Profile of acupuncture use among primary care physicians working in the Brazilian public healthcare system

2020 ◽  
Vol 38 (5) ◽  
pp. 319-326
Author(s):  
Fernanda Bedin ◽  
Ari Ojeda Ocampo Moré ◽  
Jardel Corrêa de Oliveira ◽  
Charles Dalcanale Tesser ◽  
Li Shih Min
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Trigger Point ◽  
Physical Space ◽  
Acupuncture Point ◽  
Patient Acceptance ◽  
Care Practice ◽  
Public Healthcare ◽  
Point Selection ◽  
Introductory Course

Background: An introductory acupuncture course has been offered to primary health care physicians and family medicine residents in southern Brazil since 2011. Objective: To analyze the profile of acupuncture utilization of primary care physicians who completed an introductory course of acupuncture between 2011 and 2018. Method: A survey using an electronic questionnaire was sent to all 119 physicians who completed the course. Results: Fifty-five physicians answered the questionnaire. The majority of them reported continuation of the practice of acupuncture in scheduled appointments and on spontaneous demand. The most commonly used principles of point selection were traditional acupuncture point function, myofascial trigger point needling and point protocols. As barriers to the practice of acupuncture, time limitation and inadequate physical space were predominant. The participants described the problem-solving potential of the procedure and good patient acceptance as facilitators. The most common problems treated with acupuncture were musculoskeletal pain, and mood and anxiety disorders. A reduction in referrals to specialists and reduced prescription of pain medications were also reported. Most physicians answered that they often combined acupuncture with other medications or associated acupuncture with other complementary practices. The main adverse events reported by the participants were vascular trauma and fainting. Conclusion: Most primary care physicians who completed the introductory course and answered the survey still used acupuncture in their routine, primarily for the management of musculoskeletal conditions and mental health conditions. These physicians reported reductions in specialist referrals and prescription of pain medication after integrating basic acupuncture skills into primary care practice.

WikiRecs primary care: developing rapid recommendations for primary care through effective collaboration between systematic review and guideline teams

2018 ◽  
Vol 68 (suppl 1) ◽  
pp. bjgp18X697085
Author(s):  
Trudy Bekkering ◽  
Bert Aertgeerts ◽  
Ton Kuijpers ◽  
Mieke Vermandere ◽  
Jako Burgers ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Clinical Practice ◽  
Primary Care Physicians ◽  
Urinary Stones ◽  
Care Practice ◽  
Supporting Evidence ◽  
Supervised Exercise ◽  
Review Team ◽  
New Evidence

BackgroundThe WikiRecs evidence summaries and recommendations for clinical practice are developed using trustworthy methods. The process is triggered by studies that may potentially change practice, aiming at implementing new evidence into practice fast.AimTo share our first experiences developing WikiRecs for primary care and to reflect on the possibilities and pitfalls of this method.MethodIn March 2017, we started developing WikiRecs for primary health care to speed up the process of making potentially practice-changing evidence in clinical practice. Based on a well-structured question a systematic review team summarises the evidence using the GRADE approach. Subsequently, an international panel of primary care physicians, methodological experts and patients formulates recommendations for clinical practice. The patient representatives are involved as full guideline panel members. The final recommendations and supporting evidence are disseminated using various platforms, including MAGICapp and scientific journals.ResultsWe are developing WikiRecs on two topics: alpha-blockers for urinary stones and supervised exercise therapy for intermittent claudication. We did not face major problems but will reflect on issues we had to solve so far. We anticipate having the first WikiRecs for primary care available at the end of 2017.ConclusionThe WikiRecs process is a promising method — that is still evolving — to rapidly synthesise and bring new evidence into primary care practice, while adhering to high quality standards.

Information Technology in Primary Care Practice in the United States

2011 ◽  
pp. 131-163
Author(s):  
James G. Anderson ◽  
E. Andres Balas
Keyword(s):  
Primary Care ◽  
Information Technology ◽  
Primary Care Physicians ◽  
Point Of Care ◽  
Medical Specialty ◽  
The United States ◽  
Care Practice ◽  
It Applications ◽  
The Cost ◽  
Privacy And Confidentiality

The objective of this study was to assess the current level of information technology used by primary care physicians in the U.S. Primary care physicians listed by the American Medical Association were contacted by e-mail and asked to complete a Web-based questionnaire. A total of 2,145 physicians responded. Overall between 20% and 25% of primary care physicians reported using electronic medical records, e-prescribing, point-of-care decision support tools and electronic communication with patients. This indicates a slow rate of adoption since 2000-2001. Differences in adoption rates suggest that future surveys need to differentiate primary care and office-based physicians by specialty. An important finding is that one-third of the physicians surveyed expressed no interest in the four IT applications. Overcoming this barrier may require efforts by medical specialty societies to educate their members as to the benefits of IT in practice. The majority of physicians perceived benefits of IT, but they cited costs, vendor inability to deliver acceptable products and concerns about privacy and confidentiality as major barriers to implementation of IT applications. Overcoming the cost barrier may require that payers and the federal government share the costs of implementing these IT applications.

