Journal of General and Family Medicine最新文献

{"title":"Outpatient superficial partial-thickness burn care of an elderly patient successfully treated with Eppikajutsuto","authors":"Hiroki Ishibashi MD,&nbsp;Ryo Yoshinaga MD, PhD,&nbsp;Tetsuhisa Yamada MD, PhD","doi":"10.1002/jgf2.685","DOIUrl":"10.1002/jgf2.685","url":null,"abstract":"<p>Eppikajutsuto (EPTJ) is used to reduce redundant body fluids and suppress inflammation. We observed that EPTJ shortened the duration of treatment in an elderly patient with burn injuries. A 96-year-old man suffered superficial partial-thickness burns on the dorsum of his right hand and left knee. The injuries showed early improvement with the use of EPTJ. This suggests that EPTJ could contribute to shortening the duration of healing for superficial partial-thickness burns in elderly patients who may experience slow wound healing and have a high mortality rate. Eppikajutsuto needs to be considered as a treatment for burns in primary care.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 3","pages":"158-161"},"PeriodicalIF":1.6,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.685","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249137","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Descriptive epidemiology of prevalence of exercise habits among participants with hypertension: The National Health and Nutrition Survey 2013–2018","authors":"Noritoshi Fukushima MD, PhD,&nbsp;Shiho Amagasa PhD,&nbsp;Hiroyuki Kikuchi PhD,&nbsp;Susumu S. Sawada PhD,&nbsp;Masaki Machida MD, PhD,&nbsp;Shigeru Inoue MD, PhD","doi":"10.1002/jgf2.683","DOIUrl":"10.1002/jgf2.683","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The current Japanese hypertension management guidelines (2019) recommend regular exercise for all patients with hypertension. However, limited evidence is available regarding the prevalence of exercise habits in these patients. Therefore, we examined the proportion of participants who met the recommendations on exercise in the Japanese hypertension management guidelines (2019) using a nationally representative sample.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Participants aged ≥20 years from the Japanese National Health and Nutrition Examination Survey conducted from 2013 to 2018 were included. Participants with hypertension were defined as those with blood pressure level ≥140/90 mmHg or those who used antihypertensive drugs. Adherence to the guideline recommendations, stratified by gender, age category, blood pressure level, and medication status, was examined.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>This study included 13,414 participants with hypertension (age 68.2 ± 11.7 years, 48.1% men). Among them, 31.8% of participants with hypertension (36.8% of men and 27.3% of women) met the guidelines. Regarding age, the 20–64 years age group had the lowest proportion of patients who met the guidelines (22.4%), followed by those in the 65–74 (37.7%) and ≥75 years age groups (34.5%). Adherence to the guidelines did not significantly differ according to blood pressure levels (&lt;120/&lt;80, 120–129/&lt;80, 130–139/80–89, 140–159/90–99, and 160–179/100–109 mmHg) and presence of antihypertensive medications.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>One-third of participants with hypertension engaged in exercise as recommended by the current hypertension management guidelines. Promotion of exercise therapy and monitoring exercise habits among participants with hypertension is warranted.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 3","pages":"128-139"},"PeriodicalIF":1.6,"publicationDate":"2024-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.683","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140091534","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Use of artificial hydration in patients diagnosed with senility as the cause of death by home care physicians: A cross₋sectional study","authors":"Teruhiko Imanaga MD, PhD","doi":"10.1002/jgf2.681","DOIUrl":"10.1002/jgf2.681","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The aim of this study was to investigate the frequency, effectiveness, and reasons for the use of artificial hydration (AH) in senile patients in the last week, and patient-related factors associated with its usage.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Between April and May 2023, I conducted a cross₋sectional study among medical institutions affiliated with the Japan Network of Home Care Supporting Clinics. Eligible cases included those in which senility was listed as the cause of death on the death certificate from January 1, 2022, to December 31, 2022. The questions asked use of AH, reasons for AH, and symptoms that improved or worsened with AH. Patient characteristics, including age, gender, place of death, length of treatment, and complication of dementia, were also asked. Descriptive statistics were performed. Univariate and multivariate analyses were conducted to examine the association between patient characteristics and the use of AH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Eighty-three medical institutions (12.5%) provided responses, contributing a total of 714 cases. AH was administered in 236 cases (33.1%). The most common reason was “due to family preference” in 110 cases (46.6%). One hundred thirty-five cases (57.2%) reported “no improved symptoms,” while symptom worsening was reported as “no worsened symptoms” in 176 cases (74.6%). Multivariate analysis on 699 cases using complete-case analysis identified age (risk ratio [RR]:0.98, 95% confidence interval [CI]: 0.96–0.99) and female (RR:0.73, 95% CI:0.58–0.92) as factors associated with the use of AH.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>This study revealed that AH was commonly used based on family preferences and to alleviate psychological burdens on the family.