Journal of the American Board of Family Medicine最新文献

{"title":"Perceptions and Preferences for Defining Biosimilar Products in Prescription Drug Promotion.","authors":"Mihaela Johnson, Jessica E Thompson, Avery A Tilley, Amie C O'Donoghue, Kathryn J Aikin","doi":"10.3122/jabfm.2024.240151R1","DOIUrl":"10.3122/jabfm.2024.240151R1","url":null,"abstract":"<p><strong>Background: </strong>Prescription biosimilars are highly similar to and have no clinically meaningful differences from existing FDA-approved reference products. Despite increased availability in the marketplace, consumers and clinician lack awareness of these products. Our study experimentally tested understanding of and preference for brief descriptions of biosimilars in the form of disclosure statements in a fictitious prescription drug advertisement.</p><p><strong>Methods: </strong>Consumers (n = 379) and HCPs (n = 368) viewed a mock advertisement and responded to an online survey. Study participants were randomized to 1 of 7 biosimilar disclosure definitions or a control. Disclosure conditions varied with regard to 1) identifying the product as a biosimilar; 2) information provided in the definition; and 3) naming the reference product. We tested the effects of disclosure conditions on comprehension, perceptions, attitudes, intentions, and preferences.</p><p><strong>Results: </strong>Overall, comprehension of information in the biosimilar disclosure was less than optimal (48.5%-62.0% and 68.4%-88.4% for consumers and HCPs, respectively), even when provided with a definition. Perceptions of benefit, comparative efficacy, and safety were neutral. Content of the biosimilar definition generally did not influence outcomes, except that HCPs reported more positive attitudes toward the biosimilar and stronger intentions to prescribe when provided with expanded definitions. Both groups preferred the expanded definitions, and HCPs preferred seeing a named reference product. HCPs generally agreed with a statement that biosimilars could be used \"interchangeably\" with the reference product.</p><p><strong>Conclusions: </strong>Our findings signal some knowledge gaps and uncertainty regarding biosimilars among consumers and HCPs. Further education is warranted around these products, and communications for both groups require careful testing to ensure that the information is understood and does not result in a negative perception of the product.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 1","pages":"94-106"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144047809","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}

{"title":"Re: Physician and Advanced Practice Clinician Burnout in Rural and Urban Settings.","authors":"Cody J Klinker","doi":"10.3122/jabfm.2024.240300R0","DOIUrl":"10.3122/jabfm.2024.240300R0","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 1","pages":"192-193"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029869","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}

{"title":"Evaluating Pragmatism of Lung Cancer Screening Randomized Trials with the PRECIS-2 Tool.","authors":"Erin A Hirsch, Jamie L Studts, Susan Zane, Marina McCreight, Amy G Huebschmann","doi":"10.3122/jabfm.2024.240142R1","DOIUrl":"10.3122/jabfm.2024.240142R1","url":null,"abstract":"<p><strong>Objective: </strong>Lung cancer screening (LCS) implementation has been challenging for community and rural primary care settings. One contributing factor may be that the randomized clinical trials (RCTs) that form the evidence base are guided by explanatory methods not reflective of primary care settings. This study applied the <b>PR</b>agmatic <b>E</b>xplanatory <b>C</b>ontinuum <b>I</b>ndicator <b>S</b>ummary (PRECIS - 2) tool to determine the pragmatism of LCS RCTs envisioned through a decentralized, primary care lens.</p><p><strong>Methods: </strong>LCS RCTs were identified from efficacy meta-analyses, and the VA Demonstration Project was chosen as a nonrandomized multi-center comparator case. Two independent raters evaluated PRECIS-2 domains for each trial. Ratings were completed on a 5-point scale, where 1 indicated completely explanatory and 5 indicated completely pragmatic. Mean PRECIS-2 scores were calculated for each study and each domain. Descriptive information from raters' comments was used to describe differences between the most pragmatic and most explanatory RCTs.</p><p><strong>Results: </strong>Eleven RCTs and the VA Demonstration Project were evaluated. Mean PRECIS-2 scores for each study ranged from 2.12 to 3.33, with the DLSCT rated the most explanatory and the Lung Screening Study and ITALUNG studies rated the most pragmatic. Six domains had a mean score <3, indicating more explanatory (eligibility, recruitment, setting, organization, staff flexibility, follow-up). The remaining 3 domains had mean scores >3, indicating more pragmatic (adherence, outcome, analysis).</p><p><strong>Discussion: </strong>This approach of evaluating each study from a primary care lens demonstrated that LCS RCTs trended toward a more explanatory nature, incorporating considerable support and infrastructure that extend beyond the capacity of typical primary care settings in the US.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 1","pages":"56-83"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050033","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}

