scholarly journals The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods

2019 ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A Munro Neville ◽  
Ralph G Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Community Setting ◽  
Annual Incidence ◽  
Free Text ◽  
Novel Approach ◽  
Australian Community

Abstract Background: There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF. Methods: We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals. Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were aged 18 years and above. Of these patients 16,930 were classified as having ‘definite HF’, 4873 as having ‘probable HF’ and 36,517 as having ‘possible HF’. A further 40,992 were identified as having an aetiological condition associated with HF. These estimates accord with findings in similar populations from other countries. Among ‘active patients’ (regular attenders of a practice), the crude prevalence of HF was 1.813% (95%CI:1.79–1.84%), and the age-standardised prevalence was 2.199% (95%CI:2.168-2.23%). The annual incidence was 0.291% (95%CI:0.286–0.296%), and the age-standardised annual incidence was 0.348% (95%CI:0.342–0.354%). The estimates of prevalence and incidence suggest that almost 420,000 people were living with HF in Australia in 2017, and over 66,000 new cases of HF occurred that year. Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.

scholarly journals The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods

2020 ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A Munro Neville ◽  
Ralph G Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Venous Pressure ◽  
Community Setting ◽  
Annual Incidence ◽  
Free Text ◽  
Australian Community

Abstract There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF. Methods : We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals. Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were aged 18 years and above. Of these patients 16,930 were classified as having ‘definite HF’, 4873 as having ‘probable HF’ and 36,517 as having ‘possible HF’. A further 40,992 were identified as having an aetiological condition associated with HF. A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify ‘definite’ HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify ‘probable HF’ patients. The majority of ‘possible’ HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign. Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.

scholarly journals The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods

2020 ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A Munro Neville ◽  
Ralph G Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Venous Pressure ◽  
Community Setting ◽  
Annual Incidence ◽  
Free Text ◽  
Australian Community

Abstract Background: There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF.Methods: We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals.Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were aged 18 years and above. Of these patients 16,930 were classified as having ‘definite HF’, 4873 as having ‘probable HF’ and 36,517 as having ‘possible HF’. A further 40,992 were identified as having an aetiological condition associated with HF. A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify ‘definite’ HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify ‘probable HF’ patients. The majority of ‘possible’ HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign.Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.

scholarly journals The epidemiology of heart failure in the general Australian community - Study of Heart failure in the Australian Primary carE setting (SHAPE): methods

2020 ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A Munro Neville ◽  
Ralph G Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Venous Pressure ◽  
Community Setting ◽  
Annual Incidence ◽  
Free Text ◽  
Australian Community

Abstract Background: There is a paucity of information on the epidemiology of heart failure (HF) in Australia. The Study of Heart failure in the Australian Primary carE setting (SHAPE) study aims to estimate the prevalence and annual incidence of HF in the general Australian community and to describe the demographic and key clinical profile of Australians with HF.Methods: We undertook a retrospective cohort study based on analysis of non-identifiable medical records of adult patients cared for at 43 general practices between 1 July 2013 and 30 June 2018. Data were extracted from coded (diagnosis, pathology and prescription fields) and uncoded fields (clinical notes) in the medical records. The latter searches of free text looked for common synonyms relevant to HF. The population was stratified into three groups based on a hierarchy of selection criteria: (1) definite HF, (2) probable HF and (3) possible HF. The prevalence and annual incidence of HF were calculated, along with 95% confidence intervals.Results: The practices provided care to 2.3 million individual patients over the five-year study period, of whom 1.93 million were adults and 1.12 million were regular patients. Of these patients 15,468 were classified as having ‘definite HF’, 4751 as having ‘probable HF’ and 33,556 as having ‘possible HF’. A further 39,247 were identified as having an aetiological condition associated with HF. A formal HF diagnosis, HF terms recorded as text in the notes and HF-specific medication were the most common methods to identify ‘definite’ HF patients. Typical signs and symptoms in combination with a diuretic prescription was the most common method to identify ‘probable HF’ patients. The majority of ‘possible’ HF patients were identified by the presence of 2 or more of the typical signs or symptoms. Dyspnoea was the commonest recorded symptom and an elevated jugular venous pressure the commonest recorded sign.Conclusions: This novel approach to undertaking retrospective research of primary care data successfully analysed a combination of coded and uncoded data from the electronic medical records of patients routinely managed in the GP setting. SHAPE is the first real-world study of the epidemiology of HF in the general Australian community setting.

scholarly journals The epidemiology of heart failure in the general Australian community - study of heart failure in the Australian primary carE setting (SHAPE): methods

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Richard Whaddon Parsons ◽  
Danny Liew ◽  
A. Munro Neville ◽  
Ralph G. Audehm ◽  
Deepak Haikerwal ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Community Study ◽  
Australian Community

A Novel Approach to Depression Care: Efficacy of an Adapted Interpersonal Therapy in a Large, Urban Primary Care Setting

2020 ◽  
Author(s):  
Kenneth M. Fifer ◽  
Katherine Small ◽  
Samantha Herrera ◽  
Yang Doris Liu ◽  
Lauren Peccoralo
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Depression Care ◽  
Interpersonal Therapy ◽  
Novel Approach

scholarly journals Palliative Care in a Death-Denying Culture: Exploring Barriers to Timely Palliative Efforts for Heart Failure Patients in the Primary Care Setting

2020 ◽  
Vol 38 (1) ◽  
pp. 77-83 ◽  
Author(s):  
Rebecca M. Crimmins ◽  
Lydia Elliott ◽  
Darren T. Absher
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Palliative Care ◽  
Patient Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Primary Care Providers ◽  
Cochrane Library ◽  
Care Providers ◽  
Communication Time

