Journal of the American Board of Family Medicine最新文献_第3页

Implementation Strategies Used by Facilitators to Improve Control of Cardiovascular Risk Factors in Primary Care. 促进者为改善初级保健中对心血管风险因素的控制而采用的实施策略。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-08-14 DOI: 10.3122/jabfm.2023.230312R1

Allison M Cole, Gina A Keppel, Laura-Mae Baldwin, Erika Holden, Michael Parchman

{"title":"Implementation Strategies Used by Facilitators to Improve Control of Cardiovascular Risk Factors in Primary Care.","authors":"Allison M Cole, Gina A Keppel, Laura-Mae Baldwin, Erika Holden, Michael Parchman","doi":"10.3122/jabfm.2023.230312R1","DOIUrl":"10.3122/jabfm.2023.230312R1","url":null,"abstract":"Background: Practice facilitation supports practice change in clinical settings. Despite its widespread use little is known about how facilitators enable change.Objective: This study identifies which implementation strategies practice facilitators used and the frequency of their use in a study to improve the quality of cardiovascular care in primary care.Design: Cross-sectional analysis of data collected by practice facilitators in the Healthy Hearts Northwest (H2N) study.Participants: Notes collected by facilitators in the H2N study.Approach: We coded these field notes for a purposeful sample of 44 practices to identify Expert Recommendations for Implementation Change (ERIC) strategies used with each practice and calculated the proportion of practices where each implementation strategy was coded at least once. Strategies were categorized as foundational (used in 80% to 100% of practices), moderately used (20%-<80% of practices), rarely used (1-[Formula: see text]% of practices), or absent (0%).Key results: We identified 26 strategies used by facilitators. Five strategies were foundational: Develop and/or implement tools for quality monitoring, Assess barriers that may impede implementation, Assess for readiness or progress, Develop and support teams, and Conduct educational meetings.Conclusions: Commonly used strategies can help guide development of the core components of practice facilitation strategies.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"444-454"},"PeriodicalIF":2.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11514367/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472100","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Barriers and Facilitators to Using a Clinical Decision Support Tool for Opioid Use Disorder in Primary Care. 在初级医疗中使用阿片类药物使用障碍临床决策支持工具的障碍和促进因素。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-08-14 DOI: 10.3122/jabfm.2023.230308R1

Stephanie A Hooker, Leif I Solberg, Kathleen M Miley, Caitlin M Borgert-Spaniol, Rebecca C Rossom

{"title":"Barriers and Facilitators to Using a Clinical Decision Support Tool for Opioid Use Disorder in Primary Care.","authors":"Stephanie A Hooker, Leif I Solberg, Kathleen M Miley, Caitlin M Borgert-Spaniol, Rebecca C Rossom","doi":"10.3122/jabfm.2023.230308R1","DOIUrl":"10.3122/jabfm.2023.230308R1","url":null,"abstract":"Purpose: Clinical decision support (CDS) tools are designed to help primary care clinicians (PCCs) implement evidence-based guidelines for chronic disease care. CDS tools may also be helpful for opioid use disorder (OUD), but only if PCCs use them in their regular workflow. This study's purpose was to understand PCC and clinic leader perceptions of barriers to using an OUD-CDS tool in primary care.Methods: PCCs and leaders (n = 13) from clinics in an integrated health system in which an OUD-CDS tool was implemented participated in semistructured qualitative interviews. Questions aimed to understand whether the CDS tool design, implementation, context, and content were barriers or facilitators to using the OUD-CDS in primary care. Recruitment stopped when thematic saturation was reached. An inductive thematic analysis approach was used to generate overall themes.Results: Five themes emerged: (1) PCCs prefer to minimize conversations about OUD risk and treatment; (2) PCCs are enthusiastic about a CDS tool that addresses a topic of interest but lack interest in treating OUD; (3) contextual barriers in primary care limit PCCs' ability to use CDS to manage OUD; (4) CDS needs to be simple and visible, save time, and add value to care; and (5) CDS has value in identifying and screening patients and facilitating referrals.Conclusions: This study identified several factors that impact use of an OUD-CDS tool in primary care, including PCC interest in treating OUD, contextual barriers, and CDS design. These results may help others interested in implementing CDS for OUD in primary care.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"389-398"},"PeriodicalIF":2.4,"publicationDate":"2024-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11555580/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141472087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Artificial Intelligence and Family Medicine. 人工智能与家庭医学。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI: 10.3122/jabfm.2024.240233R0

Dean A Seehusen, Marjorie A Bowman, Jacqueline Britz, Christy J W Ledford

引用次数: 0

Be SMART About Asthma Management: Single Maintenance and Reliever Therapy. 哮喘管理要SMART：单一维持和缓解疗法

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI: 10.3122/jabfm.2023.230456R1

Alexander F Infante, Christina Wells, Julie Loza, Keia Hobbs, Jennie B Jarrett, Abigail T Elmes

引用次数: 0

Potential Drawbacks of Noninvasive Diagnostic Methods for Nonalcoholic Fatty Liver Disease. 非酒精性脂肪肝无创诊断方法的潜在缺点。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI: 10.3122/jabfm.2023.230005R2