{"title":"Association of Social Needs with Diabetes Outcomes in an Older Population.","authors":"David M Mosen, Stephanie L Fitzpatrick, Erin M Keast, John F Dickerson, Briar L Ertz-Berger, Matthew P Banegas","doi":"10.3122/jabfm.2024.240139R2","DOIUrl":"10.3122/jabfm.2024.240139R2","url":null,"abstract":"<p><strong>Background: </strong>Identifying and addressing social needs is important to improve health for older adults with type 2 diabetes mellitus (T2DM). However, few studies have examined the association between social needs and T2DM-related outcomes among older populations within integrated health care systems. This study examined the association between social needs and DM-related outcomes among older adults with T2DM receiving care at Kaiser Permanente Northwest.</p><p><strong>Methods: </strong>From a cohort of 1954 Medicare members ages 65 and older who completed a social needs questionnaire, we examined the association between 5 dichotomous (yes vs no) social needs measures (financial strain, food insecurity, housing instability, social isolation, and transportation needs) and 3 DM-specific outcomes in the 12 months after assessment: 1) good glycemic control (HbA1c < 8%); 2) any DM-specific emergency department (ED) utilization; and 3) any DM-specific hospital admissions.</p><p><strong>Results: </strong>About 40% of the study population reported 1 or more social needs. Financial strain (OR = 0.56, 95% CI = 0.36-0.85), food insecurity (OR = 0.47, 95% CI = 0.28-0.81) and housing instability (OR = 0.50, 95% CI = 0.25-0.99) were associated with lower odds of good glycemic control. All 5 social needs were associated with higher ED utilization (financial strain: OR = 1.65, 95% CI = 1.17-2.33; food insecurity: OR = 1.62, 95% CI = 1.02-2.57; housing instability: OR = 2.14, 95% CI = 1.23-3.75; social isolation: OR = 1.36, 95% CI = 1.06-1.74; transportation needs: OR = 1.83, 95% CI = 1.23-2.71). Financial strain was also associated with higher hospital admissions (OR = 1.77, 95% CI = 1.17-2.68).</p><p><strong>Discussion: </strong>Associations between social needs and DM-specific outcomes demonstrate the need to develop programs to address social needs in the clinical setting and test whether such interventions improve DM-related outcomes.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 1","pages":"125-132"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096382/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144050070","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}

{"title":"Successful Implementation of Integrated Behavioral Health.","authors":"W Perry Dickinson, Mark Gritz, Kyle E Knierim, Stephanie Kirchner, Douglas H Fernald, Allyson Gottsman, Kimberly Wiggins, L Miriam Dickinson","doi":"10.3122/jabfm.2024.240081R1","DOIUrl":"10.3122/jabfm.2024.240081R1","url":null,"abstract":"<p><strong>Introduction: </strong>The Colorado State Innovation Model (SIM) initiative aimed to support primary care practices in implementing behavioral health integration and other aspects of advanced primary care. This project evaluated implementation of behavioral health integration and the Building Blocks of High Performing Primary Care in primary care practices.</p><p><strong>Methods: </strong>A total of 334 practices participated in SIM in 3 cohorts for 1 year (cohort 3) or 2 years (cohorts 1 and 2). Practice transformation support for implementation of advanced primary care and behavioral health integration was provided. Measures included 1) Comprehensive Primary Care Practice Monitor, completed at baseline, 12, and 24 months to assess implementation of the building blocks of primary care and behavioral integration, and 2) Behavioral health clinical quality measures, reported quarterly.</p><p><strong>Results: </strong>Practices improved on implementation of all building blocks, including leadership, data driven improvement, empanelment, team-based care, patient-team partnerships, population management, continuity of care access to care, care coordination, resource utilization, behavioral health integration, and general behavioral health improvement (all <i>P</i> < .0001). Onsite behavioral health integration was implemented by 78% of practices by the end of the intervention. Practices improved on depression screening and monitoring (<i>P</i> < .0001) and maternal depression screening (<i>P</i> < .001). Implementation of several building blocks mediated improvement in depression screening and monitoring and maternal depression screening (<i>P</i> < .05).</p><p><strong>Discussion: </strong>Practices in the SIM initiative successfully implemented behavioral health integration and the building blocks of high performing primary care, yielding improved behavioral clinical quality measures. Implementation of the building blocks mediated improvements in clinical quality measures.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 1","pages":"107-118"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096373/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143990439","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}

