scholarly journals Translating Evidence-Based Depression Management Services to Community-Based Primary Care Practices

2004 ◽  
Vol 82 (4) ◽  
pp. 631-659 ◽  
Author(s):  
AMY M. KILBOURNE ◽  
HERBERT C. SCHULBERG ◽  
EDWARD P. POST ◽  
BRUCE L. ROLLMAN ◽  
BEA HERBECK BELNAP ◽  
...  
Keyword(s):  
Primary Care ◽  
Evidence Based ◽  
Community Based ◽  
Depression Management ◽  
Care Practices ◽  
Primary Care Practices ◽  
Management Services

scholarly journals The STUN (STop UNhealthy) Alcohol Use Now Trial: Study Protocol for an Adaptive Randomized Trial on Dissemination and Implementation of Screening and Management of Unhealthy Alcohol Use in Primary Care

2021 ◽  
Author(s):  
Daniel E. Jonas ◽  
Colleen Barclay ◽  
Debbie Grammer ◽  
Chris Weathington ◽  
Sarah A. Birken ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Practice Facilitation ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
The Us ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background: Unhealthy alcohol use is a leading cause of preventable deaths in the US and is associated with many societal and health problems. Less than a third of people who visit primary care providers in the US are asked about or ever discuss alcohol use with a health professional. Methods/design: This study is an adaptive, randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in small-to-medium-sized primary care practices. Study participants will include primary care practices in North Carolina with 10 or fewer providers. All enrolled practices will receive a practice facilitation intervention that includes quality improvement (QI) coaching, electronic health record (EHR) support, training, and expert consultation. After 6 months, practices in the lower 50th percentile (based on performance) will be randomized to continued practice facilitation or provision of telehealth services plus ongoing facilitation for the next 6 months. Practices in the upper 50th percentile after the initial 6 months of intervention will continue to receive practice facilitation alone. The main outcome measures include the number (and %) of patients in the target population who are screened for unhealthy alcohol use, screen positive, and receive brief counseling. Additional measures include the number (and %) of patients who receive pharmacotherapy for AUD or are referred for AUD services.Discussion: A successful intervention would significantly reduce morbidity among adults from unhealthy alcohol use by increasing counseling and other treatment opportunities. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. It will also generate scientific knowledge about whether embedded telehealth services can improve use of evidence-based screening and interventions for practices with slower uptake. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices.Trial registration: ClinicalTrials.gov NCT04317989. March 23, 2020 –registered, https://www.clinicaltrials.gov/ct2/show/NCT04317989?titles=STUN&draw=2&rank=1

Evidence-Based Care For Depression In Managed Primary Care Practices

1999 ◽  
Vol 18 (5) ◽  
pp. 89-105 ◽  
Author(s):  
Lisa V. Rubenstein ◽  
Maga Jackson-Triche ◽  
Jürgen Unützer ◽  
Jeanne Miranda ◽  
Katy Minnium ◽  
...  
Keyword(s):  
Primary Care ◽  
Evidence Based ◽  
Care Practices ◽  
Primary Care Practices ◽  
Evidence Based Care

scholarly journals Efficacy of an Evidence-Based Clinical Decision Support in Primary Care Practices

2013 ◽  
Vol 173 (17) ◽  
pp. 1584 ◽  
Author(s):  
Thomas G. McGinn ◽  
Lauren McCullagh ◽  
Joseph Kannry ◽  
Megan Knaus ◽  
Anastasia Sofianou ◽  
...  
Keyword(s):  
Primary Care ◽  
Decision Support ◽  
Clinical Decision Support ◽  
Clinical Decision ◽  
Evidence Based ◽  
Care Practices ◽  
Primary Care Practices

scholarly journals The STUN (STop UNhealthy) Alcohol Use Now trial: study protocol for an adaptive randomized trial on dissemination and implementation of screening and management of unhealthy alcohol use in primary care

Trials ◽  
2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Daniel E. Jonas ◽  
Colleen Barclay ◽  
Debbie Grammer ◽  
Chris Weathington ◽  
Sarah A. Birken ◽  
...  
Keyword(s):  
Primary Care ◽  
Alcohol Use ◽  
Dissemination And Implementation ◽  
Evidence Based ◽  
Practice Facilitation ◽  
Unhealthy Alcohol Use ◽  
Unhealthy Alcohol ◽  
The Usa ◽  
Care Practices ◽  
Primary Care Practices

