scholarly journals Assessment and management: Primary hypothyroidism in women

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Cynthia S. Watson ◽  
Janis Guilbeau
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Primary Care Providers ◽  
Primary Hypothyroidism ◽  
Pharmacologic Treatment ◽  
Care Providers ◽  
Endocrine Disorder ◽  
Euthyroid State

Hypothyroidism is a common endocrine disorder affecting nearly 2 in 100 women. Primary hypothyroidism can be diagnosed and effectively managed by primary care providers. Pharmacologic treatment is essential and lifelong, with most patients achieving euthyroid state and enjoying good quality of life.

The role of annual personal health visits (APHV) on patients' with cancer knowledge and perceptions of the harms of continued smoking.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 152-152
Author(s):  
Delaram Farzanfar ◽  
Lin Lu ◽  
Jie Su ◽  
Devon Alton ◽  
Rahul Mohan ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Cancer Survivors ◽  
Cancer Patients ◽  
Primary Care Providers ◽  
Smoking History ◽  
Care Providers ◽  
Risk Of Death ◽  
Increase Risk

152 Background: With improvements in cancer detection and therapies, important secondary prevention measures in survivorship include smoking cessation. Primary care providers have an opportunity to discuss these measures with cancer survivors at APHV. We evaluated whether having a recent APHV is associated with cancer patients’ awareness and perceptions of the harms of continued smoking. Methods: Cancer survivors were surveyed from April 2014 to May 2016 with respect to their smoking history, knowledge and perceptions of the harms of continued smoking along with the date of their most recent APHV (term changed from annual health physical examination in 2013). Multivariable logistic regression analyses assessed the association of having an APHV with knowledge and perceptions of the harms of continued smoking. Results: Of 985 cancer patients, 23% smoked at diagnosis; 34% quit > 1 year prior to diagnosis; 55% had tobacco-related cancers; 77% received curative therapy. From a knowledge viewpoint, over 52% reported being unaware that smoking negatively impacts cancer outcomes; despite this, most perceived smoking to negatively influence quality of life (75%), survival (76%), and fatigue (73%). Within the last year, 48% had an APHV, while 84% had an APHV at any time in the past; 18 (2%) reported not having a family doctor. Patients who had an APHV in the last year were more likely to be aware that continued smoking can increase risk of death (adjusted odds ratio (aOR)=1.49, 95% CI [1.13-1.96], P=0.004), and more likely to perceive smoking to negatively impact quality of life (aOR=1.37 [0.94-1.99], P=0.10), survival (aOR=1.60 [0.95-2.71], P=0.08), and fatigue (aOR=1.63 [1.11-2.39], P=0.01). Those ever having an APHV were more likely aware that smoking can increase risk of death (aOR=1.61 [1.07-2.43], P=0.02) and second primaries (aOR=1.53 [1.02-2.33], P=0.04). Conclusions: Having a recent APHV was associated with improved awareness and perceptions of the harms of continued smoking, but it is unclear whether this is related to provider counseling or a healthy bias effect. APHV may be an appropriate time for primary care providers to treat tobacco addiction in their cancer survivors.

scholarly journals The Role of Primary Care in Asthma Control and Severity

Spectrum ◽  
2019 ◽  
Author(s):  
Joel Agarwal ◽  
Monette Dimitrov ◽  
Kerri MacKay ◽  
Alan Kaplan ◽  
Donald Cockcroft ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Emergency Department ◽  
Asthma Control ◽  
Primary Care Providers ◽  
Care Utilization ◽  
Life Questionnaire ◽  
Care Providers ◽  
Ed Visits

