scholarly journals Management of Chronic Kidney Disease in an Academic Primary Care Clinic

2002 ◽  
Vol 23 (1) ◽  
pp. 47-54 ◽  
Author(s):  
Ajay Israni ◽  
Cynthia Korzelius ◽  
Raymond Townsend ◽  
Douglas Mesler
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Academic Primary Care

scholarly journals Associated Factors of Chronic Kidney Disease among Hyponatraemic Elderly Patients Attending a Primary Care Clinic

2018 ◽  
Author(s):  
Chai Li Tay
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Elderly Patients ◽  
Associated Factors ◽  
Demographic Data ◽  
Primary Care Clinic ◽  
Loop Diuretics ◽  
Care Clinic ◽  
End Stage

Introduction: Chronic kidney disease (CKD) emerges to be an important geriatric health issue. It may progress to end stage renal failure and affect the quality of life. However, little is known about the associated factors of CKD. So this study aimed to determine the associated factors of CKD among hyponatraemic elderly. Methods: This is a retrospective study of hyponatraemic patients aged ≥ 60 years attending outpatient clinic in 2014. Blood test results of glucose, potassium, creatinine, medical history, blood pressure, medication and demographic  data were  captured from patient records. Each patient’s estimated glomerular filtration rate (eGFR) was calculated using the CKD-EPI Creatinine Equation. CKD is defined as eGFR of < 60 ml/min/1.73m2. SPSS 21 was used to do the analysis. Results: Totally 257 patients with mean age of 72.9 ± 7.3 years were enrolled in this study. Of them 73 (28.4 %) elderly had CKD. The mean eGFR was 72.62 ± 24.14 ml/min/1.73m2, mean BP was (135.75 ± 18/10) mmHg. Of the participants, 134 (52.1 %) were men, 151 (58.8 %) were diabetics, 247 (96.1 %) had hypertension. The independent associated factors of CKD were increasing age (OR 1.08; 95 % CI 1.03-1.13; p = 0.002), hyperglycaemia (OR 1.10; 95 % CI 1.02-1.18; p = 0.017) and the use of loop diuretics (OR 5.15; 95 % CI 1.52-17.38; p = 0.008). Conclusion: Hyperglycaemia and loop diuretics usage are found to be significantly associated with CKD among elderly patients attending a primary care clinic. Hence every effort should be made to optimise glucose control and cautious in the usage of loop diuretics to retard the decline in renal function.

scholarly journals A clinical audit of the diagnosis and management of chronic kidney disease in a primary care clinic

2021 ◽  
Vol 16 (3) ◽  
pp. 68-76
Author(s):  
Jazlan Jamaluddin ◽  
Mohamed Syarif Mohamed Yassin ◽  
Siti Nuradliah Jamil ◽  
Mohd Azzahi Mohamed Kamel ◽  
Mohamad Ya’akob Yusof
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Diabetic Kidney Disease ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Team Members ◽  
Diagnosis And Management ◽  
Dedicated Team ◽  
Level Monitoring

Introduction: This audit was performed to monitor the diagnosis and management of chronic kidney disease (CKD) according to the clinical practice guidelines (CPGs) of CKD 2018 in a primary care clinic. Methods: Patients who attended the clinic from April to June 2019 and fulfilled the diagnosis of CKD were included in this study, except for those diagnosed with a urinary tract infection, pregnant women and those on dialysis. These criteria were set based on the CPGs. The standards were set following discussions with the clinic team members with reference to local guidelines, the 2017 United Kingdom National CKD audit and other relevant studies. Results: A total of 384 medical records were included in this audit. Overall, 5 out of 20 criteria for processes and 3 of 8 clinical outcomes for CKD care did not meet the set standards. These included the following: documentation of CKD classification based on albumin category (43.8%); CKD advice (19.0%); dietitian referral (9.1%); nephrologist referral (45.5%); haemoglobin level monitoring (65.7%); overall blood pressure (BP) control (45.3%); BP readings for diabetic kidney disease (DKD) and non-DKD with > 1 g/day of proteinuria (≤ 130/80 mmHg, 37.0%); eGFR reduction of < 25% over the past year (77.2%). Identified problems included the absence of a CKD registry, eGFR and albuminuria reports, and a dedicated team, among other factors. Conclusions: Overall, 8 out of 28 criteria did not meet the standards of CKD care set for this audit. The problems identified in this audit have been addressed. Moreover, strategies have also been formulated to improve the diagnosis and management of CKD in this clinic.

