Dr. Margaret Carpenter, a family physician in New York, has been indicted by a Louisiana grand jury for prescribing abortion medication to a minor via telemedicine. Louisiana, one of the strictest anti-abortion states in the U.S., classifies abortion medication as a "controlled dangerous substance." Under Louisiana law, prescribing or mailing abortion pills is a felony punishable up to five years in prison and fines between $5,000 and $50,000.

The case is unprecedented—it is the first time a doctor has faced criminal charges for prescribing abortion pills to an out-of-state patient. The minor’s mother reportedly requested the medication online, and Carpenter sent the prescription legally from New York, where abortion remains fully legal. However, Louisiana authorities are now pursuing criminal charges against both Carpenter and the minor’s mother.

New York Governor Kathy Hochul has stated she will not allow Carpenter to be extradited, citing New York's "shield laws," which were enacted to protect doctors who provide abortion care to patients in states with bans.  With 8,000 women receiving abortion pills monthly in states with strict bans, telemedicine has become an essential access point for care. But with increasing legal risks, physicians may now face prosecution for providing what they consider standard medical treatment within their own jurisdiction...Read more

Do you feel that medicine is becoming a battleground for political conflicts? Have you seen similar cases in your country?

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From 2009 to 2020, a child was most likely to be killed in a mass shooting by a parent or other family member, according to a research letter published online Feb. 10 in JAMA Pediatrics.

Pamela Emengo, M.D., from the Stanford University School of Medicine in California, and colleagues delineated the perpetrator-victim relationship in mass shootings that involved child victims in a cross-sectional study. Data from two sources were compiled to create a list of mass shootings from 2009 to 2020.

The researchers found that from Jan. 27, 2009, to Dec. 25, 2020, there were 121 pediatric mass shootings, which included 308 pediatric deaths (victims' ages, 0 to 17 years). The largest group was White children (51.9 percent) followed by Black children (19.2 percent). The parent-child relationship was the most common perpetrator-victim relationship, which accounted for 40.9 percent of all mass shooting deaths. Perpetrators related by family to the victim accounted for 59.1 percent of mass shooting deaths when family-type categories were collapsed into a single category. Acquaintances, strangers, and classmates were the next largest groups (14.6, 12.0, and 6.8 percent, respectively).

"As new efforts emerge to address firearm violence in our communities, our findings add to the growing body of literature that suggests one of the most dangerous places for pediatric firearm injury may be within the home," the authors write.

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A federal judge has ordered the U.S. Centers for Disease Control and Prevention (CDC) and Food and Drug Administration (FDA) to restore access to public health websites that were removed or modified in response to a Trump administration executive order on gender.

The order, issued Feb. 11 by U.S. District Judge John Bates, grants a temporary restraining order requested by Doctors for America, a nonprofit group that sued the administration over the website removals.

The affected sites, some of which have been online for decades, contain public health information on HIV prevention, youth health risks, fertility treatments and more.

The ruling states that the two health agencies removed the sites without explanation and likely violated federal law.

“By removing long relied upon medical resources without explanation, it is likely that … each agency failed to ‘examine the relevant data and articulate a satisfactory explanation for its action,’” Bates wrote.

He ordered the CDC and FDA to restore access by the day's end Tuesday, a process that staff members were scrambling to complete.

“It was a double waste for us because we took them offline, put some of them back, edited others and now are putting it back again,” a federal health official who wanted to remain anonymous told The Washington Post.

The removed sites included:

• The CDC's guidelines for HIV and PrEP, a medication that reduces the risk of contracting AIDS.

• The CDC's Social Vulnerability Index -- which was key to identifying high-risk hot spots during COVID.

• FDA databases that track diversity in clinical trials.

• The National Assisted Reproductive Technologies Surveillance System, which monitors fertility treatment success rates.

• Information on youth health risks.

Some researchers also reported that scientific studies on racial health disparities were removed, The Washington Post reported.

Lucia Leone, an associate professor of community health and health behavior at the University of Buffalo, said in a social media post that a 2017 study she co-authored on food access in low-income communities was taken down, likely because it contained the word “diverse."

