Family practice最新文献

{"title":"Expanding the primary care workforce by integrating genetic counselors in multidisciplinary care teams.","authors":"Rachel Vanneste, Sasha A Bauer, Kennedy Borle, Erika Dreikorn","doi":"10.1093/fampra/cmae057","DOIUrl":"10.1093/fampra/cmae057","url":null,"abstract":"<p><p>Collectively, rare diseases are common, affecting approximately 8% of the population in Canada and the USA. Therefore, the majority of primary care (PC) clinicians will care for patients who are affected or at risk for a genetic disease. Considering the increasing ways in which genetics is being implemented into all areas of healthcare, one way to address these needs and expand the capacity of the PC workforce is through the integration of genetic counselors (GCs) into PC multidisciplinary teams. GCs are Masters-educated allied health professionals with specialized training in molecular genetics, communication, and short-term psychotherapeutic counseling. The current models of GCs in PC mimic other multidisciplinary models. Complex tasks related to genetics, such as pre- and post-test counseling, genetic test selection, and results interpretation, are conducted by GCs, which, in turn, allows physicians, nurse practitioners, and other PC providers to work at the top of their scope of practice. Quality genetics services provided by GCs improve clinical outcomes for patients and their families; the simultaneous provision of genetic education and psychological support by a GC is associated with an increase in patient knowledge, perceived personal control, decrease in distress, and can lead to positive health behavior changes, all of which are aligned with the goals of primary healthcare. With their extensive training in clinical care, medical communication, and psychotherapeutic counseling, integrating GCs into PC care teams will improve the care patients receive and allow PC clinicians to ensure their patients are at the forefront of the personalized medicine revolution.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809246/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142497734","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case control study of access to medications during COVID-19 and primary care patients managing multiple chronic conditions.","authors":"Hinpetch Daungsupawong, Viroj Wiwanitkit","doi":"10.1093/fampra/cmaf004","DOIUrl":"https://doi.org/10.1093/fampra/cmaf004","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656414","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: A 2-item version of the Japanese Consultation and Relational Empathy measure: a pilot study using secondary analysis of a cross-sectional survey in primary care.","authors":"","doi":"10.1093/fampra/cmae060","DOIUrl":"10.1093/fampra/cmae060","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809249/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142568287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are we ready? assessing effectiveness and implementation of cancer control strategies in primary care: a comprehensive review of systematic reviews.","authors":"Javiera Martinez-Gutierrez, María Gabriela Soto, Andrea Rioseco, Catalina Bienzobas, Madeline Fowler, Gonzalo Ulloa, Mauricio Soto, Jon David Emery, Klaus Puschel","doi":"10.1093/fampra/cmae078","DOIUrl":"10.1093/fampra/cmae078","url":null,"abstract":"<p><strong>Background: </strong>Cancer is a major global cause of death, and primary care is crucial for cancer prevention and early detection. However, there is conflicting information on the effectiveness, implementation, and sustainability of cancer control interventions in primary care.</p><p><strong>Objective: </strong>This study aimed to summarize the evidence for cancer control in primary care, focussing on identifying relevant factors for implementation and sustainability.</p><p><strong>Study setting and design: </strong>We conducted a narrative, mixed-methods review of systematic reviews, guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Four databases were screened, and two independent reviewers selected studies reporting on cancer prevention, screening, or early detection in primary or community settings. We analysed findings using the extended Reach-Effectiveness-Adopt-Implementation-Maintenance (RE-AIM) Framework.</p><p><strong>Principal findings: </strong>From the 37 reviews that met the inclusion criteria, 6 focussed on primary prevention, 23 on screening, and 12 on early detection. Most reviews (78%) addressed intervention effectiveness, such as HPV vaccination, tobacco cessation, and cervical, breast, and colorectal screening. One-third of the reviews mentioned adoption and implementation factors, including barriers and facilitators to the implementation of cancer screening programs. Only one review addressed maintenance and sustainability factors, exploring continuous resources and funding strategies.</p><p><strong>Conclusion: </strong>While numerous interventions are effective for cancer prevention and detection in primary care, literature on implementation and sustainability strategies is lacking. Focusing on continuous resources and funding for cancer strategies in primary care may aid sustainability. Future research should prioritize reporting on implementation and sustainability factors to enhance cancer prevention and control in primary care settings.