Context: Heart failure (HF) is a complex, life-limiting disease that is prevalent and burdensome. All major cardiology societies and international clinical practice guidelines recommend the integration of palliative care (PC) interventions alongside usual HF management. Objectives: The purpose of this review of the literature was to evaluate the various barriers to the early initiation of PC for HF patients in the primary care setting. Methods: An integrative literature review was conducted in order to assess and incorporate the diverse sources of literature available. An EBSCO search identified relevant articles in the following databases: Medline complete, Academic Search Premier, CINAHL, PsycINFO, Cochrane Library, and SocINDEX. The search was limited to full text, peer reviewed, English only, and published between 2010 and 2019. Results: Barriers to the integration of PC for HF patients include poor communication between provider/patient and interdisciplinary providers, the misperception and miseducation of what PC is and how it can be incorporated into patient care, the unpredictable disease trajectory of HF, and the limited time allowed for patient care in the primary care setting. Conclusion: The results of this review highlight a lack of communication, time, and knowledge as barriers to delivering PC. Primary care providers caring for patients with HF need to establish an Annual Heart Failure Review to meticulously evaluate symptoms and allow the time for communication involving prognosis, utilize a PC referral screening tool such as the Needs Assessment Tool: Progressive Disease-Heart Failure, and thoroughly understand the benefits and appropriate integration of PC.

scholarly journals Prevalence of dementia and cognitive impairment with no dementia in a primary care setting in southern Brazil

2021 ◽  
Vol 79 (7) ◽  
pp. 565-570
Author(s):  
Sérgio Ferreira de Ferreira-Filho ◽  
Wyllians Vendramini Borelli ◽  
Rodrigo Mantovani Sguario ◽  
Gustavo Fiorentin Biscaia ◽  
Vitória Schneider Müller ◽  
...  
Keyword(s):  
Older Adults ◽  
Primary Care ◽  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Medical Records ◽  
Care Setting ◽  
Primary Care Setting ◽  
Cognitive Screening ◽  
Southern Brazil ◽  
Symptoms Of Depression

ABSTRACT Background: Cognitive decline is a common condition, but is still underrepresented in studies conducted in developing countries. Objective: To calculate the prevalence of cognitive decline and depression in an elderly community-dwelling population in a city in southern Brazil. Methods: We calculated the prevalences of dementia, cognitive impairment with no dementia (CIND) and symptoms of depression in an elderly population relying on the public healthcare system. This epidemiological study in Pelotas, Brazil, was conducted within the primary care setting. It included 299 older adults (mean age = 69.75 ± 7.6 years) who presented low levels of education (mean = 4.16 ± 3.17 years of education). They underwent cognitive screening and their medical records were analyzed. Results: Among these older adults, 142 (47.5%) presented cognitive decline: 104 (34.8%) matching the cognitive criteria for CIND and 38 (12.7%) matching the cognitive criteria for dementia. Among all the individuals who completed the cognitive screening, 141 (48.4%) were positive for symptoms of depression, of whom 99 (34%) did not have any previous diagnosis in their medical records. Conclusion: There was high prevalence of cognitive impairment among these older adults in a primary care setting. A large number of older adults were found to have symptoms of depression without any diagnosis.

Identifying key roles of the pharmacy technician in primary care settings

2021 ◽  
Author(s):  
Shannon Gadd ◽  
Conrad E Lopez ◽  
Cory A Nelson ◽  
Trung Q Le ◽  
Cynthia S Valle-Oseguera ◽  
...  
Keyword(s):  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Pharmacy Practice ◽  
Care Practice ◽  
Professional Judgment ◽  
Free Text ◽  
Pharmacy Technician ◽  
Pharmacy Technicians ◽  
Patient Outreach

Abstract Disclaimer In an effort to expedite the publication of articles, AJHP is posting manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose As the pharmacist’s role expands, particularly in primary care practice settings, there is an opportunity for expansion of pharmacy technician duties to aid in administrative and clinical tasks that do not require the pharmacist’s professional judgment. Identifying, defining, and expanding the roles of pharmacy technicians has been deemed a key part of the pharmacy practice model. These roles have been shown to enhance pharmacist efficiency and patient outreach; however, examples of the various innovative activities performed by technicians in the primary care setting are lacking in the literature. Methods The duties of primary care pharmacist technicians were compiled and defined in 2 different healthcare systems. The role of the technician was separately implemented at each institution, and study designs and protocols were individually created and executed. One institution utilized a 4-round consensus-building process to systematically refine and codify tasks for a dictionary of duties. The second institution utilized a free-text survey, task documentation data in the electronic medical record, and a telephone discussion with the technicians. Results Despite a lack of methods- and data-sharing between the 2 institutions, similar tasks were identified, including conducting patient outreach, assisting with medication affordability and access, providing patient education, managing referrals, and scheduling appointments. Differences in technician involvement were noted in areas such as prior authorization, care coordination meetings, and quality improvement projects. Conclusion Pharmacy technicians are a helpful, yet underutilized, resource in the primary care setting. Further exploration of technician roles is needed to determine the financial and clinical impact of expanding these roles.

scholarly journals P4395Characteristics of patients with heart failure prescribed sacubitril/valsartan in the primary care setting in Germany

2017 ◽  
Vol 38 (suppl_1) ◽  
Author(s):  
S. Klebs ◽  
B. Balas ◽  
S.S. Grunow ◽  
M. Schindler ◽  
J. Engelhard ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Patients With Heart Failure
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