Physicians and researchers were alarmed about the removals.

“Restoring access to this vital data is welcome news, if it happens," Dr. Steven Woolf, director emeritus and professor of family medicine and population health at Virginia Commonwealth University, told The Washington Post. “But this list doesn’t cover everything that has gone missing.”

Some doctors who treat HIV patients said they were already struggling without the CDC’s HIV and PrEP guidelines.

“We recently had an outbreak of chlamydia at the high school where I work and are actively meeting with school leadership to address increasing our efforts around STI testing and prevention,” Dr. Stephanie Liou, who screens students for sexually transmitted infections and prescribes PrEP, said in a court declaration. “Without these crucial CDC resources, I am not able to do my job to help address this urgent situation that is affecting our youth.”

Dr. Reshma Ramachandran, assistant professor at the Yale School of Medicine, said the CDC’s contraceptive guidance for providers was also removed, The Washington Post reported.

“I take care of female patients of reproductive age, many of whom have other medical conditions making it imperative to select the appropriate contraceptive that would not interfere with their existing comorbidities and other medications,” Ramachandran explained.

The lawsuit argues that the CDC and FDA violated federal law by failing to follow correct procedures for removing public information.

The Justice Department, defending the Trump administration, claimed Doctors for America lacked legal standing to challenge the actions. It said the sites could still be accessed through an online archive called the Wayback Machine, The Washington Post reported.

“The doctors just prefer not to search," Justice Department attorney James Harlow argued in a legal filing. "But one’s ‘desire’ for information from a preferred government source and in a preferred format does not establish informational injury when the content is otherwise obtainable.”

Bates' 21-page opinion rejected that argument, ruling that the health agencies’ actions would harm “everyday Americans, and most acutely, underprivileged Americans, seeking health care."

“If those doctors cannot provide these individuals the care they need (and deserve) within the scheduled and often limited time frame, there is a chance that some individuals will not receive treatment, including for severe, life-threatening conditions,” Bates wrote.

More information

Read the full memorandum opinion here.

SOURCES: The Washington Post, media report, Feb. 11, 2025; Memorandum opinion, Doctors for America v. Office of Personnel Management et al., Feb. 11, 2025

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 Many general practitioners prescribe antibiotics for suspected community-acquired pneumonia (CAP) even when chest radiograph (CR) results are negative, according to a study published in the November/December issue of the Annals of Family Medicine.

Juliette Pinot, M.D., from the Université Paris Cité and Université Sorbonne Paris Nord, and colleagues analyzed antibiotic initiation by general practitioners for patients with suspected CAP according to CR. The analysis included 259 patients.

The researchers found that 55.6 percent had a positive CR. Higher clinical severity was seen in patients with positive versus negative CR, with longer-lasting symptoms. Antibiotics were initiated for 99.3 percent of patients with positive CR and 68.7 percent with negative CR. Among the 115 CR-negative patients, there were no clinically relevant characteristics that were significantly different between those for whom antibiotics were and were not initiated. 

"For patients with suspected CAP, general practitioners systematically took into account results of positive CRs to initiate antibiotics and took much less account of negative CRs," the authors write. "These results justify clarification of what should be done in cases of clinical suspicion of CAP without radiologic confirmation."

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Seasonal maternal respiratory syncytial virus (RSV) vaccination and nirsevimab for infants demonstrate cost-effectiveness, according to two studies published online Nov. 25 in Pediatrics.

David W. Hutton, Ph.D., from the University of Michigan in Ann Arbor, and colleagues simulated RSV infection and disease with and without seasonal RSVpreF vaccination in half of pregnant women in the annual U.S. birth cohort. The researchers found that 45,693 outpatient visits, 15,866 emergency department visits, and 7,571 hospitalizations among infants would be prevented each year by year-round maternal vaccination. The societal incremental cost of vaccination was $396,280 per quality-adjusted life-year (QALY) saved and decreased to $163,513 per QALY saved with vaccination from September through January. Outcomes ranged from cost-saving to $800,000 per QALY saved with changes to the most influential inputs.

