Canadian Family Physician最新文献

{"title":"Évaluer et traiter la consommation d’alcool chez les patients adultes âgés.","authors":"Chris Frank, Frank Molnar, Sonja Rummell, Peter Chan","doi":"10.46747/cfp.720708e239","DOIUrl":"10.46747/cfp.720708e239","url":null,"abstract":"","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"e239-e241"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431201/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622744","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Recognizing ethnic and cultural variation in menopause care.","authors":"Josheil Kaur Boparai, Jessica Canning, Kathy Chan, Sheila Wijayasinghe","doi":"10.46747/cfp.720708446","DOIUrl":"10.46747/cfp.720708446","url":null,"abstract":"","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"446-448"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453122/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Updating Canada's diagnostic coding system for physician billing: Exploring family physician perspectives of ICD-11 and ICPC-3.","authors":"Dewdunee Himasara Pathiraja, Kerry McBrien, Jim Dickinson, Noah Crampton, Cathy A Eastwood, Danielle Southern, Kees van Boven, Huib Ten Napel, Alexander G Singer, Maeve O'Beirne, Keith Denny, Terrence McDonald, Olawunmi Olagundoye, David J T Campbell, Neil Drummond, Hude Quan, Rubee Dev, William A Ghali, Tyler Williamson, Stephanie Garies","doi":"10.46747/cfp.720708e244","DOIUrl":"10.46747/cfp.720708e244","url":null,"abstract":"<p><strong>Objective: </strong>To assess how family physicians use and perceive the <i>International Classification of Diseases, 11th Revision</i> (ICD-11) and the <i>International Classification of Primary Care, Version 3</i> (ICPC-3) compared to the ICD-9.</p><p><strong>Design: </strong>Cross-sectional, pre-implementation study.</p><p><strong>Setting: </strong>Canada.</p><p><strong>Participants: </strong>Family physicians.</p><p><strong>Main outcome measures: </strong>This mixed-methods study used an online patient vignette coding exercise and postcoding survey. Time taken to code and coding consistency were assessed and determined using the coding exercise. Physician-reported satisfaction measures and perspectives related to the 3 systems were evaluated using the postcoding survey.</p><p><strong>Results: </strong>A total of 161 family physicians participated in this study. Participants coded significantly faster with the ICPC-3 (median=48 seconds, interquartile range [IQR]=64 seconds), compared to the ICD-11 (median=59 seconds, IQR=71 seconds) and the ICD-9 (median=57 seconds, IQR=75 seconds). There were no differences in coding consistency based on the coding system used. More participants rated both the ICD-11 and ICPC-3 positively compared to the ICD-9 with respect to comprehensiveness, ability to find codes, precision, ease of use, ability to capture necessary information, and ability to capture medical and social complexity.</p><p><strong>Conclusion: </strong>This study demonstrated that the alternative coding systems, ICD-11 and ICPC-3, were associated with better utility and a more positive user experience among family physicians compared to the ICD-9. These study findings can be used as a foundation for future discussions toward an improved coding system in Canada.</p>","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"e244-e253"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431206/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Digital health that serves family medicine.","authors":"Sarah Cook","doi":"10.46747/cfp.720708507","DOIUrl":"10.46747/cfp.720708507","url":null,"abstract":"","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"507"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431189/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating and treating alcohol use in older adult patients.","authors":"Chris Frank, Frank Molnar, Sonja Rummell, Peter Chan","doi":"10.46747/cfp.720708466","DOIUrl":"10.46747/cfp.720708466","url":null,"abstract":"","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"466-468"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431212/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622738","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Erratum.","authors":"","doi":"10.46747/cfp.720708445","DOIUrl":"10.46747/cfp.720708445","url":null,"abstract":"","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"445"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431190/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622692","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reconnaître les variations ethniques et culturelles dans les soins pour la ménopause.","authors":"Josheil Kaur Boparai, Jessica Canning, Kathy Chan, Sheila Wijayasinghe","doi":"10.46747/cfp.720708e217","DOIUrl":"10.46747/cfp.720708e217","url":null,"abstract":"","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"e217-e220"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453125/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622751","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Update on Lyme disease diagnostic approaches and protocols in Canada: Overview of existing testing strategies and limitations.","authors":"Kashika Sareen, Cole Schonhofer, Calvin Ka-Fung Lo, Alan Gou, Hasan Hamze, Muhammad Morshed","doi":"10.46747/cfp.720708451","DOIUrl":"10.46747/cfp.720708451","url":null,"abstract":"<p><strong>Objective: </strong>To provide an update on the state of Lyme disease diagnostic approaches and protocols across Canada, as well as guidance for family physicians regarding the complexities of available tests.