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Ann Fam Med 2018 Nov;16(6):iii

Ann Fam Med 2018 Nov;16(6):573-575

American Board of Family Medicine.

Ann Fam Med 2018 Nov;16(6):572-573

AAFP News.

Ann Fam Med 2018 Nov;16(6):571

Ann Fam Med 2018 Nov;16(6):570

Ann Fam Med 2018 Nov;16(6):568-569

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Society of Teachers of Family Medicine.

Ann Fam Med 2018 Nov;16(6):566

Department of Family and Community Medicine, Saint Louis University, St Louis, Missouri.

Ann Fam Med 2018 Nov;16(6):563-565

Kaiser Permanente of Washington, Seattle, Washington

Empanelment in a "clinic first" residency has helped me develop competency in medicine and understand the value of primary care. Taking care of a panel of patients longitudinally aligns with education research on how we best learn; we learn best when learning sessions are longitudinal, spaced in time and interleaved with diverse topics. By caring for patients longitudinally, I have developed competency and proficiency in providing comprehensive care to my patients. Read More

Ann Fam Med 2018 Nov;16(6):559-562

National LGBT Health Education Center at The Fenway Institute, Fenway Health, Boston, Massachusetts

The increasing visibility of transgender people and others who do not conform to traditional gender norms challenges us to think about gender in new ways, and to use new terminology when communicating with patients. People who describe themselves as nonbinary have a gender identity that is not exclusively girl/woman or boy/man. A small but growing body of research indicates they experience high levels of societal victimization and discrimination, and are misunderstood by health care clinicians. Read More

Ann Fam Med 2018 Nov;16(6):555-558

Lyle S. Hallman Faculty of Social Work, Wilfrid Laurier University, Waterloo, Ontario, Canada.

Transgender patients report negative experiences in health care settings, but little is known about clinicians' willingness to see transgender patients. We surveyed 308 primary care clinicians in an integrated Midwest health system and 53% responded. Most respondents were willing to provide routine care to transgender patients (85. Read More

Ann Fam Med 2018 Nov;16(6):552-554

Fischell Department of Bioengineering and Director of Regulatory Science Initiative, University of Maryland, College Park, Maryland.

The purpose of our study was to clarify limitations of off-label use for low cost nonmedical use (NMU) pulse oximeters by primary care providers. These devices are widely marketed over the Internet and in drugstores but are not intended for medical use or reviewed by the Food and Drug Administration (FDA). Our study compared oxygen saturation (SpO) in patients from 1 medical use (MU) pulse oximeter to 8 NMU pulse oximeters. Read More

Ann Fam Med 2018 Nov;16(6):549-551

University of British Columbia, Vancouver, British Columbia, Canada

We aimed to determine if a history of recent imprisonment affects access to primary care. Using patient roles, we telephoned to request an initial appointment with all family physicians (n = 339) who were accepting new patients in British Columbia, Canada. We sequentially assigned patient scenarios: male or female recently released from prison; male or female control. Read More

Ann Fam Med 2018 Nov;16(6):546-548

Department of Medicine, MetroHealth System, Cleveland, Ohio.

Large panel sizes are often held responsible for worse access to appointments in primary care. We evaluated the relationship between appointment backlog, panel size, and primary care clinician time in clinic, using Spearman correlation and multiple regression in a retrospective analysis. We found no independent association between panel size and days until third next available appointment, but larger panel size adjusted for clinician time in clinic was associated with worse access. Read More

Ann Fam Med 2018 Nov;16(6):538-545

Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.

Purpose: Access to a usual source of care (USC) is associated with better preventive health and chronic disease treatment. Although most older adults have a USC, loss of USC, and factors associated with loss of USC, have not previously been examined.

Methods: We followed 7,609 participants of the National Health and Aging Trends Study annually for up to 6 years (2011-2016). Read More

Ann Fam Med 2018 Nov;16(6):530-537

The Johns Hopkins University School of Medicine, Baltimore, Maryland.

Purpose: Clinical practice guidelines recommend incorporating long-term life expectancy to inform a number of decisions in primary care. We aimed to examine older adults' preferences for discussing life expectancy in a national sample.

Methods: We invited 1,272 older adults (aged 65 or older) from a national, probability-based online panel to participate in 2016. Read More

Ann Fam Med 2018 Nov;16(6):521-529

The School of Public Health and Primary Care, The Chinese University of Hong Kong, Hong Kong.

Purpose: We performed a phase 2 randomized clinical trial to evaluate the preliminary effectiveness of a clinic-based patellar mobilization therapy (PMT) in patients with knee osteoarthritis.

