Preventive care among primary care patients living with spinal cord injury.
Identifieur interne : 000066 ( Main/Corpus ); précédent : 000065; suivant : 000067Preventive care among primary care patients living with spinal cord injury.
Auteurs : Aisha Lofters ; Maha Chaudhry ; Morgan Slater ; Andree Schuler ; James Milligan ; Joseph Lee ; Sara J T. GuilcherSource :
- The journal of spinal cord medicine [ 2045-7723 ] ; 2019.
English descriptors
- KwdEn :
- Adult (MeSH), Aged (MeSH), Aged, 80 and over (MeSH), Diagnostic Tests, Routine (statistics & numerical data), Early Detection of Cancer (statistics & numerical data), Family Practice (statistics & numerical data), Female (MeSH), Humans (MeSH), Influenza Vaccines (therapeutic use), Male (MeSH), Mass Vaccination (statistics & numerical data), Middle Aged (MeSH), Ontario (epidemiology), Physical Examination (statistics & numerical data), Physicians, Family (statistics & numerical data), Primary Health Care (statistics & numerical data), Primary Prevention (statistics & numerical data), Retrospective Studies (MeSH), Spinal Cord Injuries (epidemiology).
- MESH :
- chemical , therapeutic use : Influenza Vaccines.
- geographic , epidemiology : Ontario.
- epidemiology : Spinal Cord Injuries.
- statistics & numerical data : Diagnostic Tests, Routine, Early Detection of Cancer, Family Practice, Mass Vaccination, Physical Examination, Physicians, Family, Primary Health Care, Primary Prevention.
- Adult, Aged, Aged, 80 and over, Female, Humans, Male, Middle Aged, Retrospective Studies.
Abstract
Objective: Context/Objective: Family physicians may lack the knowledge or resources to adequately support patients with spinal cord injury (SCI). Our objectives were to determine patterns of preventive care for patients with SCI in a primary care setting (i.e. cancer screening, influenza vaccinations, general physicals, bone mineral density tests), and determine physicians' level of comfort with providing primary care to patients with SCI.Design: i) Retrospective chart review, ii) Survey of physicians in the family practice.Setting: Six primary care practice sites in Ontario, Canada.Participants: All adult rostered patients of the family practice with SCI; All family physicians in the six sites.Outcome Measures: Proportion of patients up-to-date on cancer screening, proportion of patients with influenza vaccinations, general physicals, bone mineral density tests; physicians' level of comfort with providing care to patients with SCI.Results: Sixty patients were included in analyses. Rates of cancer screening were generally poor. The highest uptake was seen for cervical cancer screening, where 50% of eligible women were up-to-date on Pap tests. Only 36.7% of patients were up-to-date on colorectal cancer screening. Only 14 (23.3%) patients had a documented general physical exam in their electronic record. There was a recorded flu vaccination for 55% of patients, and of those, there was a median of 19 months since last vaccination. Fifteen physicians (21.4%) responded to the survey. Ten physicians reported at least one patient with SCI, with the maximum being 20 patients. Comfort level in managing SCI-relevant conditions varied and was lowest for spasticity, respiratory issues and autonomic dysreflexia, where only 27.3% of respondents had some level of comfort.Conclusion There are many opportunities to improve the preventive care of patients living with SCI.
DOI: 10.1080/10790268.2018.1432308
PubMed: 29424661
PubMed Central: PMC6830240
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Guilcher</name><affiliation><nlm:affiliation>Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2019">2019</date><idno type="RBID">pubmed:29424661</idno><idno type="pmid">29424661</idno><idno type="doi">10.1080/10790268.2018.1432308</idno><idno type="pmc">PMC6830240</idno><idno type="wicri:Area/Main/Corpus">000066</idno><idno type="wicri:explorRef" wicri:stream="Main" wicri:step="Corpus" wicri:corpus="PubMed">000066</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Preventive care among primary care patients living with spinal cord injury.</title><author><name sortKey="Lofters, Aisha" sort="Lofters, Aisha" uniqKey="Lofters A" first="Aisha" last="Lofters">Aisha Lofters</name><affiliation><nlm:affiliation>Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Chaudhry, Maha" sort="Chaudhry, Maha" uniqKey="Chaudhry M" first="Maha" last="Chaudhry">Maha Chaudhry</name><affiliation><nlm:affiliation>Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Slater, Morgan" sort="Slater, Morgan" uniqKey="Slater M" first="Morgan" last="Slater">Morgan Slater</name><affiliation><nlm:affiliation>Department of Family and Community Medicine, St. Michael's Hospital, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Schuler, Andree" sort="Schuler, Andree" uniqKey="Schuler A" first="Andree" last="Schuler">Andree Schuler</name><affiliation><nlm:affiliation>Department of Family and Community Medicine, St. Michael's Hospital, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Milligan, James" sort="Milligan, James" uniqKey="Milligan J" first="James" last="Milligan">James Milligan</name><affiliation><nlm:affiliation>Department of Family Medicine, McMaster University, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Department of Family Medicine, Western University, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Lee, Joseph" sort="Lee, Joseph" uniqKey="Lee J" first="Joseph" last="Lee">Joseph Lee</name><affiliation><nlm:affiliation>Department of Family Medicine, McMaster University, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Centre for Family Medicine Family Health Team, Ontario, Canada.