{"title":"Training in Gender Affirming Care is Medically Necessary.","authors":"K Fallin-Bennett, M Arterburn, S T Marks","doi":"10.3122/jabfm.2024.240266R1","DOIUrl":"10.3122/jabfm.2024.240266R1","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":" ","pages":"976-978"},"PeriodicalIF":2.4,"publicationDate":"2025-02-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143069054","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}
Dean A Seehusen, Marjorie A Bowman, Jacqueline Britz, Christy J W Ledford
{"title":"Research on the Social Context of Medicine and the Modern Family Physician.","authors":"Dean A Seehusen, Marjorie A Bowman, Jacqueline Britz, Christy J W Ledford","doi":"10.3122/jabfm.2024.240443R0","DOIUrl":"10.3122/jabfm.2024.240443R0","url":null,"abstract":"<p><p>This <i>JABFM</i> issue has new research on a wide variety of clinical topics. Four articles study the social context of patients and its impact on health care. Insurance churn, prescription biosimilars, integrated behavioral health, and lung cancer screening are additional topics covered. Another group of articles report on a variety of aspects of modern family medicine practice. For example, what is the scope of care of today's family medicine physicians and how does that change over the course of a career? How do family physicians cope with their own chronic medical issues? This issue also addresses the role of family physicians as leaders, including their role in mitigating a growing challenge of maternity care desert.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 1","pages":"1-3"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096387/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144059441","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":"Buprenorphine: A Better Option for Opioid Use Disorder Treatment in Pregnancy Compared to Methadone.","authors":"Bailey Sanford, Alejandra Espinoza, Kehinde Eniola","doi":"10.3122/jabfm.2024.240349R0","DOIUrl":"10.3122/jabfm.2024.240349R0","url":null,"abstract":"<p><p>Buprenorphine, rather than methadone, should be considered the preferred first-line therapy for opioid use disorder in pregnancy due to its more favorable neonatal outcomes.<sup>1</sup>.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 1","pages":"188-191"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096386/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144024482","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}
Rebecca T Putnam, Phillip M Hughes, Chelsea C Atkins, C Micha Belden
{"title":"A Consultation Model for Intellectual and Developmental Disability Care.","authors":"Rebecca T Putnam, Phillip M Hughes, Chelsea C Atkins, C Micha Belden","doi":"10.3122/jabfm.2024.240183R2","DOIUrl":"10.3122/jabfm.2024.240183R2","url":null,"abstract":"<p><strong>Purpose: </strong>To provide an overview of an innovative, consultative care model for patients with Intellectual and Developmental Disabilities (IDD) within a Family Medicine department.</p><p><strong>Methods: </strong>We conducted a retrospective chart review of all patients seen in the clinic between 2017 to 2023 to identify patient demographics (eg, age), clinical needs (eg, diagnoses and referral needs), and administrative characteristics (eg, Medicaid status). We also conducted a spatial analysis to evaluate each patient's estimated travel distance and time to the clinic.</p><p><strong>Results: </strong>The number of patients seen in the IDD clinic totaled 184, with 65% male patients (n = 120) and a mean age of 31.29 years (SD = 16.27). More than half of patients, 65%, were insured by Medicaid (n = 119), and almost half received services paid for by the state Medicaid waiver (43%, n = 80). Many patients lived with family (64%, n = 117) and reported family guardianship (55%, n = 101). The spatial analysis identified that the majority of patients, 86% (n = 159) were nonrural residents based on Rural-Urban Continuum Codes. The mean distance traveled was 20.41 (SD = 21.36) miles with a mean travel time of 27.08 minutes (SD = 21.78). Following the consultations, 38% received outgoing referrals. Referral locations included psychiatry (8%), neurology (3%), behavioral health counseling (3%), and other medical services (17%).</p><p><strong>Conclusion: </strong>This study demonstrates the diverse characteristics of patients with IDD receiving care through a consultative-based model of care. This model appeared to provide services for patients from a wide geographic catchment area that may not have otherwise had health care access.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"38 1","pages":"180-187"},"PeriodicalIF":2.4,"publicationDate":"2025-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096379/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144062956","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}
Haritomane Brillakis, Sarah Fleischer, Rachel Hogg-Graham, Lars E Peterson
