scholarly journals Trends in health services utilization, medication use, and health conditions among older adults: a 2-year retrospective chart review in a primary care practice

2009 ◽  
Vol 9 (1) ◽  
Author(s):  
Ketan Vegda ◽  
Jason X Nie ◽  
Li Wang ◽  
C Shawn Tracy ◽  
Rahim Moineddin ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Health Services ◽  
Chart Review ◽  
Primary Care Practice ◽  
Medication Use ◽  
Retrospective Chart Review ◽  
Health Conditions ◽  
Care Practice ◽  
Services Utilization

scholarly journals Referral pathways between the mental health services and Jigsaw

2018 ◽  
Vol 36 (3) ◽  
pp. 195-199
Author(s):  
E. Beatty ◽  
R. Keogh ◽  
D. Cohen ◽  
G. McDonald ◽  
C. McDonald ◽  
...  
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Mental Health Services ◽  
Health Services ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Mental Health Difficulties ◽  
Self Harm ◽  
Clinical Profiles ◽  
Similarities And Differences

ObjectivesTo examine similarities and differences in the demographic and clinical profiles of young people (15–25 years of age) referred between the mental health services (MHS) and Jigsaw Galway.MethodsA retrospective chart review was conducted of clinical files of individuals attending secondary MHS who had been referred to or from Jigsaw Galway over a 5-year period. Differences in demographic and clinical data between individuals referred to or from Jigsaw Galway were compared.ResultsA recent act of self-harm was more prevalent in individuals referred from Jigsaw to the adult MHS (p=0.02). No other demographic or clinical differences were detected between individuals attending Jigsaw Galway and the MHS.ConclusionsEducation sessions for clinical staff working in primary care, Jigsaw Galway and the MHS are suggested to support clinicians in choosing the best referral pathway, which may more optimally address young people’s mental health difficulties.

scholarly journals Exploring Pharmacy Trainee Experiential Learning in a Full Scope Collaborative Rural Primary Care Practice: A Retrospective Chart Review

Pharmacy ◽  
2021 ◽  
Vol 9 (3) ◽  
pp. 155
Author(s):  
Sara Robinson ◽  
Feng Chang
Keyword(s):  
Primary Care ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Drug Level ◽  
Care Practice ◽  
Patient Transfers ◽  
Rural Primary Care ◽  
Time Basis ◽  
Acceptance Rates ◽  
The Impact

Despite reported benefits of pharmacy trainees (e.g., pharmacy students, pharmacy residents) in hospital settings, limited research on the impact of these trainees has been conducted in rural primary care. To explore the potential benefits and impact of pharmacy trainees practicing in a supervised collaborative rural primary care setting, a retrospective chart review was conducted. Drug therapy problems (DTPs) were classified using the Pharmaceutical Care Network Europe (PCNE V9) system. Valuation was measured using a validated tool developed by Overhage and Lukes (1999). Over 16 weeks on a part-time basis, pharmacy trainees (n = 3) identified 366 DTPs during 153 patient encounters. The most common causes for DTPs were related to patient transfers and the need for education. Drug level interventions carried out directly by trainees under supervision accounted for 13.1% of total interventions. Interventions that required prescriber authorization had an acceptance rate of 83.25% higher than previous acceptance rates found in urban primary care settings. About half (51%) of the interventions proposed and made by pharmacy trainees were classified as significant or very significant, suggesting these trainees added significant value to the pharmacy service provided to rural community residents. This study suggests that pharmacy trainees can be effective resources and contribute meaningfully to patient care in a collaborative rural primary care team setting.

The Effect of a Primary Care Practice–Based Depression Intervention on Mortality in Older Adults

2008 ◽  
Vol 148 (3) ◽  
pp. 245 ◽  
Author(s):  
Joseph J. Gallo ◽  
Knashawn Morales ◽  
Edward Post ◽  
Hillary Bogner ◽  
Julia Lin ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Primary Care Practice ◽  
Care Practice ◽  
Depression Intervention

scholarly journals Transforming Primary Care Practice Into Age-Friendly Health Systems

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 729-729
Author(s):  
Marla Berg-Weger ◽  
Erin Emery-Tiburcio ◽  
Nina Tumosa
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Primary Care Practice ◽  
Medical Center ◽  
Well Being ◽  
Falls Prevention ◽  
Care Practice ◽  
Saint Louis ◽  
Saint Louis University ◽  
Rural And Urban

Abstract Transforming primary care practice to improve the health of older adults is a major focus of the Geriatric Workforce Enhancement Program (GWEP). Using the 4Ms of an Age-Friendly Health System (What Matters, Mentation, Medication, and Mobility) as a framework, presenters will describe their GWEP’s ongoing development, training, and evaluation initiatives aimed at increasing providers’ knowledge and practice skills, and improving older adult’s health outcomes. These initiatives are creating increased professional competencies in geriatric care that will: 1) help older adults maximize their health and wellbeing, and 2) better support caregivers and families. In this symposium, presenters from three GWEPs, Pennsylvania State University, Rush University Medical Center, and Saint Louis University will describe AFHS initiatives with rural and urban primary care partner sites. Educational and programmatic initiatives and strategies that map onto the 4Ms that will be discussed including geriatric assessment, dementia-focused interventions, falls prevention, opioid assessment, and caregiver well-being and support. Outcomes in older adult’s health and functional status will be discussed. Presenters will highlight the importance of building AFHS in primary care and strategies to bridge this framework into the community.