The adoption of preventive care practice guidelines by primary care physicians

1995 ◽  
Vol 10 (3) ◽  
pp. 138-144 ◽  
Author(s):  
Scoff Weingarten ◽  
Erin Stone ◽  
Robert Hayward ◽  
Sean Tunis ◽  
Mitch Pelter ◽  
...  
Keyword(s):  
Primary Care ◽  
Preventive Care ◽  
Practice Guidelines ◽  
Primary Care Physicians ◽  
Care Practice

Spectrophotometric Otoscope: A New Tool in the Diagnosis of Otitis Media

2007 ◽  
Vol 15 (4) ◽  
pp. 209-215 ◽  
Author(s):  
Zeev Schmilovitch ◽  
Victor Alchanatis ◽  
Menashe Shachar ◽  
Yehud Holdstein
Keyword(s):  
Primary Care ◽  
Otitis Media ◽  
Primary Care Physicians ◽  
Acute Otitis Media ◽  
Care Physician ◽  
Public Healthcare ◽  
Least Squares Regression ◽  
Double Blind ◽  
Diagnostic Aid ◽  
Serous Otitis Media

Otitis media is one of the most common childhood ailments and, therefore, has a significant impact on public healthcare expenditure. The initial diagnosis is usually performed by a primary-care physician and is based upon otoscopy and symptomatology; the certainty of diagnosis of acute otitis media is only 58–73%. This study aimed to assess the efficacy of a spectrophotometer-based system in identifying otitis media by comparing the output from the system with the clinical diagnosis of an experienced otologist and, hence, to evaluate the system as a diagnostic aid to primary-care physicians. The study was prospective and double blind. An otologist examined 258 patients consecutively with an oto-microscope and all of the patients were simultaneously examined with a spectrometer-based data acquisition system incorporated in a standard otoscope. The otologist's diagnosis served as a “gold standard”. The acquired data were analysed by means of partial least squares regression. The system correctly differentiated acute otitis media from serous otitis media and normal ears with sensitivity of 93% and specificity of 88%. The sensitivity and specificity were 89 and 95%, respectively, in a subset of subjects aged 12 y or less. Spectrophotometry was found to be a highly accurate means of diagnosing acute otitis media. We consider that it will become an important diagnostic aid for primary care physicians.

scholarly journals Call your doctor: prospective description study of telemedicine during the first COVID-19 outbreak in a Swiss primary care practice

2020 ◽  
Author(s):  
Joëlle Suillot ◽  
Sophie Zuercher ◽  
Lydie Zufferey ◽  
Julien Sagez
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Practice ◽  
Emergency Services ◽  
Phone Call ◽  
Categorical Variables ◽  
Care Practice ◽  
Or Groups ◽  
Swiss Primary Care

Abstract Background: Telemedicine is a healthcare assistance method which has been promoted during the COVID-19 pandemic for the management of patients. The aim of this study is to quantify the type of request that primary care physicians are experiencing, as well as the healthcare assistance modalities and ultimately, how many physical consultations are necessary.Methods: We conducted a prospective, descriptive study in a primary care practice in Switzerland on telephone consultations related to COVID-19. The data collected included the reasons for the call, symptoms, healthcare assistance modalities and follow-up. The categorical variables are expressed as percentages of the total cases or groups.Results: We included 200 calls corresponding to 113 patients. The majority of patients (76.1%) were taken care of solely through telemedicine. The physical consultations were due to the need: for a swab test (12.4%), for a somatic assessment at the practice (9.7%) and for an emergency services consultation (1.8%). In 64.6% of cases, patient assistance required only one phone call. Calls lasted 7.85 minutes on average and were more frequent on Mondays (24%) and Fridays (18.5%). Calls led to the prescription of medication in 12.5% of cases, of a bronchodilator in 3% of cases and of an antibiotic in 0.5% of cases.Conclusion: A rigorous telephone follow-up strategy carried out by primary care physicians requires few physical consultations in patients showing symptoms of COVID-19.

scholarly journals The chronic need to improve the management of pain

2003 ◽  
Vol 8 (4) ◽  
pp. 187-188 ◽  
Author(s):  
Eldon Tunks
Keyword(s):  
Primary Care ◽  
Palliative Care ◽  
Primary Care Physicians ◽  
Opioid Analgesics ◽  
Care Practice ◽  
Eligibility Criteria ◽  
Chronic Noncancer Pain ◽  
Primary Care Doctors ◽  
Third Line ◽  
Noncancer Pain

In this issue, Drs Morley-Forster, Clark, Speechley and Moulin report on their survey conducted by Ipsos-Reid in June 2001 (pages 189-194). Only physicians who met the eligibility criteria of having written 20 or more prescriptions for moderate to severe pain in the preceding four weeks or having devoted 20% of their time to palliative care were eligible to participate. Sixty-eight per cent of the respondents thought that moderate to severe chronic pain was not well managed in Canada. Despite this opinion, 23% of physicians in palliative care practice and 34% of primary care doctors stated that they would not use opioids to treat moderate to severe chronic noncancer pain even as a third-line treatment after two previous medications had failed. One-quarter to one-third were concerned about the potential for addiction, and a smaller percentage reported concern about the potential for patient abuse and/or misuse, and side effects. Fear of a College audit resulting in the loss of their medical licence was cited by 10% of primary care physicians. When asked what obstacle hindered their use of strong opioid analgesics, an unexplained 10% of palliative care doctors and 14% of primary care doctors answered "nothing in particular".

