Journal of Primary Care and Community Health最新文献

{"title":"A Social Network Lens to Community Health Worker Influence and Impact.","authors":"Reza Yousefi Nooraie, Deniz Naghibi, Ruthmarie Hernández-Torres, Paula Cupertino","doi":"10.1177/21501319241306706","DOIUrl":"10.1177/21501319241306706","url":null,"abstract":"<p><p>Community Health Workers (CHWs) are members of healthcare teams that are integrated in, and often share language, beliefs, and lived experiences with their communities. They use their formal and informal social networks to promote healthy behavior, to connect community members to resources, and to build more resilient community networks. We propose a framework to conceptualize CHW interventions aiming to operationalize and optimize CHW social relations and networks. CHW-mediated network interventions can focus on the dissemination and diffusion of health messages, using the channels of trust and formal and informal relations, as well as, engaging communities to enhance the cascade of spreading/diffusion. Network interventions can also focus on network-building and community dialog, relying on the role of CHWs in bringing the community members together in facilitating conversation, promoting social justice and inclusion, and mobilizing the community in collective action. In addition, the network interventions can aim for boundary-spanning and bridging activities, to facilitate the community's access to health services and external resources, as well as bringing the community voice to health systems to influence priorities and policies. Similar to any other complex interventions, CHW network interventions should be fine-tuned and adapted to local and community needs, capacities, and network structures, and actively involve community members in the conceptualization, delivery, and evaluation.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319241306706"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11724407/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determinants of Familiarity and Experience with HIV Pre-Exposure Prophylaxis in Primary Care Providers in Ontario, Canada.","authors":"Jorge Martinez-Cajas, Beatriz Alvarado, Carmela Rapino, Emma Nagy, T Hugh Guan, Nicholas Cofie, Nancy Dalgarno, Pilar Camargo, Bradley Stoner","doi":"10.1177/21501319251315566","DOIUrl":"10.1177/21501319251315566","url":null,"abstract":"<p><strong>Background: </strong>Despite increased access to HIV pre-exposure prophylaxis (PrEP) in Canada, familiarity and experience among primary care providers (PCPs)-including family doctors and those working with key populations-remains limited. To understand the barriers and facilitators of PrEP familiarity and experience, we conducted a situational analysis in PCPs in sub-urban and rural Ontario.</p><p><strong>Methods: </strong>We surveyed a non-probabilistic sample of PCPs using an online questionnaire, designed with the Consolidated Framework for Implementation Research (CFIR). Poisson regressions with robust variance were used to assess the relationship between CFIR domains, sociodemographic, and practice characteristics on both PrEP familiarity and experience.</p><p><strong>Results: </strong>A total of 54 PCPs participated (6% response rate), comprising 80% physicians and 20% nurses. Nearly 30% of the sample worked with key populations, including sexual health clinics and community care centers, 18% of respondents reported high familiarity with PrEP, and 44% reported PrEP experience (referred, started a conversation, or prescribed). PrEP familiarity and experience were associated with working in an organization serving key populations, working with gender minorities, and having colleagues providing PrEP. Providers with a positive perception of PrEP and its necessity for populations at risk were more likely to have PrEP-related experience. Higher familiarity and experience were reported by PCPs with specific clinical skills related to PrEP, and with the perception that PrEP was compatible with their practice as primary provider.</p><p><strong>Conclusions: </strong>Our findings suggest that organizational support, and additional training and education would facilitate PrEP provision by PCPs in suburban/rural Ontario.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251315566"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11755537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143025226","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing an Online Instrument to Measure Nurse Practitioner Workload: A Feasibility Study.","authors":"Kelley Kilpatrick, Véronique Landry, Eric Nguemeleu Tchouaket, André Daigle, Mira Jabbour","doi":"10.1177/21501319251321302","DOIUrl":"10.1177/21501319251321302","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Nurse practitioners (NPs) improve access to care in community-based primary care. Determining an appropriate workload for NPs is complex. The number of patients seen by NPs represents an important consideration. We sought to determine the feasibility, acceptability and appropriateness of implementing the online NP workload measurement index (NP-WI).