PARTICIPA

PARTICIPA

domingo, 21 de enero de 2018

Family physician access to specialist advice by telephone | The College of Family Physicians of Canada


Family physician access to specialist advice by telephone

Reduction in unnecessary specialist consultations and emergency department visits

Abstract

Problem addressed Timely access to specialist care is an important issue for patients with mild to moderate symptoms, and wait times for referrals are currently quite long.

Objective of program To provide FPs with quick telephone access to other specialists for treatment advice for patients with nonserious conditions that they would otherwise refer to specialist care.

Program description The RACE (Rapid Access to Consultative Expertise) program is a telephone hot-line providing FPs and nurse practitioners in the Vancouver, BC, area with timely access to specialist consultations. An evaluation of data from RACE found 60% of RACE calls prevented patients from visiting a specialist and 32% of calls prevented FP referrals to hospital emergency departments.

Conclusion Supported by RACE, FPs can more effectively remain the locus of patient care, calling on other specialist expertise when appropriate and providing better coordination of care for their patients. Evaluations to date suggest RACE helps reduce system costs by reducing unnecessary emergency department visits and face-to-face specialist consultations.

Timely access to specialist care is an important issue for patients, especially for those with mild to moderate symptoms. Results from the 2014 Commonwealth Fund report show 24% of older adults in British Columbia (BC) waited for at least 2 months to see specialists.1 In BC, a survey of physicians found the wait time from FP referral to psychiatric care for patients with mild mood disorders, such as anxiety or depression, was longer than 5 months.2 These wait times result in unnecessary delays in the delivery of patient care.

sábado, 20 de enero de 2018

Canadian physicians’ knowledge and counseling practices related to antibiotic use and antimicrobial resistance | The College of Family Physicians of Canada


Canadian physicians' knowledge and counseling practices related to antibiotic use and antimicrobial resistance

Two-cycle national survey

Abstract

Objective To establish a baseline for physicians' knowledge of and counseling practices on the use of antibiotics and antimicrobial resistance (AMR), and to determine potential changes in these measures after the implementation of a national AMR awareness campaign.

Design Cross-sectional design.

Participants A total of 1600 physicians.

Main outcome measures Physicians' knowledge of and counseling practices on antibiotic use and AMR at baseline and after implementation of the AMR awareness campaign.

Results A total of 336 physicians responded to the first-cycle survey (before the campaign), and 351 physicians responded to the second-cycle survey (after the campaign). Overall, physicians' knowledge of appropriate antibiotic use and AMR was high and their counseling practices in relation to antibiotics were appropriate in both surveys. Counseling levels about topics related to infection prevention and control (eg, food handling, household hygiene) were slightly lower. Counseling levels were also lower for certain antibiotic-use practices (eg, proper disposal of antibiotics). In addition, physicians with less than 10 years of practice experience had significantly lower odds of counseling their patients on topics related to preventing antibiotic resistance and infection prevention than those with 15 or more years of practice experience (adjusted odds ratio = 0.27, 95% CI 0.10 to 0.74). Significantly more physicians from the second-cycle survey counseled patients on the appropriate disposal of antibiotics (P = .03), as well as on some of the infection prevention topics (eg, using antibacterial hand soap [P = .02] and cleaning supplies [P = .01]). Most respondents in both surveys reported feeling confident with respect to counseling their patients on the appropriate use of antibiotics and AMR.

Conclusion Physicians' knowledge of and levels of counseling on the use of antibiotics and AMR were high and fairly stable in both survey results. This shows that Canadian physicians are demonstrating behaviour patterns of AMR stewardship. Existing gaps in counseling practices might be a result of physicians believing that pharmacists or nurses are addressing these issues with patients. Future national surveys conducted among pharmacists and nurses would contribute to the evidence base for AMR stewardship activities.

viernes, 12 de enero de 2018

5 ARTICULOS RELEVANTES (PEARLS)


5 ARTICULOS RELEVANTES (PEARLS)

1: Wallis KA, Andrews A, Henderson M. Swimming Against the Tide: Primary Care  Physicians' Views on Deprescribing in Everyday Practice. Ann Fam Med. 2017  Jul;15(4):341-346. doi: 10.1370/afm.2094. PubMed PMID: 28694270; PubMed Central  PMCID: PMC5505453.
http://www.annfammed.org/content/15/4/341.long

The Minimal Important Difference in Physical Activity in Patients with COPD

1: Demeyer H, Burtin C, Hornikx M, Camillo CA, Van Remoortel H, Langer D,  Janssens W, Troosters T. The Minimal Important Difference in Physical Activity in  Patients with COPD. PLoS One. 2016 Apr 28;11(4):e0154587. doi:  10.1371/journal.pone.0154587. eCollection 2016. PubMed PMID: 27124297; PubMed  Central PMCID: PMC4849755.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849755/
1: Leelakanok N, Holcombe AL, Lund BC, Gu X, Schweizer ML. Association between  polypharmacy and death: A systematic review and meta-analysis. J Am Pharm Assoc  (2003). 2017 Nov - Dec;57(6):729-738.e10. doi: 10.1016/j.japh.2017.06.002. Epub  2017 Aug 5. PubMed PMID: 28784299.
http://www.japha.org/article/S1544-3191(17)30714-8/fulltext
1: Hippisley-Cox J, Coupland C. Predicting risk of emergency admission to  hospital using primary care data: derivation and validation of QAdmissions score.  BMJ Open. 2013 Aug 19;3(8):e003482. doi: 10.1136/bmjopen-2013-003482. PubMed  PMID: 23959760; PubMed Central PMCID: PMC3753502.

 1: Barker I, Steventon A, Deeny SR. Association between continuity of care in

general practice and hospital admissions for ambulatory care sensitive  conditions: cross sectional study of routinely collected, person level data. BMJ.  2017 Feb 1;356:j84. doi: 10.1136/bmj.j84. PubMed PMID: 28148478.
http://www.bmj.com/content/356/bmj.j84.long

Antimicrobial Stewardship: A competency-based approach - | OpenWHO

Este curso sobre uso apropiado de antibióticos es online de la oms y gratis al parecer(free). Alguien se anima.
https://openwho.org/courses/AMR-competency


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Behavioral Interventions and Inappropriate Antibiotic Prescribing | Geriatrics | JAMA | The JAMA Network

https://jamanetwork.com/journals/jama/fullarticle/2488307


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viernes, 5 de enero de 2018

¿Cuál es el Orden de Llenado de Tubos en una analítica? - Chuletas Médicas

http://www.chuletasmedicas.com/orden-llenado-tubos-analitica/


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manuel sanchez molla compartió un enlace: TripleCare to provide telemedicine at Midwest SNFs | Health Data Management



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manuel sanchez molla compartió un enlace: Significado de los cambios en el cuello uterino: Guía para la salud de la mujer - National Cancer Institute



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manuel sanchez molla compartió un enlace: Targeted Pre-Op Care for Seniors May Boost Outcomes | Medpage Today



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