Objective: To evaluate the impact of a registered nurse (RN)-led Medicare annual wellness visit (AWV) on preventive services in a family medicine clinic. Patients and Methods: A retrospective chart review was performed on patients who underwent an RN-led AWV and patients who underwent a standard assessment (SA) between October 2017 and October 2018. A total of 630 patients (330 AWV and 300 SA) were included in this study. Results: There were seven preventive services examined for in women and five preventive services examined for in men. Each service was used more often by patients in the AWV group than the SA group (all odds ratios ≥1.64; all P values ≤.004). Conclusion: The RN-led AWV is an effective way to assist Medicare beneficiaries in meeting their preventive needs while allowing physicians more time to focus on chronic and acute needs.
Primary hyperparathyroidism is the most common cause of hypercalcemia in the outpatient setting and is typically caused by a single benign parathyroid adenoma. Most patients with hyperparathyroidism are postmenopausal women. Patients can be asymptomatic or minimally symptomatic. Parathyroidectomy is the definitive cure for primary hyperparathyroidism, and no medical therapies have been approved by the Food and Drug Administration for this disorder. Guidelines for surgery have been established by a National Institutes of Health consensus panel, but many patients do not meet these guidelines or have comorbid conditions that prohibit surgery. This review describes alternative treatment options for patients who decide against or are unable to proceed with surgery.
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