword(s):

Primary Care ◽

Family Physicians ◽

And Training

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Teaching Skin Cancer Detection to Medical Students Using a Dermoscopic Algorithm

PRiMER ◽

10.22454/primer.2021.304379 ◽

2021 ◽

Vol 5 ◽

Author(s):

Peggy R. Cyr ◽

Wendy Craig ◽

Hadjh Ahrns ◽

Kathryn Stevens ◽

Caroline Wight ◽

...

Keyword(s):

Primary Care ◽

Medical Students ◽

Skin Cancer ◽

Primary Care Physicians ◽

Survival Rates ◽

Family Physicians ◽

Skin Lesions ◽

Posttest Score ◽

Malignant Skin ◽

Attending Physicians

Introduction: Early detection of melanoma skin cancer improves survival rates. Training family physicians in dermoscopy with the triage amalgamated dermoscopic algorithm (TADA) has high sensitivity and specificity for identifying malignant skin neoplasms. In this study we evaluated the effectiveness of TADA training among medical students, compared with practicing clinicians. Methods: We incorporated the TADA framework into 90-minute workshops that taught dermoscopy to family physicians, primary care residents, and first- and second-year medical students. The workshop reviewed the clinical and dermoscopic features of benign and malignant skin lesions and included a hands-on interactive session using a dermatoscope. All participants took a 30-image pretest and a different 30-image posttest. Results: Forty-six attending physicians, 25 residents, and 48 medical students participated in the workshop. Mean pretest scores were 20.1, 20.3, and 15.8 for attending physicians, resident physicians and students, respectively (P<.001); mean posttest scores were 24.5, 25.9, and 24.1, respectively (P=.11). Pre/posttest score differences were significant (P<.001) for all groups. The medical students showed the most gain in their pretest and posttest scores. Conclusion: After short dermoscopy workshop, medical students perform as well as trained physicians in identifying images of malignant skin lesions. Dermoscopy training may be a valuable addition to the medical school curriculum as this skill can be used by primary care physicians as well as multiple specialists including dermatologists, gynecologists, otolaryngologists, plastic surgeons, and ophthalmologists, who often encounter patients with concerning skin lesions.

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Latvian Family Physicians’ Experience and Attitude in Diagnosing and Managing Depression

Proceedings of the Latvian Academy of Sciences Section B Natural Exact and Applied Sciences ◽

10.2478/prolas-2019-0026 ◽

2019 ◽

Vol 73 (2) ◽

pp. 164-170

Author(s):

Vineta Viktorija Vinogradova ◽

Jeļena Vrubļevska ◽

Elmārs Rancāns

Keyword(s):

Primary Care ◽

Mental Disorders ◽

Common Mental Disorders ◽

Current Knowledge ◽

Family Physicians ◽

Research Programme ◽

Primary Care Settings ◽

National Research Programme ◽

Management Approaches ◽

Training Programmes

Abstract Depression is among the most common mental disorders in primary care. Despite high prevalence rates it remains to be under-diagnosed in primary care settings over the world. This study was aimed to identify Latvian family physicians’ (FPs) experience and attitude in diagnosing and managing depression. It was carried out within the framework of the National Research Programme BIOMEDICINE 2014–2017. After educational seminars on diagnosing and managing depression, FPs were asked to complete a structured questionnaire. In total 216 respondents were recruited. Most of the doctors, or 72.2% (n = 156), agreed with the statement that patients with depression use primary care facilities more often than other patients. More than a half of physicians, or 66.3% (n = 143) quite often asked their patients about their psycho-emotional status and 65.7% (n = 142) of clinicians thought that they can successfully assess a patient’s psychoemotional status and possible mental disorders. The majority, or 91.6 % (n = 198), supposed that routine screening for depression is necessary in Latvia. Despite the fact that a significant number, or 62.6% (n = 135) of FPs thought that their practice was well suitable for the treatment of depressive patients, half of the respondents, or 50.9% (n = 110), assessed their ability to build a trustful contact and to motivate patients for treatment as moderate. Although FPs acknowledged the importance and necessity to treat depression, current knowledge and management approaches were far from optimal. This justifies the need to provide specific training programmes for FPs.

