Primary Care

Research Findings

Research Activities, September 2012:
Distance-based training in spirometry use increases the quality of asthma diagnosis
Radionovela promotes awareness and knowledge of cervical cancer vaccine among Hispanic parents

Research Activities, August 2012:
State Medicaid policy changes increasingly driven by evidence
Insulin pump and glucose monitoring improve blood-sugar control for diabetes patients
Provider-patient dialogue could be improved to foster medication adherence in HIV care
Patients often say good things about their physicians on rate-your-doc Web sites, but are less positive about system issues

Research Activities, July 2012:
Having a usual source of care promotes preventive health counseling for children
Electronic health records can help detect diagnostic errors in primary care
Primary care practices can boost clinical preventive services with electronic health records and quality improvement support
Although the patient-centered medical home is a promising model of care, more studies are needed to assess its effectiveness
AHRQ report finds teamwork and followup as strengths of medical offices but work pressure and pace are problematic

Research Activities, June 2012:
Dual Veterans Administration/Medicare users are not hospitalized more for ambulatory care sensitive conditions
1 in 10 computer-generated prescriptions include at least one error
Paper previsit reminders for doctors do not add value to electronic reminders from an electronic health record system

Research Activities, May 2012:
Muscle training effective in treating urinary incontinence for women
Older, busier clinicians who see complex patients are more likely to use novel electronic health record (EHR) functions
Rural health care providers in California look to telehealth to supply the training needed to manage childhood obesity
Clinical inertia may represent good clinical judgment in hypertension telemanagement

Research Activities, April 2012:
Majority of conditions treated in emergency departments are treatable in primary care clinics
Primary care providers who provide contraceptive counseling increase patients' contraceptive use
Primary care visits every 2 weeks linked to better treatment outcomes for patients with diabetes
A "diabetes dashboard" screen helps clinicians quickly and accurately access patient data needed for quality diabetes care
Blood pressure control persists after physician-pharmacist intervention ends
Physician personality factors do not seem to influence whether patients with symptoms undergo extended diagnostic evaluations
C-reactive protein testing is not more effective than an educational intervention to decrease antibiotic prescriptions for patients seen for acute cough
Self-measured blood pressure monitoring to manage hypertension may offer a small benefit

Research Activities, March 2012:
Electronic health records in community health centers provide a better picture of care than insurance claims data
Growth in the physician assistant workforce will be insufficient to meet future needs of primary care

Research Activities, February 2012:
E-prescribing systems within electronic health records reduce ambulatory prescribing errors in community-based practices
Physicians need better understanding of factors that patients use to decide about colorectal cancer screening
Children's unmet health needs similar for low- and middle-income families with either public or private insurance

Research Activities, January 2012:
Experts call for integrating mental health into primary care
Primary care coordination is more difficult for patients who see many specialists
Accessible services in primary care practices promote preventive health screenings and care
Residents should document sexual history during health care maintenance visits for older, asymptomatic adults
Medical residents can use quality improvement methods to promote obesity screening
Measuring quality of care for middle ear infection has many pitfalls

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Research Activities, December 2011:
Transitioning to new electronic health records can result in potential safety problems
Pediatric care providers identify desired characteristics for computerized flu vaccination alerts
Volume of paid outpatient malpractice claims underscores need for greater patient safety efforts in this area
Enrollment in Medicare Advantage managed care plans reduces racial/ethnic disparities in primary care quality in some States
Deaf patients who use American Sign Language receive more preventive care if their clinician also uses sign language

Research Activities, November 2011:
Among patients with diabetes, racial/ethnic discrimination by health care providers is uncommon
Primary care model helps treat underserved patients with hepatitis C virus infection
Physicians who use electronic health records more intensively are more likely to use patient registries to improve care
Parents are satisfied with telemedicine care for their child’s obesity

Research Activities, October 2011:
Patients with type 2 diabetes express mixed reactions to a mobile phone and Web-based disease management program
Study identifies costs of implementing electronic health records in network of physician practices
Medicare Part D reduces out-of-pocket costs and modestly boosts prescription volume