In a second study, Hutton and colleagues simulated health care utilization and deaths from RSV with and without nirsevimab among infants aged 0 to 7 months and aged 8 to 19 months during a single RSV season. The researchers estimated that if half of the U.S. birth cohort received nirsevimab, 107,253 outpatient visits, 38,204 emergency department visits, and 14,341 hospitalizations could be averted each year, which would cost $153,517 per QALY saved. For children facing a 10-fold higher risk for hospitalization, nirsevimab in the second season would cost $308,468 per QALY saved. The cost-effectiveness ratios would be between cost-saving and $323,788 per QALY saved.

"The high costs associated with these products will require those administering these vaccines, such as pediatricians, family physicians, hospitals, and health systems, to be meticulous in their ordering, inventory, and billing management practices to make them feasible to deliver in real-world settings," Sean T. O'Leary, M.D., M.P.H., from the University of Colorado School of Medicine/Children's Hospital Colorado in Aurora, writes in an accompanying editorial. "If these immunizations can be successfully delivered broadly, we will then see the dramatic reductions in the burden from this highly morbid pathogen that these products offer."

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A 57-year-old woman with COPD has received the world's first fully robotic double lung transplant.

The breakthrough surgery was performed in October at NYU Langone Health in New York City by Dr. Stephanie Chang. Just a month before, Chang performed a fully robotic single lung transplant — the nation's first.

"This latest innovation is a watershed moment in lung transplantation surgery worldwide and just the beginning of a new era in patient care," said Dr. Ralph Mosca, chair of cardiothoracic surgery at NYU Grossman School of Medicine, in New York City.

Chang and her team use a da Vinci Xi robot to perform the minimally invasive transplants.

They make small incisions between the ribs, then use the robot to remove and replace the damaged lungs.

The groundbreaking double transplant was performed on Oct. 22, four days after patient Cheryl Mehrkar was added to the transplant list after months of careful evaluation.

"For a long time, I was told I wasn't sick enough for a transplant," she recalled in an NYU news release.

"I'm so grateful to the donor and their family for giving me another chance at life," Mehrkar added. "And I'm so grateful to the doctors and nurses here for giving me hope."

Mehrkar, a volunteer emergency medical technician with the Union Vale Fire Department in Dutchess County, N.Y., inherited a genetic risk for lung disease.

She was 43 when she was diagnosed with COPD in 2010. A bout with COVID-19 in 2022 made her COPD worse.

Until her health relegated her to the sidelines, Mehrkar traveled the world as a scuba divemaster and, with her husband, Shahin, earned a black belt in karate. For many years, they owned a dojo, where she taught martial arts.

Mehrkar said she looks forward to being more active once again and praised her transplant team for making her quality of life a priority.

Surgical director of the lung transplant program at NYU Langone Transplant Institute, Chang was assisted in performing the double transplant by Dr. Travis Geraci and Dr. Eugene Grossi.

"It is one of the greatest privileges to be able to help patients return to a healthy quality of life," Chang said. "By using these robotic systems, we aim to reduce the impact this major surgery has on patients, limit their postoperative pain and give them the best possible outcome."

More information

Johns Hopkins Medicine has more about lung transplantation.

SOURCE: NYU Langone Health/NYU Grossman School of Medicine, news release, Nov. 21, 2024

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The supply of health care professionals available to provide HIV care is expected to continue to decline over the next five years, according to research published in the November/December issue of the Journal of the Association of Nurses in AIDS Care.

Andrea Norberg, D.N.P., R.N., from the Rutgers School of Nursing in Newark, New Jersey, and colleagues conducted an anonymous survey of 1,004 prescribing clinicians currently providing HIV-related health care.

The researchers found that clinicians who were younger and Black, advanced practice registered nurses, and family medicine physicians were more likely to report continuing with the same number of patients or increasing the number of patients in their HIV practice in the next five years. However, 17.8 percent of respondents reported plans to stop HIV clinical care wholly or to decrease the number of people living with HIV in their practice over the next five years. Retirement, administrative burden, and burnout were the most common reasons for leaving.

