scholarly journals Creating an integrated care model for childhood obesity: a randomized pilot study utilizing telehealth in a community primary care setting

2016 ◽  
Vol 6 (6) ◽  
pp. 380-388 ◽  
Author(s):  
A. Fleischman ◽  
S. E. Hourigan ◽  
H. N. Lyon ◽  
M. G. Landry ◽  
J. Reynolds ◽  
...  
Keyword(s):  
Primary Care ◽  
Childhood Obesity ◽  
Pilot Study ◽  
Integrated Care ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Model

FRI0512 INTEGRATED CARE NETWORK AS A BUILDING STONE FOR SUSTAINABLE AND COMPREHENSIVE CARE FOR PATIENTS WITH ARTHRALGIA

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 855.1-855
Author(s):  
E. Van Delft ◽  
K. H. Han ◽  
J. Hazes ◽  
D. Lopes Barreto ◽  
A. Weel
Keyword(s):  
Primary Care ◽  
Usual Care ◽  
Integrated Care ◽  
Usual Care Group ◽  
Inflammatory Arthritis ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Group ◽  
Care Network ◽  
The Right

Background:Western countries experience an increasing demand for care, particularly for inflammatory arthritis (IA), while the healthcare budget decreases1. The innovative value-based primary care strategy2includes integrated care networks, where primary and secondary care bundle their expertise to improve patient value by providing the right care at the right place.General practitioners (GPs) have difficulties recognising IA, leading up to only 20% IA diagnoses of all newly referred arthralgia patients. However, since IA needs to be treated as early as possible to overcome progression, it is worthwhile to analyse whether integrated care networks have an impact on patient outcomes and cost-effectiveness. Triage by a rheumatologist in a primary care setting is one of the most promising integrated care networks for efficient referrals3.Objectives:To assess the effect of triage by a rheumatologist in a primary care setting in patients suspect for inflammatory arthritis.Methods:The present study follows a cluster randomized controlled trial design. The intervention, triage by a rheumatologist in a local primary care centre, will be compared to usual care. Usual care means that patients are referred to a rheumatology outpatient clinic based on the opinion of the general practitioner.The primary outcome is the frequency of IA diagnoses assessed by a rheumatologist. Patient reported outcome measures (PROMs (EQ-5D)) and costs (work productivity (iPCQ) and healthcare utilization (iMCQ)) were determined at baseline, after three, six and twelve months. The target was to include 267 patients for each study group (power level 0.8). Since this study is still ongoing we can only show first results on the efficiency of referrals.Results:In the period between February 2017 and December 2019 a total of 543 participants were included; 275 in the usual care group and 268 in the triage group. Mean age (51.3 ± 14.6 years) and percentage of men (23.6%) were comparable between groups (page=0.139; psex=0.330).The preliminary data show that the number of referred patients in the triage group is n=28 (10.5%) (Fig. 1). 32 patients (11.9%) were not referred directly but advice was given for additional diagnostics. Since all patients in the usual care group were referred there is a decrease of at least 77.6% in referrals when rheumatologists are participating in the integrated practice units.Preliminary data on diagnosis are available for all referred patients in the triage group and for n=137 (49.8%) in the usual care group at this point. In the triage group n=18 (64.2%) of referred patients were diagnosed with IA (6.7% of the total study population). In the usual care group this was n=52 (38.0%) of the patients yet diagnosed.Conclusion:These preliminary results of an integrated care network are promising. Approximately three-quarters of all patients can be withheld from expensive outpatient care. PROMs data and cost-effectiveness analysis will give clear answers in order to provide evidence whether this integrated care network can be implemented as a standard of care.References:[1] Rijksoverheid. (2018). Bestuurlijk akkoord medisch-specialistische zorg 2019 t/m 2022.https://www.rijksoverheid.nl/.[2] Porter ME, Pabo EA, Lee TH. (2013). Redesigning Primary Care: a strategic vision to improve value by organizing around patients’ needs. Health affairs, 32(3);516-525[3] Akbari A, et al. (2008). Interventions to improve outpatient referrals from primary care to secondary care. Cochrane Database Syst Rev, 4,CD005471.Disclosure of Interests:None declared

scholarly journals A Pilot Study on Using the Patient Health Questionnaire in the Primary Care Setting in Japan

