Approach To Joint Pain In The Elderly For Osteopathic Providers

2020 ◽  
pp. 24-28
Author(s):  
Syna Daudfar ◽  
Natalia Nakajima ◽  
Khristopher Faiss ◽  
Luke Tegeler ◽  
Jessica Kuo ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Communities ◽  
Joint Pain ◽  
The Elderly ◽  
Primary Care Providers ◽  
Care Providers ◽  
Elderly Male ◽  
Case Based Learning ◽  
Advanced Organizer ◽  
Pain In The Elderly

Joint pain in the elderly is becoming ever more ubiquitous in the primary care setting. Primary care providers, especially in rural communities, may be required to manage patients with rheumatologic conditions because consultation is unavailable. Literature supporting the approach to the diagnosis of joint pain in the elderly population is limited. The purpose of this manuscript is to present a case-based learning opportunity for osteopathic primary care providers, residents, and medical students regarding an elderly male with joint pain. In this manuscript, the authors have presented an advanced organizer to be used in the medical education setting which differentiates patients suffering from joint pain based on timing, the number of joints involved, and the size of the joint affected. We conclude with osteopathic considerations in evaluating an elderly patient with joint pain and the tools available to appropriately evaluate and treat the patient.

ECHO Care of the Elderly – Using Technology to Build Capacity of Primary Care Providers in Long-term Care

2019 ◽  
Vol 20 (3) ◽  
pp. B10-B11
Author(s):  
Sid Feldman ◽  
L. Sokoloff ◽  
S. Feldman ◽  
A. Moser ◽  
D. Conn
Keyword(s):  
Primary Care ◽  
Long Term Care ◽  
The Elderly ◽  
Primary Care Providers ◽  
Care Providers ◽  
Term Care

scholarly journals Access to CKD Care in Rural Communities of India: A Qualitative Study Exploring the Barriers and Facilitators

2019 ◽  
Author(s):  
Tazeen Jafar ◽  
Chandrika Ramakrishnan ◽  
Oommen John ◽  
Abha Tewari ◽  
Benjamin Cobb ◽  
...  
Keyword(s):  
Primary Care ◽  
Rural Communities ◽  
Primary Care Physicians ◽  
Group Discussion ◽  
Healthcare Providers ◽  
Primary Care Providers ◽  
System Level ◽  
Rural India ◽  
Care Providers ◽  
Timely Initiation

Abstract Introduction Chronic kidney disease (CKD) has become a public health challenge globally, especially in lower- and middle- income countries. The implications of adverse social and economic consequences of CKD are particularly grave in a populous country like India where CKD risk factors like diabetes and hypertension are widely prevalent. Although with early detection and timely initiation of interventions CKD progression can be slowed, huge knowledge-practice gap exists. Moreover, factors that influence access to CKD care at the community level have not been studied previously. This study aimed to explore the experiences and views of key stakeholders to identify factors that influence access to CKD care in rural India. We also sought to discern the current practices and preparedness for CKD, understand the facilitators and barriers to CKD care, and feasibility and acceptability of mobile-technology based clinical decision support system (mCDSS) for CKD care in primary care.Methods Using 15 in-depth interviews and one focus group discussion (n=6), we aimed to explore the experiences and views of different stakeholdres from primary healthcare system in rural India. We employed Lévesque’s framework for access to care, and inductive and deductive approaches in the analysis. The interviews were audio-recorded and transcribed verbatim. Using QSR nVivio 11, coding and thematic analysis was undertaken.Results Our study identified barriers in relation to access to CKD care in rural India. Fore most among them was poor knowledge and lack of awareness to CKD among patients as well as primary care physicians. Health system-level barriers like shortages of skilled healthcare professionals and medicines, fragmented referrals pathways with inadequate follow up care were identified. Increasing awareness of CKD among healthcare providers and patients, provision of CKD related supplies, and a system-level approach to care coordination were key facilitators.Conclusions Lack of awareness and knowledge on CKD among primary care providers and patients, and unprepared primary care infrastructure are key barriers for access to CKD care in rural India. There is an urgent need to raise CKD awareness among primary care physicians and patients, improve supplies for diagnostics and medications, and create efficient referral pathways for CKD in primary care.

scholarly journals Improving the Referral Process, Timeliness, Effectiveness, and Equity of Access to Specialist Medical Services Through Electronic Consultation: Pilot Study (Preprint)

2019 ◽  
Author(s):  
Véronique Nabelsi ◽  
Annabelle Lévesque-Chouinard ◽  
Clare Liddy ◽  
Maxine Dumas Pilon
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Rural Communities ◽  
Social Services ◽  
Primary Care Providers ◽  
Referral Process ◽  
Care Providers ◽  
Face To Face ◽  
Primary Care Clinics ◽  
Electronic Consultation