</p><p><strong>Methods: </strong>Feasibility study supported by the Theoretical Framework of Acceptability, conducted across 3 health regions in Québec, Canada. Data were collected from January to July 2024 using the online NP-WI (<i>n</i> = 66), 8-item acceptability questionnaire (<i>n</i> = 47), weekly implementation team meetings with NPs and decision-makers (<i>n</i> = 11), field notes and interviews (<i>n</i> = 13). Data analysis completed using descriptive statistics and content analysis, with data integration using joint displays.</p><p><strong>Results: </strong>NPs indicated that the NP-WI was easy to use. Acceptability scores were positively rated. Daily data entry took 5 to 7 min to complete. NPs deemed a 4-week collection period sufficient to capture a representative workload sample. The NP-WI captured patient, provider and organizational characteristics and the number of patients seen by NPs.</p><p><strong>Conclusions: </strong>NP-WI implementation was feasible. The instrument can support healthcare workforce planning with more adequate estimations of NP workload in community-based primary care, and provide greater equity in resource allocation and distribution of NP workload.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251321302"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840855/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459855","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Determining Patient Panel Size in Primary Care: A Meta-Narrative Review.","authors":"Abd Moain Abu Dabrh, Wigdan H Farah, Heidi M McLeod, Parisa Biazar, Arya B Mohabbat, Bala Munipalli, Rachel Garofalo, Robert J Stroebel, Nilay Shah, Kurt B Angstman, Richard J Presutti, Bryan Farford, Jennifer L Horn, Summer V Allen, Adam I Perlman, Ana Lucia Chong Lau, Larry J Prokop, M Hassan Murad","doi":"10.1177/21501319251321294","DOIUrl":"10.1177/21501319251321294","url":null,"abstract":"<p><p>The optimal patient panel size (PPS) in primary care and the factors determining it remain unclear. We conducted a meta-narrative review of the literature to evaluate factors influencing PPS and assess its association with patient outcomes. A comprehensive search of electronic databases was performed from inception through December 2023, focusing on original studies reporting factors used to determine PPS and related outcomes (eg, clinical outcomes, process measures, and resource utilization). A total of 48 studies were included, identifying 7 key factors influencing PPS. Smaller panels were associated with improved patient satisfaction, continuity of care, and health promotion, while clinical outcomes, utilization, and costs showed minimal impact by PPS. Panel size was primarily associated with patient age, sex, comorbidities, and practice type and structure. Community-based centers typically managed smaller panels, often staffed by female clinicians and serving socioeconomically disadvantaged populations with greater health needs than hospital-based practices. Female clinicians were also independently associated with managing smaller panels, higher quality care indicators, fewer emergency department visits, and improved patient satisfaction. Determining the ideal PPS is a multifaceted process influenced by practice setting, patient demographics, and clinician characteristics. While practice-related factors showed limited association with PPS, patient-reported outcomes were more closely linked to it. Primary care practices should tailor panel sizes to their patient populations, emphasizing a patient-centered approach and ensuring adequate infrastructure support to optimize care delivery.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251321294"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11843711/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459897","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adapting the MUSIQ Calculator for Practice Facilitators to Evaluate Primary Care Clinic Performance in a Colorectal Cancer Screening Quality Improvement Project.","authors":"Dannell Boatman, Susan Eason, Kelcie Sturgeon-Danley, Catherine Whitworth, Stephenie Kennedy-Rea","doi":"10.1177/21501319251327849","DOIUrl":"10.1177/21501319251327849","url":null,"abstract":"<p><p>The Model for Understanding Success in Quality (MUSIQ) is a framework designed to understand the contextual factors that can influence healthcare quality improvement (QI) initiative