Annals of family medicine
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Annals of family medicine · Nov 2024
Predicting unplanned hospitalisations in older adults using routinely recorded general practice data.
Context: Unplanned hospitalisations represent a hazardous event for older persons. Timely identification of high-risk individuals using a prediction tool may facilitate preventive interventions. Objective: To develop and validate an easy-to-use prediction model for unplanned hospitalisations in community-dwelling older adults using readily available data to allow rapid bedside assessment by general practitioners. ⋯ Conclusions: Our models showed satisfactory predictive ability. Reducing the number of predictors and geographic validation did not impact predictive performance, demonstrating the robustness of the model. We developed an easy-to-use tool that may assist general practitioners in decision-making and targeted preventive interventions.
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Annals of family medicine · Nov 2024
Prehospital Clinical Decision-Making for Medication Administration for Behavioral Emergencies.
Introduction. Prehospital behavioral emergency protocols provide guidance on when a medication may be necessary; however, the final decision of which medication to administer to a patient is made independently by paramedics. This study sought to describe the clinical decision-making process of prehospital behavioral emergencies when paramedics consider chemical restraints, and determine the factors associated with choosing specific medications to administer. ⋯ Conclusion. This study suggests there are several factors, such as safety and the etiology of the behavioral emergency, that contributed to paramedics' decision-making. The results of this study could help Emergency Medical Services administrators in revising behavioral emergency protocols.
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Annals of family medicine · Nov 2024
Health-Related Social Needs Following Onset of the COVID-19 Pandemic in Oregon.
Efforts during the COVID-19 pandemic to address the health-related social needs (HRSN) of Medicare and Medicaid beneficiaries, such as food and housing, were insufficient. We examined HRSN data from the Accountable Health Communities study collected in Oregon to understand changes in these needs at the onset and during the first 2 years of the pandemic. ⋯ The jump in HRSN following the start of the pandemic and the persistence of need, particularly in food and housing, highlight the importance of research to better understand which public health and health care interventions, investments, and policies effectively address HRSN.
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Annals of family medicine · Nov 2024
Building Timely Consensus Among Diverse Stakeholders: An Adapted Nominal Group Technique.
Building timely consensus among diverse stakeholders is important in primary health care research. Consensus can be obtained using the nominal group technique which includes 5 steps: (1) introduction and explanation; (2) silent generation of ideas; (3) sharing ideas; (4) discussion; and (5) voting and ranking. The main challenges in using this technique are a lack of representation of different stakeholder opinions and the amount of time taken to reach consensus. In this paper, we demonstrate how to effectively achieve consensus using an adapted nominal group technique that mitigates the challenges. ⋯ This adapted nominal group technique is an effective and enriching method when timely consensus is needed among diverse stakeholders. Health care researchers in various fields can benefit from using this research methodology.
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Annals of family medicine · Nov 2024
Learning From Ervin's Care: Ethics, Health Care Finance, and Human Connection.
A 70-year-old man with complex multimorbidity and intellectual disability was my patient for the last 5 years of his life. He taught me important lessons about the challenges of practicing medicine as a primary care physician. ⋯ The gaps in his care revealed shortcomings of the US health care system, but his care in his final years also showed some of the bright spots in coordinated, team-based care. Most importantly, caring for this patient taught me about the rewards of the human connections that primary care physicians establish with their patients.