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 3","pages":"121-127"},"PeriodicalIF":1.6,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.681","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140432842","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Serosurvey of anti-rubella and anti-measles IgG antibodies in young females in Jahrom, southern west Iran in 2012: A review of literature of the serological profile in Iran","authors":"Najmeh Mojarad MD,&nbsp;Fatemeh Forouzani MD,&nbsp;Zahra Mohammadi MD,&nbsp;Reza Shahriarirad MD","doi":"10.1002/jgf2.677","DOIUrl":"https://doi.org/10.1002/jgf2.677","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Rubella and measles are two highly contagious viral childhood diseases. However, the high possibility of brutal effects of both microorganisms during pregnancy has kept them emerging as a major public health issue. The current study aimed to investigate the seroprevalence of rubella and measles among 15–25-year-old females in southwest Iran.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Method</h3>\u0000 \u0000 <p>This descriptive study was performed in Jahrom, southern west Iran during 2012. Serum samples from female individuals with an age of 15–25 years visiting main laboratories in our study location were collected and evaluated by a commercial ELISA kit for anti-rubella and measles IgG antibodies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Among the 179 participants, regarding anti-rubella antibodies, 171 (95.0%) were positive, 3 (1.7%) were negative, and 6 (3.3%) were borderline. Regarding anti-measles antibodies, 166 (92.2%) of the subjects were positive, 1 (5.6%) was negative, and 13 (17.2%) were borderline. By assuming a positive value for the borderline cases, the ultimate findings demonstrated that 98.3% and 99.4% of the participants were immune against rubella and measles, respectively. There was no statistically significant association between measles and rubella immunity with age or the use of immunosuppressor medication.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Implementation of vaccine program has obtained significant immunity level in inhabitants, particularly women of childbearing age who play a more important role in herd immunity. Therefore, maintaining the national immune screening against rubella and measles is needed to take into consideration to maintain the current satisfactory level of immunization.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 2","pages":"95-101"},"PeriodicalIF":1.6,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.677","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140104547","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of clinical findings and subjective symptoms in a case of multiple evanescent white dot syndrome (MEWDS): A case report from a patient's perspective","authors":"Kotaro Sugimoto MD, PhD,&nbsp;Toshiki Murakami MD,&nbsp;Akira Ojima MD, PhD,&nbsp;Tetsuju Sekiryu MD, PhD","doi":"10.1002/jgf2.680","DOIUrl":"10.1002/jgf2.680","url":null,"abstract":"<p>A 38-year-old pathologist developed multiple evanescent white dot syndrome (MEWDS). He documented his visual impairment in detail utilizing a light microscope for pathological diagnosis. Notably, the subjective defects illustrated by the patient were in good spatiotemporal agreement with diagnostic outcomes. The present report enhances the understanding of visual impairment associated with MEWDS through a comparative analysis of subjective experiences and objective clinical findings.</p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 3","pages":"154-157"},"PeriodicalIF":1.6,"publicationDate":"2024-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.680","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140432338","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Availability of primary care physicians and hepatocellular carcinoma-related mortality in the United States","authors":"Daniyal Raza MD,&nbsp;Udhayvir Singh Grewal MD","doi":"10.1002/jgf2.679","DOIUrl":"https://doi.org/10.1002/jgf2.679","url":null,"abstract":"<p>Hepatocellular carcinoma (HCC) is the fifth leading cause of cancer worldwide and majority cases are diagnosed at an intermediate or advanced stage. Per our analysis, greater availability of primary care physicians correlates with lower HCC-related mortality. Our results underscore the need for efforts to expand access to primary care among all populations, especially African Americans, to improve overall HCC-related outcomes.\u0000 <figure>\u0000 <div><picture>\u0000 <source></source></picture><p></p>\u0000 </div>\u0000 </figure></p>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 2","pages":"118-119"},"PeriodicalIF":1.6,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.679","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140104431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Treatment interruption in hypertensive patients during the COVID-19 pandemic: An interrupted time series analysis using prescription data in Okayama, Japan","authors":"Naoko Nakamura MD, MPH,&nbsp;Toshiharu Mitsuhashi MD, PhD,&nbsp;Naomi Matsumoto MD, PhD,&nbsp;Shunsaku Hayase BEc,&nbsp;Takashi Yorifuji MD, PhD","doi":"10.1002/jgf2.678","DOIUrl":"https://doi.org/10.1002/jgf2.678","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The COVID-19 pandemic has impacted healthcare behaviors, leading to fewer pediatric visits in Japan and potentially fewer visits by adult patients. However, existing Japanese studies on treatment interruptions have generally relied on questionnaire-based methods. In this study, we assessed the impact of the pandemic on antihypertensive treatment interruption using real-world prescription data.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted an interrupted time series analysis using the National Health Insurance Database in Okayama Prefecture, Japan. Participants included individuals aged 40–69 years with at least one antihypertensive prescription between 2018 and 2020. Treatment interruption was defined as a 3-month or longer gap in prescriptions after medication depletion. We used segmented Poisson regression with models unadjusted and adjusted for seasonality and over-dispersion to assess monthly treatment interruptions before and after Japan's April 2020 emergency.