Background: Asthma is a common chronic inflammatory disease of the airways affecting 3 millionCanadians. Primary Care Providers (PCPs) are integral to care coordination, enhanced through thedevelopment of a strong patient-PCP relationship with Continuity of Care (COC). A recent CIHI studynoted that 40% of Albertans do not have a COC model for primary care.Objectives: We aim to evaluate how primary care for adults with asthma impacts different measures ofcontrol.Methods: Prospective population-based recruitment of adults through various community venuesacross Alberta. Those who had self-reported asthma and were willing to participate completed a surveywhich included demographics, comorbidities, medication use (including biologics, allergy medications,steroids), Asthma Control Questionnaire (ACQ-5), Asthma Control Test (ACT), Quality of Life (QoL)measured through the mini-Asthma Quality of Life Questionnaire (mini-AQLQ) and health care utilization(including Emergency Department (ED) visits, hospitalizations and ICU stays for asthma).Results: Of the 1685 individuals approached, 61 (3.6%) reported having asthma, of which 47 lived inAlberta. Most (41, 87%) had a PCP, with 30 (64%) visiting their PCP at least twice a year. Uncontrolledasthma was noted in 21 (45%) with either the ACQ-5 or ACT. The mini-AQLQ indicated 5 (11%) withreduced QoL. Mean lifetime hospitalizations, lifetime Emergency Department (ED) visits, and ICU staysrelated to asthma were 1.52, 4.55 and 0.25 respectively. Further, mean hospitalizations and ED visits inthe past 12 months related to asthma were 0.05 and 0.30 respectively.Conclusions: Asthma control was poor in 21 (45%) surveyed individuals, suggesting sub-optimal asthmamanagement in Alberta. Knowledge of Primary Care Networks (PCNs) was low, while ED and hospitalusage was high.

Associations of Eczema Severity and Parent Knowledge With Child Quality of Life in a Pediatric Primary Care Population

2018 ◽  
Vol 57 (13) ◽  
pp. 1506-1514 ◽  
Author(s):  
Corinna J. Rea ◽  
Katherine D. Tran ◽  
Maria Jorina ◽  
Larissa M. Wenren ◽  
Elena B. Hawryluk ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Treatment Plan ◽  
Life Quality ◽  
Primary Care Providers ◽  
Individual Treatment ◽  
Care Providers ◽  
Large Hospital ◽  
Cross Sectional

We investigated factors associated with quality of life (QOL) in children with eczema. We conducted a cross-sectional analysis of survey data from 224 parents of children with eczema attending a large, hospital-based pediatric clinic. Parents completed a validated eczema severity scale (Patient-Oriented Eczema Measure), a QOL scale (Infants’ Dermatitis QOL Index or Children’s Dermatology Life Quality Index), and a knowledge and understanding questionnaire. In adjusted multivariate analyses, worse eczema severity was associated with worse overall QOL (β = 0.5; 95% confidence interval [CI] = [0.5, 0.6]), while a higher knowledge score was associated with better QOL (β = −3.4; 95% CI = [−6.6, −0.2]). Similarly, even after adjustment for eczema severity, greater understanding of a child’s individual treatment plan was associated with better QOL (β = −0.7; 95% CI = [−1.4, −0.08]), while increased frequency of worrying about a child’s eczema was associated with worse QOL (β = 0.7; 95% CI = [0.03, 1.1]). These results suggest primary care providers may be able to influence QOL through optimal eczema management and family education.

scholarly journals Patient Suffering in Chronic Digestive Diseases: Will Primary Care-Specialist Collaboration With Effective Interactive Communication and Integrative Medicine in the Plan of Care Improve Quality of Life?