Transition for Youth With Chronic Conditions: Primary Care Physicians’ Approaches

PEDIATRICS ◽  
2002 ◽  
Vol 110 (Supplement_3) ◽  
pp. 1315-1321 ◽  
Author(s):  
Peter Scal
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Chronic Conditions ◽  
Primary Care Physicians ◽  
Care Transitions ◽  
Transition Services ◽  
Professional Organizations ◽  
Care Practice ◽  
Primary Care Settings ◽  
Health Care Transitions

Since the US Surgeon General’s conference on health care transitions in 1989, transition from pediatric to adult-oriented health care for youth with chronic conditions continues to develop as an important issue among youth, parents, and health professionals. Key professional organizations, public agencies, and disease-specific organizations have promoted research on transition and the development of transition services. Although there is evidence of the advancement of the science and practice of transition in the context of subspecialty medical care, the same may not be true for transition in the context of primary care practice. Little has been written about the role of the primary care provider in facilitating transition, and little is published in the medical literature about how transition occurs in primary care settings.

scholarly journals Primary Care Practice Addressing Child Overweight and Obesity: A Survey of Primary Care Physicians at Four Clinics in Southern Appalachia

2011 ◽  
Vol 104 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Nicole Holt ◽  
Karen E. Schetzina ◽  
William T. Dalton ◽  
Fred Tudiver ◽  
Hazel Fulton-Robinson ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Physicians ◽  
Primary Care Practice ◽  
Overweight And Obesity ◽  
Care Practice ◽  
Southern Appalachia ◽  
Child Overweight

scholarly journals Impact of financial incentives for primary care to give long acting reversible contraceptive advice

2020 ◽  
Vol 30 (Supplement_5) ◽  
Author(s):  
R Ma ◽  
E Cecil ◽  
R French ◽  
A Bottle ◽  
S Saxena
Keyword(s):  
Primary Care ◽  
Financial Incentives ◽  
Primary Care Physicians ◽  
Pay For Performance ◽  
Age Groups ◽  
Step Change ◽  
Practice Research ◽  
Care Practice ◽  
Clinical Practice Research Datalink ◽  
Long Acting

Abstract Background Long acting reversible contraceptives (LARC) are cost-effective but uptake remains poor even in high income settings. In 2009/10, a pay-for-performance (P4P) scheme in the United Kingdom was introduced for primary care physicians to offer advice about LARC to women attending for contraceptive care. We examined the equity and impact of this scheme on LARC uptake and abortions Methods We examined records of women aged 13 to 54 years registered with a primary care practice in the UK Clinical Practice Research Datalink from 2004/05 to 2013/14. We used interrupted time series analysis to examine trends in annual LARC and non-LARC hormonal contraception (NLHC) uptake and abortion rates, stratified by age, region and deprivation groups, before and after P4P was introduced in 2009/10. Results LARC uptake among women of all ages increased immediately after P4P with step change of 5.36 per 1,000 women (95% CI 5.26 to 5.45). Largest increase was in women aged 20 to 24 years (8.40, 8.34 to 8.47). NLHC uptake fell in all women with a step change of -22.9 (-24.5 to -21.2). Among LARC methods, contraceptive injection and implant had the greatest increase after P4P; step changes were 1.68 (1.67 to 1.70) and 1.64 (1.63 to 1.65) respectively. Abortion rates fell across all 12 regions in UK and in all women immediately after P4P with a step change of -2.28 (-2.99 to -1.57). The largest falls occurred in women aged 13 to 19 years (step change -5.04, -7.56 to -2.51) and women from the most deprived group (step change -4.40, -6.89 to -1.91). Conclusions Pay-for-performance scheme for primary care physicians to give LARC advice to women attending for contraception was associated with desirable impact and equity of LARC prescriptions and abortion. LARC uptake increased in women of all ages, especially 13-19 and 20-24 years. Abortion rates fell in all UK regions and age groups, particularly 13-19 and 20-24 years and those from deprived quintile. Key messages Pay-for-performance scheme for primary care practitioners to give LARC advice to women attending for contraception was associated with desirable impact and equity of LARC prescriptions and abortion. LARC uptake increased in women of all ages, especially 13-19 and 20-24 years. Abortion rates fell in all UK regions and age groups, particularly 13-19 and 20-24 years and those from deprived quintile.

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