</nlm:affiliation></affiliation></author><author><name sortKey="Guilcher, Sara J T" sort="Guilcher, Sara J T" uniqKey="Guilcher S" first="Sara J T" last="Guilcher">Sara J T. Guilcher</name><affiliation><nlm:affiliation>Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada.</nlm:affiliation></affiliation><affiliation><nlm:affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada.</nlm:affiliation></affiliation></author></analytic><series><title level="j">The journal of spinal cord medicine</title><idno type="eISSN">2045-7723</idno><imprint><date when="2019" type="published">2019</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult (MeSH)</term><term>Aged (MeSH)</term><term>Aged, 80 and over (MeSH)</term><term>Diagnostic Tests, Routine (statistics & numerical data)</term><term>Early Detection of Cancer (statistics & numerical data)</term><term>Family Practice (statistics & numerical data)</term><term>Female (MeSH)</term><term>Humans (MeSH)</term><term>Influenza Vaccines (therapeutic use)</term><term>Male (MeSH)</term><term>Mass Vaccination (statistics & numerical data)</term><term>Middle Aged (MeSH)</term><term>Ontario (epidemiology)</term><term>Physical Examination (statistics & numerical data)</term><term>Physicians, Family (statistics & numerical data)</term><term>Primary Health Care (statistics & numerical data)</term><term>Primary Prevention (statistics & numerical data)</term><term>Retrospective Studies (MeSH)</term><term>Spinal Cord Injuries (epidemiology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Influenza Vaccines</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Ontario</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Spinal Cord Injuries</term></keywords><keywords scheme="MESH" qualifier="statistics & numerical data" xml:lang="en"><term>Diagnostic Tests, Routine</term><term>Early Detection of Cancer</term><term>Family Practice</term><term>Mass Vaccination</term><term>Physical Examination</term><term>Physicians, Family</term><term>Primary Health Care</term><term>Primary Prevention</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Adult</term><term>Aged</term><term>Aged, 80 and over</term><term>Female</term><term>Humans</term><term>Male</term><term>Middle Aged</term><term>Retrospective Studies</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><b>Objective: Context/Objective:</b> Family physicians may lack the knowledge or resources to adequately support patients with spinal cord injury (SCI). Our objectives were to determine patterns of preventive care for patients with SCI in a primary care setting (i.e. cancer screening, influenza vaccinations, general physicals, bone mineral density tests), and determine physicians' level of comfort with providing primary care to patients with SCI.<b>Design:</b> i) Retrospective chart review, ii) Survey of physicians in the family practice.<b>Setting:</b> Six primary care practice sites in Ontario, Canada.<b>Participants:</b> All adult rostered patients of the family practice with SCI; All family physicians in the six sites.<b>Outcome Measures:</b> Proportion of patients up-to-date on cancer screening, proportion of patients with influenza vaccinations, general physicals, bone mineral density tests; physicians' level of comfort with providing care to patients with SCI.<b>Results:</b> Sixty patients were included in analyses. Rates of cancer screening were generally poor. The highest uptake was seen for cervical cancer screening, where 50% of eligible women were up-to-date on Pap tests. Only 36.7% of patients were up-to-date on colorectal cancer screening. Only 14 (23.3%) patients had a documented general physical exam in their electronic record. There was a recorded flu vaccination for 55% of patients, and of those, there was a median of 19 months since last vaccination. Fifteen physicians (21.4%) responded to the survey. Ten physicians reported at least one patient with SCI, with the maximum being 20 patients. Comfort level in managing SCI-relevant conditions varied and was lowest for spasticity, respiratory issues and autonomic dysreflexia, where only 27.3% of respondents had some level of comfort.<b>Conclusion</b> There are many opportunities to improve the preventive care of patients living with SCI.</div></front></TEI><pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">29424661</PMID><DateCompleted><Year>2020</Year><Month>06</Month><Day>17</Day></DateCompleted><DateRevised><Year>2020</Year><Month>06</Month><Day>17</Day></DateRevised><Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">2045-7723</ISSN><JournalIssue CitedMedium="Internet"><Volume>42</Volume><Issue>6</Issue><PubDate><Year>2019</Year><Month>11</Month></PubDate></JournalIssue><Title>The journal of spinal cord medicine</Title><ISOAbbreviation>J Spinal Cord Med</ISOAbbreviation></Journal><ArticleTitle>Preventive care among primary care patients living with spinal cord injury.</ArticleTitle><Pagination><MedlinePgn>702-708</MedlinePgn></Pagination><ELocationID EIdType="doi" ValidYN="Y">10.1080/10790268.2018.1432308</ELocationID><Abstract><AbstractText><b>Objective: Context/Objective:</b> Family physicians may lack the knowledge or resources to adequately support patients with spinal cord injury (SCI). Our objectives were to determine patterns of preventive care for patients with SCI in a primary care setting (i.e. cancer screening, influenza vaccinations, general physicals, bone mineral density tests), and determine physicians' level of comfort with providing primary care to patients with SCI.