Research Activities, September 2011:
The challenge of prioritizing care for complex patients
Uninsured patients respond well to paying a monthly retainer for primary care services
Children's underenrollment in State health insurance programs may be due in part to parents' confusion about coverage
Low- and middle-income children with public and private insurance have similar rates of unmet health care needs
Computer system compares well with clinicians in assessing, but not treating children with asthma
Providers perceive e-prescribing as being very efficient

Research Activities, August 2011:
AHRQ's clinical care tools help clinicians ensure better and safer care
Having a usual source of care as well as insurance reduces unmet health needs
Parents and primary care physicians are satisfied with children's use of nonurgent emergency department services
A usual source of care may be more important than insurance on children's receipt of preventive health counseling
When primary care providers apply fluoride varnish, young Medicaid-insured children have fewer cavities

Research Activities, July 2011:
Health care quality gaps and disparities persist in every State
Studies examine safety of pain killers among older adults
Communication problems between hospitalists and primary care providers lead to postdischarge problems for seniors
Many primary care patients are at risk for obstructive sleep apnea, but few are sent for testing
Guideline familiarity does not equal guideline adherence
Chronic Care Model linked to exercise discussions during primary care office visits for diabetes
Over 3 million look to hospitals for headache relief
Report shows physicians view e-prescribing features as cumbersome
Connecting local providers to academic medical centers using video improved hepatitis C outcomes

Research Activities, June 2011:
Community hubs ensure better care for the most vulnerable
Treatment by physicians with same race and language as the patient may improve medication adherence
Hispanics with HIV have different communication styles with their health care providers than whites
An automated phone response system can help track adverse drug events in primary care patients
Doctor's comments during a child's physical exam can affect whether parents push for antibiotics

Research Activities, May 2011:
Practice setting, ownership, and specialty all affect volume of charity care provided by physicians
Specific primary care strategies may improve medication safety
Primary care physicians spend a fifth of their time in patient care activities outside of office visits

Research Activities, April 2011:
Medication safety indicators can guide improvement in primary care drug selection, dosing, and monitoring
Parents find telemedicine care of children in school and childcare to be helpful and convenient

Research Activities, March 2011:
Children with a medical home more likely to receive health screenings and advice
Innovations show the benefits of using phone-based care management

Research Activities, February 2011:
Primary care physicians' performance ratings depend on the makeup of their patient population
Primary care practices that take part in research networks report benefits beyond the study itself
Clinicians' adoption and use of electronic prescribing is likely linked to their views on technology

Research Activities, January 2011:
Health information technology improves care and saves lives
Most patients with type 2 diabetes suffer an adverse event between office visits

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Research Activities, December 2010:
Nationwide survey shows free clinics provide care to nearly 2 million patients
For hypertensive patients with diabetes, blood pressure drops quicker with more frequent interactions with clinicians
Despite their helpfulness to guiding care, home blood pressure readings are rarely documented in routine clinical care

Research Activities, November 2010:
Medical home concept not well defined in 2007 legislation

Research Activities, October 2010:
Pay-for-performance does not improve care quality in the short term in safety-net settings
Use of certain electronic health record features is associated with improved primary care quality measures
Regional health information exchanges must do more to attract small practices

Research Activities, September 2010:
Physicians' use of "we" during patient visits does not necessarily foster patient-physician partnership
Geographic information system reveals primary care needs of Hispanics
Minority pediatricians are more likely to care for minority children
Physicians report care barriers for young adults with childhood onset chronic diseases
Study shows Guided Care benefits family caregivers, chronically ill older adults, and physicians, and may reduce costs
Patients more likely to follow medication regimens if they share their doctor's beliefs about causes of health outcomes
Primary care doctors prefer additional medical record information when making decisions about patient test results
Electronic prescribing with clinical decision support reduces medication errors in community-based practices
Electronic prescribing improves safety, but with a small increase in physician time
Early followup with a physician reduces readmissions for Medicare patients hospitalized for heart failure

Research Activities, July 2010:
Adequate financial bonuses and peer support motivate providers to adhere to evidence-based treatment guidelines
Doctors remain remiss in advising overweight patients about healthy eating

Research Activities, June 2010:
Physician-pharmacist teams can help lower blood pressure