2005 ◽  
Vol 6 (1) ◽  
pp. 9-16
Author(s):  
Kazuhiro Waza ◽  
Graham Antonnette ◽  
Zyzanski Stephen ◽  
Kazuo Inoue ◽  
Masato Sasaki ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Patient Health Questionnaire ◽  
Health Questionnaire ◽  
Patient Health

Crisis Intervention in Integrated Care

2017 ◽  
Author(s):  
Scott A. Simpson ◽  
Robert E. Feinstein
Keyword(s):  
Primary Care ◽  
Integrated Care ◽  
Crisis Intervention ◽  
Care Setting ◽  
Primary Care Setting ◽  
Care Environment ◽  
Intervention Treatment ◽  
Response To Stress ◽  
Life Stressor ◽  
Integrated Team

A crisis occurs when a life stressor overwhelms a person’s ability to cope with a problematic life situation. Crises often become evident in the primary care setting. People in crisis feel distressed and alone; they experience a psychological disorganization that affects their mood and functioning. Most patients can benefit from a brief crisis intervention treatment delivered in an integrated care environment. Behavioral health specialists can lead crisis intervention therapy with the support of the primary care provider, nurses, staff, and a consulting psychiatrist. Crisis intervention treatment includes identifying the life stressor, understanding the patient’s response to stress, assessing the patient’s social system, listing possible solutions to the crisis, and working to implement those solutions. As the crisis resolves, the integrated team provides anticipatory guidance for the patient and primary provider.

Efficacy of Using Physical Activity Mentors to Increase the Daily Steps of Older Adults in the Primary Care Setting: A Pilot Study

2014 ◽  
Vol 22 (1) ◽  
pp. 16-24 ◽  
Author(s):  
Karen A. Croteau ◽  
Vijiayurani Suresh ◽  
Elanna Farnham
Keyword(s):  
Physical Activity ◽  
Older Adults ◽  
Primary Care ◽  
Pilot Study ◽  
Repeated Measures ◽  
Care Setting ◽  
Primary Care Setting ◽  
Chronic Illnesses ◽  
Main Effects

The purpose of this pilot study was to determine if using physical activity (PA) mentors has any additional impact on daily steps of older adults participating in the Maine in Motion (MIM) program in the primary care setting. Participants were randomly assigned to a MIM-only group (n= 14) or a MIM+ mentor group (n= 14). The MIM intervention lasted 6 months with follow-up at 12 months. Average age of participants was 64 ± 8.8 years and most participants had multiple chronic illnesses. At baseline, mean body mass index (BMI) was 32.2 ± 5.1 and average daily steps were 4,236 ± 2,266. Repeated-measures ANOVA revealed significant main effects for steps,F(2.324, 59.104) = 4.168,p= .015, but no main effects for group,F(1, 25) = 2.988,p= .096, or time-by-group interaction,F(2.324, 59.104) = 0.905,p= .151. All participants significantly increased daily steps over the course of the intervention, with MIM+ participants maintaining increases at follow-up. No significant findings were found for BMI.

scholarly journals Patients’ Utilization and Perception of an Artificial Intelligence–Based Symptom Assessment and Advice Technology in a British Primary Care Waiting Room: Exploratory Pilot Study

10.2196/19713 ◽  
2020 ◽  
Vol 7 (3) ◽  
pp. e19713 ◽  
Author(s):  
Stephen Miller ◽  
Stephen Gilbert ◽  
Vishaal Virani ◽  
Paul Wicks
Keyword(s):  
Artificial Intelligence ◽  
Primary Care ◽  
Pilot Study ◽  
Health System ◽  
Care Setting ◽  
Primary Care Setting ◽  
Symptom Assessment ◽  
Medical Attention ◽  
Self Assessment ◽  
Care Clinic