<b>Design:</b> i) Retrospective chart review, ii) Survey of physicians in the family practice.<b>Setting:</b> Six primary care practice sites in Ontario, Canada.<b>Participants:</b> All adult rostered patients of the family practice with SCI; All family physicians in the six sites.<b>Outcome Measures:</b> Proportion of patients up-to-date on cancer screening, proportion of patients with influenza vaccinations, general physicals, bone mineral density tests; physicians' level of comfort with providing care to patients with SCI.<b>Results:</b> Sixty patients were included in analyses. Rates of cancer screening were generally poor. The highest uptake was seen for cervical cancer screening, where 50% of eligible women were up-to-date on Pap tests. Only 36.7% of patients were up-to-date on colorectal cancer screening. Only 14 (23.3%) patients had a documented general physical exam in their electronic record. There was a recorded flu vaccination for 55% of patients, and of those, there was a median of 19 months since last vaccination. Fifteen physicians (21.4%) responded to the survey. Ten physicians reported at least one patient with SCI, with the maximum being 20 patients. Comfort level in managing SCI-relevant conditions varied and was lowest for spasticity, respiratory issues and autonomic dysreflexia, where only 27.3% of respondents had some level of comfort.<b>Conclusion</b> There are many opportunities to improve the preventive care of patients living with SCI.</AbstractText></Abstract><AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Lofters</LastName><ForeName>Aisha</ForeName><Initials>A</Initials><Identifier Source="ORCID">0000-0002-7322-0894</Identifier><AffiliationInfo><Affiliation>Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Chaudhry</LastName><ForeName>Maha</ForeName><Initials>M</Initials><Identifier Source="ORCID">0000-0001-5382-8280</Identifier><AffiliationInfo><Affiliation>Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Slater</LastName><ForeName>Morgan</ForeName><Initials>M</Initials><AffiliationInfo><Affiliation>Department of Family and Community Medicine, St. Michael's Hospital, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Schuler</LastName><ForeName>Andree</ForeName><Initials>A</Initials><AffiliationInfo><Affiliation>Department of Family and Community Medicine, St. Michael's Hospital, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Milligan</LastName><ForeName>James</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Family Medicine, McMaster University, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Department of Family Medicine, Western University, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Lee</LastName><ForeName>Joseph</ForeName><Initials>J</Initials><AffiliationInfo><Affiliation>Department of Family Medicine, McMaster University, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Centre for Family Medicine Family Health Team, Ontario, Canada.</Affiliation></AffiliationInfo></Author><Author ValidYN="Y"><LastName>Guilcher</LastName><ForeName>Sara J T</ForeName><Initials>SJT</Initials><Identifier Source="ORCID">0000-0002-9552-9139</Identifier><AffiliationInfo><Affiliation>Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Ontario, Canada.</Affiliation></AffiliationInfo><AffiliationInfo><Affiliation>Leslie Dan Faculty of Pharmacy, University of Toronto, Ontario, Canada.</Affiliation></AffiliationInfo></Author></AuthorList><Language>eng</Language><PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType><PublicationType UI="D013485">Research Support, Non-U.S. 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data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D055088" MajorTopicYN="N">Early Detection of Cancer</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005194" MajorTopicYN="N">Family Practice</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D007252" MajorTopicYN="N">Influenza Vaccines</DescriptorName><QualifierName UI="Q000627" MajorTopicYN="N">therapeutic use</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D032541" MajorTopicYN="N">Mass Vaccination</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="N">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D009864" MajorTopicYN="N" Type="Geographic">Ontario</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010808" MajorTopicYN="N">Physical Examination</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D010821" MajorTopicYN="N">Physicians, Family</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011320" MajorTopicYN="N">Primary Health Care</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D011322" MajorTopicYN="N">Primary Prevention</DescriptorName><QualifierName UI="Q000706" MajorTopicYN="Y">statistics & numerical data</QualifierName></MeshHeading><MeshHeading><DescriptorName UI="D012189" MajorTopicYN="N">Retrospective Studies</DescriptorName></MeshHeading><MeshHeading><DescriptorName UI="D013119" MajorTopicYN="N">Spinal Cord Injuries</DescriptorName><QualifierName UI="Q000453" MajorTopicYN="Y">epidemiology</QualifierName></MeshHeading></MeshHeadingList><KeywordList Owner="NOTNLM"><Keyword MajorTopicYN="Y">Cancer screening</Keyword><Keyword MajorTopicYN="Y">Family medicine</Keyword><Keyword MajorTopicYN="Y">Preventive care</Keyword><Keyword MajorTopicYN="Y">Primary care</Keyword><Keyword MajorTopicYN="Y">Spinal cord injuries</Keyword></KeywordList></MedlineCitation><PubmedData><History><PubMedPubDate PubStatus="pmc-release"><Year>2020</Year><Month>11</Month><Day>01</Day></PubMedPubDate><PubMedPubDate 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