implementation. The MUSIQ calculator was originally developed to help clinics identify contextual factors that may affect QI success. This retrospective study adapted the MUSIQ calculator to serve as an evaluative tool for practice facilitators engaged in a colorectal cancer screening initiative. Eight primary care clinics were scored in 6 contextual factors categories using the adapted MUSIQ calculator. Average MUSIQ scores were used to identify high and low contextual factors clinics, and their colorectal cancer screening rates were assessed across a 4-year period of active engagement with the colorectal cancer screening initiative. There were statistically significant, strong, correlations between overall contextual factors scores and colorectal cancer screening rates across all 4 years. There was a statistically significant difference between screening rate changes during the period of active engagement and high or low contextual factors scores (<i>P</i> = .047). There were statistically significant correlations between 3 contextual factors and colorectal cancer screening rate changes with \"Microsystem\" and \"QI Support\" having the strongest associations (<i>P</i> < .001). Low or high contextual factors classification statistically significantly predicted colorectal cancer screening rate changes across the observed timeframe (<i>P</i> = .047). By adapting existing tools with a strong track record of success, like MUSIQ, practice facilitators can identify potential challenges earlier in the QI process providing an important opportunity to intervene to prompt greater success.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251327849"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11910739/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143634873","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Workplace Violence Against Primary Care Physicians in Chengdu, China: A Cross-sectional Survey.","authors":"Xin Zeng, Chuan Zou, Hongxia Tao, Xueming Huang, Yu Lei, Chunyao Xiao, Tao Peng, Jing Shen, Wai Kit Wong","doi":"10.1177/21501319251318837","DOIUrl":"10.1177/21501319251318837","url":null,"abstract":"<p><strong>Background: </strong>The purpose of this study is to examine workplace violence (WPV) toward primary care physicians (PCPs), including prevalence, associated factors, impacts, and response to WPV in Chengdu, China.</p><p><strong>Methods: </strong>We used an online cross-sectional design to collect data from October to November 2022 with a structured self-administered questionnaire from a purposive sample of 568 PCPs in Chengdu city.</p><p><strong>Results: </strong>Among the 490 valid questionnaires, 44.3% of respondents reported at least encountered 1 type of WPV in the preceding year, with 38.0% experiencing emotional abuse, 24.5% threats, 9.8% experiencing physical assault, 5.5% verbal sexual harassment, and 1.6% sexual abuse. The common perpetrators of WPV were patients (81.6%) and their relatives (44.2%). A multilevel analysis showed that PCPs without night shift had lower odds of experiencing WPV (odds ratios [OR] = 0.461, 95% confidence interval [CI] = 0.299-0.700, <i>P</i> = .0004), while higher education levels were associated with increased odds (OR = 1.835, 95% CI = 1.126-3.005, <i>P</i> = .015). The common reasons of causing WPV perceived by PCPs were \"rejected unreasonable demands\" (81.6%), \"unmet the expectations\" (51.2%), and \"waiting too long\" (47.9%). In response to WPV, 80.6% of PCPs had communicated positively with patients, 61.8% informed superiors, and 23.5% called security guards/police officers, but still 10.6% took no action. Most respondents (82.9%) did not receive training on how to deal with WPV. After experiencing WPV, PCPs reported low work efficiency (56.2%), decreased patient trust (32.7%), and anxious feelings (32.7%).</p><p><strong>Conclusions: </strong>This study revealed a moderate prevalence of violence against PCPs in primary care settings. Most PCPs lack coping strategies to handle WPV and suffer many negative effects. It is imperative that PCPs receive formal training in WPV management, and our study provides evidence to support such training programs.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251318837"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905042/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606620","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrated Care for People Living With Rare Disease: A Scoping Review on Primary Care Models in Organization for Economic Cooperation and Development Countries.","authors":"Nada Vidic, Anna McGlynn, Fatemeh Abdi, Chun Wah Michael Tam, Reginald Michael Crampton, Kean-Seng Lim, Elizabeth Emma Palmer, Natalie Taylor, Ben Harris-Roxas","doi":"10.1177/21501319241311567","DOIUrl":"10.1177/21501319241311567","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Individually rare, rare diseases are collectively common resulting in frequent health system use. Navigating the health system persists as a challenge. Primary care provides longitudinal contact with the health system and is placed to provide integrated rare-disease-care.