Beliefs and Communication Practices Regarding Cognitive Functioning Among Consumers and Primary Care Providers in the United States, 2009

Background The demand for complementary and integrative health (CIH) is increasing by patients who want to receive more CIH referrals, in-clinic services, and overall care delivery. To promote CIH within the context of primary care, it is critical that providers have sufficient knowledge of CIH, access to CIH-trained providers for referral purposes, and are comfortable either providing services or co-managing patients who favor a CIH approach to their healthcare. Objective The main objective was to gather primary care providers’ perspectives across the northwestern region of the United States on their CIH familiarity and knowledge, clinic barriers and opportunities, and education and training needs. Methods We conducted an online, quantitative survey through an email invitation to all primary care providers (n = 483) at 11 primary care organizations from the WWAMI (Washington, Wyoming, Alaska, Montana and Idaho) region Practice and Research Network (WPRN). The survey questions covered talking about CIH with patients, co-managing care with CIH providers, familiarity with and training in CIH modalities, clinic barriers to CIH integration, and interest in learning more about CIH modalities. Results 218 primary care providers completed the survey (45% response rate). Familiarity with individual CIH methods ranged from 73% (chiropracty) to 8% (curanderismo). Most respondents discussed CIH with their patients (88%), and many thought that their patients could benefit from CIH (41%). The majority (89%) were willing to co-manage a patient with a CIH provider. Approximately one-third of respondents had some expertise in at least one CIH modality. Over 78% were interested in learning more about the safety and efficacy of at least one CIH modality. Conclusion Primary care providers in the Northwestern United States are generally familiar with CIH modalities, are interested in referring and co-managing care with CIH providers, and would like to have more learning opportunities to increase knowledge of CIH.

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Barriers that Nurse Practitioners Face as Primary Care Providers in the United States

Annals of Global Health ◽

10.1016/j.aogh.2017.03.250 ◽

2017 ◽

Vol 83 (1) ◽

pp. 112

Author(s):

C. Pando

Keyword(s):

United States ◽

Primary Care ◽

Nurse Practitioners ◽

Primary Care Providers ◽

The United States ◽

Care Providers

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Knowledge Assessment of “Addendum Guidelines for the Prevention of Peanut Allergy in the United States” Among Pediatric Primary Care Providers

Journal of Allergy and Clinical Immunology ◽

10.1016/j.jaci.2019.12.779 ◽

2020 ◽

Vol 145 (2) ◽

pp. AB49

Author(s):

Alicia Alvarez ◽

Malika Gupta ◽

Pavadee Poowuttikul ◽

Alan Baptist

Keyword(s):

United States ◽

Primary Care ◽

Peanut Allergy ◽

Primary Care Providers ◽

The United States ◽

Knowledge Assessment ◽

Pediatric Primary Care ◽

Care Providers

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Predictors and Outcomes of Burnout Among Primary Care Providers in the United States: A Systematic Review

Medical Care Research and Review ◽

10.1177/1077558719888427 ◽

2019 ◽

Vol 77 (5) ◽

pp. 387-401 ◽

Cited By ~ 1

Author(s):

Cilgy M. Abraham ◽

Katherine Zheng ◽

Lusine Poghosyan

Keyword(s):

United States ◽

Primary Care ◽

Primary Care Providers ◽

The United States ◽

Organizational Level ◽

Care Practice ◽

Practice Environment ◽

Care Providers ◽

Cross Sectional ◽

Study Designs

Primary care providers (PCPs) in the United States work in challenging environments and may be at risk for burnout. This article identifies the predictors and outcomes of burnout among PCPs in the United States. A comprehensive literature search of eight databases was conducted to identify studies investigating predictors or outcomes of PCP burnout. The Joanna Briggs Institute’s critical appraisal checklists for cross-sectional and cohort studies were used for quality appraisal. Overall, 21 studies met inclusion criteria, had sufficient quality, reported personal and/or organizational predictors of burnout, and described burnout outcomes at the patient, provider, or organizational level. Prevalence of PCP burnout ranged from 13.5% to 60%. The primary care practice environment was the most common predictor of PCP burnout. In conclusion, developing interventions to improve the practice environment may help reduce PCP burnout. Future studies using robust study designs and standardized instruments to consistently measure burnout are needed.

