Annals of Family Medicine最新文献

Addressing Research Pathway Gaps: Insights from a Needs Assessment at the AAFP Future Conference.

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.250096

Nicole L Gentile, Amanda Weidner, Ian Bennett, Samantha Elwood

引用次数: 0

Feasibility and Acceptability of the "About Me" Care Card as a Tool for Engaging Older Adults in Conversations About Cognitive Impairment.

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.240165

Stuart W Grande, Mikele Epperly, Karynn Yee-Huey Tan, Supriya Yagnik, Michael Ellenbogen, Jane Pederson, Alberto Villarejo-Galende, Rae Lynn Ziegler, Greg Kotzbauer

{"title":"Feasibility and Acceptability of the \"About Me\" Care Card as a Tool for Engaging Older Adults in Conversations About Cognitive Impairment.","authors":"Stuart W Grande, Mikele Epperly, Karynn Yee-Huey Tan, Supriya Yagnik, Michael Ellenbogen, Jane Pederson, Alberto Villarejo-Galende, Rae Lynn Ziegler, Greg Kotzbauer","doi":"10.1370/afm.240165","DOIUrl":"10.1370/afm.240165","url":null,"abstract":"Purpose: We aimed to address fears and lived experiences of cognitive decline among adults via whole-person conversations that elicit problems and goals that matter most to patients. Currently, 6.7 million Americans have Alzheimer disease or related dementias, with an additional 28 million people reporting subjective cognitive decline-a possible indicator of Alzheimer disease and related dementias. A review of tools for older adults with cognitive impairment showed strong clinical specificity, with insufficient whole-person support for patients. We developed and tested the feasibility and acceptability of a tool to enhance conversations for adults with cognitive impairment at the point of care.Methods: We conducted a feasibility study to build a conversation tool, guided by principles of shared decision making, called the \"About Me\" Care Card. Informed by an environmental scan, we created and pilot-tested prototypes at implementation sites. All phases were overseen by a multidisciplinary steering committee.Results: Fourteen diverse clinicians consisting of 7 clinician types across 7 institutions piloted the card during in-person visits or by telephone. Observations showed that the card (1) allowed time to elicit what matters most to patients, (2) created space for personalized care conversations, (3) opened an examination of social care needs, and (4) moderated emotional relationships between families and individuals.Conclusion: A community-based codesign process led to a feasible tool for primary care teams to facilitate whole-person conversations with aging adults. The About Me Care Card appeared to broaden conversations compared with routine care. More work is needed to determine scalability and effects on outcomes.","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 2","pages":"117-126"},"PeriodicalIF":4.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936360/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702020","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease.

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.240030

Wilson D Pace, Elisabeth Callen, Gabriela Gaona-Villarreal, Asif Shaikh, Barbara P Yawn

{"title":"Adverse Outcomes Associated With Inhaled Corticosteroid Use in Individuals With Chronic Obstructive Pulmonary Disease.","authors":"Wilson D Pace, Elisabeth Callen, Gabriela Gaona-Villarreal, Asif Shaikh, Barbara P Yawn","doi":"10.1370/afm.240030","DOIUrl":"10.1370/afm.240030","url":null,"abstract":"Purpose: We aimed to assess long-term inhaled corticosteroid (ICS) risks in chronic obstructive pulmonary disease (COPD) management.Methods: We extracted electronic health record data for individuals aged >45 years with COPD from a data repository. The prevalent cohort required a diagnosis of COPD any time during the observation period, and the inception cohort required a diagnosis of COPD made after entry into the database. A composite outcome of any new diagnosis of type 2 diabetes, cataracts, pneumonia, osteoporosis, or nontraumatic fracture; and recurrent event outcomes of repeated pneumonia or nontraumatic fracture were compared for long-term (>24 months) vs short-term (<4 months) ICS exposure.Results: We assessed outcomes for 318,385 and 209,062 individuals in the prevalent and inception cohorts, respectively. The composite dichotomous outcome was significantly greater for long-term vs short-term ICS use for the prevalent (hazard ratio [HR] = 2.65; 95% CI, 2.62-2.68; P <.001) and inception (HR = 2.60; 95% CI, 2.56-2.64; P <.001) cohorts. For the inception cohort, the absolute risk difference of the composite outcome was 20.26% (29.41% minus 9.15%), with a number needed to harm of 5. Hazard ratios were significantly increased in the prevalent and inception cohorts for recurrent pneumonia (HR = 2.88; 95% CI, 2.62-3.16; P <.001 and HR = 2.85; 95% CI, 2.53-3.22; P <.001, respectively) and recurrent fracture (HR = 1.77; 95% CI, 1.42-2.21; P <.001 and HR = 1.57; 95% CI, 1.20-2.06; P <.001).Conclusions: Long-term ICS use for COPD is associated with significantly greater rates of the composite outcome of type 2 diabetes, cataracts, pneumonia, osteoporosis, and nontraumatic fracture; recurrent pneumonia; and recurrent fracture.","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 2","pages":"127-135"},"PeriodicalIF":4.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936369/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701943","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

What do Primary Care Patients Want? 初级保健患者想要什么？

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.250081

Michael E Johansen

引用次数: 0

When the Death of a Colleague Meets Academic Publishing: A Call for Compassion. 当同事之死遇上学术出版：呼吁同情》（When the Death of a Colleague Meets Academic Publishing: A Call for Compassion）。

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.240287

Catherine G Derington

引用次数: 0

The General Public Vastly Overestimates Primary Care Spending in the United States.