"Our study provides new insights into the numbers and characteristics of clinicians who will be available to provide HIV care in the coming years," Norberg said in a statement. "This information will inform efforts to build the HIV workforce amid the ongoing shift from specialist care to primary care strategies."

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Serum zinc is often deficient in patients with liver cirrhosis and hepatic encephalopathy (HE), according to a study published online in the September issue of the Journal of Family Medicine and Primary Care.

Divakar Kumar, M.D., from the Rajendra Institute of Medical Sciences Ranchi in India, and colleagues measured the serum zinc level in 150 patients with liver cirrhosis with HE.

The researchers found that the majority of patients with liver cirrhosis with HE had zinc deficiency. There was a statistically significant association between low serum zinc levels and West Haven criteria grades of HE. Across classes of cirrhosis, serum zinc levels showed highly significant differences. In patients who died, the mean serum zinc level was significantly low (35.56 versus 48.36). There was a strong positive correlation between serum zinc and serum albumin levels (r = 0.88).

"All patients with liver cirrhosis with HE and hypoalbuminemia should be evaluated for zinc deficiency. Hypozincemia is significantly associated with mortality in HE so it can also be used as a prognostic marker," the authors write. "Early screening for serum zinc level in patients with liver cirrhosis with HE and its replacement could result in prevention of worsening of HE and can also be used in treatment of HE, which can be proved by larger study particularly a case control study or randomized control trial."

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Lack of knowledge of antibiotic risks contributes to primary care patients' expectations of antibiotics for common symptoms, according to a study published online in the September/October issue of the Annals of Family Medicine.

Lindsey A. Laytner, Ph.D., from the Baylor College of Medicine in Houston, and colleagues conducted a survey (January 2020 to June 2021) in public and private primary care clinics to study the prevalence and predictors of patients’ antibiotic expectations for common symptoms/illnesses. The analysis included 564 patients (Black: 33 percent; Hispanic/Latine: 47 percent).

The researchers found that more than 93 percent of respondents expected to receive an antibiotic for at least one of the five predefined symptoms/illnesses. The expectation of antibiotics for a sore throat, diarrhea, and cold/flu was twice as high for patients of public clinics versus private clinics. Increased antibiotic expectations for diarrhea (odds ratio, 1.6) and cold/flu symptoms (odds ratio, 2.9) were associated with lack of knowledge of potential risks of antibiotic use. Predictors of antibiotic expectations for diarrhea included lower education and inadequate health literacy.

"Using these findings, we are developing a patient-clinician antibiotic education tool to educate and empower patients on proper antibiotic use and assist clinicians in discussing alternative (nonantibiotic) treatment options with their patients," the authors write.

One author disclosed ties to Genentech and Peptilogics.

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U.S. birthing hospitals staffed exclusively by family medicine (FM) physicians are more likely to have lower cesarean section rates, according to a study published online in the September/October issue of the Annals of Family Medicine.

Emily White VanGompel, M.D., from the University of Illinois at Chicago, and colleagues characterized the effect of the FM presence on unit culture and a key perinatal quality metric in Iowa hospital intrapartum units. The analysis included survey results from 849 Iowa clinicians (physicians, nurses, and midwives) delivering intrapartum care at 39 hospitals participating in a quality improvement initiative to decrease the incidence of cesarean delivery.

The researchers reported that 13 hospitals were FM-only (all rural), 11 OB-only, and 15 hospitals were both. They found that among hospitals with <1,000 annual births, births at FM-only hospitals had an adjusted lower risk for cesarean delivery (adjusted incident rate ratio, 0.66) versus hospitals with both. Nurses reported that at FM-only hospitals, unit norms were significantly more supportive of vaginal birth and had a stronger safety culture.

"Birthing hospitals staffed exclusively by FM physicians were more likely to have lower cesarean rates and stronger nursing-rated safety culture," the authors write. "Both access and quality of care provide strong arguments for reinforcing the pipeline of FM physicians training in intrapartum care."

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For Black African adults with uncontrolled hypertension, a low-dose triple-pill protocol achieves better blood pressure lowering and control than standard care, according to a study published online Aug. 31 in the Journal of the American Medical Association to coincide with the European Society of Cardiology Congress 2024, held from Aug. 30 to Sept. 2 in London.