2020 ◽  
Vol 7 (6) ◽  
pp. 989-993
Author(s):  
Andrew Thomas ◽  
Annie Thomas
Keyword(s):  
Quality Of Life ◽  
Primary Care ◽  
Health Care ◽  
Health Care Providers ◽  
The United States ◽  
Care Providers ◽  
Physician Visits ◽  
Digestive Diseases ◽  
Care Specialist

Acute and chronic digestive diseases are causing increased burden to patients and are increasing the United States health care spending. The purpose of this case report was to present how nonconfirmatory and conflicting diagnoses led to increased burden and suffering for a patient thus affecting quality of life. There were many physician visits and multiple tests performed on the patient. However, the primary care physician and specialists could not reach a confirmatory diagnosis. The treatment plans did not offer relief of symptoms, and the patient continues to experience digestive symptoms, enduring this burden for over 2 years. The central theme of this paper is to inform health care providers the importance of utilizing evidence-based primary care specialist collaboration models for better digestive disease outcomes. Consistent with patient’s experience, the authors propose to pilot/adopt the integrative health care approaches that are proven effective for treating digestive diseases.

scholarly journals Private ownership of primary care providers associated with patient perceived quality of care

Medicine ◽  
2017 ◽  
Vol 96 (1) ◽  
pp. e5755 ◽  
Author(s):  
Xiaolin Wei ◽  
Jia Yin ◽  
Samuel Y.S. Wong ◽  
Sian M. Griffiths ◽  
Guanyang Zou ◽  
...  
Keyword(s):  
Primary Care ◽  
Quality Of Care ◽  
Primary Care Providers ◽  
Perceived Quality ◽  
Private Ownership ◽  
Care Providers ◽  
Perceived Quality Of Care

Improving diagnosis and treatment of benign paroxysmal positional vertigo

2021 ◽  
pp. 42-46
Author(s):  
Larry D. McIntire ◽  
Kindall Martin ◽  
Kunal Shah ◽  
Lauren Malinowski ◽  
John Paulson
Keyword(s):  
Primary Care ◽  
Population Health ◽  
Healthcare Costs ◽  
Benign Paroxysmal Positional Vertigo ◽  
Primary Care Providers ◽  
Diagnosis And Treatment ◽  
Care Providers ◽  
Positional Vertigo ◽  
Paroxysmal Positional Vertigo

Background: Vertigo is defined as an illusion of motion caused by a mismatch of information between the visual, vestibular and somatosensory systems. The most common diagnosis associated with whirling vertigo is benign paroxysmal positional vertigo (BPPV), which affects approximately 3.4% of patients older than 60 years of age. Objective: This paper aims to educate primary care providers on how to diagnose BPPV by performing canalith repositioning maneuvers at the initial point of care. Timely treatment of BPPV in the primary care office is believed to reduce healthcare costs by way of limiting unnecessary diagnostic testing and lowering referrals for specialty care. Immediate treatment is also believed to improve the quality of healthcare delivery for the vertigo patient by reducing morbidity and resolving the condition without the need for referrals or imaging. Population Health: A review of the literature finds that delayed diagnosis and treatment of BPPV is associated with a host of deleterious effects on patients. Population health impacts include increased rates of anxiety and depression; loss of work and/or change of career paths; inappropriate use of medications or emergency care resources; decreased access to healthcare services; increased healthcare costs; and reduced quality of care. Diagnosis: A history of positional vertigo and evidence of nystagmus with Dix-Hallpike positioning confirms the diagnosis. A detailed description of the performance of this test is elucidated. Treatment: The observed nystagmus is analyzed and classified based on directionality. Treatment can be initiated immediately with canalith repositioning maneuvers.

Compliance, capacity, and quality in colonoscopy screening for CRC: A novel solution.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 357-357 ◽  
Author(s):  
S. C. Lloyd
Keyword(s):  
Primary Care ◽  
Training Program ◽  
Primary Care Physicians ◽  
African American Men ◽  
Primary Care Providers ◽  
Care Providers ◽  
Adenoma Detection ◽  
Before And After ◽  
Outstanding Quality