</p><p><strong>Methods: </strong>This scoping review used Joanna Briggs Institute and PRISMA methods with a Consolidated Framework for Implementation Research based data extraction tool to find how integrated rare-disease-care is delivered, enablers and barriers to the same, in primary care settings in contemporary literature in OECD countries.</p><p><strong>Results: </strong>The Primary Care Provider (PCP) role varies from routine primary care to shared-rare-disease-care models. In the 26 papers, the most frequently cited PCP roles included involvement in diagnosis (n = 14), care coordination (n = 16), primary and preventative care (n = 18), management of components of rare-disease-care (n = 13), and treatment monitoring (n = 10). Individuals whose PCP was actively involved in their care were reported to have shortened diagnostic delay, improved transitions of care across the lifespan, reduced unplanned utilization of emergency and hospital services, comprehensive psychosocial care, improved quality of life across environments including home, school and work and improved palliative care experiences.</p><p><strong>Conclusions: </strong>Sufficient communication from specialists, information, resources, time and reimbursement for complex care are still needed. Future integrated-rare-disease-care models should be developed by, or with, PCPs.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319241311567"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11707790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142956796","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Partnered Training in Trauma-Informed Primary Care for Patients Experiencing Reentry From Incarceration: A Pilot Training Study.","authors":"Lauren E Szkodny, Mahlet A Yared, Shoshana H Bardach, Joseph Lascaze, Randy Stevens, Anna M Adachi-Mejia, Milan F Satcher","doi":"10.1177/21501319241312577","DOIUrl":"10.1177/21501319241312577","url":null,"abstract":"<p><strong>Introduction/objectives: </strong>Patients returning to the community from incarceration (ie, reentry) are at heightened risk of experiencing trauma when interacting with the healthcare system. Healthcare professionals may not recognize patients' trauma reactions or know how to effectively respond. This paper describes the development and pilot evaluation of a single-session training to prepare primary care teams to deliver trauma-informed care (TIC) to patients experiencing reentry.</p><p><strong>Methods: </strong>A multidisciplinary team including community members with lived experience engaged in a multiphase human-centered design process that incorporated interviews, discussions, and a participatory process to design and evaluate a single-session interactive pilot training targeting providers' attitudes toward formerly incarcerated patients and confidence to deliver TIC.</p><p><strong>Results: </strong>Both pre- and post-training surveys were completed by 12 TIC training attendees, which included primary care providers and staff. Trainees reported significant increases in confidence to reduce potentially re-traumatizing practices and improved attitudes toward formerly incarcerated individuals. They also expressed interest in receiving additional TIC training and learning how best to care for and meet the needs of persons with a history of incarceration. Trainees described the panel of community members with lived experience as one of the most rewarding aspects of the training.</p><p><strong>Conclusion: </strong>Centering people with lived experience in the training design and delivery produced a single-session TIC training that was both well-received and effective. Our TIC training helped primary care providers and staff move from being merely informed on trauma to having the self-efficacy to prevent and respond to trauma reactions during encounters with <i>all</i> patients, particularly those with a history of incarceration.