Dike B. Ojji, Ph.D., from the University of Abuja in Nigeria, and colleagues compared the effectiveness and safety of a novel low-dose triple-pill protocol with a standard-care protocol for lowering blood pressure in a trial conducted in public hospital-based family medicine clinics in Nigeria. Black African adults with uncontrolled hypertension who were untreated or receiving a single blood pressure-lowering drug were randomly assigned to low-dose triple-pill or standard-care protocols. The triple-pill protocol involved a novel combination of telmisartan, amlodipine, and indapamide in triple one-quarter, one-half, and standard doses; the standard-care protocol started with amlodipine.

The researchers found that at month 6, mean home systolic blood pressure was on average 31 and 26 mm Hg lower in the triple-pill and standard-care protocols, respectively. At month 6, in the triple-pill and standard-care protocols, clinical blood pressure control was 82 and 72 percent, respectively, and home blood pressure control was 62 versus 28 percent, respectively. None of the participants discontinued treatment due to adverse events.

"The results demonstrate that the World Health Organization goal to achieve greater than 80 percent blood pressure control in those treated for hypertension is possible in low-income settings," the authors write.

Several authors disclosed ties to industry.

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Only one-fourth of family physicians report being very satisfied with their electronic health record (EHR), according to a study published online Aug. 29 in JAMA Network Open.

A. Jay Holmgren, Ph.D., from the University of California, San Francisco, and colleagues measured family physician satisfaction with their EHR, EHR usability, and the association of EHR usability with satisfaction and burnout. The analysis included survey responses from 2,067 family physicians seeking American Board of Family Medicine recertification in 2022.

The researchers found that 27.2 percent were very satisfied, 37.5 percent were somewhat satisfied, 16.7 percent were somewhat dissatisfied, and 9.6 percent were very dissatisfied with their EHR. The highest usability was seen for readability of information, with 26.3 percent of respondents rating it as excellent. Usefulness of alerts had the lowest usability, with 12.7 percent of respondents rating it as excellent. Good or excellent usability for entering data (β = 0.09), alignment with workflow processes (β = 0.11), ease of finding information (β = 0.14), and usefulness of alerts (β = 0.11) were associated with physicians being very satisfied with their EHR, and being very satisfied with the EHR was associated with reduced frequency of burnout (β = −0.64).

"One-fourth reported being somewhat or very dissatisfied, a concerning finding amplified by the inverse association between EHR satisfaction and burnout," the authors write.

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Millions of Americans use the opioid-like herbal supplement known as kratom, but evidence of its dangers continue to mount.

The U.S. Food and Drug Administration has issued another alert for consumers to stay away from one brand of kratom in particular, OPMS Black Liquid Kratom.

"The FDA recently received an adverse event report of a person who died after using OPMS Black Liquid Kratom," the agency noted.

"This is one of many reports of serious adverse events individuals have reported" after using the supplement, the FDA added.

Kratom is an herbal supplement derived from the dried leaves of a tropical evergreen tree in the coffee family. A chemical called mitragynine, found in kratom, tweaks some of the same brain receptors that respond to opioids.

However, overdoses of mitragynine are toxic to the liver and can prove fatal.

Kratom has been used for centuries in its native Southeast Asia to produce increased energy and relaxation, according to the U.S. National Institute on Drug Abuse.

The drug is largely unregulated: Anyone can buy kratom online, and it can be found in convenience stores, gas stations and vape shops. Some bars serving botanical drinks offer kratom tea.

About 1.7 million people 12 and older used kratom in the United States in 2021, according to the National Survey on Drug Use.

The new alert from the FDA noted that many users of OPMS Black Liquid Kratom reported adverse health effects, including "withdrawal symptoms, addiction, digestive issues, restless leg syndrome, skin problems, aggressive behavior, increased anxiety, lack of energy and inability to focus."

Mitragynine and 7-hydroxymitragynine (7-OH mitragynine) are listed as ingredients on the product's label, the FDA said.

