Annals of Family Medicine

NOVEMBER 20, 2024

BACKGROUND: Despite the emphasis of primary care’s (PC) role in breast cancer follow-up improvements have had limited clinical impact. OBJECTIVE: To prioritize implementation strategies to support PC adoption of evidence to guide breast cancer follow-up care.

Primary Care 130

Primary Care Screening Education Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: In May 2023, Mayo Clinic implemented a revised screening tool to assess social determinants of health (SDOH) for its patients. Objective: To assess the impact of a question on need for assistance with social risk factors identified through routine screening. Study Design and Analysis: Descriptive analysis of secondary data.

Primary Care 130

Primary Care Referral Routine Screenings Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Chronic pain stands as a leading cause of disability globally, with patients often reporting inadequate access to primary care. Relevant primary care nursing activities for CP management remain poorly defined, limiting the full utilization of nurses' competencies and expertise in chronic disease management.

Primary Care 130

Primary Care Management Chronic Disease Management Finance 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: The rampant rise in the prevalence of diabetes presents a public health burden and a challenge to the primary care setting. Diabetes Self-management Coaching is an emergent, client-centered, solution-focused approach to enhancing self-efficacy and self-care behavior.

Primary Care 130

Primary Care Diabetes Individual Management 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Patient advocacy groups engage patients, families, and caregivers in navigating the cancer landscape, focusing on early detection/screening, as well as psychosocial and financial support during treatment. Outcome Measures Perceptions of primary care’s role in breast cancer survivorship care.

Primary Care 130

Primary Care Patients Finance Diagnosis 130

Annals of Family Medicine

NOVEMBER 20, 2024

Unfortunately, most individuals suffering from OUD do not have access to necessary care. While primary care (PC) settings have the potential to bridge this gap in care, many care teams lack the education and training required to effectively manage patients with OUD.

Primary Care 130

Primary Care Education Individual Screening 130

Annals of Family Medicine

NOVEMBER 20, 2024

The increased inbox burden has particularly impacted primary care physicians. Objective Our goal was to examine how message prioritization (as distinct from categorization) occurs in primary care, and to understand the approaches primary care clinicians deployed for managing their inbox workflows.

Primary Care 130

Primary Care Management Primary Care Physician Patients 130

Family Medicine Initiative

APRIL 29, 2025

In November 2024, two new RCTs were published that investigated whether atrial fibrillation screening using an ECG is effective. A limitation was that only 49% of those invited participated in the screening. UK National Screening Committee (2019): “Screening is not currently recommended for this condition.”

Screening 130

Screening DO Family Medicine Primary Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective: Evaluate the economic impact of receiving tele-legal services from Medicaid’s perspective with regard to a) fee- for service (FFS) total cost of care; b) FFS cost of primary care; c) utilization for FFS primary care; d) utilization for FFS and capitated behavioral health (BH) and BH emergency department encounters.

Primary Care 130

Primary Care Medical Behavioral Health Services Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: In 2012, the United States cervical cancer screening (CCS) guidelines changed to add co-testing (Papanicolaou [Pap] and human papillomavirus [HPV] test) to Pap-only. Setting or dataset: Electronic health record data from 25 primary care clinics in 3 FQHCs in Washington and Idaho PBRN from 2012-2017. were White, 16.0%

Screening 130

Screening Insurance Patient-Centered Primary Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Population Studied: 119,926 adult patients with one or more primary care visits during the 30-month study period. Results: Among 119,926 patients, 40% did not have SDOH assessed; 31% had 3 or more social needs identified during screening, 11% had 2, 7% had 1, and 11% had no social needs.

Primary Care 130

Primary Care Referral Electronics Individual 130

Annals of Family Medicine

NOVEMBER 20, 2024

The USPSTF recommends 1-time screening for AAA with ultrasonography in men aged 65 to 75 years who have ever smoked. (B Number of patients who meet inclusion criteria at Family Medicine Clinics: 6,551 Patients. Outcome Measures: Whether or not a screening study was ordered on the patient per guidelines. cm or larger.

