Annals of family medicine
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Annals of family medicine · Jul 2022
Designing and Implementing an Electronic Health Record-Embedded Card Study in Primary Care: Methods and Considerations.
Card studies-short surveys about the circumstances within which patients receive care-are traditionally completed on physical cards. We report on the development of an electronic health record (EHR)-embedded card study intended to decrease logistical challenges inherent to paper-based approaches, including distributing, tracking, and transferring the physical cards, as well as data entry and respondent prompts, while simultaneously decreasing the complexity for participants and facilitating rich analyses by linking to clinical and demographic data found in the EHR. ⋯ Once built, the EHR-embedded card study simplified survey implementation for both the research team and clinic staff, resulting in research-quality data, the ability to link survey responses to relevant EHR data, and a 79% response rate. This detailed accounting of the development and implementation process, including issues encountered and addressed, might guide others in conducting EHR-embedded card studies.
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Annals of family medicine · Jul 2022
Use of the Electronic Health Record During Clinical Encounters: An Experience Survey.
Use of the electronic health record (EHR) during face-to-face clinical encounters affects communication, and prior research has been inconclusive regarding its effect. This survey study assessed health care practitioner use of EHR-specific communication skills and patient and practitioner experiences and attitudes regarding EHR use during clinical encounters. ⋯ A discrepancy existed in this study between patient and practitioner experiences and attitudes about EHR use, which appeared to negatively affect the experience of health care practitioners but not patients. Organizations should adopt formal strategies to improve practitioner experiences with EHR use.
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As we have traversed the last 2 years of the COVID-19 pandemic juxtaposed against an increased awakening to the realities of racial inequities in society and health care, the grief of Black individuals and communities has largely been underrecognized. This reflective essay explores the grief experience of Blacks in the wake of continual losses and acknowledges the impact of racism in these losses. I speak from my experiences as a Black mother, survivor of sibling loss, and pediatric palliative care pediatrician to examine this complex issue and what the medical community can do to stand with Black patients and families in their grief experience.
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Annals of family medicine · Jul 2022
Observational StudyCOPD Population in US Primary Care: Data From the Optimum Patient Care DARTNet Research Database and the Advancing the Patient Experience in COPD Registry.
To describe demographic and clinical characteristics of chronic obstructive pulmonary disease patients managed in US primary care. ⋯ Our findings highlight the high exacerbation, symptom, and treatment burdens experienced by COPD patients managed in US primary care, and the need for more real-life effectiveness trials to support decision making at the primary care level.
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Annals of family medicine · Jul 2022
Strategies Associated With Reducing Benzodiazepine Prescribing to Older Adults: A Mixed Methods Study.
Unlike in many community-based settings, benzodiazepine (BZD) prescribing to older veterans has decreased. We sought to identify health care system strategies associated with greater facility-level reductions in BZD prescribing to older adults. ⋯ Initiatives to reduce BZD prescribing to older adults that are primarily limited to passive strategies, such as education and patient identification, might have limited success. Clinicians might benefit from additional recommendations, support, and incentives to modify prescribing practices.