Annals of family medicine
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Annals of family medicine · Jan 2013
Enhancing the primary care team to provide redesigned care: the roles of practice facilitators and care managers.
Efforts to redesign primary care require multiple supports. Two potential members of the primary care team-practice facilitator and care manager-can play important but distinct roles in redesigning and improving care delivery. ⋯ Care managers provide direct patient care by coordinating care and helping patients navigate the system, improving access for patients, and communicating across the care team. These complementary roles aim to help primary care practices deliver coordinated, accessible, comprehensive, and patient-centered care.
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Annals of family medicine · Jan 2013
Primary care physicians' use of an informed decision-making process for prostate cancer screening.
Leading professional organizations acknowledge the importance of an informed decision-making process for prostate cancer screening. We describe primary care physicians' reports of their prescreening discussions about the potential harms and benefits of prostate cancer screening. ⋯ Much of the variability in physicians' use of an informed decision-making process can be attributed to beliefs about screening. Concerns about medicolegal risk remain an important barrier for shared decision making.
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Annals of family medicine · Jan 2013
Comparative Study Clinical TrialVascular outcomes in patients with screen-detected or clinically diagnosed type 2 diabetes: Diabscreen study follow-up.
Screening guidelines for type 2 diabetes recommend targeting high-risk individuals. Our objective was to assess whether diagnosis of type 2 diabetes based on opportunistic targeted screening results in lower vascular event rates compared with diagnosis on the basis of clinical signs or symptoms. ⋯ Opportunistic targeted screening for type 2 diabetes detected patients with higher CVD morbidity at baseline when compared with clinical diagnosis but showed similar CVD mortality and major CVD morbidity after 7.7 years. Opportunistic targeted screening and guided care appears to improve vascular outcomes in type 2 diabetes in primary care.
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Annals of family medicine · Jan 2013
Life disruptions for midlife and older adults with high out-of-pocket health expenditures.
Physicians prescribing new medications often do not convey important medication-related information. This study tests an intervention to improve physician-patient communication about newly prescribed medications. ⋯ A physician-targeted educational session improved the content of and enhanced patient ratings of physician communication about new medication prescriptions. Further work is required to assess whether improved communication stimulated by the intervention translates into better clinical outcomes.