Journal of Primary Care and Community Health最新文献

{"title":"The Impact of Medicaid Expansion on Acute Diabetes Complication by Care Delivery Settings.","authors":"Danielle Kulbak, Dang Dinh, Annie E Larson, Andrew Suchocki, Rachel Springer, Miguel Marino, Jennifer E DeVoe, Jun Hwang, Nathalie Huguet","doi":"10.1177/21501319251320161","DOIUrl":"10.1177/21501319251320161","url":null,"abstract":"<p><strong>Objective: </strong>This study evaluates whether gaining Medicaid following the Affordable Care Act (ACA) expansion led to changes in the rate of acute diabetes complications diagnosed in primary care settings, relative to in inpatient, emergency department (ED), or urgent care (UC) settings.</p><p><strong>Methods: </strong>This retrospective cohort study used Medicaid administrative claims data linked to electronic health records for 3767 patients, aged 19 to 64 years, who experienced acute preventable complications of diabetes between 2014 and 2019 diagnosed in inpatient, ED, UC, or primary care settings in the state of Oregon. These patients were classified as either continuously Medicaid-insured or having gained Medicaid.</p><p><strong>Results: </strong>Annual rates of acute complications diagnosed in primary care and inpatient/ED/UC settings increased for both continuously [Adjusted Rate Ratio (aRR) = 2.20, 95% CI = 1.65-2.91] and newly Medicaid-insured patients (aRR = 2.67, 95% CI = 2.05-3.47) after the ACA. Among newly Medicaid-insured, annual rates of abnormal blood glucose diagnosed in primary care settings significantly increased with time while those diagnosed in inpatient/ED/UC decreased (2014 vs 2016 aRR = 3.36, 95% CI = 1.60-7.09).</p><p><strong>Conclusion: </strong>We found a significantly greater rate of abnormal blood glucose diagnosed in primary care clinics among patients who gained Medicaid post-ACA and a corresponding decline in diagnosis in inpatient/ED/UC settings.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251320161"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11826838/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143415817","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":"An Evaluation of the Decline in Primary Care Physician Visits, 2010 to 2021.","authors":"Anuradha Jetty, Marie Ezran, Alison N Huffstetler, Yalda Jabbarpour","doi":"10.1177/21501319251321618","DOIUrl":"https://doi.org/10.1177/21501319251321618","url":null,"abstract":"<p><strong>Introduction: </strong>Primary care is the backbone of the United States healthcare system, yet it continues to be underfunded and inaccessible to many. Previous studies explored primary care visit patterns until 2016, leaving gaps in our understanding of how recent factors like state Medicaid expansions, the Coronavirus Disease 2019 (COVID-19) pandemic, and population growth have influenced these patterns. Hence, the objective of the current study was to analyze the trends in primary care visits provided by outpatient clinicians over time and by visit type and contextualize study findings within the changing healthcare landscape.</p><p><strong>Methods: </strong>The Medical Expenditure Panel Survey data (2010-2021) were used to examine trends in the total number and share of ambulatory, preventive, acute, and chronic care visits and investigate sociodemographic factors associated with a given clinician visit. The outcome variable was the clinician type: Primary Care Physicians (PCPs), Internal Medicine (IM) subspecialists, and Nurse Practitioners or Physician Assistants or Registered Nurses (NP/PA/RNs). Explanatory variables included gender, age, race/ethnicity, education, region of respondent's residence, income-to-poverty ratio, insurance coverage, number of chronic conditions, and survey year. Univariate, bivariate, and multinomial logistic regression analyses were performed.</p><p><strong>Results: </strong>The visits led by PCPs and IM subspecialists declined by 43% and 23% between 2010 and 2021, respectively. However, visits led by NP/PA/RNs increased by 98%. From 2010 to 2021, the proportion of preventive care visits provided by PCPs, IMs, and NP/PA/RNs increased by 25%, 7%, and 4%, respectively. PCPs provided fewer acute and chronic care visits in 2021 than in 2010. Regression analyses illustrated that relative to Non-Hispanic White patients, non-White patients had a higher likelihood of seeing PCPs. Patients reporting 1 chronic condition were more likely to obtain care from an IM or NP/PA/RN than a PCP. In contrast, those with 2 or more chronic conditions had a greater propensity to see PCP than NP/PA/RN.</p><p><strong>Conclusion: </strong>Despite a growing need for primary care services, the decrease in visits to PCPs is concerning and requires further examination. The declining trends in acute and chronic care visits raise questions as to whether primary care, in its current form, can continue to provide its essential attributes and services.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251321618"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459617","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing Virtual Healthcare Deployment: Insights From the Implementation of Telerobotic Ultrasound to Bridge Healthcare Inequities in Rural and Remote Communities Across Canada.","authors":"Amal Khan, Sandro Galea, Ivar Mendez","doi":"10.1177/21501319251329314","DOIUrl":"10.1177/21501319251329314","url":null,"abstract":"<p><p>The COVID-19 pandemic has accelerated the integration of virtual care into healthcare systems, presenting a unique opportunity to address healthcare inequities in rural and remote communities, particularly those that are Indigenous. This commentary outlines critical steps and best practices for deploying virtual care in underserved regions, drawing on over a decade of experience in Saskatchewan. Key recommendations include creating detailed community profiles, assessing digital literacy, and using standardized readiness tools to evaluate infrastructure and clinical needs. A weighted prioritization framework ensures efficient resource allocation, while partnerships with Indigenous-led institutions, such as SIIT, equip local healthcare assistants to support virtual care delivery. Examples from successful telerobotic ultrasonography deployments in the rural and remote communities of Saskatchewan highlight the potential of virtual care to improve healthcare access, outcomes, and sustainability. By tailoring interventions to community-specific contexts and involving local stakeholders, <i>virtual care</i> can bridge health disparities and serve as a replicable model for similar settings worldwide.