Browsing by Subject "Physicians, Primary Care"

Now showing 1 - 3 of 3
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    Closing the False Divide: Sustainable Approaches to Integrating Mental Health Services into Primary Care
    (Springer-Verlag, 2017-04) Kroenke, Kurt; Unutzer, Jurgen; Department of Medicine, School of Medicine
    Mental disorders account for 25% of all health-related disability worldwide. More patients receive treatment for mental disorders in the primary care sector than in the mental health specialty setting. However, brief visits, inadequate reimbursement, deficits in primary care provider (PCP) training, and competing demands often limit the capacity of the PCP to produce optimal outcomes in patients with common mental disorders. More than 80 randomized trials have shown the benefits of collaborative care (CC) models for improving outcomes of patients with depression and anxiety. Six key components of CC include a population-based approach, measurement-based care, treatment to target strategy, care management, supervision by a mental health professional (MHP), and brief psychological therapies. Multiple trials have also shown that CC for depression is equally or more cost-effective than many of the current treatments for medical disorders. Factors that may facilitate the implementation of CC include a more favorable alignment of medical and mental health services in accountable care organizations and patient-centered medical homes; greater use of telecare as well as automated outcome monitoring; identification of patients who might benefit most from CC; and systematic training of both PCPs and MHPs in integrated team-based care.
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    Primary care physician perceptions of adult survivors of childhood cancer
    (Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins, 2014-03) Sima, Jody L.; Perkins, Susan M.; Haggstrom, David A.; Department of Biostatistics, IU School of Medicine
    Increasing cure rates for childhood cancers have resulted in a population of adult childhood cancer survivors (CCS) that are at risk for late effects of cancer-directed therapy. Our objective was to identify facilitators and barriers to primary care physicians (PCPs) providing late effects screening and evaluate information tools PCPs perceive as useful. We analyzed surveys from 351 practicing internal medicine and family practice physicians nationwide. A minority of PCPs perceived that their medical training was adequate to recognize late effects of chemotherapy (27.6%), cancer surgery (36.6%), and radiation therapy (38.1%). Most PCPs (93%) had never used Children's Oncology Group guidelines, but 86% would follow their recommendations. Most (84% to 86%) PCPs stated that they had never received a cancer treatment summary or survivorship care plan but (>90%) thought these documents would be useful. PCPs have a low level of awareness and receive inadequate training to recognize late effects. Overall, PCPs infrequently utilize guidelines, cancer treatment summaries, and survivorship care plans, although they perceive such tools as useful. We have identified gaps to address when providing care for CCS in routine general medical practice.
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    What should I address at follow-up of patients who survive critical illness?
    (Cleveland Clinic Foundation, 2018-07) Golovyan, Dmitriy M.; Khan, Sikandar H.; Wang, Sophia; Khan, Babar A.; Department of Medicine, Indiana University School of Medicine