Primary Care Commons^™

Developing A Questionnaire And Data Analysis Process: Identification Of Practice And Provider Stigma Score In Order To Improve And Measure Training Efforts, Jessica Deemer, Angela Colistra Lpc, Phd, Ms

Research Scholars Poster Presentation

No abstract provided.

You Don’T Have To Get Diabetes, Mitch Kaminski, Md, Mba, Nevaneva White, Dnp, Crnp, Cdces

Department of Family & Community Medicine Presentations and Grand Rounds

The goal is to streamline the steps required to make referrals to and enroll in the National Diabeties Prevention Program (DPP).

Cancer Prevention And Therapeutics For The Primary Care Clinician, Richard C. Wender, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Outline

•Basics of cancer screening •Recommended options for colorectal cancer screening •Trends in incidence and mortality •The 80% in Every Community initiative

Misuse Of Prescription Stimulants And Their Effect On Cognition, Zachary Friederichs

Theses and Graduate Projects

Prescription stimulants like Adderall and Ritalin are increasingly being diverted and misused by college students who fail to recognize the potential health risks in an effort to improve academic performance. The main aim of this literature review is to address the prevalence of their misuse, the effects they have on cognition, and adverse side effects that are typically associated with their use. Despite being frequently referred to as "cognitive enhancers" or "smart pills," results from studies on these m􏰗edications remain mixed/unclear as to whether cognitive domains such as memory, executive function, and processing speed are actually enhanced. However, not surprisingly, …

Esrd And Endoavf: A Giant Leap Forward, Alison Tan, Md

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Defining And Characterizing Frequent Attenders: Systematic Literature Review And Recommendations, Dip Shukla, Erik Faber, Brian Sick

Journal of Patient-Centered Research and Reviews

Purpose: To decrease cost and improve efficiency, health care organizations have focused on frequent attenders — patients with high health care utilization. Prior studies have investigated singular health care settings, used varying definitions of frequent attendance, and inconsistently identified factors correlated with frequent attendance. The purpose of this article is to suggest a uniform definition of frequent attenders for different health care settings and to determine factors correlated with frequent attendance.

Methods: This systematic review of three databases identified 2761 unique articles; 174 met inclusion criteria. Studies were analyzed for their definition of frequent attenders and factors associated with frequent …

A 2-Hour Diabetes Self-Management Education Program For Patients With Low Socioeconomic Status Improves Short-Term Glycemic Control, Michael G. Jakoby Iv, Melissa Schleder, Vickie Luff, Cynthia Yergler, Albert Botchway, Cheryl Burns

Journal of Patient-Centered Research and Reviews

Diabetes self-management education (DSME) improves glycemic control, but patients with low socioeconomic status face institutional and personal barriers to receiving DSME. A retrospective single cohort study of a 2-hour group DSME program prioritizing accessibility and completion of a tightly focused curriculum was performed to determine if glycemic control improved and whether a longer, more comprehensive, prospective evaluation of the program is indicated. All patients who participated in the program from September 2017 to December 2018 were included in the analysis. The primary study endpoint was change in hemoglobin A1c (HbA1c) from baseline. A total of 58 out of 94 patients …

Solutions To Address Frequent Hospital Attendance, Glenda Sundberg

Journal of Patient-Centered Research and Reviews

In this editorial, practical solutions and considerations in helping the most complex and at-risk patients in our health systems are discussed. These patients, sometimes referred to as health care “super-utilizers” in the literature, tend to be frequently seen and cared for in costly hospital and emergency department settings. Innovative care models that aim to bridge system gaps, achieve better health outcomes, and improve the well-being of both patients and providers are needed and should continue to be explored.

Hiv Preexposure Prophylaxis And Treatment As Prevention — Beliefs And Access Barriers In Men Who Have Sex With Men (Msm) And Transgender Women: A Systematic Review, Joshua J. Matacotta, Francisco J. Rosales-Perez, Christian M. Carrillo

Journal of Patient-Centered Research and Reviews

Purpose: While the annual rate of new HIV infections and diagnoses has remained stable for most groups, troubling increases are seen in transgender women and racial/ethnic-minority men who have sex with men (MSM), groups that are disproportionately affected by HIV. The primary purpose of this systematic review is to examine factors that impact attitudes and beliefs about preexposure prophylaxis (PrEP) and treatment as prevention (TasP) and to explore barriers to PrEP uptake in MSM and transgender women.

Methods: Using MeSH terms and relevant keywords, we conducted a systematic review of studies published between 2010 and 2019. We searched 4 literature …

Comparison Of Non-Nsaid Pain Management In The Treatment Of Patients With Symptomatic Knee Osteoarthritis, Nicholas Schmitz

Theses and Graduate Projects

Objective To compare the efficacy of other modalities and interventions versus standard first-line therapy of nonsteroidal anti-inflammatory drugs for pain management in patients with symptomatic knee osteoarthritis

Methods Perform literature reviews outlining patients suffering from Grade II or higher KOA using the Kellgren-Lawrence classification system and currently experiencing symptoms of pain, stiffness, and impaired physical functioning. Use data and results from various studies to compare improvement of symptoms from these modalities versus improvement of NSAIDs alone.

