Preventive Care of Liver Disease by Primary Care Providers

2009 ◽  
Vol 104 ◽  
pp. S153-S154
Author(s):  
Freddy Caldera ◽  
Maria Melguiz-Castro ◽  
Jeffrey Gilbert ◽  
Lisbeth Selby
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Preventive Care ◽  
Primary Care Providers ◽  
Care Providers

scholarly journals A Primary Care Provider’s Guide to Preventive Health After Spinal Cord Injury

2020 ◽  
Vol 26 (3) ◽  
pp. 209-219
Author(s):  
James Milligan ◽  
Stephen Burns ◽  
Suzanne Groah ◽  
Jeremy Howcroft
Keyword(s):  
Primary Care ◽  
Health Care ◽  
Spinal Cord ◽  
Spinal Cord Injury ◽  
Preventive Care ◽  
Primary Care Providers ◽  
Preventive Health ◽  
Care Providers ◽  
Health Maintenance ◽  
Cord Injury

Objective: Provide guidance for preventive health and health maintenance after spinal cord injury (SCI) for primary care providers (PCPs). Main message: Individuals with SCI may not receive the same preventive health care as the general population. Additionally, SCI-related secondary conditions may put their health at risk. SCI is considered a complex condition associated with many barriers to receiving quality primary care. Attention to routine preventive care and the unique health considerations of persons with SCI can improve health and quality of life and may prevent unnecessary health care utilization. Conclusion: PCPs are experts in preventive care and continuity of care, however individuals with SCI may not receive the same preventive care due to numerous barriers. This article serves as a quick reference for PCPs.

scholarly journals Usual Source of Primary Care and Preventive Care Measures in a Pandemic: A Nationwide Study in Japan

2021 ◽  
Author(s):  
Takuya Aoki ◽  
Yasuki Fujinuma ◽  
Masato Matsushima
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Preventive Care ◽  
Short Form ◽  
Primary Care Providers ◽  
Sensitivity Analyses ◽  
Care Providers ◽  
Usual Source ◽  
Care Assessment ◽  
Care Performance

Objectives. In a pandemic when there are many barriers to providing preventive care by health care workers, it is unclear whether primary care contributes to the quality of preventive care and what type of preventive care delivery is a challenge for primary care providers. This study aimed to assess multiple preventive care measures and to examine their associations with having a usual source of primary care and primary care performance during the COVID-19 pandemic in Japan. Design. Nationwide cross-sectional study. Setting. Japanese general adult population. Participants. 1,757 adult residents. Primary outcome measures. Fourteen preventive care measures aggregated the overall, screening, immunization, and counseling composites. Results. Depression screening, zoster vaccination, and tetanus vaccination had low implementation rates even among participants with a usual source of primary care. After adjustment for possible confounders, having a usual source of primary care was positively associated with all preventive care composites. Primary care performance assessed by the Japanese version of Primary Care Assessment Tool Short Form was also dose-dependently associated with an increase in all composites. Results of the sensitivity analyses using a different calculation of preventive care composite were similar to those of the primary analyses. Conclusions. Receipt of primary care, particularly high-quality primary care, contributed to increased preventive care utilization even during the COVID-19 pandemic. However, the rate of mental health screening in primary care was at a very low level. Therefore, addressing mental health issues should be a major challenge for primary care providers during and after the pandemic.

Nonalcoholic Fatty Liver Disease (NAFLD) for Primary Care Providers: Beyond the Liver

2020 ◽  
Vol 16 ◽  
Author(s):  
Eddison Godinez-Leiva ◽  
Fernando Bril
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Fatty Liver ◽  
Nonalcoholic Fatty Liver Disease ◽  
Fatty Liver Disease ◽  
Systemic Disease ◽  
Primary Care Providers ◽  
Major Public Health Problem ◽  
Care Providers ◽  
Nonalcoholic Fatty Liver

Abstract:: Nonalcoholic fatty liver disease (NAFLD) has consolidated as a major public health problem, affecting ~25% of the global population. This percentage is significantly higher in the setting of obesity and/or type 2 diabetes. Presence of NAFLD is associated with severe liver complications, such as nonalcoholic steatohepatitis (NASH; i.e., presence of inflammation and necrosis), cirrhosis and hepatocellular carcinoma. However, the majority of these patients die of cardiovascular disease. For this reason, management of this condition requires a multidisciplinary team, where primary care providers are at center stage. However, important misconceptions remain among primary care providers, preventing them from appropriately approach these patients. Nonalcoholic fatty liver disease should be understood as part of a systemic disease, characterized for abnormal accumulation of fat in tissues other than the adipose tissue. This, in turn, produces dysfunction of those organs or tissues (process sometimes referred to as lipotoxicity). Therefore, due to the systemic nature of this condition, it should not surprise that NAFLD is closely related to other metabolic conditions. In this review, we will focus on the extrahepatic manifestations of NAFLD and its metabolic and cardiovascular implications. We believe these are the most important issues primary care providers should understand, in order to effectively manage these complicated patients. In addition, we have provided a simple and straightforward approach to the diagnosis and treatment of patients with NAFLD and/or NASH. We hope this review will serve as a guide for primary care providers to approach their patients with NAFLD.

