Annals of family medicine
-
Context: Cancer is associated with many risk factors, including obesity. Specifically, abdominal obesity is linked to metabolic syndrome and is quantified by waist circumference (WC). Compared to WC, body mass index (BMI) is more accessible in the office to assess a patient's overall body fat composition. ⋯ We found that BMI and WC were significantly correlated in this cohort. Further follow-up is needed with a larger sample size and over a longer period. As body composition in this cohort has not been previously studied, further analyses may provide more biomarkers to aid in disease management.
-
Annals of family medicine · Jan 2023
Evaluation of Childhood Beverage Consumption and Perceptions of Water Safety.
Context: Children ages 1-3 should consume about 35oz of plain water per day. The CDC and AAP recommend that children under 12 months do not receive any juice and children over 12 months should receive no more than 4oz of 100% juice with no sugar-sweetened beverages (SSBs). SSB consumption is associated with overweight and obesity, as well as an increase of tooth decay. 22% of preschool children do not regularly drink plain water and 46% regularly drink SSBs. ⋯ Conclusions: Children drank more juice and SSBs and less water than recommended. Previous assessment suggests that families may be more open to beverage consumption changes that other lifestyle changes that prevent childhood obesity. Improved perceptions of tap water safety may be a possible mechanism to decrease juice and SSB and increase water consumption.
-
Annals of family medicine · Jan 2023
The Contribution of Pharmacogenetic Drug Interactions to 90-Day Hospital Readmissions in a Real-World Health System.
Context: Clinical Pharmacogenetics Implementation Consortium (CPIC) guidelines exist for many medications commonly prescribed prior to hospital discharge, yet there is limited data regarding the contribution of gene-x-drug interactions to hospital readmissions. Objective: The present study evaluated the relationship between prescription of CPIC medications prescribed within 30 days of hospital admission and 90-day hospital readmission from 2010-2020. Study Design and Analysis: Retrospective cohort study. ⋯ Univariate analyses indicated that the presence of at least one identified gene-x-drug interaction increased risk of 90-day readmission by more than 40% (OR=1.42, 95% confidence interval (CI) 1.09-1.84)(p=0.01). A multivariable model adjusting for age, race, sex, employment status, body mass index, and medical conditions, slightly attenuated the effect (OR=1.32, 95% CI 1.02-1.73)(p=0.04). Conclusions: Our results suggest that the presence of one or more CPIC gene-x-drug interactions increases the risk of 90-day hospital readmission, even after adjustment for demographic and clinical risk factors.
-
Annals of family medicine · Jan 2023
Considerations for Creating a Restricted Data Environment with Complete Primary Care Electronic Medical Record Data.
Background: Historically, primary care databases have been limited to subsets of the full electronic medical record (EMR) data to maintain privacy. With the progression of artificial intelligence (AI) techniques (i.e., machine learning, natural language processing, and deep learning), practice-based research networks (PBRNs) have an opportunity to utilize previously difficult to access data to conduct essential primary care research and quality improvement. However, to ensure patient privacy and data security, novel infrastructure and processes are required. ⋯ Five major elements were recurrent throughout the QFAMR development process: data and technology, privacy, legal documentation, decision-making frameworks, and ethics and consent. Conclusion: Overall, the development of the QFAMR has provided a secure platform to successfully access data-rich primary care EMR records without data ever leaving Queen's University. Although accessing complete primary care EMR records has certain technological, privacy, legal, and ethical considerations and challenges, QFAMR is a significant opportunity to conduct novel and innovative primary care research.
-
Annals of family medicine · Jan 2023
Trends in Pediatric Primary Care Visits During the COVID-19 Pandemic.
Context: The COVID-19 pandemic has impacted the volume and nature of pediatric primary care visits nationwide. Objective: This study aimed to identify trends in pediatric visits during COVID-19 at our institution to reveal challenges and opportunities to improve care. Study Design: Retrospective chart review of all pediatric visits from January 1, 2019 through September 30, 2021 using the electronic health record (EHR). ⋯ Video visit volume decreased from 2020-2021 in all age categories except for adolescents aged 12-<18, which remained stable at 43% of all visits. Conclusions: A sharp increase in behavioral health concerns among adolescents stands out as the most notable impact of COVID-19 on pediatric care at our institution. Our findings raise questions about how behavioral health care can be optimized for children and adolescents now and in the post-pandemic era.