Family Medicine Commons^™

Patient-Centered Home Cancer Screening Attitudes During Covid-19 Pandemic, Christelle El Khoury, Elizabeth Haro, Martha Alves, Marie Claire O'Dwyer, Kate Meixner, Laura Crespo Albiac, J Nicoll Capizzano, Manasi Ramakrishnan, Cullen Salada, Sherri Sheinfeld Gorin, Masahito Jimbo, Ananda Sen, Diane M. Harper

Journal of Patient-Centered Research and Reviews

The COVID-19 pandemic disrupted health care delivery of cancer screenings. The primary aim of our work was to evaluate the degree to which populations were accepting of home-based screenings for colorectal cancer (CRC) and cervical cancer (ie, primary human papillomavirus [HPV] testing). Three groups of adults having distinct health burdens that may affect acceptance of home-based cancer screening were identified through outpatient electronic medical records: those having survived a COVID-19 hospitalization; those having been positive for a non-COVID-19 respiratory illness; or those having type 2 diabetes. A total of 132 respondents (58% female) completed an online survey with hypothetical cases …

Limb Salvage Therapy In Septic Diabetic Foot Ulcer In Patients Unwilling To Undergo Amputation, Luke Hong

Clinical Research in Practice: The Journal of Team Hippocrates

A clinical decision report appraising

Shojaiefard A, Khorgami Z, Larijani B. Septic diabetic foot is not necessarily an indication for amputation. J Foot Ankle Surg. 2008;47(5):419-423. https://doi.org/10.1053/j.jfas.2008.05.005

for a patient with a septic diabetic foot.

Integrated Behavioral Health (Ibh) Program Updates And Evidence For Ibh In Sud, Rachelle Rene, Phd, Bcb, Hsmi

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

At the end of this presentation, the participant will be able to:

1. Describe core components of the Primary Care Behavioral Health Model
2. Identify IBH Program implementation highlights and challenges
3. Discuss at least one intervention to address SUD in primary care

Management Of Recurrent Bacterial Vaginosis, Barbara Cymring, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Review the importance of appropriate management of recurrent BV (rBV)
• Review the appropriate diagnosis of rBV
• Review the causes and risk factors for BV and rBV
• Review the current literature on treatment for rBV
• Discuss some preventative measures for decreasing risk of BV infection

Teratogenic Medication Usage In Primary Care Of Women Of Reproductive Age, Krys Foster, Md, Mph, Faafp

Department of Family & Community Medicine Presentations and Grand Rounds

Introduction

• Teratogenic medications are commonly prescribed to individuals with pregnancy potential
• Despite knowledge of potential teratogenic effects, data suggest that effective communication regarding the risks and benefits of medication use in the context of the patient’s fertility goals remains inadequate
• We will discuss recommendations for changes in education and healthcare delivery to facilitate thoughtful prescribing in this population

Learning Objectives

• To review a common scenario faced by primary care physicians caring for individuals at risk of pregnancy
• To recognize factors that might place certain patients at increased risk of teratogenic exposure in early pregnancy
• To gain competence in assessing fertility …

Osteoporosis, Susan Mockus Parks, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

Review importance of bone health

Define and identify osteopenia and osteoporosis

Learn treatment options for osteopenia

• How to counsel patients
• How to use FRAX calculator to assist with treatment decisions

Learn treatment options for osteoporosis

• Become familiar with treatment guidelines and options

Utilization Of Patient-Controlled Analgesia Reduces Length Of Stay Of Sickle Cell Crisis Hospitalizations, Brett M. Prestia, Talha Ramzan, Catherine Waldron, Ameer Malik, Robert M. Pallay, Candace R. Murbach, Mike Flynn, Eric Shaw Phd, Abdullah Kutlar, Daniel Lowe

HCA Healthcare Journal of Medicine

Background

Sickle cell crisis hospitalizations are emotionally and financially burdensome to patients and healthcare systems, and processes to decrease the frequency or length of stay of these crises should be examined.

Methods

This is a multicenter retrospective hospital record review of sickle cell crisis hospitalizations as defined by ICD-10 codes (D57.1-4), from January 2016 through December 2019, examining inpatient medication administration records and length of stay among admitted adults aged 18–65 years. Patient controlled analgesia orders using morphine, hydromorphone, fentanyl and/or merperidine at any point of an admission (n=188) were compared to admissions without any patient-controlled analgesia orders (n=2,159). The …

Use Of Ultrasound-Guided Platelet-Rich Plasma In The Treatment Of Carpometacarpal Osteoarthritis, Manuel Britto, Siraaj Dawood, Siyang Lu, Martin Canillas

HCA Healthcare Journal of Medicine

Introduction

Osteoarthritis (OA) is the most common form of arthritis and can severely affect function and quality of life. Platelet-rich plasma (PRP) is derived from a patient’s own blood and has potential as an adjunct to treat OA. However, research has been limited for small joints such as the carpometacarpal (CMC) joint.