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Characteristics Associated with Trust in and Disclosure of Sexual Behavior to Primary Care Providers Among Gay, Bisexual, and Other Men Who Have Sex with Men in the United States

LGBT Health ◽

10.1089/lgbt.2019.0214 ◽

2020 ◽

Vol 7 (4) ◽

pp. 208-213

Author(s):

Christopher B. Stults ◽

Christian Grov ◽

Kathryn Anastos ◽

Elizabeth A. Kelvin ◽

Viraj V. Patel

Keyword(s):

United States ◽

Primary Care ◽

Sexual Behavior ◽

Primary Care Providers ◽

The United States ◽

Care Providers ◽

Sex With Men

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Understanding primary care providers’ perceptions of cancer prevention and screening in a predominantly rural healthcare system in the upper Midwest

BMC Health Services Research ◽

10.1186/s12913-019-4872-9 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 1

Author(s):

Daniel M. Saman ◽

Kayla M. Walton ◽

Melissa L. Harry ◽

Stephen E. Asche ◽

Anjali R. Truitt ◽

...

Keyword(s):

United States ◽

Primary Care ◽

Cancer Screening ◽

Cancer Risk ◽

Cancer Prevention ◽

Primary Care Providers ◽

The United States ◽

Comfort Level ◽

Care Providers ◽

Cancer Prevention And Screening

Abstract Background Cancer is the leading cause of death in the United States, with the burden expected to rise in the coming decades, increasing the need for effective cancer prevention and screening options. The United States Preventive Services Task Force has suggested that a shared decision-making process be used when clinicians and patients discuss cancer screening. The electronic medical record (EMR) often provides only reminders or alerts to primary care providers (PCPs) when screenings are due, a strategy with limited efficacy. Methods We administered a cross-sectional electronic survey to PCPs (n = 165, 53% response rate) at 36 Essentia Health primary care clinics participating in a large, National Cancer Institute-funded study on a cancer prevention clinical decision support (CDS) tool. The survey assessed PCP demographics, perceptions of the EMR’s ability to help assess and manage patients’ cancer risk, and experience and comfort level discussing cancer screening and prevention with patients. Results In these predominantly rural clinics, only 49% of PCPs thought the EMR was well integrated to help assess and manage cancer risk. Both advanced care practitioners and physicians agreed that cancer screening and informed discussion of cancer risks are important; however, only 53% reported their patients gave cancer screening a high priority relative to other health issues. Conclusions The impact of EMR-linked CDS delivered to both patients and PCPs may improve cancer screening, but only if it is easy to use and saves PCPs time.

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Dementia assessment and management in primary care settings: a survey of current provider practices in the United States

BMC Health Services Research ◽

10.1186/s12913-019-4603-2 ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 2

Author(s):

Alissa Bernstein ◽

Kirsten M. Rogers ◽

Katherine L. Possin ◽

Natasha Z.R. Steele ◽

Christine S. Ritchie ◽

...

Keyword(s):

United States ◽

Primary Care ◽

Clinical Practice ◽

Diagnostic Criteria ◽

Management Practices ◽

Primary Care Providers ◽

The United States ◽

Cognitive Testing ◽

Care Providers ◽

High Confidence

Abstract Background Primary care providers (PCPs) are typically the first to screen and evaluate patients for neurocognitive disorders (NCDs), including mild cognitive impairment and dementia. However, data on PCP attitudes and evaluation and management practices are sparse. Our objective was to quantify perspectives and behaviors of PCPs and neurologists with respect to NCD evaluation and management. Methods A cross-sectional survey with 150 PCPs and 50 neurologists in the United States who evaluated more than 10 patients over age 55 per month. The 51-item survey assessed clinical practice characteristics, and confidence, perceived barriers, and typical practices when diagnosing and managing patients with NCDs. Results PCPs and neurologists reported similar confidence and approaches to general medical care and laboratory testing. Though over half of PCPs performed cognitive screening or referred patients for cognitive testing in over 50% of their patients, only 20% reported high confidence in interpreting results of cognitive tests. PCPs were more likely to order CT scans than MRIs, and only 14% of PCPs reported high confidence interpreting brain imaging findings, compared to 70% of specialists. Only 21% of PCPs were highly confident that they correctly recognized when a patient had an NCD, and only 13% were highly confident in making a specific NCD diagnosis (compared to 72 and 44% for neurologists, both p < 0.001). A quarter of all providers identified lack of familiarity with diagnostic criteria for NCD syndromes as a barrier to clinical practice. Conclusions This study demonstrates how PCPs approach diagnosis and management of patients with NCDs, and identified areas for improvement in regards to cognitive testing and neuroimaging. This study also identified all providers’ lack of familiarity with published diagnostic criteria for NCD syndromes. These findings may inform the development of new policies and interventions to help providers improve the efficacy of their decision processes and deliver better quality care to patients with NCDs.

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