Methods: We recruited 208 patients with knee osteoarthritis at primary care clinics in Hong Kong. Patients were randomly assigned (1:1) to the intervention group or the control group. Read More

Ann Fam Med 2018 Nov;16(6):515-520

Department of Family Medicine, McMaster University, Hamilton, Ontario, Canada.

Purpose: Polypharmacy is a key clinical challenge for primary care. Drugs that should be prescribed for an intermediate term (longer than 3 months, but not indefinitely) that are not appropriately discontinued could contribute to polypharmacy. We named this type of prescribing . Read More

Ann Fam Med 2018 Nov;16(6):507-514

Department of Family Medicine, University of Michigan, Ann Arbor, Michigan

Purpose: Up to one-third of female smokers with Medicaid deny tobacco use during pregnancy. Point-of-care urine tests for cotinine, a tobacco metabolite, can help to identify women who may benefit from cessation counseling. We sought to evaluate patient and clinician perspectives about using such tests during prenatal care to identify smokers, with particular focus on the impact of testing on clinical relationships and the potential for tobacco cessation. Read More

Ann Fam Med 2018 Nov;16(6):498-506

Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

Purpose: The purpose of this study was to examine the incremental effect of performance coaching, delivered as part of a multicomponent intervention (Ottawa Model for Smoking Cessation [OMSC]), in increasing rates of tobacco-dependence treatment by primary care clinicians.

Methods: In a cluster-randomized controlled trial, 15 primary care practices were randomly assigned to 1 of the following active-treatment conditions: OMSC or OMSC plus performance coaching (OMSC+). All practices received support to implement the OMSC. Read More

Ann Fam Med 2018 Nov;16(6):492-497

American Board of Family Medicine, Lexington, Kentucky.

Purpose: Continuity of care is a defining characteristic of primary care associated with lower costs and improved health equity and care quality. However, we lack provider-level measures of primary care continuity amenable to value-based payment, including the Medicare Quality Payment Program (QPP). We created 4 physician-level, claims-based continuity measures and tested their associations with health care expenditures and hospitalizations. Read More

Ann Fam Med 2018 Nov;16(6):490-491

Department of Health Services Research, Management, and Policy, University of Florida, Gainesville, Florida

Ann Fam Med 2018 Nov;16(6):488-489

Ann Fam Med 2018 Sep;16(5):iii

Rush Medical College.

Ann Fam Med 2018 Sep;16(5):473-475

Communications and Programs, Society of Teachers of Family Medicine.

Ann Fam Med 2018 Sep;16(5):473

ABFM.

Ann Fam Med 2018 Sep;16(5):471-472

AAFP News.

Ann Fam Med 2018 Sep;16(5):470-471

Ann Fam Med 2018 Sep;16(5):469-470

Ann Fam Med 2018 Sep;16(5):468-469

GME Initiative, Colorado State.

Ann Fam Med 2018 Sep;16(5):467

Ann Fam Med 2018 Sep;16(5):466

Ann Fam Med 2018 Sep;16(5):465

Brown University, Providence, Rhode Island, Providence Community Health Centers, Providence, Rhode Island

Ann Fam Med 2018 Sep;16(5):464

Department of Family & Community Medicine, Thomas Jefferson University, Philadelphia, Pennsylvania

Ann Fam Med 2018 Sep;16(5):461-463

Family Medicine and Community Health, University of Wisconsin School of Medicine

Historically, family physicians moved among all the venues of medical care- office, hospital, community-and were a part of a connected professional community. That connected community was sustained in great part through informal gatherings of clinicians in hospitals, clinics, and professional organizations. The current fragmentation of medicine into narrowly defined, boundaried workspaces and job descriptions, as well as the increasing size of practices has negatively affected the professional culture in which physicians work. Read More

Ann Fam Med 2018 Sep;16(5):447-460

The Upstream Lab, Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.

Purpose: Employment is a key social determinant of health. People who are unemployed typically have worse health than those employed. Illness and disability can result in unemployment and be a barrier to regaining employment. Read More

Ann Fam Med 2018 Sep;16(5):443-446

Department of Family Medicine and Population Health, Virginia Commonwealth University, Richmond, Virginia.

Buprenorphine can be used in primary care to treat opioid use disorder, but many family physicians feel unprepared to care for patients with opioid addiction. We sought to describe preparedness to provide and current provision of buprenorphine treatment by early career family physicians using data from the 2016 National Family Medicine Graduate Survey. Of 1,979 respondents, 10. Read More

Ann Fam Med 2018 Sep;16(5):440-442

Department of Family Medicine, Department of Medicine, and The Oregon Institute for Occupational Health Sciences, Oregon Health and Science University, Portland, Oregon.