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251329314"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11952026/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143732286","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":"Exploring the Characteristics and Utilization of General Practice Healthcare by Adults With Cerebral Palsy: A Systematic Review.","authors":"Prue Morgan, Asfarina Zanudin","doi":"10.1177/21501319251320160","DOIUrl":"10.1177/21501319251320160","url":null,"abstract":"<p><strong>Background: </strong>Individuals with cerebral palsy (CP) experience acute and chronic health issues requiring lifespan primary care. This review aimed to investigate characteristics and utilization of general practitioner (GP) access by adults with CP. Secondary aims included exploring reasons prompting access, identifying interventions provided, and personal features affecting access.</p><p><strong>Methods: </strong>Using systematic review methodology, 5 databases were searched using keywords relating to adults, CP, and primary care, relating to quantitative studies (January 2000-July 2024). Data was extracted, collated, and analyzed descriptively, with additional meta-analyses to estimate proportion of GP visits.</p><p><strong>Results: </strong>Fifteen studies were included describing GP access by 6231 adults with CP. The proportion annually accessing a GP was 78% (95% CI = 69%-85%). The frequency of GP access ranged from 1.76 to 11.7 visits per year, increased with advancing age and disability severity. Comorbid intellectual disability and pain also increased GP attendance. Limited data was available reporting healthcare needs prompting GP access, and no interventions were described.</p><p><strong>Conclusions: </strong>Advancing age, greater disability severity, comorbid intellectual disability, and pain may prompt increased GP access by adults with CP. Identification of reasons for seeking primary care, and interventions provided are required through data linkage studies to enhance lifespan care.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251320160"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905038/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143606618","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":"Augmenting Community Nursing Practice With Generative AI: A Formative Study of Diagnostic Synergies Using Simulation-Based Clinical Cases.","authors":"Odelyah Saad, Mor Saban, Erika Kerner, Chedva Levin","doi":"10.1177/21501319251326663","DOIUrl":"10.1177/21501319251326663","url":null,"abstract":"<p><strong>Objective: </strong>To compare the diagnostic accuracy and clinical decision-making of experienced community nurses versus state-of-the-art generative AI (GenAI) systems for simulated patient case scenarios.</p><p><strong>Methods: </strong>In the months of 5 to 6/2024, 114 community Israeli nurses completed a questionnaire including 4 medical case studies. Responses were also collected from 3 GenAI models (ChatGPT-4, Claude 3.0, and Gemini 1.5), analyzed both without word limits and with a 10-word constraint. Responses were scored on accuracy, speed, and comprehensiveness.</p><p><strong>Results: </strong>Nurses scored higher on average compared to the shortened GenAI responses. GenAI responses were faster but more verbose, and contained unnecessary information. Gemini (full version) and Claude (full version) achieved the highest accuracy among the GenAI models.</p><p><strong>Conclusions: </strong>While GenAI shows potential to support aspects of nursing practice, human clinicians currently exhibit advantages in holistic clinical reasoning abilities, a skill requiring experience, contextual knowledge, and ability to bring concise and practical responses. Further research is needed before GenAI can adequately substitute nursing expertise.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251326663"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11938853/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143711569","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":"Effectiveness of a Family-Based Self-Management Intervention for Type 2 Diabetes Patients Receiving Family Doctor Contract Services: A Community-Based Randomized Controlled Trial.","authors":"Lan Zhu, Jing Wang, Zhigang Pan, Wei Zhang, Jing Tang, Hua Yan, Fulai Shen, Yi Shen","doi":"10.1177/21501319251330384","DOIUrl":"10.1177/21501319251330384","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Introduction: &lt;/strong&gt;The community-based management of type 2 diabetes in China remains suboptimal. Incorporating family support presents a promising approach to enhancing facilitators and addressing barriers to effective diabetes self-management, particularly in the Chinese context where familial relationships and collective family responsibility play a central role in health-related decision-making and daily life. We aimed to validate a family support-based self-management behavioral intervention program, Systematic evaluation, core education, self-directed planning, triple feedback, and develop a habit program (SeCe-STRIVE). The program comprises 5 modules: systematic evaluation, core education, self-directed planning, triple feedback, and habit development.