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11803426/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143364177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing the role of general practitioner trainers in supporting antibiotic stewardship initiatives.","authors":"Waseem Jerjes","doi":"10.1093/fampra/cmae058","DOIUrl":"10.1093/fampra/cmae058","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Variation in general practitioners' follow-up of depressed patients starting antidepressant medication: a register-based cohort study.","authors":"Anneli B Hansen, Øystein Hetlevik, Valborg Baste, Inger Haukenes, Tone Smith-Sivertsen, Sabine Ruths","doi":"10.1093/fampra/cmae063","DOIUrl":"10.1093/fampra/cmae063","url":null,"abstract":"<p><strong>Background: </strong>Guidelines recommend follow-up within 2 weeks for patients starting medication for depression. Knowledge is lacking about how general practitioners' (GPs) follow-up varies with patients' sociodemographic characteristics.</p><p><strong>Objective: </strong>To describe follow-up by GP and specialist in mental healthcare provided to men and women with depression within 3 months of starting drug therapy. Furthermore, to examine whether follow-up varied according to patients' age and education.</p><p><strong>Methods: </strong>Registry-based cohort study comprising all patients aged ≥18 years in Norway with a new depression episode in 2014 who started on antidepressants within 12 months from diagnosis. Patients' age and educational level were the exposures. Outcomes were follow-up by GP and/or mental healthcare specialist, and talking therapy with GP, within 90 days of first prescription. Cox proportional hazard models were used to estimate the likelihood of having follow-up contacts. Log binomial regression analysis was performed to explore the likelihood of having talking therapy with a GP. Time to first contact was illustrated by Kaplan-Meier survival curves.</p><p><strong>Results: </strong>The study population comprised 17 000 patients, mean age 45.7 years, 60.6% women. Only 27.8% of the patients were followed up by GP and/or specialist within 2 weeks of the first drug dispensing, 67.1% within 90 days. Older or less educated men and women received less and later contacts than the younger or more highly educated.</p><p><strong>Conclusions: </strong>Differences in age and educational level were associated with follow-up of depressed patients who started medication. This may indicate unwarranted variation in depression care that GPs should consider when prescribing antidepressants.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11809248/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142681020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Provider experiences delivering collaborative care for co-occurring opioid and mental health disorders: a qualitative study.","authors":"Jasen Christensen, Grace Hindmarch, Lizeth Cueto, Maya Rabinowitz, Valerie Carrejo, Scott Jeansonne, John Bettler, Seth Williams, Miriam Komaromy, Katherine Watkins, Karen Chan Osilla","doi":"10.1093/fampra/cmaf007","DOIUrl":"10.1093/fampra/cmaf007","url":null,"abstract":"<p><strong>Background: </strong>Opioids are the primary contributor to overdose death in the USA and represent a major public health crisis despite the availability of highly effective evidence-based treatments. A co-occurring mental health disorder further complicates efforts to utilize effective treatments and leads to poorer outcomes. Collaborative care has shown promise in improving care for those with substance use disorders and those with mental health disorders. This study explores the experiences of providers participating in a randomized controlled trial of collaborative care for both opioid use disorder (OUD) and co-occurring depression and/or posttraumatic stress disorder (COD).</p><p><strong>Methods: </strong>Semi-structured interviews were conducted with healthcare providers of collaborative care as part of a randomized controlled trial at two health systems. Interviewed participants included primary care providers, care coordinators, behavioral health providers, clinic administrators, and psychiatric consultants. Data was analyzed with content analysis to identify common themes and subthemes among experiences.</p><p><strong>Findings: </strong>Participants perceived differences between patients diagnosed with only OUD and those with COD, such as heightened stigma, greater symptom severity, and more barriers to treatment. They perceived the positive impacts of the collaborative care intervention for patients with COD and the clinics and providers caring for this population, and identified considerations for future implementation efforts.</p><p><strong>Conclusions: </strong>Although participants noted challenges in treating patients with COD compared to those with only OUD, they also perceived the benefits of using collaborative care in this complex population. Participants supported using collaborative care in the future, but noted important systems and policy suggestions needed for successful implementation.