Clinical Findings

A 65-year-old Caucasian male complained of bilateral wrist and neck pain after a motor vehicle accident. His initial exam noted swelling, tenderness and pain with movement at the bilateral thumb CMC joints and anatomic snuffboxes. However, there was no strength, range of motion or tactile deficits …

Management And Diagnosis Of Hypothyroidism, Catherine Guariglia, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Goals

• Recognize the different etiologies of hypothyroidism
• Identify signs and symptoms of hypothyroidism
• Feel comfortable diagnosing and treating primary hypothyroidism
• Define subclinical hypothyroidism and when/if it is necessary to treat
• Recognize how pregnancy influences hypothyroidism management
• Be able to counsel patients on treatment for hypothyroidism

Heart Failure Transitions Of Care Program, Samantha Macko, Pharmd

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Heart failure overview; statistics, risk factors, signs and symptoms
• List heart failure therapeutic treatment options
• Explain importance of continuation of care for heart failure patients after initial hospital discharge
• Discuss importance of multidisciplinary approach to treatment of heart failure (HF) patients
• Discuss components of heart failure transitions of care (HFTOC) program at Thomas Jefferson University Hospital

Adhd In Adolescents And Adults, Hannah Facey, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Understand the concept of neurodiversity
• Define ADHD
• Review the diagnostic criteria and challenges with diagnosis for ADHD in adults
• Explore our role as family medicine physicians in diagnosis and treatment
• Discover the prevalence of comorbid conditions associated with ADHD
• Obtain a general understanding of the categories of medical treatments available for adults with ADHD
• Gain a deeper appreciation for the role that biases play in the under- and misdiagnosis of women and BIPOC

Pharmaceutical Management Of Weight Loss, Jake Schutzman, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Briefly review some context & consequences of the US obesity epidemic
• Review available prescription anti-obesity medications
• Discuss details specific to each of these medications
• Review other medications affecting weight

After this lecture, I hope you will:

• Have a greater understanding of available anti-obesity medications
• Be more comfortable in patient discussions & management of obesity

Contraception For Pcps 2021, Krys Foster, Md, Mph, Faafp

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives:

• Review evidence-based, flexible and patient-centered approaches to contraceptive management in individuals with reproductive potential
• Discuss updates in contraceptive prescribing and management
• Highlight considerations for management of contraception in the time of COVID-19 and in special populations

Outline

• Introduction
• Approach to initiation of contraception
• Overview of methods of contraception
• Special Considerations
• Resources (Medical Eligibility and Special Practice Recommendations; Contraception App)
• Summary
• References

Copd Topic Discussion, Clarice Resso, Pharmd, Farzana Tarannum, Pharmd

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Physician Burnout Among West Virginia Primary Care Providers, Kevin S. Mccann, Adam Baus, Joanna Bailey, Laura Boone, Jennifer Boyd, Martha Cook-Carter, Dan Doyle

Marshall Journal of Medicine

Introduction

Work related burnout is highly prevalent in US physicians and linked to adverse effects on patients, providers and organizations. This study measures burnout in West Virginia (WV) primary care providers, allowing for comparison of results to a similar, recent study of US physicians.

Methods

Anonymous survey through email that included Maslach Burnout Inventory, demographic, workload, and practice characteristics. Responses were analyzed using JMP Pro 13. Analysis used JMP Pro 13 for descriptive statistics, chi-square and regression modeling.

Results

Subjects = 110, female/male ratio 1.4, all primary care physicians (PCP), or advanced practice registered nurses or physician assistants (APRN/PA). PCP …

Qualitative Research Methods, Erin Kelly, Md

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Global Initiative For Asthma (Gina): What’S New In Gina 2021?, Christopher Chambers, Md

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Loneliness In Primary Care Patients: Relationships With Body Mass Index And Health Care Utilization, Tamara K. Oser, Siddhartha Roy, Jessica Parascando, Rebecca Mullen, Julie Radico, Alexis Reedy-Cooper, Jennifer Moss

Journal of Patient-Centered Research and Reviews

Purpose: Rates of loneliness and obesity have increased in recent decades. Loneliness and obesity independently have been found to be risk factors for negative physical and mental health outcomes. This study examined the rates and interrelationships of loneliness, body mass index (BMI), and health care utilization in a primary care setting.

Methods: A cross-sectional survey of adult patients presenting for outpatient care at 7 family medicine clinical practices in Pennsylvania was conducted. Survey questions included self-reported measures of loneliness, height/weight, number of health care visits, and potential confounders (eg, sociodemographic variables, health status). Bivariate and multivariable linear regression models were …

Determining The Perception And Willingness Of Primary Care Providers To Prescribe Advanced Diabetes Technologies, Alexander O’Donovan, Sean M. Oser, Jessica Parascando, Arthur Berg, Donald E. Nease Jr., Tamara K. Oser

