Do electronic health records used by primary care practices support recommended alcohol-related care?

Objective: The quality of alcohol-related prevention and treatment in US primary care is poor. The purpose of this study was to describe the extent to which Electronic Health Records (EHRs) used by 167 primary care practices across 7 states currently include the necessary prompts, clinical support, and performance reporting essential for improving alcohol-related prevention and treatment in primary care.

Materials And Methods: Experts from five regional quality improvement programs identified basic EHR features needed to support evidence-based alcohol-related prevention (ie, screening and brief intervention) and treatment of alcohol use disorders (AUD).

Improving screening, brief intervention and referral to treatment for unhealthy alcohol use in diverse, low-resourced primary care clinics.

Background: Implementation of screening brief intervention and referral to treatment (SBIRT) and medication-assisted treatment for alcohol use disorder (MAUD) remains low in primary care. ANTECEDENT (Partnerships to Enhance Alcohol Screening, Treatment, and Intervention) was a practice-facilitator led implementation study to increase SBIRT and MAUD use in diverse primary care clinics.

Methods: From November 2019 - April 2023, we conducted a convergent parallel mixed methods evaluation.

Test-retest reliability of a single isometric mid-thigh pull protocol to assess peak force and strength-endurance.

The purpose of this study was to examine the test-retest reliability of strength-endurance protocols using isometric mid-thigh pull (IMTP). Twenty-eight participants (23.2 ± 4.

Characterisation of the morphology of surface-assembled Au nanoclusters on amorphous carbon.

In this study, aberration-corrected scanning transmission electron microscopy is employed to investigate the morphology of Au clusters formed from the aggregation of single atoms sputtered onto an amorphous carbon surface. The morphologies of surface-assembled clusters of > 100 atoms are referenced against the morphologies of size-selected clusters determined from previously published results. We observe that surface-assembled clusters (at the conditions employed here) are approximately spherical in shape.

Shared decision-making approach to type 2 diabetes management.

Objective: To provide an online interactive decision aid to facilitate shared decision making in the context of medication choices for patients with type 2 diabetes mellitus (T2DM).

Sources Of Information: The best available clinical prediction model for patients with T2DM was selected based on a review of guidelines, DynaMed, and UpToDate and a search of PubMed. A list of pharmacotherapeutic options for T2DM was compiled based on a review of guidelines, narrative reviews, and expert opinion.

Direct Secure Messaging in Practice: Addressing Workflow Challenges.

Direct Secure Messaging (DSM) is a sender-initiated communication technology for exchanging patient-specific information among clinicians and disparate healthcare organizations. As DSM adoption increases it becomes more difficult for clinicians and staff to manage the volume and variety of external data received. This can lead to information hazards that can produce cognitive overload and decrease the ability of clinicians to process patient data when reviewing multiple sources.

Quality of antibiotic prescribing for pediatric community-acquired Pneumonia in outpatient care.

Background: Antibiotics remain the primary treatment for community acquired pneumonia (CAP), however rising rates of antimicrobial resistance may jeopardize their future efficacy. With higher rates of disease reported in the youngest populations, effective treatment courses for pediatric pneumonia are of paramount importance. This study is the first to examine the quality of pediatric antibiotic use by agent, dose and duration.

Lipid-lowering therapies for cardiovascular disease prevention and management in primary care: PEER umbrella systematic review of systematic reviews.

Objective: To assess the benefits and harms of lipid-lowering therapies used to prevent or manage cardiovascular disease including bile acid sequestrants (BAS), ezetimibe, fibrates, niacin, omega-3 supplements, proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors, and statins.

Data Sources: MEDLINE, the Cochrane Database of Systematic Reviews, and a grey literature search.

Study Selection: Systematic reviews of randomized controlled trials published between January 2017 and March 2022 looking at statins, ezetimibe, PCSK9 inhibitors, fibrates, BAS, niacin, and omega-3 supplements for preventing cardiovascular outcomes were selected.

PEER simplified lipid guideline 2023 update: Prevention and management of cardiovascular disease in primary care.

Objective: To update the 2015 clinical practice guideline and provide a simplified approach to lipid management in the prevention of cardiovascular disease (CVD) for primary care.

Methods: Following the Institute of Medicine's , a multidisciplinary, pan-Canadian guideline panel was formed. This panel was represented by primary care providers, free from conflicts of interest with industry, and included the patient perspective.

Horizon scanning: what next for bovine TB control in England?

England is currently in year nine of its 25-year strategy to achieve TB freedom. This talk will speculate on what new tools and approaches could be introduced in the future to help us achieve our goal.Using Defra's response to the independent review of its TB programme as a starting point and building on the plenary talk by the UK CVO, I will look at some opportunities that could arise under the different aspects of the response.

Tolerability of bedtime diuretics: a prospective cohort analysis.

Objectives: We sought to validate, or refute, the common belief that bedtime diuretics are poorly tolerated due to nocturia.

Design: Prespecified prospective cohort analysis embedded within the randomised BedMed trial, in which hypertensive participants are randomised to morning versus bedtime antihypertensive administration.

Setting: 352 community family practices across 4 Canadian provinces between March 2017 and September 2020.

Translation and cultural adaptation of MedStopper®-A web-based decision aid for deprescribing in older adults: A protocol.

Background: Older patients are more likely to have medication-related problems, which are associated with changes in pharmacokinetics and pharmacodynamics, multimorbidity, and polypharmacy. Polypharmacy and inappropriate prescribing are well-known risk factors which commonly cause adverse clinical outcomes in older people. Prescribers struggle to identify potentially inappropriate medications and to choose an adequate tapering approach.

Improving screening, treatment, and intervention for unhealthy alcohol use in primary care through clinic, practice-based research network, and health plan partnerships: Protocol of the ANTECEDENT study.

Background: Unhealthy alcohol use (UAU) is a leading cause of morbidity and mortality in the United States, contributing to 95,000 deaths annually. When offered in primary care, screening, brief intervention, referral to treatment (SBIRT), and medication-assisted treatment for alcohol use disorder (MAUD) can effectively address UAU. However, these interventions are not yet routine in primary care clinics.