Objective: Describe users' experience with participation in clinical decision-making at Family Health Centers (CESFAM) in the Primary Health Care (PHC) system.
Methods: Qualitative descriptive study. Focus groups made up of CESFAM users were held in southeastern Santiago, Chile, and the information was thematically analyzed using Atlas.ti version 6 software.
Results: Five focus groups were held (n = 41). The main themes that emerged from the discussions were the passive role of users in decisions and delegated decision-making, based on their trust in the health professional. Users' passive role limits their opportunities for participation in clinical decision-making, ceding power to the health professional. However, establishing a therapeutic partnership allows users to feel that they are being treated as unique individuals whom the professional listens to and respects, ensuring that the decisions of the health team can be trusted, since they look out for the users' real interests.
Conclusion: Users' participation in clinical encounters is still limited in Chile. However, bolstering that participation is essential for increasing user satisfaction and promoting people-centered care.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6385627 | PMC |
http://dx.doi.org/10.26633/RPSP.2018.133 | DOI Listing |
Int J Pharm Pract
January 2025
School of Pharmacy and Biomolecular Sciences, Liverpool John Moores University, Liverpool, United Kingdom.
Objectives: To explore the perspectives of stakeholders on the General Pharmaceutical Council's revised Standards for the Initial Education and Training of Pharmacists that enable pharmacists to prescribe at the point of registration, from 2026.
Methods: This qualitative study used the Theoretical Domains Framework (TDF) to develop schedules for structured interviews that were conducted with various stakeholders and recorded via Microsoft Teams. Recordings were transcribed verbatim, checked for accuracy, and then analysed using the Framework approach, facilitated by NVIVO® software.
JAMA Health Forum
January 2025
Division of General Internal Medicine, University of Pennsylvania, Philadelphia.
Importance: Dual-eligible older adults rely on Medicaid to pay for Medicare premiums and cost sharing in addition to supplemental services including dental and long-term care. However, the unique experiences of dual-eligible older adults with Medicaid unwinding remain unknown.
Objective: To assess the awareness and experiences of dual-eligible older adults with Medicaid redetermination.
JAMA Health Forum
January 2025
Department of Health Systems, Management, and Policy, University of Colorado Cancer Center, Aurora.
Importance: Medicare Advantage (MA) plans are designed to incentivize the use of less expensive drugs through capitated payments, formulary control, and preauthorizations for certain drugs. These conditions may reduce spending on high-cost therapies for conditions such as cancer, a condition that is among the most expensive to treat.
Objective: To determine whether patients insured by MA plans receive less high-cost drugs than those insured by traditional Medicare (TM).
JAMA Netw Open
January 2025
Department of Ophthalmology, Johns Hopkins University School of Medicine, Baltimore, Maryland.
Importance: Determining spectacle-corrected visual acuity (VA) is essential when managing many ophthalmic diseases. If artificial intelligence (AI) evaluations of macular images estimated this VA from a fundus image, AI might provide spectacle-corrected VA without technician costs, reduce visit time, or facilitate home monitoring of VA from fundus images obtained outside of the clinic.
Objective: To estimate spectacle-corrected VA measured on a standard eye chart among patients with diabetic macular edema (DME) in clinical practice settings using previously validated AI algorithms evaluating best-corrected VA from fundus photographs in eyes with DME.
JAMA Netw Open
January 2025
University Centre for Rural Health, School of Health Sciences, University of Sydney, Lismore, New South Wales, Australia.
Importance: An unhealthy lifestyle is believed to increase the development and persistence of low back pain, but there is uncertainty about whether integrating support for lifestyle risks in low back pain management improves patients' outcomes.
Objective: To assess the effectiveness of the Healthy Lifestyle Program (HeLP) compared with guideline-based care for low back pain disability.
Design, Setting, And Participants: This superiority, assessor-blinded randomized clinical trial was conducted in Australia from September 8, 2017, to December 30, 2020, among 346 participants who had activity-limiting chronic low back pain and at least 1 lifestyle risk (overweight, poor diet, physical inactivity, and/or smoking), referred from hospital, general practice, and community settings.
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