Interventions to promote the evidence-based care of children with ADHD in primary-care settings

2009 ◽  
Vol 9 (4) ◽  
pp. 477-487 ◽  
Author(s):  
Joshua M Langberg ◽  
William B Brinkman ◽  
Philip K Lichtenstein ◽  
Jeffery N Epstein
Keyword(s):  
Primary Care ◽  
Evidence Based ◽  
Children With Adhd ◽  
Primary Care Settings ◽  
Evidence Based Care

Evidence-Based Care Models for Recognizing and Treating Alcohol Problems in Primary Care Settings: Part I

2001 ◽  
Author(s):  
Katherine E. Watkins ◽  
Harold Alan Pincus ◽  
Terri L. Tanielian
Keyword(s):  
Primary Care ◽  
Alcohol Problems ◽  
Evidence Based ◽  
Primary Care Settings ◽  
Care Models ◽  
Evidence Based Care

Cost-effectiveness of an Evidence-Based Childhood Asthma Intervention in Real-World Primary Care Settings

2018 ◽  
Vol 41 (3) ◽  
pp. 213-224 ◽  
Author(s):  
Avi Dor ◽  
Qian Luo ◽  
Maya Tuchman Gerstein ◽  
Floyd Malveaux ◽  
Herman Mitchell ◽  
...  
Keyword(s):  
Primary Care ◽  
Cost Effectiveness ◽  
Real World ◽  
Childhood Asthma ◽  
Evidence Based ◽  
Primary Care Settings ◽  
Asthma Intervention

scholarly journals The Capacity of Primary Care for Improving Evidence-Based Care: Early Findings From AHRQ’s EvidenceNOW

2018 ◽  
Vol 16 (Suppl 1) ◽  
pp. S2-S4 ◽  
Author(s):  
Sarah J. Shoemaker ◽  
Robert J. McNellis ◽  
Darren A. DeWalt
Keyword(s):  
Primary Care ◽  
Evidence Based ◽  
Evidence Based Care

Assessing children with ADHD in primary care settings

2008 ◽  
Vol 8 (4) ◽  
pp. 627-641 ◽  
Author(s):  
Joshua M Langberg ◽  
Tanya E Froehlich ◽  
Richard EA Loren ◽  
Jessica E Martin ◽  
Jeffery N Epstein
Keyword(s):  
Primary Care ◽  
Children With Adhd ◽  
Primary Care Settings

scholarly journals Formative Evaluation Prior to Implementation of a Brief Treatment for Posttraumatic Stress Disorder in Primary Care

2021 ◽  
Author(s):  
Sarah E. Valentine ◽  
Cara Fuchs ◽  
Natalya Sarkisova ◽  
Elyse A. Olesinski ◽  
A. Rani Elwy
Keyword(s):  
Primary Care ◽  
Posttraumatic Stress Disorder ◽  
Posttraumatic Stress ◽  
Formative Evaluation ◽  
Stress Disorder ◽  
Safety Net ◽  
Successful Implementation ◽  
Evidence Based ◽  
Primary Care Settings ◽  
Evidence Based Treatments

Abstract Background Successful implementation of evidence-based treatments for posttraumatic stress disorder (PTSD) in primary care may address treatment access and quality gaps by providing care in novel and less stigmatized settings. Yet, PTSD treatments are largely unavailable safety net primary care settings. We aimed to collect data on four potential influences on implementation, including the degree of less-than-best practices, determinants of the current practice, potential barriers and facilitators of implementation, and the feasibility of a proposed strategy for implementing a brief treatment for PTSD. Methods Our mixed-methods developmental formative evaluation (Stetler et al., 2006) was guided by the Consolidated Framework for Implementation Research (CFIR), including a) surveys assessing implementation climate and attitudes towards evidence-based treatments and behavioral health integration and b) semi-structured interviews to identify barriers and facilitators to implementation and need for intervention and system augmentation. Participants were hospital employee stakeholders (N = 22), including primary care physicians, integrated behavioral health clinicians, community wellness advocates, and clinic leadership. We examined frequency and descriptive data from surveys and conducted directed content analysis of interviews. We used a concurrent mixed-methods approach, integrating survey and interview data collected simultaneously using a joint display approach to inform implementation efforts. We utilized a primary care community advisory board (CAB) comprised of employee stakeholders to refine interview guides, and apply findings to the specification of a revised implementation plan. Results Stakeholders described strong attitudinal support, yet therapist time and capacity restraints are major PTSD treatment implementation barriers. Patient engagement barriers such as stigma, mistrust, and care preferences were also noted. Recommendations based on findings included tailoring the intervention to meet existing workflows, system alignment efforts focused on improving detection, referral, and care coordination processes, protecting clinician time for training and consultation, and embedding a researcher in the practice. Conclusions Our evaluation identified key factors to be considered when preparing for implementation of PTSD treatments in safety net integrated primary care settings. Our project also demonstrated that successful implementation of EBTs for PTSD in safety net hospitals necessitates strong stakeholder engagement to identify and mitigate barriers to implementation.