Internal Medicine 130

Internal Medicine DO Family Medicine Screening 130

Annals of Family Medicine

NOVEMBER 20, 2024

Therefore, we have developed Proactive, a self-administered screening questionnaire that enables older people to independently monitor their risk of functional decline. Population studied: Individuals aged 65 years and older recruited in primary care clinics or senior residences. Objective: To validate Proactive.

Screening 130

Screening Primary Care Clinic Patient-Centered 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Primary care physicians and practice teams face well-documented challenges increasing colorectal cancer (CRC) screening rates among their patients. Multi-level interventions that address patients, clinicians, clinical care environments and larger systems (hospitals, networks, etc.)

Primary Care 130

Primary Care Screening Primary Care Physician Clinic 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting or Dataset: Interviews with 21 primary care clinicians in Colorado who treat patients with diabetes. Population Studied: Clinicians across a range of roles and geographic locations, represented 11 different primary care clinics located in both rural and urban areas of Colorado.

Mental Health 130

Mental Health Diabetes Relationship Primary Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Primary care delivery was significantly impacted by COVID-19, with rapid deployment of telehealth after the United States’ national public health emergency (PHE) declaration in March 2020. In the years following the PHE, rates of screening for tobacco use decreased, particularly during telehealth visits.

Primary Care 130

Primary Care Screening Telehealth Community 130

Annals of Family Medicine

NOVEMBER 20, 2024

SUD screening is not universally done in primary care (PC). In our institution, screenings are completed for patients ≥15 years during well visits; those not presenting for well visits and under 15 may represent missed opportunities. A score ≥2 constitutes a positive screen for possible substance misuse.

Primary Care 130

Primary Care Screening Referral Wellness Visit 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: News and scholarly reports have highlighted that primary care professionals, including physicians, nurses, social workers, and administrators, are leaving comprehensive family medicine practice because of COVID-19 circumstances that may have fostered moral distress.

Primary Care 130

Primary Care Healthcare Professional DO Family Medicine 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting or Dataset: We used data from Epic on social needs screening and Compass Rose utilization. Population Studied: Three sites, representing 13 urban and rural primary care practices in Minnesota, Wisconsin, and Florida participated in the Compass Rose pilot.

Referral 130

Referral Community Transportation Utilities 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context While poverty is a risk factor for many chronic conditions, when it is recognized by care providers social screening can be used to positively impact patients’ health. Joseph’s Primary Care Clinic in Saint John, NB, Canada in 2023. Nearly all missed screens were attributed to forgetfulness (94.4%).

Primary Care 130

Primary Care Screening Provider Clinic 130

Annals of Family Medicine

NOVEMBER 20, 2024

Implementing a better public active screening strategy is crucial. Point-of-care capillary HbA1c (POC-cHbA1c) holds promise as a solution, yet randomized trials assessing its effectiveness as a T2DM screening strategy are scarce, and none have been done in HK. It shows promise as an effective T2DM screening strategy.

Primary Care 130

Primary Care Screening Diabetes Consulting 130

Integrated Care News by CFHA

MAY 1, 2025

Within minutes he integrated the latest findings into practical recommendations for the family. Evidence‑informed care was literally at his fingertips. Reclaiming Time and Attention Primary care professionals may log more than eleven hours a day, over half of it in the electronic health record (Menchaca, 2025).

Patient-Centered 130

Patient-Centered Integrated Care Primary Care Healthcare Professional 130

Annals of Family Medicine

NOVEMBER 20, 2024

Delivering parental tobacco treatment during pediatric primary care visits may help to reduce the effects of these structural barriers, thereby increasing the likelihood of parental tobacco cessation and reducing children’s tobacco exposure in these populations. Setting: Primary care clinics in the Minneapolis-St.

Primary Care 130

Primary Care Screening Clinic Preventive Care 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Recognizing that health-related social needs drive health inequities, healthcare settings are increasingly beginning to screen and refer patients for social needs. Yet, many patients who screen positive for social needs decline to be referred to resources or do not have their needs resolved.

