Primary Care

13 Feb

Posted at 23:48h in Author Interviews, BMJ, Primary Care, Pulmonary Disease
Professor Chris van Weel Emeritus Professor of Family Medicine/General Practice Radboud University Nijmegen, The Netherlands Professor of Primary Health Care Research, Australian National University, Canberra Past President of WoncaMedicalResearch.com: Interview with: Professor Chris van Weel Emeritus Professor of Family Medicine/General Practice Radboud University Nijmegen, The Netherlands Professor of Primary Health Care Research, Australian National University, Canberra Background from Professor Chris van Weel Thank you for the opportunity to respond to your questions.  My paper was a commentary to the study of Jones and colleagues, Opportunities to diagnose chronic obstructive pulmonary disease in routine care in the UK: a retrospective study of a clinical cohort looking at the implications of the study findings. MedicalResearch.com: What are the main findings of the study? Answer: Jones and colleagues reported that in the UK, there are many missed opportunities to diagnose COPD. My comments are that this is not a unique UK problem, but a universal one: under-diagnosis or late diagnosis of COPD is a universal problem in most if not all countries in the world. To understand it, it is important to analyse more in-depth the diagnostic challenge in primary care, for general practitioners(GP)/family physicians (FP). The paper of Jones highlights this diagnostic problem - symptoms of COPD are initially insidious and may fluctuate over time. And from my earlier research it is also clear that patients 'adept' their daily activities (less physical activities) and therefore may underplay or even become unaware of, their symptoms. At the same time, this is a problem for the physician, when encountering these symptoms. As I highlighted in my commentary, GPs/FPs have to pay attention to other possible diseases that might cause these symptoms: pneumonia, heart failure, lung cancer. The 'low key symptoms' and the need of applying a broad diagnostic scope together cause what Jones and his colleagues called the 'missed opportunities' to diagnose COPD.

26 Jan

Posted at 20:37h in Author Interviews, Health Care Systems, JAMA, Primary Care
Dr. Lyndonna Marrast MD Fellow in General Internal Medicine Cambridge Health Alliance 1493 Cambridge Street Cambridge, MA 02139 MedicalResearch.com Interview with: Dr. Lyndonna Marrast MD Fellow in General Internal Medicine Cambridge Health Alliance Cambridge, MA 02139 MedicalResearch.com:   What are the main findings of the study? Dr. Marrast: We found that disadvantaged patients (categorized as racial and ethnic minorities, non-English home language speakers, being low income, having Medicaid, or reporting fair or poor health) were more likely than other patients to be cared for by a minority physician. A majority, 54%, of black, Hispanic and Asian patients received care from a minority doctor and the vast majority, 70%, of those who report not speaking English at home got care from a minority physician.

19 Sep

Posted at 11:34h in Addiction, CMAJ, JAMA, Pharmacology, Primary Care
Richard Saitz, MD MPH Professor of Medicine and Epidemiology Boston University Schools of Medicine and Public Health Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, MassachusettsMedicalResearch.com Interview with: Richard Saitz, MD MPH Professor of Medicine and Epidemiology Boston University Schools of Medicine and Public Health Clinical Addiction Research and Education Unit, Boston Medical Center, Boston, Massachusetts MedicalResearch.com: What are the main findings of the study? Dr. Saitz: Chronic care management in primary care did not improve health outcomes (abstinence from cocaine, opioids or heavy drinking; or any other clinical outcomes, like addiction consequences, emergency or hospital use, health-related quality of life, addiction severity) for people with alcohol or other drug dependence.

15 Aug

Posted at 12:09h in Primary Care
MedicalResearch.com Interview with: Dr. Richard Adair Medicine Clinic, 2800 Chicago Avenue South, #250, Minneapolis, MN 55407 MedicalResearch.com: What are the main findings of the study? Answer: Layperson "care guides" working in primary care offices can help chronic disease patients reach recommended care goals at a reasonable cost.