Evidence-Based Care For Depression In Managed Primary Care Practices

1999 ◽  
Vol 18 (5) ◽  
pp. 89-105 ◽  
Author(s):  
Lisa V. Rubenstein ◽  
Maga Jackson-Triche ◽  
Jürgen Unützer ◽  
Jeanne Miranda ◽  
Katy Minnium ◽  
...  
Keyword(s):  
Primary Care ◽  
Evidence Based ◽  
Care Practices ◽  
Primary Care Practices ◽  
Evidence Based Care

Revolutionising the wound care pathway for patients with lower limb wounds

2020 ◽  
Vol 26 (5) ◽  
pp. 110-112
Author(s):  
Una Adderley
Keyword(s):  
Primary Care ◽  
Lower Limb ◽  
Care Pathway ◽  
Wound Care ◽  
Evidence Based ◽  
Common Condition ◽  
Evidence Based Care

Lower limb ulceration is common and costly, with evidence of variation in practice and under-use of evidence-based care. This has resulted in poor healing rates and exacerbated costs. Commissioning to achieve better organised care that supports early delivery of evidence-based interventions is needed to improve the management of this very common condition in community and primary care.

scholarly journals Measuring and Improving Evidence-Based Patient Care Using a Web-Based Gamified Approach in Primary Care (QualityIQ): Randomized Controlled Trial (Preprint)

2021 ◽  
Author(s):  
Trever Burgon ◽  
Linda Casebeer ◽  
Holly Aasen ◽  
Czarlota Valdenor ◽  
Diana Tamondong-Lachica ◽  
...  
Keyword(s):  
Primary Care ◽  
Real Time ◽  
Primary Care Physicians ◽  
Primary Care Providers ◽  
The United States ◽  
Physician Satisfaction ◽  
Evidence Based ◽  
Clinical Decisions ◽  
Care Providers ◽  
Evidence Based Care

BACKGROUND Unwarranted variability in clinical practice is a challenging problem in practice today, leading to poor outcomes for patients and low-value care for providers, payers, and patients. OBJECTIVE In this study, we introduced a novel tool, QualityIQ, and determined the extent to which it helps primary care physicians to align care decisions with the latest best practices included in the Merit-Based Incentive Payment System (MIPS). METHODS We developed the fully automated QualityIQ patient simulation platform with real-time evidence-based feedback and gamified peer benchmarking. Each case included workup, diagnosis, and management questions with explicit evidence-based scoring criteria. We recruited practicing primary care physicians across the United States into the study via the web and conducted a cross-sectional study of clinical decisions among a national sample of primary care physicians, randomized to continuing medical education (CME) and non-CME study arms. Physicians “cared” for 8 weekly cases that covered typical primary care scenarios. We measured participation rates, changes in quality scores (including MIPS scores), self-reported practice change, and physician satisfaction with the tool. The primary outcomes for this study were evidence-based care scores within each case, adherence to MIPS measures, and variation in clinical decision-making among the primary care providers caring for the same patient. RESULTS We found strong, scalable engagement with the tool, with 75% of participants (61 non-CME and 59 CME) completing at least 6 of 8 total cases. We saw significant improvement in evidence-based clinical decisions across multiple conditions, such as diabetes (+8.3%, <i>P</i>&lt;.001) and osteoarthritis (+7.6%, <i>P</i>=.003) and with MIPS-related quality measures, such as diabetes eye examinations (+22%, <i>P</i>&lt;.001), depression screening (+11%, <i>P</i>&lt;.001), and asthma medications (+33%, <i>P</i>&lt;.001). Although the CME availability did not increase enrollment in the study, participants who were offered CME credits were more likely to complete at least 6 of the 8 cases. CONCLUSIONS Although CME availability did not prove to be important, the short, clinically detailed case simulations with real-time feedback and gamified peer benchmarking did lead to significant improvements in evidence-based care decisions among all practicing physicians. CLINICALTRIAL ClinicalTrials.gov NCT03800901; https://clinicaltrials.gov/ct2/show/NCT03800901

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