Background When someone needs to know whether and when to seek medical attention, there are a range of options to consider. Each will have consequences for the individual (primarily considering trust, convenience, usefulness, and opportunity costs) and for the wider health system (affecting clinical throughput, cost, and system efficiency). Digital symptom assessment technologies that leverage artificial intelligence may help patients navigate to the right type of care with the correct degree of urgency. However, a recent review highlighted a gap in the literature on the real-world usability of these technologies. Objective We sought to explore the usability, acceptability, and utility of one such symptom assessment technology, Ada, in a primary care setting. Methods Patients with a new complaint attending a primary care clinic in South London were invited to use a custom version of the Ada symptom assessment mobile app. This exploratory pilot study was conducted between November 2017 and January 2018 in a practice with 20,000 registered patients. Participants were asked to complete an Ada self-assessment about their presenting complaint on a study smartphone, with assistance provided if required. Perceptions on the app and its utility were collected through a self-completed study questionnaire following completion of the Ada self-assessment. Results Over a 3-month period, 523 patients participated. Most were female (n=325, 62.1%), mean age 39.79 years (SD 17.7 years), with a larger proportion (413/506, 81.6%) of working-age individuals (aged 15-64) than the general population (66.0%). Participants rated Ada’s ease of use highly, with most (511/522, 97.8%) reporting it was very or quite easy. Most would use Ada again (443/503, 88.1%) and agreed they would recommend it to a friend or relative (444/520, 85.3%). We identified a number of age-related trends among respondents, with a directional trend for more young respondents to report Ada had provided helpful advice (50/54, 93%, 18-24-year olds reported helpful) than older respondents (19/32, 59%, adults aged 70+ reported helpful). We found no sex differences on any of the usability questions fielded. While most respondents reported that using the symptom checker would not have made a difference in their care-seeking behavior (425/494, 86.0%), a sizable minority (63/494, 12.8%) reported they would have used lower-intensity care such as self-care, pharmacy, or delaying their appointment. The proportion was higher for patients aged 18-24 (11/50, 22%) than aged 70+ (0/28, 0%). Conclusions In this exploratory pilot study, the digital symptom checker was rated as highly usable and acceptable by patients in a primary care setting. Further research is needed to confirm whether the app might appropriately direct patients to timely care, and understand how this might save resources for the health system. More work is also needed to ensure the benefits accrue equally to older age groups.

Implementation of the Primary Spine Care Model in a Multi-Clinician Primary Care Setting: An Observational Cohort Study

2020 ◽  
Vol 43 (7) ◽  
pp. 667-674
Author(s):  
James M. Whedon ◽  
Andrew W.J. Toler ◽  
Serena Bezdjian ◽  
Justin M. Goehl ◽  
Robb Russell ◽  
...  
Keyword(s):  
Primary Care ◽  
Cohort Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Observational Cohort Study ◽  
Care Model ◽  
Spine Care ◽  
Observational Cohort ◽  
Primary Spine

scholarly journals Pilot study of pharmacist-assisted delivery of pharmacogenetic testing in a primary care setting

2014 ◽  
Vol 15 (13) ◽  
pp. 1677-1686 ◽  
Author(s):  
Susanne B Haga ◽  
Nancy M Allen LaPointe ◽  
Alex Cho ◽  
Shelby D Reed ◽  
Rachel Mills ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Pharmacogenetic Testing ◽  
Assisted Delivery

Translating the REACH OUT dementia caregiver intervention into a primary care setting: a pilot study

2020 ◽  
pp. 1-10
Author(s):  
Asia Sikora Kessler ◽  
Gabrielle Mock ◽  
Diane Hendricks ◽  
Laura Robbins ◽  
Harpriya Kaur ◽  
...  
Keyword(s):  
Primary Care ◽  
Pilot Study ◽  
Care Setting ◽  
Primary Care Setting ◽  
Dementia Caregiver
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