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319241312577"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11742159/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143013922","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Readmission After Geriatric Inpatient Care: A Narrative Review and a Comparative Analysis.","authors":"Carl Willers, Rikard Lindqvist, Martin Dreilich, Stefan Fors, Amelie Lindh Mazya, Gunnar H Nilsson, Anne-Marie Boström, Mahwish Naseer, Elisabeth Rydwik","doi":"10.1177/21501319251320181","DOIUrl":"10.1177/21501319251320181","url":null,"abstract":"<p><strong>Background: </strong>Readmission can be be related to the work of several stakeholders involved in the care of individuals throughout the community, including, for example, primary care and social care providers. A narrative review was performed to assess definitions and frequency of readmission for older adults found in previous research. In addition, a dataset for a cohort of older adults in Stockholm, Sweden, was used to quantify how different definitions of readmission affect frequency.</p><p><strong>Materials and methods: </strong>The review was based on pre-specified search criteria within PubMed and Embase databases. All studies based on a cohort of older adults with a primary objective to assess readmission to inpatient care, were included for the assessment of readmission criteria. The dataset was based on a cohort of older adults treated at a geriatric department in Stockholm during 2016. Estimations of readmission were performed with the most common criteria found in the narrative review.</p><p><strong>Results: </strong>The narrative review showed that definitions of readmission included predominantly time-based criteria, either alone or combined with additional criteria such as medical condition or readmitting department. Frequency of readmission based on different definitions varied substantially; a 14-day time interval implied a rate of 8.0% whilst a 30-day interval-more commonly used-rendered a rate of 12.6%. The density of readmissions per day was higher during the first weeks after discharge, and then dropped continuously.</p><p><strong>Conclusion: </strong>Transparency on definitions is imperative in studies that include rates of readmission. The levels of readmission rates are highly dependent on the study population and its context. Furthermore, the actual value of readmission monitoring is dependent on what purpose it is supposed to fulfill, and it is essential to put it into context of all relevant stakeholders including, for example, the primary care providers and different social care providers throughout the community.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251320181"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524802","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementation of a Multicancer Detection (MCD) Test in a Tertiary Referral Center in Asymptomatic Patients: An 18-Month Prospective Cohort Study.","authors":"Ryan T Hurt, Aditya K Ghosh, Brian M Dougan, Elizabeth A Gilman, Bradley R Salonen, Jay Adusumalli, Sara L Bonnes, Carl A Andersen, Amirala S Pasha, Sanjeev Nanda, Erin M Pagel, Christina D Verness, Steven D Crowley, Steven W Ressler, Jewel J Samadder, Richard J Presutti, Aadel A Chaudhuri, William Sanchez, Ivana T Croghan, Christopher R Stephenson, Karthik Ghosh","doi":"10.1177/21501319251329290","DOIUrl":"10.1177/21501319251329290","url":null,"abstract":"<p><strong>Objective: </strong>Multicancer Detection (MCD) tests, such as the GRAIL Galleri, offer a novel approach to cancer screening by detecting cancer-specific methylation patterns in cell-free DNA through a single blood sample. This study evaluated an 18-month implementation of MCD testing in a tertiary ambulatory internal medicine clinic.</p><p><strong>Patients and methods: </strong>Between June 2022 and November 2023, 2244 asymptomatic (without symptoms attributed to cancer) patients underwent MCD testing. The study focused on operational workflows, patient and physician education, and diagnostic follow-up of positive results. Standardized materials, including electronic health record (EHR) workflows, FAQs, and diagnostic pathways, were developed to facilitate implementation. Challenges included managing false positives, patient anxiety, costs, and ethical considerations.</p><p><strong>Results: </strong>Of the 2244 patients tested, 17 (0.76%) had positive results, and 15 underwent further diagnostic evaluation. Cancer was confirmed in 11 (73.3%) patients, including cases of breast, colon, esophageal, lymphoma, ovarian, and pancreatic cancers. Four patients had no identifiable malignancy despite comprehensive work-up.</p><p><strong>Conclusions: </strong>MCD testing is feasible in routine clinical workflows, with 73% of positive cases yielding cancer diagnoses. While promising, further research is required to assess long-term outcomes, cost-effectiveness, and optimal implementation strategies of cancer interception in broader healthcare settings.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251329290"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938867/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711582","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}