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Research design and methods: &lt;/strong&gt;We conducted a community-based, single-center, parallel randomized controlled trial in the Xietu community of Xuhui District, Shanghai. Eligible patients were randomly assigned to either the intervention or control group. Participants in the intervention group received the SeCe-STRIVE health management program based on family support, while those in the control group received the community-based follow-up management program for type 2 diabetes. The primary outcome measured was the total self-management behavior score and its changes across various dimensions from baseline. Secondary outcomes included family support, family function, diabetes knowledge, quality of life, self-efficacy, and biochemical markers. Post-intervention changes in both primary and secondary outcomes relative to baseline were analyzed using analysis of covariance.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The study ultimately included 113 participants in the intervention group and 112 in the control group. The intervention group's total self-management behavior score improved by 12.74 (95% CI = 10.07, 15.40, &lt;i&gt;P&lt;/i&gt; &lt; .001) points more than the control group. Across all dimensions of self-management behaviors, the intervention group showed greater improvement, including diet, exercise, blood glucose monitoring, foot care, and medication adherence. Participants with low family support exhibited greater improvements in self-management behaviors compared to those with high family support. The intervention group demonstrated significant improvements in family support, family function, diabetes knowledge, and self-efficacy. Although quality of life and biochemical indicators of glycated hemoglobin, fasting blood glucose, and blood lipids showed a decreasing trend, the differences were not statistically significant.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusions: &lt;/strong&gt;Compared to the control group, patients with type 2 diabetes who received the SeCe-STRIVE program intervention showed significant improvements in self-management behaviors, accompanied by enhancements in family support, family functioning, and self-efficacy. Further large-scale, multi-center trials with longer follow-up p","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251330384"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the Acceptability of a Vaginal Self-Sampling Device in a Rural Parish of Cuenca, Ecuador.","authors":"Dayanara Delgado López, Ana Acosta Bedón, Roque Rivas-Párraga, Micaela Heredia, Carolina Muñoz, Bernardo Vega Crespo, Heleen Vermandere, Marie Hendrickx, Ana Gama, Vivian Alejandra Neira","doi":"10.1177/21501319251320172","DOIUrl":"10.1177/21501319251320172","url":null,"abstract":"<p><strong>Introduction: </strong>Cervical Cancer (CC) is a preventable and treatable disease if detected early, yet it remains a global health challenge. In Ecuador, CC is the second most common cancer; however, screening uptake remains suboptimal due to poor knowledge, low willingness, and limited access to healthcare. Traditionally, CC screening requires a healthcare professional, creating social and access barriers. Innovative techniques such as \"self-sampling\" (SS) for human papillomavirus (HPV) detection offer a promising alternative.</p><p><strong>Objective: </strong>This study evaluates the acceptability, attitudes, and user experience of a community-based SS program among a hard-to-reach population following a local educational session.</p><p><strong>Methods: </strong>A quasi-experimental study was conducted in a rural community in Cuenca, Ecuador. Educational sessions were organized, after which women were offered the option to perform SS for HPV detection. Three questionnaires were administered to assess population characteristics, risk factors, and experiences toward the process.</p><p><strong>Results: </strong>Of the 130 participants, 90% accepted SS, and 10% rejected SS. A significant number of women reported that SS was faster and less painful compared to traditional Papanicolaou tests (<i>P</i> < .05).</p><p><strong>Conclusions: </strong>SS shows strong potential for increasing CC screening, especially in hard-to-reach areas, emphasizing the need to adapt screening programs to meet diverse community needs.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319251320172"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11840851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459618","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":"Opportunities and Challenges for Large Language Models in Primary Health Care.","authors":"Hongyang Qin, Yuling Tong","doi":"10.1177/21501319241312571","DOIUrl":"10.1177/21501319241312571","url":null,"abstract":"<p><p>Primary Health Care (PHC) is the cornerstone of the global health care system and the primary objective for achieving universal health coverage. China's PHC system faces several challenges, including uneven distribution of medical resources, a lack of qualified primary healthcare personnel, an ineffective implementation of the hierarchical medical treatment, and a serious situation regarding the prevention and control of chronic diseases. The rapid advancement of artificial intelligence (AI) technology, large language models (LLMs) demonstrate significant potential in the medical field with their powerful natural language processing and reasoning capabilities, especially in PHC. This review focuses on the various potential applications of LLMs in China's PHC, including health promotion and disease prevention, medical consultation and health management, diagnosis and triage, chronic disease management, and mental health support. Additionally, pragmatic obstacles were analyzed, such as transparency, outcomes misrepresentation, privacy concerns, and social biases. Future development should emphasize interdisciplinary collaboration and resource sharing, ongoing improvements in health equity, and innovative advancements in medical large models. There is a demand to establish a safe, effective, equitable, and flexible ethical and legal framework, along with a robust accountability mechanism, to support the achievement of universal health coverage.