Research Activities, April 2010:
Types and rates of fungal infections vary among groups and treatment is often suboptimal
Outpatient advice on pediatric medication safety is inadequate
The stability of a usual source of care is important to the care of low-income children
Providing customized clinical information to patients and physicians does not improve diabetes care
Counseling education does not significantly boost residents' dietary counseling of patients with diabetes
Primary care patients who see physician assistants and nurse practitioners are as complex as those who see doctors
Lack of time, resources to blame for primary care doctors rarely counseling women on birth-defect-causing drugs
Many minority patients do not receive or complete colorectal cancer screening tests in urban, primary care settings
A guided care approach helps curb health care costs of elderly patients with chronic conditions

Research Activities, March 2010:
Primary care organizational characteristics are linked to the self-management behaviors of patients with diabetes

Research Activities, February 2010:
Patients who are treated with empathy during office visits get over colds faster
Only one-third of adolescents are screened for emotional health during routine physicals
Primary care doctors often don't know that a child sought care for asthma in the emergency department
Rural residents depend on physician offices for their osteoporosis testing

Research Activities, January 2010:
Primary care physicians like e-prescribing systems, but make little use of their advanced features
Use of electronic prescribing has expanded among Massachusetts physicians

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Research Activities, December 2009:
Using trigger tools to review medical charts helps identify adverse drug events among older adults
Electronic patient-provider messaging is linked to good diabetes control
Majority of primary care physicians now recommend colonoscopy
Primary care physicians do not always discuss the risks and benefits of prostate cancer screening with patients
More than half of primary care physicians report stressful working conditions

Research Activities, November 2009:
Safety awareness and technological adoption are keys to managing test results in family medicine offices

Research Activities, October 2009:
Primary care nurses who convey warmth and caring enhance patient satisfaction with care
Clinicians respond more positively to an electronic health record over time

Research Activities, September 2009:
Studies examine the impact of both health insurance and a usual source of care on access to health care
Disparities persist in primary care referrals to cardiologists for cardiovascular disease
Primary care providers often prescribe antiviral medications inappropriately for influenza patients
Increasing the number of primary care physicians can reduce the rate of hospitalizations for bacterial pneumonia
Primary care practice structure affects control of risk factors for cardiovascular disease among patients with diabetes

Research Activities, August 2009:
Specialists are less likely than generalists to spot clinically important drug-drug interactions
Availability of primary care results in better mental health for rural residents
Many young adults have no health insurance and no regular doctor

Research Activities, July 2009:
Fewer than half of patients with diabetes are referred for lifestyle counseling, nutrition, and exercise
Using a chronic care model improves smoking cessation programs in primary care clinics
Quality and accessible primary care is linked to fewer emergency department visits by Medicaid-insured children
Nonelderly patients have more negative perceptions of patient-provider communication than the elderly
Patients who are connected to their doctors tend to receive care that adheres to guidelines
Minorities and the poor find communicating with doctors more difficult

Research Activities, June 2009:
Primary care recognition and treatment of chronic kidney disease can be markedly improved with a few approaches
Clinician interviews are the best method to determine whether patients with kidney failure are also depressed

Research Activities, May 2009:
Use of a chronic care model framework in primary care practices can influence patient health status
Simple, effective methods to promote increased physical activity introduced to older American Indians in a primary care setting yield positive results
Lack of self-efficacy keeps inner-city primary care providers from following national asthma management guidelines

Research Activities, March 2009:
Mandatory public reporting of care performance did not affect quality of care for Medicare managed care patients
Nurses and office staff can help report prescribing errors in primary care offices
Some pediatricians would disclose errors only if harm is evident

Research Activities, February 2009:
Prescribing errors are the most common medication errors in primary care practices

Research Activities, January 2009:
Immunization of infants with pneumococcal conjugate vaccine has wide preventive effects
Doctors tend to overprescribe antibiotics for children with upper respiratory infections
Cost-effectiveness of pertussis vaccine in adults confirmed in U.S. and German studies
Integrated mental and physical health services may help people with depression
New Web resource aims to connect primary care, public health providers, and patients

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