We aimed to better understand the association between opioid-prescribing continuity, risky prescribing patterns, and overdose risk. For this retrospective cohort study, we included patients with long-term opioid use, pulling data from Oregon's Prescription Drug Monitoring Program (PDMP), vital records, and hospital discharge registry. A continuity of care index (COCI) score was calculated for each patient, and we defined metrics to describe risky prescribing and overdose. Read More

Ann Fam Med 2018 Sep;16(5):436-439

Department of Family Medicine, College of Medicine and Life Sciences, University of Toledo, Toledo, Ohio.

POEMs (patient-oriented evidence that matters) are studies that address a relevant clinical question, demonstrate improved patient-oriented outcomes, and have the potential to change practice. For 20 years the authors of this article have reviewed more than 100 English language clinical journals monthly to identify POEMs in the medical literature relevant to primary care practice. This article identifies the POEMs in each of the last 20 years that were highest ranked for having recommended a major and persistent change in practice that year. Read More

Ann Fam Med 2018 Sep;16(5):428-435

Department of General Practice and Elderly Care Medicine, Amsterdam Public Health Research Institute, Amsterdam UMC, Vrije Iniversiteit Amsterdam, Amsterdam, The Netherlands.

Purpose: Because dizziness in older people is often chronic and can substantially affect daily functioning, it is important to identify those at risk for an unfavorable course of dizziness to optimize their care. We aimed to develop and externally validate a prediction model for an unfavorable course of dizziness in older patients in primary care, and to construct an easy-to-use risk prediction tool.

Methods: We used data from 2 prospective cohorts: a development cohort with 203 patients aged 65 years or older who consulted their primary care physician for dizziness and had substantial dizziness-related impairment (Dizziness Handicap Inventory [DHI] ≥30), and a validation cohort with 415 patients aged 65 years or older who consulted their primary care physician for dizziness of any severity. Read More

Ann Fam Med 2018 Sep;16(5):419-427

Department of Family and Community Medicine and the Centre for Urban Health Solutions in the Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Ontario, Canada.

Purpose: Compared with other high-income countries, Canada and the United States have among the highest rates of emergency department use and the lowest rates of primary care physicians reporting arrangements for after-hours care. We assessed whether enrollment in a medical home mandated to provide after-hours care in Ontario, Canada, was associated with reduced emergency department use.

Methods: We conducted a retrospective cohort study using linked administrative data. Read More

Ann Fam Med 2018 Sep;16(5):408-418

Department of Allergy, Beijing Shijitan Hospital, Capital Medical University, Beijing, China

Purpose: Our purpose was to investigate the relationship between intake of excess free fructose beverages and allergy among children and adolescents.

Methods: We analyzed data of 860 children (aged 6 to 12 years) and 1,142 adolescents (aged 13 to 19 years) from the National Health and Nutrition Examination Survey 2005-2006. Logistic regression analyses were performed to determine the associations between consumption of excess free fructose beverages and allergic symptoms or allergic sensitization. Read More

Ann Fam Med 2018 Sep;16(5):399-407

OCHIN, Inc, Portland, Oregon.

Purpose: This pilot study assessed the feasibility of implementing electronic health record (EHR) tools for collecting, reviewing, and acting on patient-reported social determinants of health (SDH) data in community health centers (CHCs). We believe it is the first such US study.

Methods: We implemented a suite of SDH data tools in 3 Pacific Northwest CHCs in June 2016, and used mixed methods to assess their adoption through July 2017. Read More

Ann Fam Med 2018 Sep;16(5):393-398

Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan

Purpose: Social isolation has been identified as a major health problem, particularly in the elderly. In the present study, we examine the association between social isolation and patient experience in elderly primary care patients.

Methods: This cross-sectional study was conducted in a primary care practice-based research network (28 clinics) in Japan. Read More

Ann Fam Med 2018 Sep;16(5):390-392

Department of General Practice, Royal College of Surgeons in Ireland (RCSI), Dublin, Ireland

Ann Fam Med 2018 Sep;16(5):388-389

Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina

Ann Fam Med 2018 Jul;16(4):iii

Ann Fam Med 2018 Jul;16(4):374-375

Ann Fam Med 2018 Jul;16(4):373-374

AAFP News Department.

Ann Fam Med 2018 07;16(4):371-373

Radboud University Medical Centre, Netherlands,