Family Medicine Commons^™

Diagnosis Does Not Stick Out Like A Sore Thumb, Crystal Duncombe, Eric Friedman

South Atlantic Division GME Research Day 2025

No abstract provided.

Pediatric Carotid Artery Dissection Following Blunt Cerebrovascular Injury, Eric Friedman, Iren Shabanova, Arpit Arora

South Atlantic Division GME Research Day 2025

No abstract provided.

A Case Of Polymethylmethacrylate Cement Pulmonary Emboli After Kyphoplasty, Denae Kappers, Jessica Odum, Chamonix Kinimaka

South Atlantic Division GME Research Day 2025

No abstract provided.

Salicylate Overdose Protocols For Family Medicine Physicians, Christine Tamayo, Denae Kappers, Patricia Gilford

South Atlantic Division GME Research Day 2025

No abstract provided.

Improving Usage Of Low-Dose Chest Ct For Lung Cancer Screening Amongst Tobacco Users That Fall Within Certain Criteria Per Uspstf Recommendations - A Quality Improvement Project, Karissa Charles, Evelyn Ogbomoh, Anthony Shadiack

South Atlantic Division GME Research Day 2025

No abstract provided.

Metformin-Associated Lactic Acidosis: A Case Report, Evelyn Ogbomoh, Karissa Charles, Devi Mahadeo, Sarah Puim

South Atlantic Division GME Research Day 2025

No abstract provided.

Starting The Conversation: Patient Perceptions Of Self-Assessed Type-2 Diabetes Risk., Bennett Collis, Huda Kutmah, Peyton Couch, Neelima J Kale, Karen L Roper

Ambulatory and Primary Care Articles

INTRODUCTION: Little is known about patients' perceptions of their risk for type-2 diabetes (T2D), or if knowledge of risk could facilitate weight and diabetes prevention discussions with health care professionals.

METHODS: In our academic family medicine practice, 25 patients completed a previsit T2D risk assessment on their phone and answered interview and survey questions to assess their understanding of their risk for developing T2D.

RESULTS: Interest in their T2D risk was high, but self-estimation of risk before obtaining their score was low (21/25 reported ≤30% chance of developing diabetes). All patients perceived T2D to be very serious, most remembered their …

Effects Of Interventions For The Prevention And Management Of Maternal Anemia In The Advent Of The Covid-19 Pandemic: Systematic Review And Meta-Analysis, John Kyalo Muthuka, Diana Kageni Mbari-Fondo, Francis Muchiri Wambura, Kelly Oluoch, Japheth Mativo Nzioki, Everlyn Musanga Nyamar, Rosemary Nabaweesi

Faculty Publications

Background:The COVID-19 pandemic presented many unknowns for pregnant women, with anemia potentially worsening pregnancy outcomes due to multiple factors.

Objective:This review aimed to determine the pooled effect of maternal anemia interventions and associated factors during the pandemic.

Methods:Eligible studies were observational and included reproductive-age women receiving anemia-related interventions during the COVID-19 pandemic. Exclusion criteria comprised non-English publications, reviews, editorials, case reports, studies with insufficient data, sample sizes below 50, and those lacking DOIs. A systematic search of PubMed, Scopus, Embase, Web of Science, and Google Scholar identified articles published between December 2019 and August 2022. Risk of bias was evaluated …

Reducing Appointment No-Shows In An Occupational Medicine Clinic: A Quality Improvement Project, Diana S. Torres, Cynthia D. Linkes

Nursing Faculty Publications

Abstract

Background: Appointment no-shows in occupational medicine delay recovery, disrupt workers’ compensation processes, and undermine employer trust. A South Texas clinic reported an average 11% no-show rate over 16 months—above the ≤8% benchmark—resulting in an estimated $379,406 in lost revenue. Contributing factors included inconsistent reminder practices, unverified contact information, and language barriers within a predominantly Spanish-speaking population.

Objective/Project Aim: This project aimed to reduce no-shows to ≤8% by implementing a structured, bilingual, multimodal reminder system that improved patient adherence and operational efficiency without increasing staff workload.

Methods: Guided by the “Getting To Outcomes” 10-Step framework, interventions included …

Second Generation Antipsychotics And Cardiovascular Adverse Effects: Developing Evidence-Based Recommendations For Primary Care Medicine, Sana Borda, Ahn-Dao Lee, Paul F. Bell

HCA Healthcare Journal of Medicine

Background

Second-generation antipsychotic medications (SGAs) are often used by primary care physicians (PCPs) to treat multiple psychiatric diagnoses. SGAs have been connected to a number of adverse effects, including cardiovascular disease. Currently, there are no published evidence-based recommendations addressing SGAs and cardiotoxicity that are directed toward PCPs. This project aims to fill this gap.