Abstract Background Unhealthy alcohol use is a leading cause of preventable deaths in the USA and is associated with many societal and health problems. Less than a third of people who visit primary care providers in the USA are asked about or ever discuss alcohol use with a health professional. Methods/design This study is an adaptive, randomized, controlled trial to evaluate the effect of primary care practice facilitation and telehealth services on evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use in small-to-medium-sized primary care practices. Study participants will include primary care practices in North Carolina with 10 or fewer providers. All enrolled practices will receive a practice facilitation intervention that includes quality improvement (QI) coaching, electronic health record (EHR) support, training, and expert consultation. After 6 months, practices in the lower 50th percentile (based on performance) will be randomized to continued practice facilitation or provision of telehealth services plus ongoing facilitation for the next 6 months. Practices in the upper 50th percentile after the initial 6 months of intervention will continue to receive practice facilitation alone. The main outcome measures include the number (and %) of patients in the target population who are screened for unhealthy alcohol use, screen positive, and receive brief counseling. Additional measures include the number (and %) of patients who receive pharmacotherapy for AUD or are referred for AUD services. Sample size calculations determined that 35 practices are needed to detect a 10% increase in the main outcome (percent screened for unhealthy alcohol use) over 6 months. Discussion A successful intervention would significantly reduce morbidity among adults from unhealthy alcohol use by increasing counseling and other treatment opportunities. The study will produce important evidence about the effect of practice facilitation on uptake of evidence-based screening, counseling, and pharmacotherapy for unhealthy alcohol use when delivered on a large scale to small and medium-sized practices. It will also generate scientific knowledge about whether embedded telehealth services can improve the use of evidence-based screening and interventions for practices with slower uptake. The results of this rigorously conducted evaluation are expected to have a positive impact by accelerating the dissemination and implementation of evidence related to unhealthy alcohol use into primary care practices. Trial registration ClinicalTrials.govNCT04317989. Registered on March 23, 2020.

Patients’ Perceptions of Electronic Monitoring Devices Affect Medication Adherence in Hypertensive African Americans

2008 ◽  
Vol 42 (5) ◽  
pp. 647-652 ◽  
Author(s):  
Antoinette Schoenthaler ◽  
Gbenga Ogedegbe
Keyword(s):  
Primary Care ◽  
African American ◽  
Medication Adherence ◽  
African Americans ◽  
Electronic Monitoring ◽  
Community Based ◽  
Monitoring Period ◽  
Care Practices ◽  
Primary Care Practices ◽  
Monitoring Devices

Background: Electronic monitoring devices (EMDs) are regarded as the gold standard for assessing medication adherence in clinical research. However, little is known about the effect of patients’ acceptance of EMDs on medication adherence in African Americans with hypertension who are followed in primary care practices Objective: To assess patients’ perceptions of EMDs, their acceptance of EMDs, and the relationship of these perceptions to medication adherence in African Americans with hypertension who are followed in community-based practices. Methods: Patients were recruited from a larger randomized controlled trial assessing the effect of motivational interviewing on medication adherence and blood pressure in hypertensive African American patients followed in 2 New York City primary care practices. Medication adherence was assessed with a Medication Event Monitoring System (MEMS) during a 12-month monitoring period. At the 12-month follow-up, patients’ perceptions of the MEMS were assessed with a 17-item questionnaire. ANOVA was used to compare patients’ responses (agree, neither, disagree) with the MEMS adherence over the monitoring period. Tukey's post hoc tests were used to determine whether there were significant differences among the 3 groups. Results: Participants were predominantly women, low-income, unemployed, had a high school education, and were a mean age of 53 years. Approximately two-thirds of the participants stated that the MEMS helped them remember to take their medications, 93% reported that the MEMS was easy to open, 85% did not find it stressful, and 75% liked the MEMS and used it everyday. One-third of patients preferred using a pillbox and 25% did not like traveling with the MEMS. Patients who stated that they used the MEMS every day, felt comfortable using it in front of others, and remembered to put refills in the MEMS had significantly better adherence over the study period than did those who disagreed (p ≤ 0.05). Conclusions: African American patients treated for hypertension in community-based practices held positive perceptions about a MEMS. Perceptions about the practicality of a MEMS may yield important information about actual medication-taking behavior.

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