scholarly journals Potential for Integrating Mental Health Specialist Video Consultations in Office-Based Routine Primary Care: Cross-Sectional Qualitative Study Among Family Physicians

10.2196/13382 ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. e13382 ◽  
Author(s):  
Mariell Hoffmann ◽  
Mechthild Hartmann ◽  
Michel Wensing ◽  
Hans-Christoph Friederich ◽  
Markus W Haun
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Qualitative Study ◽  
Primary Care Practice ◽  
Family Physicians ◽  
Health Conditions ◽  
Care Practice ◽  
Cross Sectional ◽  
Mental Health Specialist ◽  
Health Specialist

Background Although real-time mental health specialist video consultations have been proposed as an effective care model for treating patients with mental health conditions in primary care, little is known about their integration into routine practice from the perspective of family physicians. Objective This study aimed to determine the degree to which family physicians advocate that mental health specialist video consultations can be integrated into routine primary care, where most patients with mental health conditions receive treatment. Methods In a cross-sectional qualitative study, we conducted 4 semistructured focus groups and 3 telephonic interviews in a sample of 19 family physicians from urban and rural districts. We conducted a qualitative content analysis applying the Tailored Implementation in Chronic Diseases framework in a combined bottom-up (data-driven) and top-down strategy for deriving key domains. Results Family physicians indicated that mental health specialist video consultations are a promising and practical way to address the most pressing challenges in current practice, that is, to increase the accessibility and co-ordination of specialized care. Individual health professional factors were the most frequently discussed topics. Specifically, family physicians valued the anticipated clinical outcomes for patients and the anticipated resources set for the primary care practice as major facilitators (16/19, 84%). However, family physicians raised a concern regarding a lack of facial expressions and physical interaction (19/19, 100%), especially in emergency situations. Therefore, most family physicians considered a viable emergency plan for mental health specialist video consultations that clearly delineates the responsibilities and tasks of both family physicians and mental health specialists to be essential (11/19, 58%). Social, political, and legal factors, as well as guideline factors, were hardly discussed as prerequisites for individual family physicians to integrate mental health specialist video consultations into routine care. To facilitate the implementation of future mental health specialist video consultation models, we compiled a checklist of recommendations that covers (1) buy-in from practices (eg, emphasizing logistical and psychological relief for the practice), (2) the engagement of patients (eg, establishing a trusted patient-provider relationship), (3) the setup and conduct of consultations (eg, reliable emergency plans), and (4) the fostering of collaboration between family physicians and mental health specialists (eg, kick-off meetings to build trust). Conclusions By leveraging the primary care practice as a familiar environment for patients, mental health specialist video consultations provide timely specialist support and potentially lead to benefits for patients and more efficient processes of care. Integration should account for the determinants of practice as described by the family physicians. Trial Registration German Clinical Trials Register DRKS00012487; https://www.drks.de/drks_web/navigate.do? navigationId=trial.HTML&TRIAL_ID=DRKS00012487

scholarly journals The Effect of a Primary Care Practice–Based Depression Intervention on Mortality in Older Adults

2007 ◽  
Vol 146 (10) ◽  
pp. 689 ◽  
Author(s):  
Joseph J. Gallo ◽  
Hillary R. Bogner ◽  
Knashawn H. Morales ◽  
Edward P. Post ◽  
Julia Y. Lin ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Primary Care Practice ◽  
Care Practice ◽  
Depression Intervention

scholarly journals Pharmacist-led sedative-hypnotic deprescribing in team-based primary care practice

2021 ◽  
pp. 171516352110149
Author(s):  
Eric Lui ◽  
Kimberly Wintemute ◽  
Maria Muraca ◽  
Christine Truong ◽  
Rita Ha ◽  
...  
Keyword(s):  
Primary Care ◽  
Primary Care Practice ◽  
Statistical Significance ◽  
Retrospective Chart Review ◽  
Behavioural Therapy ◽  
Care Practice ◽  
Cognitive Behavioural ◽  
Lost To Follow Up ◽  
Community Team ◽  
Complete Abstinence

Background: Sedative-hypnotic (SH) medications are often used to treat chronic insomnia, with potentially serious long-term side effects. The objective of this study is to evaluate an interprofessional SH deprescribing program within a community team-based, primary care practice, with or without cognitive behavioural therapy for insomnia (CBT-I). Methods: Retrospective chart review for patients referred to the team pharmacist for SH deprescribing from February 2016 to June 2019. Results: A total of 121 patients were referred for SH deprescribing, with 111 (92%) patients who attempted deprescribing (average age 69, range 29-97 years) and 22 patients who also received CBT-I. Overall, 36 patients (32%) achieved complete abstinence, and another 36 patients (32%) reduced their dosage by ≥50%. For the 36 patients who achieved complete abstinence, 26 (72%) patients remained abstinent at 6 months (9 patients resumed using SH and 1 patient was lost to follow-up). The proportion of patients achieving complete abstinence or reduced dosage of ≥50% (successful tapering) was higher with CBT-I than without CBT-I but did not reach statistical significance (77% vs 62%, p = 0.22). There were also no statistically significant differences detected in the success between those who took a benzodiazepine and those who took a Z-drug (67% vs 61%, p = 0.55) or for those who took SH daily and those who took them intermittently (67% vs 44%, p = 0.09). Conclusion: Almost two-thirds of patients participating in our pharmacist-led program were able to stop or taper their SH medications by ≥50%. The role of CBT-I in SH deprescribing remains to be further elucidated. Can Pharm J (Ott) 2021;154:xx-xx.

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