HIV/AIDS challenges the normative model of healthcare delivery in Canada

2001 ◽  
Vol 14 (1) ◽  
pp. 55-61 ◽  
Author(s):  
P. Tsasis
Keyword(s):  
Primary Care ◽  
Human Immunodeficiency Virus ◽  
Chronic Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Healthcare Delivery ◽  
Acute Illness ◽  
Hiv Care ◽  
Normative Model ◽  
Immunodeficiency Virus

With advances in therapeutics, effective therapy for human immunodeficiency virus (HIV) has shifted the focus of HIV care from an acute illness to a chronic disease requiring the services of several disciplines in a primary care setting. This article describes a collaborative model in the delivery of HIV care for HIV-infected individuals who remain fragile, both physically and psychosocially.

HIV/AIDS Challenges the Normative Model of Healthcare Delivery in Canada

2001 ◽  
Vol 14 (1) ◽  
pp. 55-61 ◽  
Author(s):  
P. Tsasis
Keyword(s):  
Primary Care ◽  
Human Immunodeficiency Virus ◽  
Chronic Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Healthcare Delivery ◽  
Acute Illness ◽  
Hiv Care ◽  
Normative Model ◽  
Immunodeficiency Virus

With advances in therapeutics, effective therapy for human immunodeficiency virus (HIV) has shifted the focus of HIV care from an acute illness to a chronic disease requiring the services of several disciplines in a primary care setting. This article describes a collaborative model in the delivery of HIV care for HIV-infected individuals who remain fragile, both physically and psychosocially.

Assessment of Life's Simple 7™ in the primary care setting: The Stroke Prevention in Healthcare Delivery EnviRonmEnts (SPHERE) study

2014 ◽  
Vol 38 (2) ◽  
pp. 182-189 ◽  
Author(s):  
Randi E. Foraker ◽  
Abigail B. Shoben ◽  
Marcelo A. Lopetegui ◽  
Albert M. Lai ◽  
Philip R.O. Payne ◽  
...  
Keyword(s):  
Primary Care ◽  
Stroke Prevention ◽  
Care Setting ◽  
Primary Care Setting ◽  
Healthcare Delivery ◽  
Life’S Simple 7 ◽  
Life's Simple 7

scholarly journals Australian practice nurses’ perceptions of their role and competency to provide nutrition care to patients living with chronic disease

2014 ◽  
Vol 20 (2) ◽  
pp. 203 ◽  
Author(s):  
Sarah Cass ◽  
Lauren Ball ◽  
Michael Leveritt
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Nutrition Education ◽  
Care Setting ◽  
Primary Care Setting ◽  
Practice Nurses ◽  
Nutrition Care ◽  
Nurses Perceptions ◽  
Basic Level

Nutrition is important in the management of chronic disease, and practice nurses in the Australian primary care setting are increasingly providing nutrition care to patients living with chronic disease. The aim of the present study was to investigate practice nurses’ perceptions of their role and competency to provide nutrition care to patients living with chronic disease in Australia. Twenty practice nurses currently employed in general practice participated in an individual semi-structured telephone interview. Interviews were transcribed verbatim and thematically analysed. Practice nurses perceived themselves to be in a prime position to provide opportunistic nutrition care to patients. Participants perceived that the ideal role of a practice nurse is to advocate for nutrition and provide a basic level of nutrition care to patients; however, the interpretation of the term ‘basic’ varied between participants. Participants perceived that practice nurses are highly trusted and approachable, which they valued as important characteristics for the provision of nutrition care. Barriers to providing nutrition care included time constraints, lack of nutrition knowledge and lack of confidence. Participants were concerned about the availability and accessibility of nutrition education opportunities for practice nurses. The present study has demonstrated that practice nurses perceive themselves as having a significant role in the provision of nutrition care to patients with chronic disease in the Australian primary care setting. Further investigation of strategies to enhance the effectiveness of nutrition care provision by practice nurses is warranted.

scholarly journals Impact on an integrated psychiatric pharmacy service in a primary care clinic

2019 ◽  
Vol 9 (4) ◽  
pp. 269-274
Author(s):  
Benjamin Chavez ◽  
Emily Kosirog
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Care Setting ◽  
Primary Care Setting ◽  
Pharmacy Service ◽  
Psychiatric Disease ◽  
Care Practice ◽  
Psychiatric Medication ◽  
State Management ◽  
Disease States