Perspectives of Caregivers Experiencing Persistent Food Insecurity at an Academic Primary Care Clinic

2021 ◽  
Author(s):  
Ingrid L. Tablazon ◽  
Deepak Palakshappa ◽  
Faith C OBrian ◽  
Brenda Ramirez ◽  
Joseph A. Skelton ◽  
...  
Keyword(s):  
Primary Care ◽  
Food Insecurity ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Academic Primary Care

Assessing outcomes of educational videos in group visits for patients with chronic pain at an academic primary care clinic

2017 ◽  
Vol 129 (5) ◽  
pp. 524-530
Author(s):  
Carrie N. Vogler ◽  
Stacy Sattovia ◽  
Laura Y. Salazar ◽  
Tiffany I. Leung ◽  
Albert Botchway
Keyword(s):  
Primary Care ◽  
Chronic Pain ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Group Visits ◽  
Educational Videos ◽  
Academic Primary Care

Direct-to-Consumer Marketing of Osteoporosis Drugs and Bone Densitometry

2003 ◽  
Vol 37 (7-8) ◽  
pp. 976-981 ◽  
Author(s):  
Matthew F Hollon ◽  
Eric B Larson ◽  
Thomas D Koepsell ◽  
Ann E Downer
Keyword(s):  
Primary Care ◽  
Bone Densitometry ◽  
Pap Smear ◽  
Strong Association ◽  
Primary Care Clinic ◽  
Screening Tests ◽  
Care Clinic ◽  
Direct To Consumer ◽  
Academic Primary Care ◽  
Consumer Marketing

OBJECTIVE: To determine whether there is an association between a woman's exposure to direct-to-consumer (DTC) advertisements for 2 osteoporosis drugs and presentation for bone densitometry. METHODS: A matched case–control study was conducted between October and December 1998 at an academic primary care clinic in Seattle, WA. Seventeen women from the study population (aged ≥18 y, seen in the previous 2 y at the academic primary care clinic) presented for bone densitometry. All 51 women completed a self-administered questionnaire. RESULTS: Women familiar with 1 of 2 osteoporosis drugs due to exposure to advertisements had 9 times the odds of densitometry (unadjusted OR 9.3, 95% CI 1.0 to 86). Multivariate analysis, including confounders such as education level and whether a woman had previously had 3 screening tests (mammography, Pap smear, serum cholesterol), revealed a significant and strong association between exposure to advertisements and densitometry (adjusted OR 29, 95% CI 1.6 to 511). CONCLUSIONS: DTC marketing may increase health services utilization. Further independent evaluation of DTC marketing based on available observational evidence is feasible and warranted.

scholarly journals The Prevalence of Limited Health Literacy and Its Associated Factors among Elderly Patients Attending an Urban Academic Primary Care Clinic in Malaysia

2021 ◽  
Vol 18 (17) ◽  
pp. 9044
Author(s):  
Siti Nur Hidayah Abd-Rahim ◽  
Mohamed-Syarif Mohamed-Yassin ◽  
Suraya Abdul-Razak ◽  
Mohamad Rodi Isa ◽  
Noorhida Baharudin
Keyword(s):  
Primary Care ◽  
Health Literacy ◽  
Elderly Patients ◽  
Associated Factors ◽  
Medical Information ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
Limited Health Literacy ◽  
Academic Primary Care ◽  
Limited Health