BACKGROUND Access to specialty care remains a major challenge in the Canadian health care system. Electronic consultation (eConsult) services allow primary care providers to seek specialist advice often without needing the patient to go for a face-to-face consultation. It improves overall access to specialists and the referral process using an electronic care consultation service in urban and rural primary care clinics. This study describes the preliminary results of a pilot study with an eConsult service across 3 regions in the province of Quebec, Canada. OBJECTIVE The main objective of this study was to provide a 1-year snapshot of the implementation of the eConsult Quebec Service in rural and urban primary care clinics to improve access to care and the specialty referral process for primary care providers (PCPs). METHODS We established an eConsult service that covers urban and rural communities in 3 regions of Quebec. We conducted a quantitative analysis of all eConsult cases submitted from July 4, 2017, to December 8, 2018. RESULTS For over a year, 1016 eConsults have been generated during the course of this study. A total of 97 PCPs submitted requests to 22 specialty groups and were answered by 40 different specialists. The most popular specialty was internal medicine (224/1016, 22%). Overall, 63% (640/1016) of completed cases did not require a face-to-face visit. PCPs rated the service as being of high or very high value for themselves in 98% (996/1016) of cases. CONCLUSIONS The preliminary data highlight the success of the implementation of the eConsult Quebec Service across 6 primary care clinics. The eConsult platform proves to be effective, efficient, and well received by both patients and physicians. If used more widely, eConsult could help reducing wait times significantly. Recently, the Ministry of Health and Social Services of Quebec has identified developing a strategic plan to scale eConsults throughout other regions of the province as a top priority.

scholarly journals THE UNINTENDED CONSEQUENCES OF SEAMLESS IMPLEMENTATION OF A RURAL TELEMEDICINE CLINIC

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S607-S608
Author(s):  
Samantha Solimeo ◽  
Melissa J Steffen ◽  
Aaron Seaman ◽  
Karla L Miller
Keyword(s):  
Primary Care ◽  
Rural Communities ◽  
Positive Impact ◽  
Qualitative Interviews ◽  
Implementation Strategies ◽  
Primary Care Providers ◽  
Unintended Consequences ◽  
Care Providers ◽  
Workload Analysis ◽  
Care Processes

Abstract Osteoporosis is largely undetected and untreated in older men who are at-risk, with even lower rates of detection and treatment in rural communities. In this presentation we report the consequences for primary care providers (PCPs) of the implementation of an osteoporosis telemedicine clinic that targeted rural patients and is purposefully designed to minimize PCP workload. Analysis of qualitative interviews with PCPs who co-managed patients with the telemedicine clinic confirmed that implementation strategies used by the telemedicine clinic were successful at minimizing workload and had a positive impact on PCPs’ work. However, the clinic’s seamless approach may have contributed to unintended consequences of low PCP awareness of program care processes and selection criteria and a missed opportunity for PCPs to reinforce osteoporosis care goals in the primary care setting.

scholarly journals The Effect of Ergonomic Gymnastics on Joint Pain in Community-Dwelling Elderly

Jurnal NERS ◽  
2020 ◽  
Vol 14 (3) ◽  
pp. 98
Author(s):  
Martha Lowrani Siagian ◽  
Anggi Hanafiah Syarif ◽  
Andreas Wojtyla Sukur ◽  
Beatric Maria Dwijayanti Baga ◽  
Ni Ketut Emi Rayuni
Keyword(s):  
Health Care Providers ◽  
Joint Pain ◽  
Sampling Technique ◽  
The Elderly ◽  
Community Dwelling ◽  
Care Providers ◽  
Significance Level ◽  
Post Test ◽  
Primary Health Services ◽  
Pain In The Elderly

Background: The aging process that occurs in the elderly is characterized by a decreasing immune system and physical impairment. The most common complaint is joint pain. The aim was to determine the effect of ergonomic gymnastics on the elderly who experienced joint pain.Method: The samples totaled 110 respondents who had joint pain at Krembangan-Surabaya obtained through the total sampling technique. The data was collected through observation sheets with one group pre-post-test design, and it was analyzed through the Wilcoxon text. The result showed that after 9 sessions of 60 minutes each for two months found that ergonomic gymnastics could influence the reduction of joint pain with a significance level of 0.00 (p<0.05).Discussion: There were a decreasing number of respondents that felt moderate pain (82 to 44) and this automatically meant that there was an increasing number of mild pain respondents (28 to 66).Conclusion: Exercising regularly and with the correct methods could provide an excellent benefit to maintain bodily health, especially to reduce joint pain in the elderly. It is expected that all health care providers in primary health services or in a private clinics should know and be able to conduct ergonomic gymnastics using the correct methods.

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.

Pediatric primary care providers’ reported likelihood to refer to mental health specialists.

2018 ◽  
Vol 36 (3) ◽  
pp. 410-414 ◽  
Author(s):  
Emma L. Peterson ◽  
Anne E. Pidano ◽  
Lisa Honigfeld
Keyword(s):  
Mental Health ◽  
Primary Care ◽  
Primary Care Providers ◽  
Pediatric Primary Care ◽  
Care Providers
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