Visits to Primary Care Delivery Sites: United States, 2008

Hing, Esther; Uddin, Sayeedha F G

doi:10.1037/e665592010-001

Cited by 25 publications

(28 citation statements)

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“…14 More than 82% of adults had some type of encounter with a healthcare provider in 2012; in 2010, 55.5% of healthcare encounters were with primary care providers. 15 The primary care network may be the only source of care that many adults receive, and it provides the scale needed to disseminate treatments widely.…”

Section: Primary Care's Role In the Treatment Of Obesitymentioning

confidence: 99%

Obesity in the US: what is the best role for primary care?

Ard

2015

BMJ

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The increasing prevalence of obesity together with projected increases in diabetes over the next 20-30 years will put a substantial strain on the finances and resources of the US healthcare system. The best opportunity for broad scale treatment of obesity may lie in the primary care setting. This review assesses the evidence on the efficacy of treatment for obesity delivered in primary care in the United States. It summarizes an earlier systematic review, recent obesity treatment guidelines, and subsequent US based trials with a minimum follow-up of six months in which at least one member of a primary care team helped deliver comprehensive behavioral obesity treatment to adults with overweight or obesity. Overall, the evidence suggests that obesity treatment delivered in primary care has limited effectiveness. Questions remain about the optimal role of the primary care provider in the treatment of obesity and the prevention of weight gain, as well as potential systems approaches to the treatment of obesity.

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Section: Primary Care's Role In the Treatment Of Obesitymentioning

confidence: 99%

Obesity in the US: what is the best role for primary care?

Ard

2015

BMJ

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“…About 80% of primary care visits include a drug prescription [3,4] and, therefore, PGx testing may provide greater benefit in this setting than in other clinical settings. However, primary care providers may not have the knowledge and comfort level with PGx testing to routinely offer it to their patients [5,6].…”

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confidence: 99%

Primary Care Providers’ Use of Pharmacist Support for Delivery of Pharmacogenetic Testing

et al. 2017

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Aim. To investigate provider utilization of pharmacist support in the delivery of pharmacogenetic testing in a primary care setting. Methods. Two primary care clinics within Duke University Health System participated in the study between December 2012 and July 2013. One clinic was provided with an in-house pharmacist and the second clinic had an on-call pharmacist. Results: Providers in the in-house pharmacist arm consulted with the pharmacist for 13 of 15 cases, or about one of every four patients tested compared with one of every 7.5 patients in the on-call pharmacist arm. A total of 63 tests were ordered, 48 by providers in the pharmacist-in-house arm. Conclusion: These findings suggest that the availability of an in-house pharmacist increases the likelihood of pharmacogenetic test utilization.

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“…Despite declines in the number of small practices in the United States, and market forces driving consolidation, small practices continue to provide care for a major proportion of the population. 5,6 A recent survey of more than 10,000 family physicians found more than one-half worked in solo or very small practices (fewer than 5 clinicians). 7 Although an important source of primary care, these practice settings are underrepresented in the quality improvement and practice transformation literature.…”

Section: S22mentioning

confidence: 99%

Quality of Cardiovascular Disease Care in Small Urban Practices

et al. 2018

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PURPOSE We wanted to describe small, independent primary care practices' performance in meeting the Million Hearts ABCSs (aspirin use, blood pressure control, cholesterol management, and smoking screening and counseling), as well as on a composite measure that captured the extent to which multiple clinical targets are achieved for patients with a history of arteriosclerotic cardiovascular disease (ASCVD). We also explored relationships between practice characteristics and ABCS measures. METHODSWe conducted a cross-sectional, bivariate analysis using baseline data from 134 practices in New York City. ABCS data were extracted from practices' electronic health records and aggregated to the site level. Practice characteristics were obtained from surveys of clinicians and staff at each practice. RESULTSThe proportion of at-risk patients meeting clinical goals for each of the ABCS measures was 73.0% for aspirin use, 69.6% for blood pressure, 66.7% for cholesterol management, and 74.2% screened for smoking and counseled. For patients with a history of ASCVD, only 49% were meeting all ABC (aspirin use, blood pressure control, cholesterol management) targets (ie, composite measure). Solo practices were more likely to meet clinical guidelines for aspirin (risk ratio [RR ] = 1.17, P = .007) and composite (RR = 1.29, P = .011) than practices with multiple clinicians.CONCLUSION Achieving targets for ABCS measures varied considerably across practices; however, small practices were meeting or exceeding Million Hearts goals (ie, 70% or greater). Practices were less likely to meet consistently clinical targets that apply to patients with a history of ASCVD risk factors. Greater emphasis is needed on providing support for small practices to address the complexity of managing patients with multiple risk factors for primary and secondary ASCVD. INTRODUCTIONC ardiovascular disease remains the number 1 cause of death in the United States.1 One-half of the US adult population has 1 or more preventable risk factors for arteriosclerotic cardiovascular disease (ASCVD), but less than one-half are meeting all of their clinical goals. 2Increasing the adoption of effective clinical preventive services that reduce ASCVD mortality, including treating hypertension and hyperlipidemia, would result in large improvements in population health. 3HealthyHearts New York City, 1 of 7 research cooperatives funded through the EvidenceNOW initiative, is studying the effectiveness of external practice facilitation to increase capacity among small, independent primary care practices to implement innovations in health care aimed at increasing adoption of the Million Hearts ABCS (aspirin use, blood pressure control, cholesterol management, and smoking cessation) guidelines.1,4 These guidelines include aspirin when indicated, blood pressure control, cholesterol management through guideline-recommended use of lipid-lowering medications, and both screening for tobacco use and offering smokers cessation interventions or counseling. S22There is a strong ...

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Visits to Primary Care Delivery Sites: United States, 2008

Cited by 25 publications

References 0 publications

Obesity in the US: what is the best role for primary care?

Obesity in the US: what is the best role for primary care?

Primary Care Providers’ Use of Pharmacist Support for Delivery of Pharmacogenetic Testing

Quality of Cardiovascular Disease Care in Small Urban Practices

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