Methods

Relevant search terms related to SGAs and cardiovascular disease were identified and then used to search databases (PubMed, PubMed Central, and AccessMedicine). Research studies obtained from the searches were narrowed to include systematic reviews and meta-analyses. The Assessment of Multiple Systematic Reviews-2 (AMSTAR-2) tool was …

Pengaruh Durasi Pengobatan Dan Preferensi Pasien Kanker Stadium Akhir Terhadap Layanan Homecare Di Rumah Sakit Medistra Pada Tahun 2021-2023, Peter Brian Sutanto Putra Dr, Erfen Gustiawan Suwangto Dr, Tena Djuartina Dr, Iskandar Rahardjo Budianto Dr, C. Rinaldi A. Lesmana

Jurnal Penyakit Dalam Indonesia

Introduction. Cancer is still an enormous health problem in the world and rank second as the most common cause of mortality. End-stage cancer requires end-of-life or palliative care to improve the patient’s quality of life before death. Homecare services have become an option for providing palliative care to avoid long-term hospital stays. The study aimed to provide an overview of the treatment duration and other factors in end-stage cancer patients regarding the selection of homecare services at Medistra Hospital during the period of 2021-2023.

Methods. This study with a cross-sectional design analyzed medical records of end-stage cancer patients …

Partnerships To Improve Access To Healthcare For Refugees And Immigrants In Philadelphia, Jessica Deffler, Chelsea Salas-Tam, Jenna Gosnay, Marc Altshuler

Department of Family & Community Medicine Faculty Papers

The United States has welcomed refugees since World War II. Currently, the world is experiencing an unparalleled refugee crisis that calls for action by nations across the globe. There are over 82 million people who are forcibly displaced from their homes today (UNHCR Global Trends, Forced displacement in 2020. [cited 2021 Sep 28]. Available from: https://www.unhcr.org/flagship-reports/globaltrends/). Over the last decade, Philadelphia has become home to hundreds of refugees from countries in Southeast and Central Asia, Africa, the Middle East, as well as many others. For newly arrived refugees, finding stable housing, medical care, and employment is difficult due to cultural, …

The Revised Cdc Chronic Pain Guidelines And Payer Opioid Analgesic Policies In Michigan, Victoria Tutag Lehr, Cynthia L. Arfken

Michigan Journal of Public Health

Abstract

The 2016 publication of A Guideline for Prescribing Opioids for Chronic Pain by the Centers for Disease Control and Prevention motivated commercial and Medicaid payers to restrict their opioid prescribing policies including the imposition of hard limits on opioid daily dosages and duration. One result of these policies was an increase in abrupt opioid discontinuation and rapid tapering events for patients receiving long-term opioid therapy. Responding to this misapplication of the 2016 guideline, the 2022 revised guidelines emphasized individualized opioid therapy and exclusion of certain chronic diseases. However, it is not known if the payers changed their policies to …

Guidelines For Returning To Dance Following Concussion: Adaptations From Sport Concussion Literature, Sheyi Ojofeitimi, Lauren Mcintyre, Elizabeth Barchi, Sarah S. Rae, Brittney Winnitoy, Jeffrey A. Russell

Department of Family & Community Medicine Faculty Papers

Sport concussion receives substantial attention as a public health concern. Conversely, performing artists, including dancers, sustain concussions, but these aesthetic athletes do not receive the same level of consideration nor care for this injury as that offered to traditional athletes. The concussion literature pertaining to dance is sparse, and, to our knowledge, no recommendations exist for the crucial aspect of care related to returning to dance following a concussion. The purpose of this article is to assimilate the current knowledge about post-concussion return to activity management in sport—the closest analog of the physical demands required in dance—as a means to …

Addressing Alcohol Use Disorder In The Outpatient Indigenous Health Clinic Setting, Kylie M. Timmerman

Doctor of Nursing Practice (DNP) Projects

Background: Alcohol use disorder disproportionately impacts American Indian and Alaska Native (AIAN) populations at higher rates of disease morbidity and mortality. In the primary care setting, few treatment resources are available to patients outside of medication-only options.