Journal of Patient-Centered Research and Reviews

Advanced diabetes technologies have produced increasingly favorable outcomes compared to older treatments. Disparities in practice resources have led to a treatment disparity by clinical setting, where endocrinologists typically prescribe far more such technologies than primary care providers (PCPs). Fully automated artificial pancreas systems (APS), which combine technologies to deliver and adjust insulin dosing continuously in response to automatic and continuous glucose monitoring, may be more straightforward for PCPs to prescribe and manage, therefore extending their benefit to more patients. We aimed to assess willingness of PCPs to prescribe advanced diabetes technologies through a cross-sectional survey of PCPs from 4 geographically …

Medical Nutrition Therapy For Diabetes, Cheryl Marco, Rd, Cde

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

What Children Learn About Death From Film, Elissa Miller, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Discuss popular films and how they affect what children know about death
• Discuss child development and development-related concepts of death and dying
• Discuss using films to help discuss death and dying with children

The Evolution Of Breast Imaging, Susanna M. Nazarian, Md, Phd, Facs

Department of Family & Community Medicine Presentations and Grand Rounds

Overview

• A brief overview of the evolution of breast imaging
• Screening and Detection versus Intraoperative Guidance
• Emerging technologies
• Local research opportunities

Increasing Staff Awareness And Screening Practices For Adverse Childhood Experiences At A Primary Care Clinic, Kayla Wright

Doctor of Nursing Practice Projects

Adverse childhood experiences (ACEs) are present in approximately 60% of the adult population in the United States. There is a correlation between adverse childhood experiences and chronic health conditions as adults. Despite the evidence showing this correlation, there is a lack of screening for ACEs in the primary care setting. Many primary care providers and staff are unaware of ACEs or the correlation with chronic health conditions and substance abuse and, therefore, do not understand how to or recognize the benefits of screening in primary care. With education for providers and staff, primary care is the ideal setting to perform …

Case-Based Audit And Feedback Around A Decision Aid Improved Antibiotic Choice And Duration For Uncomplicated Cystitis In Primary Care Clinics, Larissa Grigoryan, Roger Zoorob, George Germanos, Mohamad Sidani, Matthew Horsfield, Fareed Khan, Mohammad Zare, Melanie Goebel, Robert Atmar, Barbara Trautner

Faculty, Staff and Students Publications

OBJECTIVES: The objective of our study was to evaluate the impact of a multifaceted stewardship intervention on adherence to the evidence-based practice guidelines on treatment of uncomplicated cystitis in primary care. We hypothesised that our intervention would increase guideline adherence in terms of antibiotic choice and duration of treatment.

DESIGN: A preintervention and postintervention comparison with a contemporaneous control group was performed. During the first two study periods, we obtained baseline data and performed interviews exploring provider prescribing decisions for cystitis at both clinics. During the third period in the intervention clinic only, the intervention included a didactic lecture, a …

Amplified Pain Syndrome In Children, Catherine Soprano, Md, Katherine S. Salamon, Phd

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Describe chronic pain conditions
• Define chronic pain from biopsychosocial perspective
• Learn ways to describe treatment philosophy of pediatric chronic pain to families

Outpatient Anticoagulation Management, Anne Du Breuil, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Warfarin Management
• Anticoagulation Module in Epic
• Brief summary of Direct Oral Anticoagulants (DOACs)
• Brief Perioperative Anticoagulation Tips

Chronic Kidney Disease For The Pcp, Lilli Flink, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Define CKD
• Review screening guidelines for CKD
• Review staging of CKD
• Outline diagnostic approach
• Review primary care management
• Understand indications for referral to specialty care

Reflections Of An Earliest Established Screening And Testing Facility For Covid-19 In The Largest Metropolis, Pakistan, Fatima Kanwal, Karishma Kanhya Lal, Asra Qureshi

Department of Family Medicine

As the world struggles to deal with the COVID-19 pandemic, this article talks about the experience and findings of the first COVID-19 screening facility in a tertiary care hospital in Karachi, Pakistan. Department of Family Medicine at Aga Khan University (AKU) took initiative where COVID-19 screening of stable patients first began in a dedicated area. Since testing kits were limited and community spread had not started, nurses would screen every walk-in patient based on the presence of fever, cough, travel history and exposure to COVID-19 positive patient in the last 14 days, and advise swab testing if indicated. Out of …

Increasing Vaccination Rates In Pregnancy Using A Multifaceted Approach Including Patient Education And Reminder/Recall Interventions, Jas Tiara Mcgee

Evidence-Based Practice Project Reports

Given the global tragedy that this most recent pandemic has caused, more attention has been given to the devastating outcomes that the spread of infectious disease outbreaks can have. Similar to those with comorbid conditions, pregnant women are also extremely vulnerable to infectious diseases, as disease manifestation does not only affect the mother, but the fetus as well. Thus, the prevention of both the influenza virus and pertussis are two major goals when providing care for this population. Preventing both of these disease processes during the intrapartum period helps to ensure optimal wellness for both mother and baby and overall …

Mindset, Medicine And You, Gregory A. Jaffe, Md, Msed

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Describe the differences between a fixed and growth mindset
• State phrases that encourage growth mindset
• Apply growth mindset techniques to medical education