Innovation: Long COVID Shared Medical Appointments: Lifestyle and Mind-Body Medicine with Peer SupportM
Yufang Lin, Robert Saper, Sonal J. Patil
Long COVID is a new rising health concern with no clear treatment guidelines. Patients have multiple distressing symptoms which are difficult to address in time-restricted clinic visits. Early evidence indicates a role of cytokines and chronic inflammatory processes in developing long COVID. Healthy lifestyle behaviors and modifying stress responses reduce chronic systemic inflammation. We created a novel shared medical appointment (SMA) program to provide healthy lifestyle education, mindfulness training, and group peer support for patients with long COVID symptoms. 20 Jan, 2022. Non-refereed, under review. Permanent URL: https://hdl.handle.net/2027.42/171444
Special Report: COVID-19 Enhanced Home Care Treatment Model: A Primary Care and Accountable Care Organization Collaboration
Mary Leen, David Dekevich, Raphael Balbino, Terry Hayes, James Clower, Alison Bartfield, Edward Gorak, Kenneth Mayer
COVID-19 caused health systems across the United States to provide innovative care within a short time period. Baptist Health System of Northeast Florida took a proactive, collaborative approach to rapidly develop and implement an enhanced home support model for patients with COVID-19 in partnership with Baptist Primary Care, Baptist Home Health Care, and durable medical equipment companies. The model was evidence-based and protocol-driven allowing patients to be safely cared for in the home setting. It also helped decompress the hospital by preserving finite health system bed and care team capacity, both of which would have otherwise been exceeded during surge peaks. Low rates of emergency department visits and inpatient hospitalizations demonstrated excellent quality of care. Experience gained from building this model allows its replication for chronic, high-risk conditions to align with long-term value-based care strategies. 3 Sept, 2021. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/169219
Original Research: Counterproductive Messaging About COVID-19 Safety Measures in Cancer Screening Outreach: Results of a Pragmatic Randomized Trial
Kristin Gagliardi, Sara Coleman Hernandez, Gina Intinarelli, Kevin Grumbach
University of California, San Francisco
COVID-19 has caused patients to defer preventive services. We conducted a pragmatic randomized trial of incorporating a message about COVID-19 safety measures into an automated telephonic outreach program targeting primary care patients overdue for cancer screening. Contrary to our hypothesis, the COVID-19 safety measure messaging resulted in significantly fewer patients in the intervention group requesting scheduling of preventive services (135 of 196 patients reached (68.9%)), compared with the standard call script group (165 of 207 patients (79.7%)), (p=0.01). Messages intended to reassure patients about the safety of obtaining in-person preventive services during the coronavirus pandemic may have unintended consequences. 1 March, 2021. Under Review, online collection only. Permanent URL: http://hdl.handle.net/2027.42/166320
Original Research: BUILDING AND SUSTAINING VIRTUAL PATIENT MEDICAL HOMES DURING THE COVID-19 PANDEMIC
Christopher Cameron, Kathleen Douglas-England, Courtenay Bolton, Samantha Sexsmith Chadwick
The purpose of this study was to evaluate the [redacted] Primary Care Network’s ([redacted] PCN) ability to support 61 primary care practices in building and sustaining virtual Patient Medical Homes (PMHs) during the COVID-19 pandemic. A mixed methods evaluation determined that the [redacted] PCN achieved this mandate. The organization provided physician members with access to allied health care team members using virtual platforms. Care coordinators continued to optimize the use of Electronic Medical Records (EMRs) from their home offices. Patient care remained of high quality, revealed through the analysis of patient experience data collected both before and during the pandemic. Despite a new requirement to work remotely, healthcare teams remained collaborative. The number of clinics that the PCN supported in improvement work remained steady as the pandemic progressed in March and thereafter. 23 February, 2021. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/166317
Special Report: Guidelines for Accessible COVID-19 Testing & Vaccination Sites
Michael McKee, Oluwaferanmi Okanlami, Philip Zazove
Over 20% of individuals report a disability. These people often struggle with health inequities and poor health care access. Many of these barriers are addressable through simple steps. Providing an avenue for patients to communicate accessibility challenges and request accommodations prior to their appointment will help these individuals obtain their COVID-19 tests and vaccines equitably upon arrival. 17 February, 2021. Under review, online collection only. Permanent URL: http://hdl.handle.net/2027.42/166308
Original Research: Primary Care's Historic Role in Vaccination and Potential Role in COVID-19 Immunization Programs
John Westfall, Elizabeth Wilkinson, Anuradha Jetty, Stephen Petterson, Yalda Jabbarpour,
Robert Graham Center for Policy Studies in Family Medicine and Primary Care
COVID-19 pandemic recovery will require a broad and coordinated effort for infection testing, immunity determination, and vaccination. With the advent of several COVID-19 vaccines, the dissemination and delivery of COVID-19 immunization across the nation is of concern. A study of the delivery of vaccinations, using 2017 Medicare Part B Fee-For-Service data and the 2013-2017 Medical Expenditure Panel Survey at the service, physician, and visit level show that Primary Care Physicians have played a crucial role in delivery of vaccinations to the U.S. population, including the elderly, between 2012-2017. These findings indicate primary care practices may be a crucial element of vaccine counseling and delivery in the upcoming COVID-19 recovery and immunization efforts in the United States. 29 January, 2021. Accepted 1/28/2021; Published 3/11/2021. URL: https://www.annfammed.org/content/early/2021/02/10/afm.2679
