Journal of the American Board of Family Medicine最新文献

{"title":"Tactics for Institutional Advocacy to Increase Research Capacity in a Family Medicine Department.","authors":"Masahito Jimbo, Gerardo Moreno","doi":"10.3122/jabfm.2024.240103R1","DOIUrl":"10.3122/jabfm.2024.240103R1","url":null,"abstract":"<p><p>Family medicine as a specialty has steadily increased its research capacity. Specific approaches are needed to attain the following: 1) Advocate for increased funding for Departments of Family Medicine from institutional leadership. 2) Identify and promote promising practices for chairs to support and fund research participation within their departments and institutions. Having each assumed the chair position recently, the authors summarize the specific approaches taken to expand the research capacity in a midsized urban and a large research intensive urban public university family medicine department. They included: obtaining adequate support from the Dean and other institutional programs at the time of on-boarding, focusing on established research themes within the department, ensuring the recruited faculty had high likelihood of success via their track record and mentorship, and getting the buy-in from all faculty through sharing of vision and helping everyone establish their scholarly niche.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"S102-S105"},"PeriodicalIF":2.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900022","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":"Doxycycline Postexposure Prophylaxis for Sexually Transmitted Infection Prevention.","authors":"Elizabeth Close, Alexander Jones, William Noggle","doi":"10.3122/jabfm.2024.240056R0","DOIUrl":"10.3122/jabfm.2024.240056R0","url":null,"abstract":"<p><p>Consider prescribing doxycycline as prophylaxis for bacterial sexually transmitted infections (STIs) in certain clinical scenarios. New data suggests that a one-time dose of 200 mg doxycycline taken within 72 hours of an unprotected sexual encounter may reduce transmission of syphilis, gonorrhea and chlamydia by a combined two thirds in a high-risk population.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"1140-1142"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015039","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":"Keep on Keeping on - Mirena IUD for 8 Years.","authors":"Samuel Holt McNair, Carl Tunink, Laura Morris","doi":"10.3122/jabfm.2024.240037R0","DOIUrl":"10.3122/jabfm.2024.240037R0","url":null,"abstract":"<p><p>Counsel patients that their Mirena IUD retains contraceptive effectiveness for extended use up to 8 years.¹ The cumulative failure rate for years 6 through 8 was 0.68%, similar to reported rates for the first 5 years of use.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"1143-1145"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015125","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":"Filtering Race Out of GFR Calculation.","authors":"Winfred Frazier, Yufei Ge","doi":"10.3122/jabfm.2024.240035R0","DOIUrl":"10.3122/jabfm.2024.240035R0","url":null,"abstract":"<p><p>Use the new eGFR_cr-cys equation (estimated glomerular filtration rate equation that incorporates both serum creatinine and serum cystatin C levels) to estimate the GFR for both Black and non-Black individuals because the equation has improved accuracy, minimizes differences in eGFR between race groups, and more accurately reflects chronic kidney disease (CKD) prognosis while eliminating the use of race in GFR estimating equations.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"1146-1148"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015044","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":"Impact of an Online Group-Coaching Program on Ambulatory Faculty Physician Well-Being: A Randomized Trial.","authors":"Tyra Fainstad, Carlos Rodriguez, Carlee Kreisel, Jennifer Caragol, Pari Shah Thibodeau, Marisa Kostiuk, Adrienne Mann","doi":"10.3122/jabfm.2024.240022R1","DOIUrl":"10.3122/jabfm.2024.240022R1","url":null,"abstract":"<p><strong>Background: </strong>Physician burnout contributes to distress, turnover, and poor patient outcomes. Evidence suggests individual professional coaching may mitigate burnout but is costly and time intensive. Group coaching evidence is lacking. Here, we assess a group coaching program in ambulatory-based faculty.</p><p><strong>Methods: </strong>A randomized trial occurred from February 1, 2023, to May 31, 2023, in 5 ambulatory and/or primary care-based departments at an academic institution. Participants were randomly assigned to an intervention (offered a 4-month, online, group coaching) or to a control group (not offered coaching). Surveys measuring validated dimensions of distress (burnout, impostor syndrome, moral injury, loneliness) and well-being (self-compassion, flourishing) were administered before and after the intervention. A linear mixed model analysis was performed on an intent-to-treat basis.</p><p><strong>Results: </strong>Among 160 participants, the mean (SD) age was 42.0 (8.4), 131 (81.9%) identified as female, and 135 (85.4%) as White. Group coaching improved intervention participants' burnout domain of depersonalization (δ: -1.72 points [CI: -3.26, -0.17]; <i>P</i> = .03), impostor syndrome (δ: -0.82 points [95% CI: -1.47, -0.18, <i>P</i> = .01), and flourishing (0.35 points (95% CI: 0.03, 0.66), <i>P</i> = .03) compared with the control. There were no significant differences in the other domains of burnout, or moral injury, loneliness, or self-compassion.</p><p><strong>Discussion: </strong>Four months of group-coaching improved some well-being outcomes in ambulatory-based clinicians. The intervention may be particularly useful given its accessibility, and online delivery supports greater scalability and lower cost than individual coaching.</p><p><strong>Conclusion: </strong>Group coaching is an institutionally provided, individually harnessed tool to heal physician burnout.