scholarly journals Knowledge and attitudes of primary care physicians in the management of patients at risk for cardiovascular events

2008 ◽  
Vol 9 (1) ◽  
Author(s):  
Hamidreza Doroodchi ◽  
Maziar Abdolrasulnia ◽  
Jill A Foster ◽  
Elyse Foster ◽  
Mintu P Turakhia ◽  
...  
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Primary Care Physicians ◽  
Cardiovascular Events ◽  
Knowledge And Attitudes ◽  
Patients At Risk

scholarly journals Evaluation of the Fracture Liaison Service within the Canadian Healthcare Setting

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Matthew Wong-Pack ◽  
Nawazish Naqvi ◽  
George Ioannidis ◽  
Ramy Khalil ◽  
Alexandra Papaioannou ◽  
...  
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Primary Care Physicians ◽  
Osteoporotic Fractures ◽  
Fracture Liaison Service ◽  
Care Physician ◽  
Osteoporosis Management ◽  
Patients At Risk ◽  
Fracture Liaison ◽  
Canadian Healthcare

Previous studies evaluating fracture liaison service (FLS) programs have found them to be cost-effective, efficient, and reduce the risk of fracture. However, few studies have evaluated the clinical effectiveness of these programs. We compared the patient populations of those referred for osteoporosis management by FLS to those referred by primary care physicians (PCP), within the Canadian healthcare system in the province of Ontario. Specifically, we investigated if a referral from FLS is similarly effective as PCP at identifying patients at risk for future osteoporotic fractures and if osteoporosis therapies have been previously initiated. A retrospective chart review of patients assessed by a single Ontario rheumatology practice affiliated with FLS between January 1, 2014, and December 31, 2017, was performed identifying two groups: those referred by FLS within Hamilton and those referred by their PCP for osteoporosis management. Fracture risk of each patient was determined using FRAX. A total of 573 patients (n = 225 (FLS group) and n = 227 (PCP group)) were evaluated. Between the FLS and PCP groups, there were no significant differences in the absolute 10-year risk of a major osteoporotic fracture (15.6% (SD = 10.2) vs 15.3% (SD = 10.3)) and 10-year risk of hip fracture (4.7% (SD = 8.3) vs 4.7% (SD = 6.8)), respectively. 10.7% of patients referred by FLS and 40.5% of patients referred by their PCP were on osteoporosis medication prior to fracture. Our study suggests that referral from FLS is similarly effective as PCP at identifying patients at risk for future osteoporotic fractures, and clinically effective at identifying the care gap with the previous use of targeted osteoporosis therapies from referral from PCP being low and much lower in those referred by FLS. Interventional programs such as FLS can help close the treatment gap by providing appropriate care to patients that were not previously identified to be at risk for fracture by their primary care physician and initiate proper medical management.

scholarly journals Addressing Suicide Risk According to Different Healthcare Professionals in Spain: A Qualitative Study

2018 ◽  
Vol 15 (10) ◽  
pp. 2117 ◽  
Author(s):  
Juan-Luis Muñoz-Sánchez ◽  
María Sánchez-Gómez ◽  
María Martín-Cilleros ◽  
Esther Parra-Vidales ◽  
Diego de Leo ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
At Risk ◽  
Suicidal Behavior ◽  
Emergency Care ◽  
Health Care Professionals ◽  
Primary Care Physicians ◽  
Healthcare Professionals ◽  
Main Concern ◽  
Patients At Risk

This study analyzes the views of four groups of healthcare professionals who may play a role in the management of suicidal behavior. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management, and prevention of suicidal behavior. Professionals included were primary care physicians, psychologists, psychiatrists, and emergency physicians. ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, danger’, or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviors are first in importance. Prevention was the second main concern with greater significance among psychiatrists. Primary care professionals call for more time to address patients at risk for suicide and easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in cases of self-harm, but they would like to receive specific training in dealing with suicidal behavior.

scholarly journals Addressing Suicide Risk According to Different Healthcare Professionals in Spain: A Qualitative Study

2018 ◽  
Author(s):  
Juan-Luis Muñoz-Sanchez ◽  
María Cruz Sánchez-Gómez ◽  
María Victoria Martín-Cilleros ◽  
Esther Parra-Vidales ◽  
Diego de Leo ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
At Risk ◽  
Emergency Care ◽  
Health Care Professionals ◽  
Suicidal Behaviour ◽  
Primary Care Physicians ◽  
Healthcare Professionals ◽  
Main Concern ◽  
Patients At Risk

OBJETIVE: This study analyses the views of four groups of healthcare professionals who may play a role in the management of suicidal behaviour. The goal was to identify key factors for suicide prevention in different areas of the healthcare system. METHODOLOGY: Qualitative research was conducted using focus groups made up of different healthcare professionals who participated in the identification, management and prevention of suicidal behaviour. Professionals included were primary care physicians, psychologists, psychiatrists and emergency physicians. RESULTS: ‘Suicide’ was amongst the most relevant terms that came up in discussions most of the times it appeared associated with words such as ‘risk’, ‘danger’ or ‘harm’. In the analysis by categories, the four groups of professionals agreed that interventions in at-risk behaviours are first in importance. Prevention was the second main concern with greater significance among psychiatrists. DISCUSSION: Primary care professionals claim for more time to address patients at risk for suicide and an easier access to and communication with the mental health network. Emergency care professionals have a lack of awareness of their role in the detection of risk for suicide in patients who seek attention at emergency care facilities for reasons of general somatic issues. Mental health care professionals are in high demand in case of self-harm but they would like to receive specific training in dealing with g suicidal behaviour.