{"title":"Associations Between Modifiable Preconception Care Indicators and Pregnancy Outcomes.","authors":"Ashwini Kamath Mulki, Melanie B Johnson, Nicole M Burgess, Kyle Shaak, Katie Nisbett, Katarzyna Jabbour, Roya Hamadani, Beth Careyva","doi":"10.3122/jabfm.2024.240133R1","DOIUrl":"10.3122/jabfm.2024.240133R1","url":null,"abstract":"<p><strong>Purpose: </strong>This study explored gaps and opportunities in preconception care with a focus on determining whether modifiable preconception care indicators are associated with preterm births.</p><p><strong>Methods: </strong>This retrospective case-control study explored prepregnancy data of patients ≥18 years old who delivered preterm (cases) versus full term (controls) between June 1, 2018, and May 31, 2019, at a health care network in Pennsylvania. Cases were matched 1:2 with controls based on age, parity, and history of preterm delivery. A literature review yielded 11 key indicators of quality preconception care. Documentation of counseling on these indicators were extracted from patient charts from their most recent primary care visit before pregnancy (preconception care) and their pregnancy intake visit (prenatal care). Bivariate analyses were used to assess whether any of the 11 preconception indicators were associated with preterm birth. All analyses were conducted using SPSS statistical software.</p><p><strong>Results: </strong>Our sample included 663 patient charts: 221 preterm births and 442 term births. Elevated blood pressure (>120/80) in the preconception period (Odds Ratio [OR] = 1.84) and at the prenatal intake visit (OR = 1.68) was significantly associated with preterm birth. In addition, patients with Body Mass Index (BMI) ≤18 or ≥30 at their prenatal visit were nearly twice as likely (OR = 1.85) to have pregnancies resulting in preterm birth.</p><p><strong>Conclusions: </strong>Our study highlights BMI and Blood Pressure (BP) as key focus points for preconception counseling. Additional studies are needed to determine whether pregnancy outcomes other than preterm birth may be influenced by these and other preconception care indicators.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"84-93"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096372/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789400","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}

{"title":"Clusters of Health-Related Social Needs Among Adult Primary Care Patients.","authors":"Joshua R Vest, Wei Wu, Kyaien Conner","doi":"10.3122/jabfm.2024.240173R1","DOIUrl":"10.3122/jabfm.2024.240173R1","url":null,"abstract":"<p><strong>Introduction: </strong>Patients frequently report multiple health-related social needs (HRSNs) at the same time. This study aimed to identify clusters of co-occurring HRSNs in an adult primary care population.</p><p><strong>Methods: </strong>We surveyed 1252 adult (>=18) primary care patients in Indianapolis, IN. Subjects completed surveys in person at 1 of 3 sites operated by 2 different health systems. Data collection was offered in both English and Spanish. Surveys comprised previously published and validated instruments covering housing instability, financial strain, food insecurity, transportation barriers, unemployment, and legal problems.</p><p><strong>Results: </strong>We identified 4 underlying clusters of HRSNs within the patient population using Complete-Linkage Agglomerative Hierarchical Clustering: \"low HRSNs\" (38.6%), \"high HRSNs\" (29.6%), \"housing dominant\" (23.2%), and \"food dominant\" (8.6%). The high HRSNs cluster had higher average comorbidity scores (<i>P</i> < .001), number of inpatient admissions (<i>P</i> = .004), number of ED visits (<i>P</i> < .001), and number of primary care visits (<i>P</i> < .001).</p><p><strong>Discussion: </strong>As health care organizations increasingly focus on HRSNs as an approach to reducing costs and improving health of patients, these findings indicate that organizational strategies and actions should consider the interrelated and co-occurring nature of HRSNs. To support a large number of patients, strategies should support multiple HRSNs.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"119-124"},"PeriodicalIF":2.4,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143789401","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}

{"title":"Answering the \"100 Most Important Family Medicine Research Questions\" from the 1985 Hames Consortium.","authors":"Christy J W Ledford, Jacqueline B Britz, Melinda L McKew, Mia V von Gal, Neha Balachandran, L A Middleton, Dean A Seehusen","doi":"10.3122/jabfm.2024.240130R1","DOIUrl":"10.3122/jabfm.2024.240130R1","url":null,"abstract":"<p><strong>Introduction: </strong>The 1985 Hames Consortium convened family medicine researchers to identify outstanding questions in their practice.</p><p><strong>Method: </strong>In this descriptive review, we collected, codified, and analyzed available literature to describe the availability of evidence to answer these questions.</p><p><strong>Results: </strong>Of 136 total questions, researchers rated 33 questions as not at all answered (24.2%), 49 questions as somewhat answered (36.0%), 37 as mostly answered (27.2%), and 17 as fully answered - will implement in practice (12.5%). Notably, 2 of the categories with the highest number of total questions, community oriented primary care and the value of comprehensive care, had the highest percentage of unanswered questions.</p><p><strong>Discussion: </strong>The Hames 100 questions and categories themselves demonstrate the values and purpose of family medicine research and can serve as a powerful tool to discuss the future of family medicine research. The varied questions illustrate the broad scope of interest of family physicians in 1985, which remains just as relevant today. Our findings indicate that relatively few questions were fully answered, with even fewer questions answered in family medicine journals.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"S106-S121"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640120","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}

{"title":"Current and Future Challenges to Publishing Family Medicine Research.","authors":"Dean A Seehusen, Sarina B Schrager, Sumi M Sexton","doi":"10.3122/jabfm.2023.230438R1","DOIUrl":"10.3122/jabfm.2023.230438R1","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"S80-S84"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640123","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}

{"title":"Past Is Prologue: The Essential Role of Advocacy in Shaping the Future of Family Medicine Research.","authors":"Winston Liaw, Sebastian T Tong, Nina DeJonghe, Hope R Wittenberg","doi":"10.3122/jabfm.2023.230407R1","DOIUrl":"10.3122/jabfm.2023.230407R1","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"S92-S95"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142640128","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}