357 Background: CRC is predominately preventable with high quality colonoscopy screenings. Unfortunately, less than half of Americans are “up-to-date.” When referred by primary care providers, less than half complete the process. We proposed to include the primary care provider (PCP) in a novel training program to extend skills from sigmoidoscopy to full colonoscopy in a “mentored and monitored” model. We know that quality in colonoscopy can vary widely (ten fold within a single 12-man group). The protective benefits of colonoscopy reflect the thoroughness of the removal of polyps. Unfortunately, the ACS projections for 2010 predict an increase of 4,400 deaths from CRC over 2009, an 8% rise! Furthermore the death rate for African American men has RISEN 28% since 1960. We are loosing a battle for which we posses the tools to win. To achieve victory we must successfully address all three factors: compliance, capacity and quality. Methods: Thirty primary care physicians in two states (SC, FL) were recruited. We measured compliance rates within the practice before and after enrollment. We further evaluated quality of the colonoscopies as reflected in completion, yield and complications. Results: Compliance more than doubled (38% to 84%). As a compliance enhancement tool, the results were outstanding. The evaluation of quality then became of paramount importance. The gross completion rate was 98.3%, the adenoma detection rate (reflecting polyp yield) was 38%. In over 20,000 cases there were only 5 perforations, substantially below published rates. The quality was consistently at the level of experienced conscientious gastroenterologists. The details of the training program and the use of the “two-man” colonoscopy technique have been reviewed elsewhere (MEDICAL CARE, Aug 2010). Conclusions: If replicated nationally, this model has the potential for saving 25,000 lives annually. The participation of the patient's PCP is a powerful influence for improved compliance. The availability of an “expert” for mentoring and monitoring results in outstanding and consistent quality. The model has the potential to dramatically enhance compliance simultaneously increasing capacity while maintaining outstanding quality. No significant financial relationships to disclose.

Driving action through data: Delivering online cancer screening reports to primary care providers.

2014 ◽  
Vol 32 (30_suppl) ◽  
pp. 174-174
Author(s):  
Nicki Cunningham ◽  
Shama Umar ◽  
Dafna Carr ◽  
Richard Smith ◽  
Patrick Flynn
Keyword(s):  
Primary Care ◽  
Cancer Screening ◽  
Clinical Guidelines ◽  
Management System ◽  
Primary Care Providers ◽  
Care Providers ◽  
Access Management ◽  
Screening Programs ◽  
Screening Activity

174 Background: The Screening Activity Report (SAR), a supplementary tool for primary care providers (PCPs), was released in April, 2014. Providers are able to access this comprehensive report securely via an online solution and view the screening activity of their patients across Cancer Care Ontario (CCO)’s three organized cancer screening programs; breast, cervical and colorectal. The objectives of the SAR are to improve the quality of cancer screening by increasing provincial screening rates, improving the rate of appropriate follow-up of abnormal results and promote the alignment of cancer screening practices with CCO’s evidence-based clinical guidelines. Methods: CCO partnered with eHealth Ontario in 2012 to leverage their identity and access management system to provide safe and secure online access to the report. Since this time, CCO has implemented a multi-faceted campaign to support registrations to the system, encourage report access, and gather feedback on how to improve the report for future iterations. Using a detailed methodology developed by a wide range of subject matter experts at CCO, the SAR employs numerous provincial data sources to provide an overview of the patient rosters. Actionable categories are assigned at the patient level using a unique algorithm based on the latest clinical guidelines. Results: Previous to April 2014, the SAR was referred to as the ColonCancerCheck SAR (CCC SAR) as it included colorectal cancer screening data only. The last release of the CCC SAR was in October, 2013. At this time 4,824 providers were registered to the identity and access management system and adoption of this report had reached 31% after being available for five months to providers. To date, 4,992 providers are now registered and adoption of the April SAR has already reached 27% after being available for almost two months. Conclusions: The SAR is the first tool of its kind to make widespread use of eHealth’s identity and access management system service and target a broad user base of PCPs. The successful launch of the SAR has provided key insights into how technology can be leveraged to share provincial data in a meaningful way with providers and support them in improving the quality of cancer screening.

Faster and better: Improving the diagnostic phase of lung cancer at a system level.