Local Problem: While the intervention site (rural Tribal Federally Qualified Health Center [FQHC]) was known to have a well-established medication-assisted treatment (MAT) program for opiate use disorder (OUD), the was a need for alcohol use disorder (AUD) resources.

Methods: A review of current evidence was conducted to explore best practices for addressing AUD in the AIAN outpatient clinic setting.

Intervention(s): A quality improvement …

Virtual Primary Care In A Large Delaware-Based Independent Academic Medical Center: Impact And Opportunity, Darrell C. Dow, Sarah E. Schenck, Tracy L. Bell, Stephanie C. Roth, Omar Khan

Department of Family & Community Medicine Faculty Papers

COVID-19 and related challenges to patient access necessitated the development of new models of care to ensure a healthy patient population. This paper describes the outcomes of a pilot virtual primary care program at a large independent academic health center in Delaware. The preliminary results are encouraging from the perspective of provider and patient satisfaction, as well as the utility of the operational model. A complete cost-benefit analysis was beyond the scope of the paper; thus, future operational research should focus on the metrics of cost and quality as key indicators of model sustainability.

Perceived Patient-Centered Care In Marching Band Artists, A L. Merrill, Z K. Winkelmann, N A. Uriegas

Bakerman Student Research Awards

Objective: Approximately 27,000 college marching band (MB) artists in the United States could benefit from access to healthcare services and patient-centered clinicians. The purpose of this study was to explore HCPs MB artists have access to and their perceptions of patient-centered care (PCC). Methods: We used a cross-sectional web-based survey of MB artists (n=751, age=20±8 years). MB directors from 242 colleges were emailed a survey link to forward to MB artists. Participants indicated which HCPs they could access. Those who reported no access or unsure were prompted to describe what they would do if an injury or illness occurred. Participants …

Obstructive Sleep Apnea And Obesity: How Weight Loss Improves Sleep Apnea Severity And Quality Of Life - An Integrative Review, Hannah Wilson, Neda Akbarshahi

Master's Projects

Introduction: With the growing prevalence of OSA due to the obesity epidemic, there is an urgent need to update treatment regimens. While CPAP continues to be the gold standard of OSA care, challenges with adherence and limited access to effective weight management strategies often impede care. The complex bidirectional relationship between obesity and OSA highlights the importance of addressing weight management in this patient population to help mitigate cardiometabolic risks. Personalized weight loss therapies should be integrated into standard OSA treatment regimens to reduce OSA severity, reduce comorbid conditions, and improve quality of life.

Aim: The objective of this integrative …

Social Media As Health Educator: An Assessment Of The Understandability And Accuracy Of Tiktok Content About Contraception, Julianna Coleman, Maetal Haas-Kogan, Andrea Pelletier, Rachel Stoddard, Natasha Johnson, Julia Beatini, Nora Sun, Alex Keuroghlian, Deborah Bartz

Department of Family & Community Medicine Faculty Papers

BACKGROUND: Contraception knowledge and attitudes are largely formed from conversations within one's social network. More recently, this network has expanded to include social media. As the fastest growing social media platform, we aimed to assess popular contraception videos on TikTok for content understandability, actionability and accuracy.

METHODS: This is a secondary analysis of the most viewed, contraception-specific TikTok videos that were previously coded as containing educational messaging in a content-analysis study. We assessed videos for understandability (ability to explain a key message) and actionability (identify what they can do to act on that message) using the Patient Education Materials Assessment …

Best Practice Advice For Asthma Exacerbation Prevention And Management In Primary Care: An International Expert Consensus, Neil Skolnik, Barbara P. Yawn, Jaime Correia De Sousa, María Mar Martínez Vázquez, Amanda Barnard, Wendy L. Wright, Austin Ulrich, Tonya Winders, Stephen Brunton

Department of Family & Community Medicine Faculty Papers

Primary care clinicians play a key role in asthma and asthma exacerbation management worldwide because most patients with asthma are treated in primary care settings. The high burden of asthma exacerbations persists and important practice gaps remain, despite continual advances in asthma care. Lack of primary care-specific guidance, uncontrolled asthma, incomplete assessment of exacerbation and asthma control history, and reliance on systemic corticosteroids or short-acting beta2-agonist-only therapy are challenges clinicians face today with asthma care. Evidence supports the use of inhaled corticosteroids (ICS) + fast-acting bronchodilator treatments when used as needed in response to symptoms to improve asthma control and …