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov Identifier: NCT05635448.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"1055-1071"},"PeriodicalIF":2.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142899959","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":"Response: Re: Effectiveness of Long-Term Opioid Therapy for Chronic Low Back Pain.","authors":"John C Licciardone, Subhash Aryal","doi":"10.3122/jabfm.2024.240264R0","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240264R0","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 5","pages":"934-935"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755489","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":"Interpersonal Continuity of Care May Help Delay Progression to Type 2 Diabetes.","authors":"Bobbie L Johannes, G Craig Wood, Arch G Mainous, Adam Cook, Alanna Kulchak Rahm, Christopher D Still, Lisa Bailey-Davis","doi":"10.3122/jabfm.2023.230382R2","DOIUrl":"10.3122/jabfm.2023.230382R2","url":null,"abstract":"<p><strong>Background: </strong>The association between interpersonal continuity of care (CoC) and progression from the prediabetic state to Type 2 Diabetes (T2D) remains unknown.</p><p><strong>Aim: </strong>To evaluate the association between interpersonal CoC and the progression to T2D among persons with prediabetes.</p><p><strong>Design and setting: </strong>A retrospective cohort study using electronic health record (EHR) data from 6620 patients at Geisinger, a large rural health care system in Danville, PA.</p><p><strong>Methods: </strong>Cox regression methods were used to estimate the hazard ratio associated with progression to T2D within 3-years of being diagnosed with prediabetes.</p><p><strong>Results: </strong>One additional visit with the primary care provider most frequently seen by the patient is associated with 14% decreased risk (HR = 0.86; 95% CI = 0.85, 0.87; <i>P</i> < .001) of transitioning to type 2 diabetes within 3 years of being diagnosed with prediabetes.</p><p><strong>Conclusions: </strong>This study demonstrates an association between increased interpersonal CoC after a person is diagnosed with prediabetes and a reduced risk of progressing to T2D within 3 years.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"936-938"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142900005","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":"For Atrial Fibrillation, DOACs Outperform Warfarin in Patients with Reduced Kidney Function.","authors":"Robert A Powell, Jessica S Coulter, Ariel L Hoffman","doi":"10.3122/jabfm.2024.240155R0","DOIUrl":"10.3122/jabfm.2024.240155R0","url":null,"abstract":"<p><p>At standard doses, direct oral anticoagulants (DOACs) were associated with a reduced risk of systemic embolism and intracranial hemorrhage (ICH) when compared with warfarin, with a greater derived benefit at lower creatinine clearance (CrCl-down to 25 mL/min). Lower doses of DOACs were associated with increased overall mortality without a significant decrease in ICH and incident bleeding when compared with standard dose DOACs and warfarin, across all CrCl down to 25 mL/min.¹.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"983-985"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143015113","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":"Care Coordination: How Is It Implemented and Is It Different If a Social Worker Is on the Team?","authors":"Leif I Solberg, Meghan M JaKa, Gregory S Knowlton, Jeanette Y Ziegenfuss, Anna R Bergdall, Robin R Whitebird, Joan M Kindt, Steven P Dehmer","doi":"10.3122/jabfm.2024.240010R1","DOIUrl":"10.3122/jabfm.2024.240010R1","url":null,"abstract":"<p><strong>Objective: </strong>To understand how primary care clinics coordinate services for complex patients and whether clinics with an integrated social worker do it differently.</p><p><strong>Methods: </strong>Cross-sectional survey of the 213 most experienced care coordinators for each of the 317 participating clinics. The survey asks about staffing, communications, care model (nursing vs integrated social worker), resources, support, services, how services are available and delivered, payment approach, and satisfaction. Clinics using the integrated model include the social worker as part of the care team, responsible for assessing and coordinating services for social needs, and communicating directly with both patients and clinicians.</p><p><strong>Results: </strong>Out of 317 clinics from 42 diverse care systems, 139 had an integrated social worker and 178 did not. Care coordinators in the integrated social worker clinics had somewhat larger patient panels and worked with almost twice as many clinicians. These care coordinators were also less likely to be on site and more likely to communicate with patients and clinicians by telephone rather than in person. Care coordinators in the integrated social worker clinics were 10 to 30% more likely to assess patients' social needs, provide a broader range of services, and to be more engaged in the process of referral for community services.</p><p><strong>Conclusion: </strong>Clinics with an integrated social worker seem to differ in the frequency and approach to care coordination as well as in how social needs are addressed from those that use a nursing model while providing most medical/nursing services at similar or higher rates.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"857-867"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069025","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":"Re: Effectiveness of Long-Term Opioid Therapy for Chronic Low Back Pain.","authors":"Richard C Waters, Claire B Simon","doi":"10.3122/jabfm.2024.240154R0","DOIUrl":"10.3122/jabfm.2024.240154R0","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"933-934"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142923826","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}