Special Report: A prioritization algorithm for healthcare personnel for the CDC's COVID-19 Phase 1a vaccine distribution plan
Grace Flood, Alison Meier, Matthew Anderson, William Ehlenbach, Shiva Bidar-Sielaff, Sang Thao, Maureen Smith
We developed an algorithm that can be used to equitably distribute COVID-19 vaccinations to healthcare personnel (HCP) during Phase 1a of the Center for Disease Control and Prevention’s (CDC) coronavirus vaccine distribution plan, if not enough vaccine is available to immunize an entire group of employees with similar job-related risk exposure. The algorithm prioritizes individuals with the highest risk of mortality using Social Vulnerability Index (SVI) and age. 30 December, 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/163774
Original Research: Becoming Don of the Doff: Navigating the Complexity of Donning and Doffing Personal Protective Equipment in the Home
Brian Kerley, Lana Tan, Denise Marshall, Cindy O'Neill, Anne Bialachowski, José Pereira
Donning and doffing personal protective equipment (PPE) in home settings is very different from the hospital setting. For example, in hospitals PPE is usually neatly stationed outside the unit or patient room and there are posters on how to safely don and doff. In the home setting where clinicians have to bring their own equipment and there are no set spaces or areas to don and doff PPE. Highlighting the urgent need to address home-based care during the pandemic, this group developed a protocol on how to don and doff PPE in the home using a rapid prototyping approach. 9 September 2020. Accepted 12/3/2020; Published 2/15/2021. URL: https://www.annfammed.org/content/early/2021/02/10/afm.2667
Methodology: Measuring Patient Experience During the Covid-19 Pandemic And Beyond
Brianna D. Sullivan, MPH, Karen Bogen, PhD, MA, Nancy Duda, PhD, MA, Deborah N. Peikes, PhD, MPA
Traditional patient experience measures may not fully capture the changes quickly transpiring in patient care due to COVID-19. This paper presents a questionnaire that could be a helpful starting point. The questionnaire addresses topics such as telehealth and non-visit-based care; care by non-physicians; discussion about end-of-life preferences, domestic violence, social health needs; and primary care follow-up after acute care. 22 June 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/155624
Social Distancing Metrics and Estimates of SARS-CoV-2 Transmission Rates: Associations between mobile telephone data tracking and R
Christopher P. Morley, Kathryn B. Anderson, Jana Shaw, Telisa Stewart, Stephen J. Thomas, Dongliang Wang
Social distancing may be flattening the epidemic curve, but it is also blamed for severe economic consequences. It is therefore essential to demonstrate whether the costs of social distancing are having the desired effect. In this brief report, we present a tool for tracking community contact rates and, thus, transmission potential. 20 May, 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/155389
Methodology: The use of primary care big data for COVID-19 research: A consensus statement from the COVID-19 Primary Care Database Consortium
Hajira Dambha-Miller, Simon J Griffin, Duncan Young, Peter Watkinson, Pui San Tan, Ashley K Clift, Rupert A Payne, Carol Coupland, Jemma C Hopewell, Jonathan Mant, Richard M Martin, and Julia Hippisley-Cox
The use of big data containing millions of primary care medical records provides an opportunity for rapid research to help inform patient care and policy decisions during the first and subsequent waves of the COVID-19 pandemic. This consensus agreement is aimed at facilitating transparency and rigour in methodological approaches, as well as consistency in defining and reporting cases, exposures, confounders, stratification variables and outcomes in relation to the pharmacoepidemiology of COVID-19. 1 May 2020. Accepted 8/31/2020; Published 3/8/2021. URL: https://www.annfammed.org/content/19/2/135
Clinical Registries Could Improve Influenza Like Illness and COVID-19 Surveillance
David H. Rehkopf, Ayin Vala, Andrew W. Bazemore, Lars Peterson, Isabella Chu, Robert L. Phillips Jr.
Capacity for tracking COVID-19 prevalence patterns is hampered by insufficient data, particularly from rural and small communities. The PRIME Registry holds data for 5.4 million patients in 47 states who made 638,983 Influenza-Like Illness (ILI) visits in 2019, mirroring CDC’s ILINet temporal patterns but with higher volume and greater rural penetration. Clinical data registries are viable partners that could fill gaps for epidemic sentinel functions and have rich patient data which may identify factors predictive of COVID-19 morbidity and mortality. 29 April 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/154853
Special Report: The Potential for Cloth Masks to Protect Healthcare Providers from SARS-CoV-2
Ariel Kiyomi Daoud, Jessica Kole Hall, Haylie Petrick, Anne Strong, Cleveland Piggott
When asked to coordinate a community effort to provide cloth masks for primary care providers in rural Colorado during the COVID-19 pandemic, the authors were surprised at the lack of a review specifically addressing the efficacy of cloth masks for protecting healthcare providers. Their rapid review suggests cloth masks may not provide healthcare workers with adequate protection against viral respiratory infections. 16 April 2020. Accepted 8/3/2020; Published 1/11/2021. URL: https://www.annfammed.org/content/19/1/55
Special Report: Hydroxychloroquine Use in the United States and the Potential Impact of Critical Shortages From SARS-CoV-2
Joshua D. Niforatos, Michael E. Johansen
Hydroxychloroquine (HCQ) is in critical shortage in the U.S. because of its use off-label for treatment of viral pneumonia secondary to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The authors argue critical drug shortages related to off-label use for SARS-COV-2 infection could impact hundreds of thousands of individuals who use the medication for rheumatological diseases. 10 April 2020. Nonrefereed, online collection only. Permanent URL: http://hdl.handle.net/2027.42/154736