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.240413

Melissa Ma, Rebecca Etz, Andrew Bazemore, Kevin Grumbach

引用次数: 0

Convenience or Continuity: When Are Patients Willing to Wait to See Their Own Doctor?

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.240299

Gregory Shumer, Dongru Chen, John Holkeboer, Lauren Marshall, Devon Kinney, Ananda Sen, Michael Klinkman, Katherine J Gold

{"title":"Convenience or Continuity: When Are Patients Willing to Wait to See Their Own Doctor?","authors":"Gregory Shumer, Dongru Chen, John Holkeboer, Lauren Marshall, Devon Kinney, Ananda Sen, Michael Klinkman, Katherine J Gold","doi":"10.1370/afm.240299","DOIUrl":"10.1370/afm.240299","url":null,"abstract":"Purpose: Much of the literature on team-based primary care has focused on physician productivity, workload, and burnout. Less is known about how team-based care influences patient satisfaction and perceptions of the trade-off between continuity and access. This study assessed the preferences of family medicine patients for seeing their primary care physician (PCP) vs other team clinicians based on visit type and wait time.Methods: Our cross-sectional online survey asked patients about their primary care clinics, PCP, portal use, self-reported health, and demographics. For multivariate analysis, we used weighted logistic regression analysis with survey data to calculate maximum likelihood estimates and converted these to odds ratios. We controlled for age and self-reported health as continuous variables and for demographics as categorical variables.Results: We surveyed 4,795 adult patients and received responses from 2,516 (52.5%). More than one-half of patients preferred to see only their PCP for an annual checkup (52.6%), follow-up of a chronic condition (54.6%), or follow-up for a mental health condition (56.8%). Similarly, the majority of patients preferred to wait 3 to 4 weeks to see their PCP for issues possibly requiring a sensitive examination (68.2%), a new mental health concern (58.9%), or a new concern about a chronic condition (61.1%).Conclusions: Our findings show that patients value having a PCP and maintaining continuity with their PCP. They also provide insight on when patients would prefer to wait to see their own PCP vs being seen more quickly by another clinician. As health care delivery and scheduling continue to evolve, these findings provide guidance for leaders in primary care.","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 2","pages":"151-157"},"PeriodicalIF":4.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936363/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143701947","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

New Advocacy Ambassadors Program Helps AAFP Members Engage With Their Legislators.

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.250095

引用次数: 0

Teamwork Among Primary Care Staff to Achieve Regular Follow-Up of Chronic Patients. 基层医疗人员团队合作，实现对慢性病患者的定期随访。

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.240176

Maram Khazen, Ligat Shalev, Avivit Golan-Cohen, Eugene Merzon, Ariel Israel, Shlomo Vinker, Adam J Rose

{"title":"Teamwork Among Primary Care Staff to Achieve Regular Follow-Up of Chronic Patients.","authors":"Maram Khazen, Ligat Shalev, Avivit Golan-Cohen, Eugene Merzon, Ariel Israel, Shlomo Vinker, Adam J Rose","doi":"10.1370/afm.240176","DOIUrl":"10.1370/afm.240176","url":null,"abstract":"Purpose: Although studies have shown that more temporally regular (TR) primary care visits are associated with improved patient outcomes, none have examined what clinic staff can do to encourage greater TR visits. This study aims to increase understanding of factors related to health care staff dynamics that contribute to more TR primary care visits for adults with chronic health conditions.Methods: We conducted semistructured interviews with 15 primary care physicians, 12 nurses, 15 administrative staff, and 4 pharmacists at 12 clinics; one-half characterized as high-TR clinics where patients had regular follow-ups, and the other as low-TR clinics. Interviews were audiotaped, transcribed, and coded using Atlas qualitative data analysis software (Lumivero, LLC).Results: Themes emerged regarding best ways to promote regular follow-up of patients with chronic conditions. These strategies included having a system to encourage follow-up (beginning with administrative staff reaching out to patients and ending with recruiting the help of patients' family members), routine staff meetings, adaptive workflow, dealing with bureaucracy on patients' behalf, informal channels of communication with patients, and consulting social workers. Clinics with more regular follow-up emphasized teamwork, a peaceful approach toward challenging patients, and flat as opposed to hierarchical organizational structures for personal relationships among staff.Conclusions: Teamwork between staff members in primary care settings can contribute to more proactive care delivery, with greater potential to prevent long-term complications. The findings suggest that a high-functioning multidisciplinary care team that focuses on creating the right sorts of interactions and teamwork among members of the staff can contribute to engaging patients more effectively.","PeriodicalId":50973,"journal":{"name":"Annals of Family Medicine","volume":"23 2","pages":"100-107"},"PeriodicalIF":4.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11936351/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143702039","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"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

Let's Dare to Be Vulnerable: Crossing the Self-Disclosure Rubicon.

IF 4.4 2区医学

Annals of Family Medicine Pub Date : 2025-03-24 DOI: 10.1370/afm.240310

Ohad Avny, Aya Alon

引用次数: 0