{"title":"Rural Family Physicians Are More Likely to Collaborate with Multisector Community Organizations.","authors":"Haritomane Brillakis, Sarah Fleischer, Rachel Hogg-Graham, Lars E Peterson","doi":"10.3122/jabfm.2024.240104R1","DOIUrl":"10.3122/jabfm.2024.240104R1","url":null,"abstract":"<p><p>Based on our analysis of data from 10,802 family physicians, we found significant variation in collaboration with local social service agencies by rurality. This variation highlights the need for tailored strategies that address disparities in health care resource utilization and collaboration, particularly improving service access and delivery.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 6","pages":"1167-1169"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674872","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 Post-Exposure Prophylaxis (doxy-PEP) for the Prevention of Bacterial Sexually Transmitted Infections for Men Who Have Sex with Men and Transgender Women.","authors":"Bryce A Ringwald","doi":"10.3122/jabfm.2024.240225R0","DOIUrl":"https://doi.org/10.3122/jabfm.2024.240225R0","url":null,"abstract":"","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 6","pages":"1149"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674795","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":"Food Insecurity Is Associated with Vitamin B12 Deficiency: The All of Us Database.","authors":"Daniel J Parente","doi":"10.3122/jabfm.2023.230454R1","DOIUrl":"10.3122/jabfm.2023.230454R1","url":null,"abstract":"<p><strong>Background: </strong>Vitamin B12 is an essential micronutrient obtained from dietary sources, but there is a paucity of information about how food security contributes to risk of vitamin B12 deficiency.</p><p><strong>Methods: </strong>I used multivariable logistic regression controlling for age, sex, and metformin exposure using the multicenter, United States National Institutes of Health All of Us precision medicine database. I included all adult participants 18 to 88 years old in the All of Us database who answered the social determinants of health survey and had a vitamin B12 measurement within 1 year of the survey.</p><p><strong>Results: </strong>8,989 participants with median age 65.9 years (Q1 53.0, Q3 73.7), who were predominantly female (63.2%), White-identifying (87.4%), and not Hispanic or Latino (93.4%) were included. 9.8% of participants reported experience of food insecurity, and 12.9% reported worry about food insecurity. 15.1% had metformin exposures. Vitamin B12 levels less than 300 pg/mL were associated with experiencing food insecurity (multivariable OR [mOR] 1.24, 95% CI 1.01-1.51, <i>P</i> = .037). Age (mOR 0.92 per decade), and male biological sex (mOR 1.16) were also both associated with vitamin B12 deficiency, but I did not detect an effect due to metformin exposure (mOR 1.05, 95% CI 0.88-1.25, <i>P</i> = .59).</p><p><strong>Conclusions: </strong>Vitamin B12 deficiency is associated with food insecurity in United States adults enrolled in the NIH All of Us database. Future analyses designed to infer causality are warranted.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 Supplement2","pages":"S156-S163"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701957","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":"Practical Recommendations for Minimizing Pain and Anxiety with IUD Insertion.","authors":"Viktoriya Ovsepyan, Petra Kelsey, Ann E Evensen","doi":"10.3122/jabfm.2024.240079R1","DOIUrl":"10.3122/jabfm.2024.240079R1","url":null,"abstract":"<p><strong>Background: </strong>Intrauterine devices (IUDs) are one of the most effective, long-lasting, and convenient contraceptive methods available in the United States. Unfortunately, the anticipated pain and anxiety associated with an IUD insertion procedure deter many people from using this contraceptive method.</p><p><strong>Methods: </strong>A literature review was conducted on PubMed by searching the terms \"IUD insertion\", \"pain management\", \"anxiety\", \"gynecologic procedures\". The Cochrane database was also searched for reviews about pain management methods during IUD insertions. Findings were summarized using the American Academy of Family Physicians' Strength of Recommendation Taxonomy (SORT) scale.</p><p><strong>Results: </strong>Pharmacologic methods that can be used to reduce pain with IUD insertion include naproxen, tramadol, lidocaine paracervical blocks, 10% lidocaine spray, lidocaine-prilocaine cream, and EMLA cream. Non-pharmacologic methods for reducing pain or anxiety during gynecologic procedures include pre-insertion counseling, \"verbal analgesia\", lavender aromatherapy, distraction with music or television, using Valsalva maneuver instead of tenaculum during IUD insertion, and use of heating pad during procedure.</p><p><strong>Conclusion: </strong>Moderately effective pharmacologic and non-pharmacologic methods exist for reducing pain and anxiety with IUD insertion. These treatment methods should be offered to create a more comfortable experience for patients. Additional research is needed to determine the comparative efficacy of these methods.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 6","pages":"1150-1155"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674871","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}