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 2","pages":""},"PeriodicalIF":2.2,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143656433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The patient experience in a virtual peer support group for patients with type 2 diabetes and obesity during the corona virus disease 19 pandemic: interview themes from a pilot study.","authors":"Kelsey E Ufholz, James J Werner, Goutham Rao","doi":"10.1093/fampra/cmaf014","DOIUrl":"10.1093/fampra/cmaf014","url":null,"abstract":"<p><strong>Background: </strong>Type 2 diabetes and obesity are lifelong conditions that require extensive lifestyle modifications. During the corona virus disease 19 (COVID-19) pandemic, in-person medical care was risky. Many patients suffered from isolation and loneliness. One remedy which would address both the need for obesity and diabetes-related self-management and social isolation is peer support groups. There is considerable evidence for the effectiveness of peer-led programs in weight management and in diabetes self-management. No prior study has evaluated the impact of a virtual peer support group for diabetes.</p><p><strong>Objectives: </strong>To determine the feasibility and acceptability of a virtual peer support group for patients with type 2 diabetes and obesity [body mass index (BMI) > 30 kg/m2].</p><p><strong>Methods: </strong>Patients at an urban, Midwestern healthcare system enrolled in an 18-month remote (Zoom) (November 2021-May 2023) peer support group. Weekly meetings featured peer discussions on topics related to diabetes self-management. Semi-structured interviews post-intervention underwent independent thematic analysis by two coders until a set of common themes emerged.</p><p><strong>Results: </strong>All participants expressed satisfaction and enjoyment with the study. The opportunity to connect with peers, increase awareness of the importance of diabetes management behaviors, and learn new skills were cited as meaningful. Many participants lived alone, making the social support offered by the group especially valuable.</p><p><strong>Conclusions: </strong>A long-term stand-alone virtual diabetes peer support group filled an important social and emotional need among its members, especially among those who were most isolated. To achieve long-term behavioral change and healthier outcomes, the support group may need to be paired with individual counseling.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143676865","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction to: Methodological quality and clinical recommendations of guidelines on the management of dyslipidaemias for cardiovascular disease risk reduction: a systematic review and an appraisal through AGREE II and AGREE REX tools.","authors":"","doi":"10.1093/fampra/cmae055","DOIUrl":"10.1093/fampra/cmae055","url":null,"abstract":"","PeriodicalId":12209,"journal":{"name":"Family practice","volume":" ","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142544545","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of antimicrobial resistance surveillance data sources in primary care setting: a scoping review.","authors":"Vimrata Mori, Gary Grant, Laetitia Hattingh","doi":"10.1093/fampra/cmaf013","DOIUrl":"10.1093/fampra/cmaf013","url":null,"abstract":"<p><strong>Background: </strong>Antimicrobial resistance (AMR) is a global health warning that increases mortality, morbidity, and medical expenses. Effective AMR surveillance is essential to guide interventions and maintain treatment efficacy. While AMR surveillance is studied in various healthcare settings, data sources in primary care settings need to be evaluated.</p><p><strong>Aim: </strong>To identify the value of utilizing AMR surveillance data in primary care settings to inform community antimicrobial stewardship (AMS) practices.</p><p><strong>Methods: </strong>Eligibility criteria included primary studies, randomized and nonrandomised controlled trials, observational studies, surveys, qualitative studies, mixed-method studies, and grey literature in primary care published worldwide from 2001 to 2024.</p><p><strong>Results: </strong>Our review of 21 included studies emphasized the significance of utilizing AMR surveillance data to enhance clinical care. Clinicians need to better understand the local AMR pattern when prescribing primary care antibiotics. Despite limitations, educational interventions can change prescribing behaviour. AMR increased because local susceptibility data frequently did not inform empirical antibiotic treatment. Digital and geospatial platforms could enhance surveillance with institutional support and standardized data integration.</p><p><strong>Conclusion: </strong>This analysis highlights the need for user-friendly, real-time, and easily accessible data visualization platforms to improve AMR surveillance and AMS in primary care. Addressing data accessibility and providing training and education are crucial elements. Standardising data and utilizing digital technologies can improve decision-making and antibiotic prescribing. These elements must be incorporated into a consistent and adaptive plan for effective AMS interventions and public health outcomes.</p>","PeriodicalId":12209,"journal":{"name":"Family practice","volume":"42 2","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11953028/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143742670","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}