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>During the study period, 23.0% of 55,431 participants experienced treatment interruptions. Cyclical fluctuations in interruptions were observed. The crude analysis indicated a 1.2-fold increase in treatment interruptions following the pandemic; however, the adjusted models showed no significant changes. Even among higher-risk groups, such as women, younger adults, and those with shorter prescriptions, no significant alterations were observed.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>We found no significant impact of the COVID-19 pandemic on antihypertensive treatment interruption in Okayama Prefecture. The less severe outbreak in the area or increased use of telemedicine and extended prescriptions may have contributed to treatment continuity. Further research is needed using a more stable and comprehensive database, broader regional data, and detailed prescription records to validate and extend our findings.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 2","pages":"102-109"},"PeriodicalIF":1.6,"publicationDate":"2024-02-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.678","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140104429","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Japanese Patient Engagement Promotion Training (J-PEPT): Learning course on the implementation strategy of patient engagement","authors":"Masaru Kurihara MD,&nbsp;Shintaro Kosaka MD,&nbsp;Yusuke Yasumoto MD,&nbsp;Akie Yamaguchi,&nbsp;Tomomi Yoshida,&nbsp;Ayako Iyasu,&nbsp;Hideyuki Kashiwagi MD,&nbsp;Toru Kimura,&nbsp;Kiichi Enomoto,&nbsp;Kiyomi Tanno PhD,&nbsp;Keiko Inoue,&nbsp;Yaeko Ishihara,&nbsp;Noriko Iwaya,&nbsp;Aoki Takuya MD, PhD","doi":"10.1002/jgf2.665","DOIUrl":"10.1002/jgf2.665","url":null,"abstract":"&lt;p&gt;Since the end of the 20th century, patient safety has become a global issue.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Although many patient safety measures (such as changing the behavior of healthcare providers) have been taken, the role of patients in safety measures has also become more important in recent years. Patient engagement (PE) is defined as patients, families, their representatives, and health professionals working in active partnerships at various levels across the healthcare system to improve health and healthcare.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; PE to address safety issues that cannot be resolved by healthcare providers alone is considered by policy makers and healthcare providers. However, in Japan, there are barriers to improving patient safety, and one of them is the emphasis on patient centeredness, including PE.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Translating patient-centered safety measures including PE from theory to implementation is challenging, making it a global issue; thus, it is important to create learning courses where PE can be taught. Therefore, to promote the PE implementation strategies in primary care, which have traditionally emphasized patient centeredness, we report a Japanese Patient Engagement Promotion Training (J-PEPT) course developed by the Committee on Quality and Patient Safety of the Japan Primary Care Association.&lt;/p&gt;&lt;p&gt;J-PEPT aims to provide participants with the necessary knowledge and skills to implement PE strategies in healthcare settings. It is held about twice a year and has been attended by more than 60 people from across the country to date. Participants include physicians, nurses, pharmacists, as well as patients. PE has been also emphasized when planning, involving not only healthcare professionals (including physicians), but also patients, families, and social scientists from various fields. This is designed such that participants can learn while incorporating diverse opinions, deepening their understanding of the importance of PE.&lt;/p&gt;&lt;p&gt;J-PEPT covers many topics regarding PE, including sessions on implementing PE in primary care using the “guide to improving patient safety in primary care settings by engaging patients and families”,&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; utilizing patient experiences, and exploring PE in telemedicine. Several measures have been taken to enhance J-PEPT's implementation in healthcare settings: first, interactive opportunities are provided to offer participants a chance to learn how to promote implementation in their respective healthcare settings. Second, a mindset that can serve as an implementation champion within healthcare institutions is conveyed. Finally, opportunities for patient input are always provided to participants to spark insights, treating the course itself as an opportunity for PE.&lt;/p&gt;&lt;p&gt;In each session, learning objectives are set, and a survey using a 5-point Likert scale (1: “strongly disagree” to 5: “strongly agree”) is conducted to assess whether these objectives have been achi","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 2","pages":"112-113"},"PeriodicalIF":1.6,"publicationDate":"2024-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.665","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139842495","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Author reply to the definition and evaluation of uncoordinated involvement of multiple healthcare providers; “Polydoctoring” as a component of care fragmentation among patients with multimorbidity","authors":"Takayuki Ando MD, MPH,&nbsp;Takashi Sasaki PhD,&nbsp;Yukiko Abe BA,&nbsp;Yoshinori Nishimoto MD, PhD,&nbsp;Takumi Hirata MD, MPH, PhD,&nbsp;Junji Haruta MD, PhD,&nbsp;Yasumichi Arai MD, PhD","doi":"10.1002/jgf2.676","DOIUrl":"https://doi.org/10.1002/jgf2.676","url":null,"abstract":"&lt;p&gt;We appreciate the opportunity to respond to the concerns raised in the letter&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; regarding our article, “Measurement of polydoctoring as a crucial component of fragmentation of care among patients with multimorbidity: Cross-sectional study in Japan.”