Birgit Khandalavala, Jenenne Geske, Morgan Karloff
{"title":"Patient-Reported Leg Cramp Treatments and Their Effectiveness.","authors":"Birgit Khandalavala, Jenenne Geske, Morgan Karloff","doi":"10.3122/jabfm.2023.230310R1","DOIUrl":"10.3122/jabfm.2023.230310R1","url":null,"abstract":"<p><strong>Background: </strong>Leg cramps are common and distressing to patients who report using many treatment options, some of which have potential for significant adverse effects. Such treatments are often underreported to their clinicians, and additional sources for information are sought. Our study investigates patient-reported treatment choices and treatment helpfulness for leg cramp symptom relief, as well as their use of the Internet to identify treatments.</p><p><strong>Methods: </strong>A newly developed cross-sectional survey was administered in Midwest primary care clinics.</p><p><strong>Results: </strong>Of 714 survey respondents, 365 reported experiencing leg cramps and are included in our report. The mean age of our participants was 52.2 years (SD = 16.7). The sample was 70.4% female, 90.2% white, and 71.5% rural. Pharmacological treatment options for leg cramps were cited less frequently than nonpharmacological treatments. The most common and helpful pharmacologic interventions were over-the-counter analgesics. Nonpharmacologic treatments included massage, stretching, and walking. Of patients who experienced leg cramps, 30.8% (n = 100) reported looking up treatments on the Internet. The most popular interventions found on the Internet were hydration with either water or electrolyte drinks, potassium, magnesium, and massage of the affected muscle.</p><p><strong>Conclusions: </strong>Patients with leg cramps use a variety of treatment options. Many nonpharmacological treatment options are at least somewhat beneficial, which thus present less estimated risk with more benefit. Nearly one-third of patients with leg cramps could be at potential risk of medication adverse events, particularly from over-the-counter analgesics. The use of the Internet could be seen as being problematic in nearly the same proportion.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 6","pages":"1123-1129"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674830","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}
Roopradha Datta, Jennifer A Lucas, Miguel Marino, Danielle M Crookes, Benjamin Aceves, David Ezekiel-Herrera, Andrew Bazemore, John D Heintzman
{"title":"Diabetes Monitoring in Foreign-Born and US-Born Latino Adults in US Community Health Centers.","authors":"Roopradha Datta, Jennifer A Lucas, Miguel Marino, Danielle M Crookes, Benjamin Aceves, David Ezekiel-Herrera, Andrew Bazemore, John D Heintzman","doi":"10.3122/jabfm.2024.240107R1","DOIUrl":"10.3122/jabfm.2024.240107R1","url":null,"abstract":"<p><strong>Introduction: </strong>The Latino population is the largest ethnic group in the United States and has a higher prevalence of diabetes mellitus than non-Latino Whites. The objective of this article is to assess if glycohemoglobin (HbA1c) monitoring rates vary across Latino patients by subgroup and nativity compared with their non-Latino White counterparts.</p><p><strong>Methods: </strong>Our sample included 43,593 adults (18 to 79 years) with Type-2 diabetes extracted from electronic health record (EHR) data from Community Health Centers (CHCs) across 16 US states, linked with neighborhood-level Latino subgroup data within the study period 2012 to 2020. The outcome was number of HbA1c monitoring tests per year. The main independent variable was self-reported ethnicity/nativity (eg, Mexican-born, US-born Latino, etc.) or for those with no EHR-recorded country of birth.</p><p><strong>Results: </strong>Compared with non-Latino White people with diabetes, US-born Latinos with diabetes had an 11% higher rate of receiving HbA1c monitoring; no foreign-born Latinos had monitoring rates that differed significantly from non-Latino Whites. Latinos with no country of birth recorded and living in high percent Mexican neighborhood had 22% higher rates of receiving HbA1c monitoring. Those living in high percent Dominican, Guatemalan and Honduran neighborhoods also had greater rates of HbA1c monitoring compared with non-Latino White patients.</p><p><strong>Conclusions: </strong>It could be beneficial for clinics to inquire about nativity and subgroup information of their Latino patients, so as to customize the treatment plan and better understand utilization patterns common in their communities.</p>","PeriodicalId":50018,"journal":{"name":"Journal of the American Board of Family Medicine","volume":"37 6","pages":"1095-1102"},"PeriodicalIF":2.4,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143674790","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}