J Am Board Fam Med
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The COVID-19 outbreak is a stark reminder of the ongoing challenge of emerging and reemerging disease, the human cost of pandemics and the need for robust research.1 For primary care, the advent of COVID-19 has forced an unprecedented wave of practice change. In turn, Practice-Based Research Networks (PBRNs) must rapidly pivot to address the changing environment and the critical challenges faced by primary care. The pandemic has also impacted the ability of PBRNs to deploy traditional research methods such as face-to-face patient and provider interactions, practice facilitation, and stakeholder engagement. ⋯ These skills will become more important than ever as primary care practices evolve in response to the current COVID-19 pandemic and the disparities in health outcomes highlighted by COVID-19 and the global Black Lives Matter social movement for justice. Throughout this issue, authors detail the work conducted by PBRNs that demonstrate many of these evolving concepts. Articles explore how PBRNs can evaluate COVID-19 in primary care, the role of PBRNs in quality improvement, stakeholder engagement, prevention and chronic care management, and patient safety in primary care.
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The American Academy of Family Physicians has 72,600 active members and a robust continuing medical education platform. A foundational principle of their work is an assumption of an intrinsic motivation of physicians to learn in order to better take care of their patients and communities. This commentary presents their vision of individualized learning portfolio in which individual family physicians utilize data to identify their gaps of knowledge and performance over time and use a varirty of CME, including performance improvement, to address and lessen those gaps, with the Academy serving as a navigator and facilitator, all while supporting intrinsic motivation to learn and improve.
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Quality Improvement has gone from practice by practice piecework to an industry driven by expertise that lies within corporate offices rather than within patient care. Using for her 20 years of experience leading and teaching quality improvement as a lens, the author makes the case for quality improvement teams to ensure a key role for clinicians and direct care staff who are closest to the patients and the improvements that need to be made.
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Cardiovascular disease is a leading cause of morbidity and mortality in the United States. Since their initial discovery, statins have become the first-line treatment for decreasing the risk of cardiovascular disease. Although they are typically well tolerated, side effects do occur and tend to affect the musculature. ⋯ This case report details the case of a 54-year-old woman who developed anti-HMGCR myopathy after several years of uncomplicated statin use. Differences between other reported cases and this 1 are discussed, including the patient's strong response to steroid therapy which resulted in the normalization of her serum creatinine kinase and alleviation of her muscle weakness. This case highlights the need for clinicians to be aware of anti-HMGCR myopathy and to consider it as a potential cause of proximal muscle weakness and persistent serum creatinine kinase elevations in patients exposed to statins even if they were previously well tolerated by the patient.
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To understand patient attitudes, access toward video calling to enhance efficiency of after-hours triage calls. ⋯ Patients seem to have access and interest in video communication for after-hours calls. Further studies are needed to evaluate whether addition of video component to after-hours triage calls will help reduce unnecessary emergency department visits.