</p><p><strong>Quality of evidence: </strong>Guidelines from the Public Health Agency of Canada, the Association of Medical Microbiology and Infectious Disease Canada, the Infectious Diseases Society of America, and the European Society of Clinical Microbiology and Infectious Diseases were reviewed and summarized, as well as websites of provincial reference laboratories. Evidence levels ranged from I to III, with Grading of Recommendations Assessment, Development and Evaluation ratings ranging from moderate to low quality.</p><p><strong>Main message: </strong>Lyme disease incidence is increasing in Canada, but diagnosis can be complicated by vague presenting symptoms, heterogeneous quality of online resources available to patients and family physicians, and non-standardized, non-guideline-based tests available from private, for-profit laboratories. Early recognition is primarily clinical, based on the characteristic erythema migrans rash and exposure to Lyme-endemic areas. While standard 2-tiered serologic testing was previously the mainstay of laboratory-based Lyme disease diagnosis in Canada, several reference laboratories have since transitioned to modified 2-tiered testing, with increased sensitivity in early disease detection and shortened turnaround time. Overall, diagnostic approaches vary across Canadian provinces and territories due to differing baseline Lyme disease incidence. Tests available from private laboratories are unreliable due to high false-positive rates and lack of proven clinical relevance within peer-reviewed studies.</p><p><strong>Conclusion: </strong>Tests and guidance available from public health reference laboratories across Canada are well aligned with international and Canadian guidelines. Diagnosis is primarily clinical in early disease and based on serologic testing in later disease. Polymerase chain reaction is less reliable outside of certain clinical specimens such as erythema migrans biopsy and synovial fluid. Family physicians should be aware of non-evidence-based assays available to patients from private laboratories in the United States and Europe.</p>","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"451-457"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13453126/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622664","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vivre et travailler avec nos patients.","authors":"David Ponka","doi":"10.46747/cfp.720708441","DOIUrl":"10.46747/cfp.720708441","url":null,"abstract":"","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"441"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431210/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148621968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why do family physicians stay in rural practice? National survey of Canadian primary care clinicians who have stayed or left.","authors":"Ian Scott, Margot Gowans, Kevin Eva","doi":"10.46747/cfp.720708472","DOIUrl":"10.46747/cfp.720708472","url":null,"abstract":"<p><strong>Objective: </strong>To determine the variables associated with family physicians staying in or leaving rural practice.</p><p><strong>Design: </strong>Survey asking family physicians currently and recently practising in rural settings in Canada about their experiences.</p><p><strong>Setting: </strong>Canada.</p><p><strong>Participants: </strong>All family physicians currently practising in rural settings and those who had left rural settings within the previous 5 years.</p><p><strong>Main outcome measures: </strong>Factor analysis was used to condense a range of variables, and comparative analyses were carried out to identify those variables that differentiated between the 2 groups. Multivariable logistic regression was used to quantify their relative importance.</p><p><strong>Results: </strong>A total of 1023 completed surveys were received, including 96 from family physicians who had moved from rural to nonrural practice within the past 5 years. Variables associated with leaving rural practice included some that could be modified through health system planning: lack of schedule control, lack of Royal College of Physicians and Surgeons of Canada specialist visits to the community, working in a rural hospital emergency department, and having a return-of-service agreement. One variable over which the health system has little control, the effect of the practice location on physicians' children, was also identified.</p><p><strong>Conclusion: </strong>In this first national study of retention of family physicians in rural areas, 5 variables that predict the likelihood of physicians leaving rural practice were identified. At least 4 could be modified through policy-makers, professional groups, health administrators, communities, and academic institutions together planning long-term, coordinated, and sustainable solutions that support the retention of rural physicians.</p>","PeriodicalId":55288,"journal":{"name":"Canadian Family Physician","volume":"72 7-8","pages":"472-480"},"PeriodicalIF":3.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13431197/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148622484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}