scholarly journals Platelet-reactivity tests identify patients at risk of secondary cardiovascular events: a systematic review and meta-analysis

2014 ◽  
Vol 12 (5) ◽  
pp. 736-747 ◽  
Author(s):  
P. P. Wisman ◽  
M. Roest ◽  
F. W. Asselbergs ◽  
P. G. de Groot ◽  
F. L. Moll ◽  
...  
Keyword(s):  
Systematic Review ◽  
At Risk ◽  
Cardiovascular Events ◽  
Platelet Reactivity ◽  
Meta Analysis ◽  
Patients At Risk

scholarly journals Using the electronic health record to build a culture of practice safety: evaluating the implementation of trigger tools in one general practice

2018 ◽  
Vol 68 (669) ◽  
pp. e279-e285 ◽  
Author(s):  
Tom Margham ◽  
Natalie Symes ◽  
Sally A Hull
Keyword(s):  
Primary Care ◽  
At Risk ◽  
General Practice ◽  
Patient Safety ◽  
Ease Of Use ◽  
High Yield ◽  
Case Review ◽  
Patients At Risk ◽  
Barriers To Implementation ◽  
Narrative Evaluation

BackgroundIdentifying patients at risk of harm in general practice is challenging for busy clinicians. In UK primary care, trigger tools and case note reviews are mainly used to identify rates of harm in sample populations.AimThis study explores how adaptions to existing trigger tool methodology can identify patient safety events and engage clinicians in ongoing reflective work around safety.Design and settingMixed-method quantitative and narrative evaluation using thematic analysis in a single East London training practice.MethodThe project team developed and tested five trigger searches, supported by Excel worksheets to guide the case review process. Project evaluation included summary statistics of completed worksheets and a qualitative review focused on ease of use, barriers to implementation, and perception of value to clinicians.ResultsTrigger searches identified 204 patients for GP review. Overall, 117 (57%) of cases were reviewed and 62 (53%) of these cases had patient safety events identified. These were usually incidents of omission, including failure to monitor or review. Key themes from interviews with practice members included the fact that GPs’ work is generally reactive and GPs welcomed an approach that identified patients who were ‘under the radar’ of safety. All GPs expressed concern that the tool might identify too many patients at risk of harm, placing further demands on their time.ConclusionElectronic trigger tools can identify patients for review in domains of clinical risk for primary care. The high yield of safety events engaged clinicians and provided validation of the need for routine safety checks.

scholarly journals Blood hydrogen peroxide break-down activity in healthy subjects and in patients at risk of cardiovascular events

2018 ◽  
Vol 274 ◽  
pp. 29-34 ◽  
Author(s):  
Roberto Carnevale ◽  
Cristina Nocella ◽  
Pasquale Pignatelli ◽  
Simona Bartimoccia ◽  
Lucia Stefanini ◽  
...  
Keyword(s):  
Hydrogen Peroxide ◽  
At Risk ◽  
Healthy Subjects ◽  
Cardiovascular Events ◽  
Patients At Risk

Identifying Patients at Risk for Fibrosis in a Primary Care NAFLD Cohort

2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Andrew D. Schreiner ◽  
Sherry Livingston ◽  
Jingwen Zhang ◽  
Mulugeta Gebregziabher ◽  
Justin Marsden ◽  
...  
Keyword(s):  
Primary Care ◽  
At Risk ◽  
Patients At Risk

Abstract 83: Effect of Dietary Cholesterol and Egg Consumption On Mortality And Cardiovascular Risk in the REGARDS Study

Stroke ◽  
2015 ◽  
Vol 46 (suppl_1) ◽  
Author(s):  
J David Spence ◽  
Suzanne Judd ◽  
Virginia Howard ◽  
Monika Safford ◽  
George Howard
Keyword(s):  
At Risk ◽  
Racial Differences ◽  
Cardiovascular Events ◽  
Dietary Cholesterol ◽  
Total Mortality ◽  
Egg Yolk ◽  
Community Dwelling ◽  
Egg Consumption ◽  
Patients At Risk ◽  
Regards Study

Background and purpose: It has long been recommended that patients at risk of cardiovascular events limit their intake of dietary cholesterol to <200 mg/day. One large egg yolk contains more than 200mg of cholesterol, and also contains 250mg of phosphatidylcholine, which is converted by intestinal bacterial to trimethylamine. In the face of increasingly widespread belief that consumption of dietary cholesterol and eggs is harmless, we analyzed the effects of these dietary constituents on mortality and cardiovascular outcomes in the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study population. Methods: A longitudinal cohort study of 30,239 community-dwelling black and white individuals aged 45+ years, recruited between January 2003 and October 2007 from the 48 contiguous states. The study oversampled black participants (44%), and residents of the southeastern “stroke belt” (56%). We analyzed total mortality and atherosclerotic events (ischemic stroke, myocardial infarction and revascularization) after 4.9 (SD 1.7) years of followup. Hazard ratios were computed for egg consumption and cholesterol consumption by quartiles, adjusted for race, age, sex, income, education, region, dyslipidemia, exercise, hypertension, diabetes, smoking, atrial fibrillation and caloric intake. Results: As shown in the table, there was a dose-related increase in all-cause mortality and atherosclerotic events with both cholesterol intake and egg consumption. Conclusions: Recommendations to limit the intake of cholesterol remain good advice for patients at risk of cardiovascular events. As one large egg yolk contains more than the daily recommended intake of cholesterol, egg yolk consumption should also be limited.

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