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Monitoring the Dissemination of an Educational Protocol on Pediatric Asthma in Family Practice: A Test of Associations between Dissemination Variables

Health Education & Behavior ◽

10.1177/109019819902600109 ◽

1999 ◽

Vol 26 (1) ◽

pp. 103-120 ◽

Cited By ~ 23

Author(s):

Ilse Mesters ◽

Ree M. Meertens

Keyword(s):

Primary Care ◽

Diffusion Of Innovation ◽

Family Practice ◽

Family Physicians ◽

Self Management ◽

Education Programs ◽

Cross Sectional ◽

Diffusion Of Innovation Theory ◽

Perceived Success ◽

Continued Use

Many asthma education programs aim at reducing morbidity. Now that effective programs are available, the next step is the nationwide dissemination to achieve morbidity reduction. A dissemination of a tested program has been undertaken in Dutch primary care, guided by the Diffusion of Innovation theory. It was hypothesized that greater awareness and concern and/or receptivity about asthma self-management would make it more likely that family physicians would adopt the program. Family physicians were considered more likely to adopt the program if they saw it as an improvement on their current way of providing education, as easy to use, and as having observable outcomes. It was expected that once the program had been adopted, and as it was being implemented, it would increasingly be perceived by its users as successful. Finally, more perceived success of performance was expected to be related to continued use. Both longitudinal and cross-sectional data largely confirmed the hypotheses.

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On the same page or in a different book? A pilot project on the perceptions of educational needs in an era of shifting mental health care to primary care (Preprint)

10.2196/preprints.32422 ◽

2021 ◽

Author(s):

Stephanie Sutherland ◽

Dahn Jeong ◽

Michael Cheng ◽

Mireille St-Jean ◽

Alireza Jalali

Keyword(s):

Mental Health ◽

Primary Care ◽

Health Care ◽

Mental Health Care ◽

Medical Management ◽

Family Physicians ◽

Educational Needs ◽

Health Conditions ◽

Care Providers ◽

Mental Health Conditions

BACKGROUND There is an unmet need for mental health care in Canada. Seventy-five percent of visits for mental health services are related to mood and anxiety disorder, which occur most frequently in the primary care setting. Primary care providers such as general practitioners and family physicians are essential part of mental health care services. However, it is currently not well known what is needed to increase care providers’ willingness, comfort and skills to adequately provide care. OBJECTIVE The aim of this study was to understand the caregiver and family physician needs regarding the care and medical management of individuals with mental health conditions. METHODS A needs assessment was designed to understand the educational needs of caregivers and family physicians with regard to the provision of mental health care, specifically, to seek advice of the format and delivery mode for an educational curriculum to be accessed by both stakeholder groups. Exploratory qualitative interviews were conducted and data was collected and analysed iteratively until thematic saturation was achieved. RESULTS Caregivers of individuals with mental health conditions (n=24) and family physicians (n=10) were interviewed. Both caregivers and family physicians expressed dissatisfaction with the status quo regarding the provision of mental health care at the family physician’s office. They stated that there was a need for more educational materials as well as additional supports. Caregivers expressed a general lack of confidence in family physicians to manage their son/daughter’s mental health condition, while family physicians sought more networking opportunities to improve and facilitate provision of mental health care. CONCLUSIONS Robust qualitative studies are necessary to identify the educational and medical management needs of caregivers and family physicians. Understanding each other’s perspectives is an essential first step to collaboratively designing, implementing, and the subsequent evaluation of community-based mental health care. Fortunately, there are initiatives underway already to address these need areas (e.g. websites such as eMentalHealth.ca/PrimaryCare as well as mentorship and collaborative care network) and information from this study can help inform the gaps in those existing initiatives. CLINICALTRIAL NA

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