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Authors:
Dickinson, J. A; Guichon, J, Wadey, W, Da Silva, K. Pages: e98 - e102 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905e98 Issue No:Vol. 69, No. 5 (2023)
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Perry, D; Moe, S. S, Thomas, B, Lindblad, A. J, Kirkwood, J, Falk, J, Potter, J, Paige, A, Allan, G. M. Pages: e103 - e107 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905e103 Issue No:Vol. 69, No. 5 (2023)
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Falk, J; Paige, A, Dugre, N, Allan, G. M. Pages: e108 - e109 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905e108 Issue No:Vol. 69, No. 5 (2023)
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Kiran, T; Rozmovits, L, OBrien, P. Pages: e113 - e119 Abstract: ObjectiveTo explore the experiences of family physicians leading quality improvement (QI) efforts and to better understand facilitators and barriers related to advancing QI in family practice.DesignQualitative descriptive study.SettingThe Department of Family and Community Medicine at the University of Toronto in Ontario. The department launched a quality and innovation program in 2011 with the dual goals of teaching QI skills to learners and supporting faculty in leading QI efforts in practice.ParticipantsFamily physician faculty who held QI leadership roles at any of the department’s 14 teaching units between 2011 and 2018.MethodsFifteen semistructured telephone interviews were conducted over 3 months in 2018. Analysis was informed by a qualitative descriptive approach. Consistency of responses across the interviews was suggestive of thematic saturation.Main findingsSubstantial variation was found in the level of engagement with QI in practice settings despite the common training, forms of support, and curriculum the department provided. Four factors influenced the uptake of QI. First, committed leadership across the organization was fundamental to developing an effective QI culture. Second, external drivers such as mandatory QI plans sometimes motivated engagement in QI but sometimes were barriers, particularly when internal priorities conflicted with external demands. Third, at many practices, QI was widely perceived as extra work rather than as a way to enable better patient care. Finally, physicians described lack of time and resources as a challenge, particularly in community practices, and advocated for practice facilitation as a mechanism to support QI efforts.ConclusionAdvancing QI in primary care practice will require committed leaders, a clear understanding among physicians of the potential benefits of QI, alignment of external demands with internal drivers for improvement, and dedicated time for QI work along with support such as practice facilitation. PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905e113 Issue No:Vol. 69, No. 5 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:Murray A. M. Pages: 308 - 309 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905308_1 Issue No:Vol. 69, No. 5 (2023)
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Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:
Loh, L. C; Fowler, N. Pages: 309 - 310 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905309_1 Issue No:Vol. 69, No. 5 (2023)
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Authors:
Hin; A. N. C. Pages: 311 - 313 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905311 Issue No:Vol. 69, No. 5 (2023)
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Dickinson, J. A; Guichon, J, Wadey, W, Da Silva, K. Pages: 314 - 318 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905314 Issue No:Vol. 69, No. 5 (2023)
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Hin; A. N. C. Pages: 319 - 323 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905319 Issue No:Vol. 69, No. 5 (2023)
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Perry, D; Moe, S. S, Thomas, B, Lindblad, A. J, Kirkwood, J, Falk, J, Potter, J, Paige, A, Allan, G. M. Pages: 325 - 329 Abstract: ObjectiveTo summarize 10 high-quality medical articles published in 2022 that are relevant to primary care physicians.Selecting the evidenceRoutine surveillance of tables of contents in relevant medical journals and EvidenceAlerts was conducted by the PEER (Patients, Experience, Evidence, Research) team, a group of primary care health care professionals with an interest in evidence-based medicine. Articles were selected and ranked based on relevance to practice.Main messagePublished articles from 2022 most likely to influence primary care practice examined the following subjects: reducing dietary sodium for heart failure; timing of blood pressure medications to reduce cardiovascular outcomes; adding as-needed corticosteroids to rescue puffers for asthma exacerbations; influenza vaccination after myocardial infarction; comparing various medications for diabetes management; tirzepatide for weight loss; low FODMAP diet for irritable bowel syndrome; prune juice for constipation; impact of regular acetaminophen use on patients with hypertension; and time required to care for patients in primary care. Two "honourable mention" studies are also summarized.ConclusionResearch published in 2022 yielded several high-quality articles on various conditions relevant to primary care, including hypertension, heart failure, asthma, and diabetes. PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905325 Issue No:Vol. 69, No. 5 (2023)