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"16 ","pages":"21501319241312571"},"PeriodicalIF":3.0,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755230","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing and Treating Major Depression in Fibromyalgia: A Narrative Primer for the Non-Psychiatrist.","authors":"Bala Munipalli, Mohit Chauhan, Anjali M Morris, Ridwan Ahmad, Maliha Fatima, Madeleine E Allman, Shehzad K Niazi, Barbara K Bruce","doi":"10.1177/21501319241281221","DOIUrl":"https://doi.org/10.1177/21501319241281221","url":null,"abstract":"<p><p>Fibromyalgia (FM) affects 2% to 8% of the general population. FM patients often experience self-stigma and feel rejected by healthcare providers and families, resulting in isolation and distressing symptoms of pain, fatigue, and poor cognitive functioning, increasing the risk of depressive symptoms. Major Depressive Disorder (MDD) is the most common comorbidity in FM patients (Any depression: 43%; MDD: 32%). Genome-wide association studies (GWAS) have identified a common genetic risk loci for major depression and fibromyalgia. Given that even minor symptoms of depression worsen the outcomes of FM patients, clinicians are challenged to identify and manage depression in these patients. However, due to overlapping symptoms, limited screening, and contamination bias, MDD often goes undiagnosed and presents a critical challenge. Unrecognized and untreated MDD in FM patients can exacerbate fatigue, sleep disturbances, and pain, reduce physical functioning, and increase the risk of developing comorbid conditions, such as substance abuse and cardiovascular disease. These comorbidities are associated with a lower treatment response rate, a higher dropout rate, and a greater risk of relapse. Clinicians may effectively identify and treat MDD in FM patients with appropriate pharmacologic agents combined with aerobic exercise and cognitive-behavioral therapies for core FM symptoms, thus significantly reducing symptom severity for both MDD and FM. Such a comprehensive approach will result in a much-improved quality of life. MedLine content was searched via PubMed to identify eligible articles between 1995 and 2023 using search terms fibromyalgia, major depressive disorder, and treatment of depression in fibromyalgia, and the most current information is presented. In this primer for clinicians caring for FM patients, we describe clinically relevant pharmacologic and non-pharmacologic management approaches for treating MDD in FM patients.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241281221"},"PeriodicalIF":3.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11409298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298458","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":"Determination of COVID-19 Late Disorders as Possible Long-COVID and/or Vaccination Consequences.","authors":"Mona Sadat Larijani, Anahita Bavand, Mohammad Banifazl, Fatemeh Ashrafian, Ladan Moradi, Amitis Ramezani","doi":"10.1177/21501319241251941","DOIUrl":"10.1177/21501319241251941","url":null,"abstract":"<p><p>In this era in which the vast majority of the global population have developed COVID-19 infection and/or got vaccinated against it, identification of the late disorders as the vaccines' side effect or long-COVID manifestation seems essential. This study included the vaccinated individuals of 4 different vaccine regimens including inactivated virus-based, subunit protein, and adenovirus-based vaccines in a follow-up schedule 6-month post the booster shot. All the documented vaccine adverse events were thoroughly assessed considering the cases' medical history by Adverse Events Committee of Pasteur Institute of Iran. Totally 329 individuals who got 3 doses of vaccination were followed 6 months after the booster shots among whom 41 (12.4%) cases with the mean age of 40.9 ± 10.48 years had a type of disorder. Gynecological and osteoarticular involvements were the most common recorded disorders of which 73.1% were possibly linked to vaccination outcomes and the rest were affected by both long-COVID-19 and vaccination. Notably, the average time of symptoms persistence was 155 ± 10.4 days. This study has the advantage of long-term follow-up which presents various forms of late events in each episode of COVID-19 infection and vaccination. About 26.8% of people with persistent complications suffered from both long-COVOD/ vaccination in whom the differentiation between the vaccine side effect and long-COVID manifestation was quite challenging. Long-term follow-up studies in large population seems essential to outline the role of long-COVID and vaccination regarding persistent complications.</p>","PeriodicalId":46723,"journal":{"name":"Journal of Primary Care and Community Health","volume":"15 ","pages":"21501319241251941"},"PeriodicalIF":3.6,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11075438/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140872973","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}