2017 ◽  
Vol 35 (8_suppl) ◽  
pp. 115-115
Author(s):  
Melissa Kaan ◽  
Claire Holloway ◽  
Julie Gilbert ◽  
Vicky Simanovski ◽  
Garth Matheson
Keyword(s):  
Lung Cancer ◽  
Primary Care ◽  
Patient Experience ◽  
Cancer Care ◽  
Primary Care Providers ◽  
Diagnostic Process ◽  
Care Providers ◽  
The Past ◽  
Rule Out

115 Background: For many patients going through diagnostic testing for cancer, the time from suspicion to diagnosis or rule-out, can be a confusing and anxious time. In 2007, Cancer Care Ontario began investing in the implementation of diagnostic assessment programs (DAPs) across Ontario, Canada to improve the quality of care during the diagnostic phase of lung cancer. DAPs consist of multidisciplinary healthcare teams that manage and coordinate a patient’s diagnostic care from testing to a definitive diagnosis. The objectives of the DAPs are to: 1) decrease time from suspicion to diagnosis or resolution; 2) optimize the patient’s experience during the diagnostic process; 3) optimize satisfaction and experience among primary care providers and specialists; and 4) provide a sustainable solution by offering good value for money. Today over 35,000 patients have been diagnosed in one of the 18 lung DAPs that exist across the province. Methods: The implementation of DAPs featured the introduction of a patient navigator to act as the primary point of contact for patients, improve the patient experience and ensure their patients were progressing through any required diagnostic imaging and consultations in a timely manner. Cancer Care Ontario also engaged with primary care providers to refer patients with findings suspicious for lung cancer to DAPs as early as possible to ensure they benefited from organized assessment. Cancer Care Ontario has collected patient level data to measure wait times and implemented a patient survey to assess patient experience. Results: In the past five years, the median wait time from referral to a lung DAP to diagnosis or rule out has decreased by 19% to 24 days and the 90th %tile has decreased by 28% to 51 days. The large majority of patients have had a positive experience with their DAPs, with 95% of patients scoring their experience in the diagnostic process as “good” or “excellent”. Conclusions: The implementation of DAPs across the province is seen as a valuable component of quality of care by improving the diagnostic phase of cancer. The sustainability of the DAP model is demonstrated by the continued improvements in access and maintained patient experience in spite of growing volumes (91% increase in the past five years).

Educating primary care physicians in the management of Alzheimer's disease: using practice guidelines to set quality benchmarks

2009 ◽  
Vol 21 (S1) ◽  
pp. S44-S52 ◽  
Author(s):  
Debra L. Cherry ◽  
Carol Hahn ◽  
Barbara G. Vickrey
Keyword(s):  
Alzheimer’S Disease ◽  
Primary Care ◽  
Alzheimer's Disease ◽  
Practice Guidelines ◽  
Primary Care Physicians ◽  
Care Management ◽  
Primary Care Providers ◽  
Dementia Care ◽  
Care Providers

ABSTRACTThis paper presents a strategy for training primary care physicians in the identification, diagnosis and management of Alzheimer's disease and related disorders. The strategy uses evidence-based practice guidelines to establish quality benchmarks and then provides training and other interventions to improve the quality of care received by these patients. The three projects described in this paper assumed that training of primary care physicians alone would not be sufficient to achieve the quality benchmarks derived from guidelines. The projects used creative training strategies supplemented by provider “tool kits”, provider checklists, educational detailing, and endorsement from organizational leadership to reinforce what the primary care providers learned in educational sessions. Each project also implemented a system of dementia care management to “wrap around” traditional primary care to ensure that quality benchmarks would be achieved. Outcomes of two completed studies support the premise that it is possible to improve quality of dementia care through physician education that occurs in association with a coordinated system of dementia care management and in collaboration with community agencies to access guideline-recommended social services.

Sign in / Sign up

Export Citation Format

Share Document