Limited health literacy (HL) is linked to many negative health outcomes, including poor self-management of chronic diseases and medication adherence among patients. There are a lack of data regarding HL in the elderly population in Malaysia. This study aimed to determine the prevalence of limited HL levels and its associated factors among elderly patients in an urban academic primary care clinic in Selangor, Malaysia. A cross-sectional study was conducted among 413 elderly patients (≥60 years old) who attended this academic primary care clinic between January 2020 and January 2021. Sociodemographic data, clinical characteristics, and health literacy scores were collected. Descriptive statistics (median with interquartile ranges (IQR), frequency, and percentages) and multiple logistic regression were utilized. The prevalence of limited HL in our population was 19.1% (95% CI: 15.3, 23). The middle-old (70–79 years) and very-old (≥80 years) age groups were more likely to have limited HL (aOR 4.05; 95% CI: 2.19, 7.52 and aOR 4.36; 95% CI: 1.02, 18.63, respectively). Those with at least secondary school education (aOR 0.06; 95% CI: 0.02, 0.24) and those who found medical information via the internet/television (aOR 0.21; 95% CI: 0.05, 0.93) had lower odds of having limited HL. In conclusion, having limited HL levels was not common among elderly patients in this primary care clinic. Further studies involving rural and larger primary care clinics in Malaysia are required to support these findings.

scholarly journals Psychiatric Disease and Hypercholesterolemia in an Urban Academic Primary Care Clinic

2006 ◽  
Vol 08 (02) ◽  
pp. 77-81
Author(s):  
Rebekah A. Kaplowitz ◽  
Mark J. Fagan ◽  
Howard D. Sesso ◽  
J. Michael Gaziano
Keyword(s):  
Primary Care ◽  
Primary Care Clinic ◽  
Psychiatric Disease ◽  
Care Clinic ◽  
Academic Primary Care

scholarly journals Trends in food insecurity rates at an academic primary care clinic: a retrospective cohort study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kimberly Montez ◽  
Callie L. Brown ◽  
Arvin Garg ◽  
Scott D. Rhodes ◽  
Eunyoung Y. Song ◽  
...  
Keyword(s):  
Primary Care ◽  
African American ◽  
Cohort Study ◽  
Food Security ◽  
Retrospective Cohort Study ◽  
Retrospective Cohort ◽  
Primary Care Clinic ◽  
Care Clinic ◽  
American Black ◽  
Academic Primary Care

Abstract Background Healthcare organizations are increasingly screening and addressing food insecurity (FI); yet, limited data exists from clinic-based settings on how FI rates change over time. The objective of this study was to evaluate household FI trends over a two-year period at a clinic that implemented a FI screening and referral program. Methods In this retrospective cohort study, data were extracted for all visits at one academic primary care clinic for all children aged 0–18 years whose parents/guardians had been screened for FI at least once between February 1, 2018 to February 28, 2019 (Year 1) and screened at least once between March 1, 2019 to February 28, 2020 (Year 2). Bivariate analyses tested for differences in FI and demographics using chi-square tests. Mixed effects logistic regression was used to assess change in FI between Years 1 and 2 with random intercept for participants controlling for covariates. The interaction between year and all covariates was evaluated to determine differences in FI change by demographics. Results Of 6182 patients seen in Year 1, 3691 (59.7%) were seen at least once in Year 2 and included in this study. In Year 1, 19.6% of participants reported household FI, compared to 14.1% in Year 2. Of those with FI in Year 1, 40% had FI in Year 2. Of those with food security in Year 1, 92.3% continued with food security in Year 2. Compared to Hispanic/Latinx participants, African American/Black (OR: 3.53, 95% CI: 2.33, 5.34; p < 0.001) and White (OR: 1.88, 95% CI: 1.06, 3.36; p = 0.03) participants had higher odds of reporting FI. African American/Black participants had the largest decrease in FI between Years 1 and 2 (− 7.9, 95% CI: − 11.7, − 4.1%; p < 0.0001). Conclusions Because FI is transitional, particularly for racial/ethnic minorities, screening repeatedly can identify families situationally experiencing FI.

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