What influences success in family medicine maternity care education programs? Qualitative exploration.

Objective: To ascertain how program leaders in family medicine characterize success in family medicine maternity care education and determine which factors influence the success of training programs.

Design: Qualitative research using semistructured telephone interviews.

Setting: Purposive sample of 6 family medicine programs from 5 Canadian provinces.

Older patient engagement in advance care planning in Canadian primary care practices: Results of a multisite survey.

Objective: To assess primary care patients' engagement in advance care planning (ACP) and predictors of engagement.

Design: Cross-sectional survey using a revised version of a validated questionnaire.

Setting: Alberta, Ontario, and British Columbia.

Deprescribing benzodiazepine receptor agonists: Evidence-based clinical practice guideline.

Objective: To develop an evidence-based guideline to help clinicians make decisions about when and how to safely taper and stop benzodiazepine receptor agonists (BZRAs); to focus on the highest level of evidence available and seek input from primary care professionals in the guideline development, review, and endorsement processes.

Methods: The overall team comprised 8 clinicians (1 family physician, 2 psychiatrists, 1 clinical psychologist, 1 clinical pharmacologist, 2 clinical pharmacists, and 1 geriatrician) and a methodologist; members disclosed conflicts of interest. For guideline development, a systematic process was used, including the GRADE (Grading of Recommendations Assessment, Development and Evaluation) approach.

Circles of care for people with intellectual and developmental disabilities: Communication, collaboration, and coordination.

Objective: To review health information exchange (HIE) processes that affect the health of people with intellectual and developmental disabilities (IDD) and to suggest practical tips and strategies for communicating, collaborating, and coordinating in the primary care setting.

Sources Of Information: The "Primary care of adults with intellectual and developmental disabilities. 2018 Canadian consensus guidelines" literature review and interdisciplinary input.

Improving transition to adulthood for adolescents with intellectual and developmental disabilities: Proactive developmental and systems perspective.

Objective: To demonstrate how family physicians can contribute to a piece of the journey of improving quality-of-life outcomes for people with intellectual and developmental disabilities (IDD) when they undergo the transition from adolescence to adulthood.

Sources Of Information: The "Primary care of adults with intellectual and developmental disabilities. 2018 Canadian consensus guidelines" literature review and interdisciplinary input.

HELP for behaviours that challenge in adults with intellectual and developmental disabilities.

Objective: To provide primary care physicians with an understanding of the causes of behaviours that challenge (BTC) in adults with intellectual and developmental disabilities (IDD), as presented in the 2018 Canadian consensus guidelines for primary care of adults with IDD; to offer a systematic approach to the assessment and treatment of such behaviours; and to link to tools to support these assessments.

Sources Of Information: This review elaborates upon guidelines 26 to 29 in the mental health section of the 2018 Canadian consensus guidelines. Several of the authors participated in the development of these guidelines, which were based on literature searches and interdisciplinary input.

Managing complexity in care of patients with intellectual and developmental disabilities: Natural fit for the family physician as an expert generalist.

Objective: To delineate the factors inherent in caring for patients with intellectual and developmental disabilities (IDD) that lead to complexity and to provide perspectives and techniques mapped to the phases of the clinical encounter.

Sources Of Information: The authors of the physical health section of the 2018 Canadian consensus guidelines on the primary care of adults with IDD consisted of family physicians, all of whom practise comprehensive family medicine with additional clinical experience in care of adults with IDD. These authors reviewed evidence on which their recommendations are based and these recommendations have undergone a rigorous peer review to ensure that they deserve special attention because they highlight what is different from what a family physician would consider to constitute "normal care" for the general population.

Barriers to and enablers of advance care planning with patients in primary care: Survey of health care providers.

Objective: To identify barriers to and enablers of advance care planning (ACP) perceived by physicians and other health professionals in primary care.

Design: Cross-sectional, self-administered survey.

Setting: Ontario, Alberta, and British Columbia.

Primary care of adults with intellectual and developmental disabilities: 2018 Canadian consensus guidelines.

Objective: To update the 2011 Canadian guidelines for primary care of adults with intellectual and developmental disabilities (IDD).

Methods: Family physicians and other health professionals experienced in the care of people with IDD reviewed and synthesized recent empirical, ecosystem, expert, and experiential knowledge. A system was developed to grade the strength of recommendations.

Diagnosis and treatment of pruritus.

Objective: To describe an approach that allows for a streamlined assessment and accurate differentiation of most patients with itch in primary care and to provide an update on the available nonpharmacologic, topical, and systemic therapies.

Sources Of Information: MEDLINE (Ovid) and PubMed were searched for the key words or Searches were refined for each cause and treatment by adding appropriate key words, and subsequent hand searches of the references of retrieved literature were performed.

Main Message: A good body of evidence from high-quality trials does not exist for treatment of pruritus, and the treatments that do exist are inconsistent in their success.

Time in therapeutic range: Warfarin anticoagulation for atrial fibrillation in a community-based practice.

Objective: To evaluate the effectiveness of an outpatient, nurse-administered warfarin anticoagulation protocol for the treatment of atrial fibrillation, and to identify clinical or biographical data that predict poor international normalized ratio control.

Design: Retrospective cohort study.

Setting: St Paul Family Health Network in Brantford, Ont.

Referral processes and wait times in primary care.

Objective: To evaluate the response times to requests for consultations from FPs and the wait times for patient appointments.

Design: Mailed invitation to participate in a survey about non-FP specialist consultation requests from April 28 to May 9, 2014.

Setting: Hamilton, Ont.

Developing family practice to respond to global health challenges: The Besrour Papers: a series on the state of family medicine in the world.

Objective: To assess family medicine's role in developing strong, coordinated, community-based, integrated health care systems in low-resource settings globally.

Composition Of The Committee: A subgroup of the Besrour Centre of the College of Family Physicians of Canada developed connections with selected international colleagues with expertise in international family medicine practice, health systems and capacity building, and teaching to map family medicine globally and give a bird's eye view of family medicine internationally.

Methods: Following a background literature review, the authors collectively reflected on their substantial international experience to attempt to describe best practices for various contexts.

Expanding the role of PAs in the treatment of severe and persistent mental illness.

Patients with severe and persistent mental illness often face limited access to psychiatric and primary care. This exploratory qualitative analysis studied the effect of introducing a PA into a comprehensive outpatient psychiatric team. Early results suggest this model improves the quality and access to primary and psychiatric care.