Annals of family medicine
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Annals of family medicine · Apr 2022
Randomized Controlled Trial Pragmatic Clinical TrialIntegrating behavioral health & primary care for multiple chronic diseases: Clinical trial of a practice redesign toolkit.
Context: Most patients in need of behavioral health (BH) care are seen in primary care, which often has difficulty responding. Some practices integrate behavioral health care (IBH), with medical and BH providers at the same location, working as a team. However, it is difficult to achieve high levels of integration. ⋯ Conclusions: The specific intervention tested in this study was inexpensive, but had only a small impact on the degree of BH integration, and none on patient outcomes. However, practices that had more integration at baseline had better patient outcomes, independent of the intervention. Although this particular intervention was ineffective, IBH remains an attractive strategy for improving patient outcomes.
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Annals of family medicine · Apr 2022
Assessing the application of continuity of care indices in the last year of life: a retrospective population-based study.
Context: Most people spend the majority of their last year of life at home or in a home-like setting, receiving outpatient healthcare. Increasing numbers of physicians and teams, including palliative care providers, may become involved in care in addition to a usual provider such as a family physician. Continuity of care (CoC) near the end of life, although considered a marker of quality of care, may be interrupted despite the provision of high-quality care. ⋯ Results were similar for other indices. Conclusions: Decedents experience low continuity of outpatient physician care in the last year of life, especially those with cancer, comorbidities, and frequent physician visits. Modifications to existing indices may be needed to serve as end-of-life care quality indicators.
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Firearm violence is a rising cause of death in the US. More than 38,000 individuals die annually from firearm violence. The estimated annual cost of firearm injuries were $174.1 billion. ⋯ Forms of firearm violence may be associated with various health related risk factors and consequences. Findings from NJ can inform NJ and other states of prevention and intervention initiatives that are locally relevant. By better understanding forms of firearm violence and their factors among various populations, we can develop tailored prevention and intervention strategies in clinical settings and communities. Clinical safety protocols are needed for individuals with risk factors, such as suicidal ideations, youth violence, and IPV.
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Annals of family medicine · Apr 2022
Participants' experience in using a point of Care Rapid Antigen Test (RAT) for SARS-CoV-2.
Learning objectives: On completion of this presentation, participant should be able to: Understand the feasibility of RAT for SARS-CoV-2 screening in primary care Understand the role of RAT for SARS-CoV-2 screening in prevention of COVID-19 transmission in community Context: The COVID-19 pandemic has paralyzed human interactions worldwide. At least half of COVID-19 transmissions could originate from asymptomatic individuals. Rapid Antigen Testing (RAT) with nasal sampling at the point of care is inexpensive, fast and less invasive than PCR testing. ⋯ More than two thirds of participants reported RAT provide them peace of mind and reduced anxiety levels. Participants found the RAT to be safe, easy, accessible and rapid. Conclusions: Rapid antigen testing for detecting COVID-19 is well accepted and could support the detection of infection at an early stage amongst asymptomatic individuals while easing their worries.
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Annals of family medicine · Apr 2022
COVID-19 vaccination hesitancy among southern rural veterans with cancer in the arkansas-louisiana-texas (ArkLATX) region.
Context: The COVID-19 pandemic continues to be a major socioeconomic disruptor in the U. S. and around the globe. The only intervention that has a far-reaching impact is the adoption of an efficient large-scale vaccination campaign with the highly effective COVID-19 vaccines. ⋯ Conclusions: This survey indicates that the majority of ArkLATX veterans with cancer are willing to be vaccinated against COVID-19. The major reasons behind vaccine hesitancy seem to be information problems consisting of questions about safety, inadequate information, and seeing no reason for the vaccine. Such barriers can be potentially circumvented by providing the appropriate information and counseling.