Primary Care 130

Primary Care Screening Patients Referral 130

Annals of Family Medicine

MAY 27, 2025

PURPOSE This study aimed to assess how agile implementation–driven iterative processes and tailored workflows can facilitate the implementation of a digital cognitive assessment (DCA) tool for patients aged 65 years or older into primary care practices. DCA screening was completed in 1,808 (10.8%) of 16,708 eligible visits.

Primary Care 130

Primary Care Screening Referral Clinic 130

Annals of Family Medicine

NOVEMBER 20, 2024

Integrated behavioral health (IBH) within primary care can help patients receive quality whole person care, however little is documented about the distribution and nature of time spent in key activities by integrated psychologists (i.e., Setting: Seven family medicine practices in one Colorado USA health system.

Primary Care 130

Primary Care Provider Illness Consulting 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Social determinants of health (SDOH) such as access to care and economic stability negatively impact colorectal cancer (CRC) screening rates. Results Among 159,491 adults age 50-75 eligible for CRC screening/surveillance, younger, male, non-white patients were less likely to be up to date on CRC testing.

Screening 130

Screening Primary Care Relationship Transportation 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context Acute pyelonephritis is a common diagnosis in the primary care and emergency settings. Outcome Measures The primary outcome measures were the proportion of clinical and microbiological cure at end of treatment. After screening, 31 full texts were reviewed, and 3 studies were included.

Primary Care 130

Primary Care Complication Diagnosis Electronics 130

Annals of Family Medicine

NOVEMBER 20, 2024

Setting or Dataset Participants were employed in 5 urban Colorado hospital-owned family medicine clinics. Population Studied Medical assistants working in primary care. Most MAs had experience with HE activities, most commonly attending presentations on health disparities and SDOH, and screening patients for social needs.

Primary Care 130

Primary Care Medical Management Screening 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Expansion of medication for opioid use disorder (MOUD) within primary care practices is often met with resistance. Population Studied: Licensed, actively practicing Internal Medicine and Family Medicine physicians and Non-physician practitioners in Kentucky.

Primary Care 130

Primary Care Education Patient-Centered Chronic Disease 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objectives Describe perspectives of clinicians and implementation leads on the role of primary care in ADRD early detection. Setting Primary care settings in the DAC-SP early detection program. Population Studied HCPs administering the DCA and BBM tools and team leads responsible for planning and implementation.

Primary Care 130

Primary Care Screening Healthcare Finance 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: The rise in social needs screening in primary care settings has led to questions about program design and implementation strategies. Multisector coordination is critical for effective screening and referral initiatives.

Primary Care 130

Primary Care Referral Screening Patient-Centered 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Screening for social needs has become increasingly expected in primary care settings, with multiple regulatory bodies and value-based care payors emphasizing the importance of incorporating screening into routine care.

Screening 130

Screening Primary Care Healthcare Patients 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Maternal depression appears to have negative effects on child development (cognitive, language, emotional) in part because of the impact of depressive symptoms on parenting practices and family life, particularly in early childhood. Study Design: Mixed-method (survey and focus group).

Family Medicine 130

Family Medicine DO Family Families 130

Annals of Family Medicine

NOVEMBER 20, 2024

Objective: To describe how primary care clinics have considered social needs in DM, and identify opportunities to support primary care clinics. family medicine, general internal medicine, endocrinology) affiliated with an academic medical center serving a diverse population in a mid-western metropolitan area.

Primary Care 130

Primary Care Diabetes Management Provider 130

Annals of Family Medicine

NOVEMBER 20, 2024

Context: Team-based models of care have become an integral part of the primary care system and is increasingly regarded as a key feature in achieving high-quality primary care by providing integrated, comprehensive, and continuous person-centred care.

Primary Care 130

Primary Care Electronics Individual Provider 130

Annals of Family Medicine

MAY 27, 2025

PURPOSE We assessed the feasibility and acceptability of implementing a digital cognitive assessment (DCA) for Alzheimer disease and related dementias (ADRD) screening into primary care. We also assessed the prevalence of positive screens and measured diagnostic and care outcomes after a positive DCA result.

Primary Care 130

Primary Care Diagnosis Screening Utilities 130