Abstract Introduction Traditionally, clinical pharmacists have been employed in the primary care setting to help manage chronic disease states, such as diabetes and hypertension. Although the benefits of pharmacists managing chronic conditions have been extensively published, published data for clinical pharmacist mental health services in primary care is limited to Veterans Affairs populations. This article describes a practice model in which pharmacists are providing psychiatric medication management and consultation in a federally qualified health center. Methods A period of 1 year from the psychiatric pharmacy service was analyzed from April 1, 2017, to March 31, 2018. Reports were generated that included information about psychiatric pharmacy consults, 1-on-1 psychiatric pharmacy visits, and psychotropic medication prescribing/dispensing trends. Each consult was further reviewed for additional details, including patient characteristics, medications prescribed, psychiatric diagnoses involved, and actions taken. Results A review of this pharmacy service showed significant pharmacist involvement in psychiatric medication consults and 1-on-1 visits. Common disease states consulted on were depressive disorders, anxiety disorders, and neurologic disorders, which reflects psychiatric disease states commonly seen in primary care practice. Provider satisfaction survey results showed that the service was valued and that providers felt their comfort in prescribing psychotropic medications improved due to the service. Discussion The service described here exemplifies the potential for pharmacists in the ambulatory care setting to expand beyond the traditional chronic disease state management. It also speaks to a potential role for psychiatric pharmacists in the primary care setting.

scholarly journals Should Human Immunodeficiency Virus Specialty Clinics Treat Patients With Hypertension or Refer to Primary Care? An Analysis of Treatment Outcomes

2017 ◽  
Vol 4 (1) ◽  
Author(s):  
A. Ben Appenheimer ◽  
Barbara Bokhour ◽  
D. Keith McInnes ◽  
Kelly K. Richardson ◽  
Andrew L. Thurman ◽  
...  
Keyword(s):  
Primary Care ◽  
Human Immunodeficiency Virus ◽  
Opportunistic Infections ◽  
Shared Care ◽  
Hiv Care ◽  
Veterans Administration ◽  
Multidisciplinary Teams ◽  
Primary Care Clinics ◽  
Immunodeficiency Virus ◽  
National Cohort

Abstract Background Care for people with human immunodeficiency virus (HIV) increasingly focuses on comorbidities, including hypertension. Evidence indicates that antiretroviral therapy and opportunistic infections are best managed by providers experienced in HIV medicine, but it is unclear how to structure comorbidity care. Approaches include providing comorbidity care in HIV clinics (“consolidated care”) or combining HIV care with comorbidity management in primary care clinics (“shared care”). We compared blood pressure (BP) control in HIV clinics practicing consolidated care versus shared care. Methods We created a national cohort of Veterans with HIV and hypertension receiving care in HIV clinics in Veterans Administration facilities and merged these data with a survey asking HIV providers how they delivered hypertension care (5794 Veterans in 73 clinics). We defined BP control as BP ≤140/90 mmHg on the most recent measure. We compared patients’ likelihood of experiencing BP control in clinics offering consolidated versus shared care, adjusting for patient and clinic characteristics. Results Forty-two of 73 clinics (57.5%) practiced consolidated care for hypertension. These clinics were larger and more likely to use multidisciplinary teams. The unadjusted frequency of BP control was 65.6% in consolidated care clinics vs 59.4% in shared care clinics (P < .01). The likelihood of BP control remained higher for patients in consolidated care clinics after adjusting for patient and clinic characteristics (odds ratio, 1.32; 95% confidence interval, 1.04–1.68). Conclusions Patients were more likely to experience BP control in clinics reporting consolidated care compared with clinics reporting shared care. For shared-care clinics, improving care coordination between HIV and primary care clinics may improve outcomes.

scholarly journals Treating Pediatric Obesity in the Primary Care Setting to Prevent Chronic Disease: Perceptions and Knowledge of Providers and Staff

2012 ◽  
Vol 73 (1) ◽  
pp. 9-14
Author(s):  
Mina Silberberg ◽  
Lori Carter-Edwards ◽  
Gwen Murphy ◽  
Meghan Mayhew ◽  
Kathryn Kolasa ◽  
...  
Keyword(s):  
Primary Care ◽  
Chronic Disease ◽  
Pediatric Obesity ◽  
Care Setting ◽  
Primary Care Setting
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