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Arya, N; Geurguis, M, Vereecken-Smith, C, Ponka, D. Pages: 330 - 336 Abstract: ObjectiveTo develop an interactive, living map of family medicine training and practice; and to appreciate the role of family medicine within, and its effect on, health systems across the world.Composition of the committeeA subgroup of the College of Family Physicians of Canada’s Besrour Centre for Global Family Medicine developed connections with selected international colleagues with expertise in international family medicine practice and teaching, health systems, and capacity building to map family medicine globally. In 2022, this group received support from the Foundation for Advancing Family Medicine’s Trailblazers initiative to advance this work.MethodsIn 2018 groups of Wilfrid Laurier University (Waterloo, Ont) students conducted broad searches of relevant articles about family medicine in different regions and countries around the world; they conducted focused interviews and then synthesized and verified information, developing a database of family medicine training and practice around the world. Outcome measures were age of family medicine training programs and duration and type of family medicine postgraduate training.ReportTo approach the question of how delivery of the family medicine model of primary care can affect health system performance, relevant data on family medicine were collated—the presence, nature, duration, and type of training and role within health care systems. The website https://www.globalfamilymedicine.org now has up-to-date country-level data on family medicine practice around the world. This publicly available information will allow such data to be correlated together with health system outputs and outcomes and will be updated as necessary through a wiki-type process. While Canada and the United States only have residency training, countries such as India have master’s or fellowship programs, in part accounting for the complexity of the discipline. The maps also identify where family medicine training does not yet exist.ConclusionMapping family medicine around the world will allow researchers, policy makers, and health care workers to have an accurate picture of family medicine and its impact using relevant, up-to-date information. The group’s next aim is to develop data on parameters by which performance in various domains can be measured across settings and to display these in an accessible form. PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905330 Issue No:Vol. 69, No. 5 (2023)
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Authors:
Falk, J; Paige, A, Dugre, N, Allan, G. M. Pages: 337 - 337 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905337 Issue No:Vol. 69, No. 5 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
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Freeman, T. R; Stewart, M, Leger, D, Jordan, J, Copeland, J, Hons, I, Thind, A, Ryan, B. Pages: 341 - 351 Abstract: ObjectiveTo examine the frequency, natural history, and outcomes of 3 subtypes of abdominal pain (general abdominal pain, epigastric pain, localized abdominal pain) among patients visiting Canadian family practices.DesignRetrospective cohort study with a 4-year longitudinal analysis.SettingSouthwestern Ontario.ParticipantsA total of 1790 eligible patients with International Classification of Primary Care codes for abdominal pain from 18 family physicians in 8 group practices.Main outcome measuresThe symptom pathways, the length of an episode, and the number of visits.ResultsAbdominal pain accounted for 2.4% of the 15,149 patient visits and involved 14.0% of the 1790 eligible patients. The frequencies of each of the 3 subtypes were as follows: localized abdominal pain, 89 patients, 1.0% of visits, and 5.0% of patients; general abdominal pain, 79 patients, 0.8% of visits, and 4.4% of patients; and epigastric pain, 65 patients, 0.7% of visits, and 3.6% of patients. Those with epigastric pain received more medications, and patients with localized abdominal pain underwent more investigations. Three longitudinal outcome pathways were identified. Pathway 1, in which the symptom remains at the end of the visit with no diagnosis, was the most common among patients with all subtypes of abdominal symptoms at 52.8%, 54.4%, and 50.8% for localized, general, and epigastric pain, respectively, and the symptom episodes were relatively short. Less than 15% of patients followed pathway 2, in which a diagnosis is made and the symptom persists, and yet the episodes were long with 8.75 to 16.80 months’ mean duration and 2.70 to 4.00 mean number of visits. Pathway 3, in which a diagnosis is made and there are no further visits for that symptom, occurred approximately one-third of the time, with about 1 visit over about 2 months. Prior chronic conditions were common across all 3 subtypes of abdominal pain ranging from 72.2% to 80.0%. Psychological symptoms consistently occurred at a rate of approximately one-third.ConclusionThe 3 subtypes of abdominal pain differed in clinically important ways. The most frequent pathway was that the symptom remained with no diagnosis, suggesting a need for clinical approaches and education programs for care of symptoms themselves, not merely in the service of coming to a diagnosis. The importance of prior chronic conditions and psychological conditions was highlighted by the results. PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905341 Issue No:Vol. 69, No. 5 (2023)
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Please help us test our new pre-print finding feature by giving the pre-print link a rating. A 5 star rating indicates the linked pre-print has the exact same content as the published article.
Authors:Loh L. C. Pages: 369 - 369 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905369 Issue No:Vol. 69, No. 5 (2023)
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Authors:Loh L. C. Pages: 370 - 370 PubDate: 2023-05-12T05:22:03-07:00 DOI: 10.46747/cfp.6905370 Issue No:Vol. 69, No. 5 (2023)
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