Yasir M Khayyat

{"title":"Potential Drawbacks of Noninvasive Diagnostic Methods for Nonalcoholic Fatty Liver Disease.","authors":"Yasir M Khayyat","doi":"10.3122/jabfm.2023.230005R2","DOIUrl":"10.3122/jabfm.2023.230005R2","url":null,"abstract":"The rising obesity epidemic is a phenomenon that has gained increasing attention from health providers and health policy makers. This led to recognition of nonalcoholic fatty liver disease (MASLD). The standard for its assessment has been histologic, which is neither practical nor acceptable by patients. Subsequently, a number of noninvasive assessment methods have been developed. However, despite ease of implementation, their confounding variables do hinder their accuracy. Nonetheless, the development of the liver stiffness measurement (LSM) and incorporation of other biological parameters has minimized but not eliminated the need for liver biopsy. Imaging methods are useful in evaluation, estimation, and following the progression of steatosis and fibrosis with particular attention to controlled attenuation parameter (CAP) and MRI-Proton Density Fat Fraction (MRI-PDFF). The choices for the family physician are broad and rely on tests' availability, cost, and patient acceptance. Great efforts have been undertaken to produce more robust and novel noninvasive markers that indicate fibrinogenesis directly in an implementable and cost-effective way.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 4","pages":"753-772"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512067","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Headache Treatment Options. 头痛治疗方案。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI: 10.3122/jabfm.2023.230450R1

Suzanne Florczyk, Taiwona Elliott, Kelley Lawrence, Lauren Penwell-Waines, Cecile Robes

引用次数: 0

Primary Care Clinicians' Interest In, and Barriers To, Medication Abortion. 初级保健临床医生对药物流产的兴趣和障碍。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI: 10.3122/jabfm.2024.240005R1

Laurel M P Neufeld, Kristen P Mark

{"title":"Primary Care Clinicians' Interest In, and Barriers To, Medication Abortion.","authors":"Laurel M P Neufeld, Kristen P Mark","doi":"10.3122/jabfm.2024.240005R1","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240005R1","url":null,"abstract":"Purpose: Providing medication abortion in the primary care setting is a promising way to increase access to abortion, a threatened service in many States. This study aimed to characterize primary care clinicians' interest in prescribing medication abortion, what barriers they face in adding this service, and what support they need.Methods: Data were collected from 162 practicing primary care clinicians in Minnesota using an online survey with closed- and open-ended response options. Data were analyzed using descriptive statistics, group comparison analyses, and content analysis for the open-ended questions.Results: Participants represented a diverse range of ages, years in practice, credentials, genders, and urban/rural practice settings, and held mixed knowledge and attitudes around medication abortion. All demographic groups surveyed expressed interest in prescribing medication abortion, with the strongest interest represented among younger respondents, women, and those practicing in urban settings. Clinicians who provide prenatal care or who already work with these medications in other contexts were more likely to want to add medication abortion to their practices. The most common barrier to providing medication abortion was a lack of knowledge about organizational policies and about the medications themselves. To empower clinicians to provide medication abortion, respondents voiced needing their health systems to build clear processes and wanting supportive networks of other clinicians for collaboration.Conclusions: Given the interest of primary care clinicians in providing medication abortion, health systems have a valuable opportunity to increase access.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 4","pages":"680-689"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142512068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Using Primary Health Care Electronic Medical Records to Predict Hospitalizations, Emergency Department Visits, and Mortality: A Systematic Review. 使用基层医疗电子病历预测住院、急诊就诊和死亡率：系统回顾。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI: 10.3122/jabfm.2023.230381R1

Rebecca Johnson, Thomas Chang, Rahim Moineddin, Tara Upshaw, Noah Crampton, Emma Wallace, Andrew D Pinto

{"title":"Using Primary Health Care Electronic Medical Records to Predict Hospitalizations, Emergency Department Visits, and Mortality: A Systematic Review.","authors":"Rebecca Johnson, Thomas Chang, Rahim Moineddin, Tara Upshaw, Noah Crampton, Emma Wallace, Andrew D Pinto","doi":"10.3122/jabfm.2023.230381R1","DOIUrl":"https://doi.org/10.3122/jabfm.2023.230381R1","url":null,"abstract":"Introduction: High-quality primary care can reduce avoidable emergency department visits and emergency hospitalizations. The availability of electronic medical record (EMR) data and capacities for data storage and processing have created opportunities for predictive analytics. This systematic review examines studies which predict emergency department visits, hospitalizations, and mortality using EMR data from primary care.Methods: Six databases (Ovid MEDLINE, PubMed, Embase, EBM Reviews (Cochrane Database of Systematic Reviews, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Methodology Register, Health Technology Assessment, NHS Economic Evaluation Database), Scopus, CINAHL) were searched to identify primary peer-reviewed studies in English from inception to February 5, 2020. The search was initially conducted on January 18, 2019, and updated on February 5, 2020.Results: A total of 9456 citations were double-reviewed, and 31 studies met the inclusion criteria. The predictive ability measured by C-statistics (ROC) of the best performing models from each study ranged from 0.57 to 0.95. Less than half of the included studies used artificial intelligence methods and only 7 (23%) were externally validated. Age, medical diagnoses, sex, medication use, and prior health service use were the most common predictor variables. Few studies discussed or examined the clinical utility of models.Conclusions: This review helps address critical gaps in the literature regarding the potential of primary care EMR data. Despite further work required to address bias and improve the quality and reporting of prediction models, the use of primary care EMR data for predictive analytics holds promise.","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 4","pages":"583-606"},"PeriodicalIF":2.4,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142511993","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Only One Quarter of Family Physicians Are Very Satisfied with Their Electronic Health Records Platform. 只有四分之一的家庭医生对其电子健康记录平台非常满意。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI: 10.3122/jabfm.2024.240034R1

Nathaniel Hendrix, Robert L Phillips, Andrew W Bazemore

引用次数: 0

Re: Friendship as Medicine. 关于友谊是药。

IF 2.4 3区医学

Journal of the American Board of Family Medicine Pub Date : 2024-07-01 DOI: 10.3122/jabfm.2024.240076R0

Kenda Al-Assi, Emily M Silver, Rekha Chandrabose, Elizabeth H Ellinas, Eman Ansari, Danielle L Sarno

引用次数: 0