&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;First, we acknowledge the point that in Japan, organ-specific specialists often undertake primary care. This indeed contributes to the prevalence of polydoctoring as patients navigate through multiple healthcare providers. We agree that this unique aspect of Japanese healthcare necessitates a more nuanced understanding of polydoctoring, particularly how it impacts patients with multimorbidity. The propensity for patients to consult multiple healthcare providers is an important aspect of our study, and it is evident that this practice has deep roots in the structural makeup of Japanese healthcare.&lt;/p&gt;&lt;p&gt;Interestingly, our data indicated that approximately one-third of the participants were engaged in regular relationships with a single institution even though they have multimorbidity. This subset of the study population presents an important contrast to the polydoctoring narrative and suggests the presence of integrated care pathways for some patients. This variation in care-seeking behavior offers a unique perspective on patient autonomy and the choices made in managing their health within the existing healthcare framework.&lt;/p&gt;&lt;p&gt;The definition of high-risk polydoctoring is a critical area for further research. The delineation between necessary multidisciplinary care and potentially detrimental polydoctoring remains ambiguous and is subject to individual patient circumstances. Our study's threshold for high-risk polydoctoring may warrant reevaluation in future research to establish more precise criteria that can reliably predict adverse outcomes. Furthermore, it is important to note that fragmentation of care is influenced not only by the number of healthcare providers involved but also by the quality of coordination among them. However, objectively assessing the quality of coordination among various healthcare professionals remains a significant challenge in the current landscape.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Future research efforts should be directed toward developing methodologies to measure the quality of coordination of care, an aspect crucial for understanding and improving patient care.&lt;/p&gt;&lt;p&gt;Regarding the concerns about selection bias, the letter accurately identifies a significant limitation of our study. Our focus on independently living elderly individuals excluded patients receiving home-based medical care. This omits a crucial subset of patients who may be receiving the most comprehensive care, potentially skewing our understanding of polydoctoring in the broader spectrum of care delivery. The homebound patients, often with diminished physical function, represent a contrasting group to the ambulatory patients who were the focus of our s","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 2","pages":"116-117"},"PeriodicalIF":1.6,"publicationDate":"2024-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.676","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140104345","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Residents' learning and behavior about tool-guided clinical assessment of social determinants of health","authors":"Junki Mizumoto MD,&nbsp;Hirohisa Fujikawa MD, PhD,&nbsp;Masashi Izumiya MD, PhD,&nbsp;Shoko Horita MD, PhD,&nbsp;Masato Eto MD, PhD","doi":"10.1002/jgf2.674","DOIUrl":"10.1002/jgf2.674","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The specific dimensions of learners that have been impacted by educational programs related to social determinants of health (SDoH) remain unknown. This study aims to elucidate how learners are affected by postgraduate education (a single 90-min educational session) regarding tool-guided clinical assessment of patients' social backgrounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A pretest-posttest design was utilized in which residents (postgraduate year (PGY) 1 or 2) and fellows in family medicine (PGY over 3) were recruited. Likert-type questions were developed based on previous qualitative findings. Participants answered these questions before, immediately after, and 1.5 months after the educational session on tool-guided clinical SDoH assessment. Paired-sample <i>t</i>-tests were used, and effect size was measured using Cohen's <i>d</i>.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 114 residents and fellows participated. After the session, participants expressed more interest in knowing their patients' social backgrounds when considering how to address their patients and were more open to embracing a pre-established assessment framework. Participants also considered clinical skills related to SDoH as learnable and improved their attitude toward patients. They reported that they did not perform specific interventions related to SDoH within 1.5 months after the session. Unlike previous qualitative findings, their concern about the implementation of SDoH-related practices did not increase significantly.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>An educational session on tool-guided SDoH assessment may have a positive impact on learners' attitudes related to addressing patients' social backgrounds without fostering concerns.</p>\u0000 </section>\u0000 </div>","PeriodicalId":51861,"journal":{"name":"Journal of General and Family Medicine","volume":"25 2","pages":"87-94"},"PeriodicalIF":1.6,"publicationDate":"2024-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jgf2.674","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139531485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}