Results Weight loss and physical activity should remain the mainstay of early osteoarthritis treatment to help slow disease progression and symptoms of KOA. Duloxetine …

Beyond The Waiver Training: Practical Tips You May Not Have Learned, Lara Weinstein, Md, Mph, Drph, Erica Li, Md

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

• Understand the critical importance of philosophy, structure, and access in MAT
• Share practical tips for starting MAT in your practice
• Discuss lessons learned with developing a MAT program

Journal Club: Emergency Department–Initiated Buprenorphine/Naloxone Treatment For Opioid Dependence, Simon Newsom

Department of Family & Community Medicine Presentations and Grand Rounds

Learning Objectives

• Briefly highlight OUD
• Current ED practices
• Review study
• Future directions

Preventive Care And Chronic Disease Management: Comparison Of Appalachian And Non-Appalachian Community Health Centers In The United States, Julie P. Marcinek, Alek Sripipatana, Sue C. Lin

Journal of Appalachian Health

Introduction: The Appalachian region is often characterized by poor health outcomes and economic depression. Health centers (HCs) are community-based and patient-directed organizations that deliver comprehensive, culturally competent, high-quality primary healthcare services in high need areas, including Appalachia, where economic, geographic, or cultural factors can hinder access to healthcare services.

Purpose: The study compares the clinical quality performance in preventive care and chronic disease management between Appalachian HCs and their non-Appalachian counterparts.

Methods: Using 2015 Uniform Data System (UDS) health center data, bivariate and multivariate linear regression analyses examine the association of Appalachian HC with performance on preventive and chronic care …

Management Of Neonatal Hyperbilirubinemia, David Schutzman

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Review Of Treatment Options For Pneumonia In The Inpatient Setting, Shirley B Bonanni

Department of Family & Community Medicine Presentations and Grand Rounds

No abstract provided.

Refugee Health In Philadelphia, Marc Altshuler

Department of Family & Community Medicine Presentations and Grand Rounds

Objectives

1. Define the U.S. refugee resettlement process
2. Discuss the history of refugee health in Philadelphia and the creation of the Jefferson Center for Refugee Health
3. Review selected data on our patients
4. Learn how to utilize new resources to care for refugees

Integrative Medicine In Health And Well-Being, Andrew Newberg, Madeline Becker

Department of Family & Community Medicine Presentations and Grand Rounds

For integrative approaches to become part of standard care, research is required to understand clinical effects. Clinical data needs to be supplemented by mechanistic studies. Integrative medicine and general medicine have multiple areas of intersection. Studies can evaluate mental and physical disorders such as depression or anxiety or chronic pain and fatigue. Studies can evaluate psychological symptoms associated with other medical and neurological disorders. It is important to establish efficacy and also mechanism. Future collaborations are very welcome!

Resident Ume Updates, Fred Markham, Marisyl Delacruz

Department of Family & Community Medicine Presentations and Grand Rounds

Agenda

1. Guidelines for Students in Clinical Spaces
2. Grading and feedback
3. RIME scheme
4. Telehealth, QI curriculum
5. Phase 3 Updates and JeffDOT
6. Q&A

The Other Epidemic, Bruce Deighton

HCA Healthcare Journal of Medicine

The epidemic level of opioid abuse in the U.S. population continues to present a major challenge to our society and to the medical profession. Medical education has a significant role in improving screening, diagnosis, appropriate treatment and management of opioid use disorder. Addressing the problem of overprescribing opioids through physician education, surveillance and opioid management has resulted in significant improvement, translating to fewer overdose deaths from prescription opioids. Graduate medical education can increase access to care by training more addiction medicine specialists, and training other physicians to prescribe buprenorphine and provide access to medically assisted care.

Evaluation Of Pharmacist- Or Nurse-Driven Long-Acting Insulin Titration Protocol In Adult Primary Care Patients With Type 2 Diabetes, Ruth Manzi, Corinn Martineau, Carmine Laporta, Mary Muca, Samantha Marrier, Donald Medd, Jennifer Aronson

Journal of Maine Medical Center

INTRODUCTION

Studies have supported protocolized insulin titration to optimize insulin therapy. We implemented a long acting insulin titration (LAIT) protocol in a primary care setting to aid patients achieve optimal control of their diabetes. The purpose of the study was to evaluate the performance of the LAIT protocol.

METHODS

This retrospective analysis included patients ≥18 years with type 2 diabetes (T2D) and a hemoglobin A1c (A1C) >8% who were managed as outpatients at clinics within our health care system. We collected demographic and clinical data before and after a patient’s enrollment in the LAIT protocol. Our primary outcome measure was …