Chronic Liver Disease Management Among Primary Care Providers

2016 ◽  
Vol 111 ◽  
pp. S364
Author(s):  
Marijeta Pekez ◽  
Courtney Fay ◽  
Bhakti Deshmukh ◽  
Anna Thomas ◽  
Yvette Wang ◽  
...  
Keyword(s):  
Primary Care ◽  
Liver Disease ◽  
Disease Management ◽  
Chronic Liver Disease ◽  
Primary Care Providers ◽  
Chronic Liver ◽  
Care Providers

scholarly journals Newborn Screening Long Term Follow-Up in the Medical Home

2019 ◽  
Vol 5 (3) ◽  
pp. 25
Author(s):  
Deborah Badawi ◽  
Katharine Bisordi ◽  
Marilyn J. Timmel ◽  
Scott Sorongon ◽  
Erin Strovel
Keyword(s):  
Primary Care ◽  
Newborn Screening ◽  
Clinical Outcomes ◽  
Data Sharing ◽  
Preventive Care ◽  
Medical Home ◽  
Primary Care Providers ◽  
Care Providers ◽  
Long Term Outcomes

This demonstration project explored the feasibility of utilizing data from pediatric primary care providers to evaluate the long-term outcomes of children with disorders identified by newborn screening (NBS). Compliance with national guidelines for care and the morbidity for this population was also examined. Primary care practices were recruited and patients with sickle cell disease or who were deaf/hard of hearing were given the opportunity to enroll in the study. Data were collected on the quality of the medical home with practice data compared to family responses. Clinical outcomes for each patient were assessed by review of medical records and patient surveys. These data sources were compared to determine accuracy of primary care data, morbidity, and receipt of preventive care. Electronic data sharing was explored through transmission of Clinical Document Architecture (CDA) files. Care coordination was a challenge, even in highly accredited medical homes. Providers did not have complete information regarding clinical outcomes and children were not consistently receiving recommended preventive care. Electronic data sharing with public health departments encountered interface challenges. Primary care providers in the USA should not currently be used as a sole source to evaluate long-term outcomes of children with disorders identified by NBS.

scholarly journals Perspectives on Providing And Receiving Preventive Health Care From Primary Care Providers and Their Patients With Mental Illnesses

2018 ◽  
Vol 32 (8) ◽  
pp. 1730-1739 ◽  
Author(s):  
Scott P. Stumbo ◽  
Bobbi Jo H. Yarborough ◽  
Micah T. Yarborough ◽  
Carla A. Green
Keyword(s):  
Primary Care ◽  
Health Care ◽  
General Population ◽  
Behavioral Health ◽  
Preventive Care ◽  
Preventive Health Care ◽  
Primary Care Providers ◽  
Safety Net ◽  
Mental Illnesses ◽  
Care Providers

Purpose: Individuals with mental illnesses have higher morbidity rates and reduced life expectancy compared to the general population. Understanding how patients and providers perceive the need for prevention, as well as the barriers and beliefs that may contribute to insufficient care, are important for improving service delivery tailored to this population. Design: Cross-sectional; mixed methods. Setting: An integrated health system and a network of federally qualified health centers and safety net clinics. Participants: Interviews (n = 30) and surveys (n = 249) with primary care providers. Interviews (n = 158) and surveys (n = 160) with patients diagnosed with schizophrenia, bipolar, anxiety, or major depressive disorders. Measures: Semi-structured interviews and surveys. Analysis: Thematic analysis for qualitative data; frequencies for quantitative data. Results: More than half (n = 131, 53%) of clinicians believed patients with mental illnesses care less about preventive care than the general population, yet 88% (n = 139) of patients reported interest in improving health. Most providers (n = 216, 88%) lacked confidence that patients with mental illnesses would follow preventive recommendations; 82% (n = 129) of patients reported they would try to change lifestyles if their doctor recommended. Clinicians explained that their perception of patients’ chaotic lives and lack of interest in preventive care contributed to their fatalistic attitudes on care delivery to this population. Clinicians and patients agreed on substantial need for additional support for behavior changes. Clinicians reported providing informational support by keeping messages simple; patients reported a desire for more detailed information on reasons to complete preventive care. Patients also detailed the need for assistive and tangible support to manage behavioral health changes. Conclusions: Our results suggest a few clinical changes could help patients complete preventive care recommendations and improve health behaviors: improving clinician–patient collaboration on realistic goal setting, increasing visit time or utilizing behavioral health consultants that bridge primary and specialty mental health care, and increasing educational and tangible patient support services.

The Perspective of Older Men With Depression on Suicide and Its Prevention in Primary Care

Crisis ◽  
2018 ◽  
Vol 39 (5) ◽  
pp. 397-405 ◽  
Author(s):  
Steven Vannoy ◽  
Mijung Park ◽  
Meredith R. Maroney ◽  
Jürgen Unützer ◽  
Ester Carolina Apesoa-Varano ◽  
...  
Keyword(s):  
Primary Care ◽  
Low Socioeconomic Status ◽  
Thematic Analysis ◽  
Older Men ◽  
Primary Care Providers ◽  
Depression Treatment ◽  
Care Providers ◽  
Low Socioeconomic ◽  
Self Image ◽  
The Impact

Abstract. Background: Suicide rates in older men are higher than in the general population, yet their utilization of mental health services is lower. Aims: This study aimed to describe: (a) what primary care providers (PCPs) can do to prevent late-life suicide, and (b) older men's attitudes toward discussing suicide with a PCP. Method: Thematic analysis of interviews focused on depression and suicide with 77 depressed, low-socioeconomic status, older men of Mexican origin, or US-born non-Hispanic whites recruited from primary care. Results: Several themes inhibiting suicide emerged: it is a problematic solution, due to religious prohibition, conflicts with self-image, the impact on others; and, lack of means/capacity. Three approaches to preventing suicide emerged: talking with them about depression, talking about the impact of their suicide on others, and encouraging them to be active. The vast majority, 98%, were open to such conversations. An unexpected theme spontaneously arose: "What prevents men from acting on suicidal thoughts?" Conclusion: Suicide is rarely discussed in primary care encounters in the context of depression treatment. Our study suggests that older men are likely to be open to discussing suicide with their PCP. We have identified several pragmatic approaches to assist clinicians in reducing older men's distress and preventing suicide.

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