"The FDA is issuing this safety alert to warn consumers about serious adverse health effects associated with OPMS Black Liquid Kratom," the agency said. "We note that consumers may believe kratom products are safe because kratom is a plant material and is available online and in some retail stores such as vape/smoke shops."

However, "the FDA continues to warn consumers not to use kratom because of the risk of serious adverse events, including liver toxicity, seizures, and substance use disorder," the agency said.

More information

Find out more about kratom at the National Institute on Drug Abuse.

SOURCE: U.S. Food and Drug Administration, news release, Aug. 2, 2024

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An additional cinnamon product sold in the United States has been found to contain high levels of lead, health officials are warning.

In a health alert issued Thursday, the U.S. Food and Drug Administration said the ground cinnamon product, sold as El Servidor, joins a growing list of cinnamon products that have contained high levels of lead.

Through testing, the cinnamon was found to have elevated lead levels at 20 parts per million. Although the FDA doesn't set limits for lead levels in spices, the United Nations’ Food and Agriculture Organization has a proposed international safety standard of 2.5 parts per million of lead for bark spices like cinnamon, NBC News reported.

The FDA noted that it has asked the distributor to recall the product.

Lead in cinnamon products has become a growing problem: In March, the FDA warned about lead in fruit puree products sold at Dollar Tree, Family Dollar and other stores. Those products had levels of lead ranging from 2.03 to 3.4 parts per million.

The cinnamon identified in the new alert was sold at a supermarket in New York City, although it's unclear whether it was distributed more widely.

Leigh Frame, director of integrative medicine at George Washington University School of Medicine and Health Sciences, told NBC News that the new recall was "alarming."

"We sort of assume things are safe until proven otherwise," Frame said. "It’s not until people get sick do we actually have these recalls. Often, it’s too late; people have already consumed the products."

"It's a little scary to think about all the things that potentially could be lurking in our food system because we don't have the resources," she added.

No illnesses have been reported in the latest FDA warning, although the agency advised consumers to throw away the product immediately.

Elevated levels of lead can be toxic, particularly for young children, who are more at risk because of their smaller body size and the fact that they are still growing, according to the FDA. High levels of lead exposure in this age group can cause learning disabilities and lowered IQ.

Short-term exposure can trigger headaches, abdominal pain, vomiting and anemia. Meanwhile, long-term exposure can cause irritability, lethargy, fatigue, muscle aches or burning, constipation, difficulty concentrating, tremor and weight loss.

Frame recommends limiting exposure, particularly with young children.

“If you have cinnamon oatmeal every morning, maybe switch to a different variety for a while until we figure things out, just to reduce the exposure,” she advised.

More information

The CDC has more on lead poisoning.

SOURCE: U.S. Food and Drug Administration, health alert, July 25, 2024; NBC News

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The prevalence of impaired awareness of hypoglycemia (IAH) is high among patients using sulfonylureas long term, according to a study published in the July/August issue of the Annals of Family Medicine.

Hsiang-Ju Cheng, M.D., from the National Cheng Kung University in Tainan, Taiwan, and colleagues investigated the relationship between duration of medication use and prevalence of IAH among patients with insulin-treated or sulfonylurea-treated type 2 diabetes. Analysis included 898 patients (41.0 percent insulin users; 65.1 percent sulfonylurea users).

The researchers found that overall, IAH prevalence was 41.0 percent using the Gold questionnaire and 28.2 percent using the Clarke questionnaire among insulin users, and 65.3 and 51.3 percent, respectively, among sulfonylurea users. For sulfonylurea use, prevalence increased with longer duration, whereas it decreased with the duration of insulin use. Five or more years of sulfonylurea use was significantly associated with threefold increases in the odds of IAH, regardless of criteria used. Regular blood glucose testing and retinal examinations cut odds of IAH in both insulin and sulfonylurea users.

"The reasons for the differential association of hypoglycemia history with IAH between insulin users and sulfonylurea users need more study," the authors write.

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Decreases in primary care visit volume were partially offset by increasing telehealth use for all patients during the COVID-19 pandemic, according to a study published in the July/August issue of the Annals of Family Medicine.

Zachary J. Morgan, from the American Board of Family Medicine in Lexington, Kentucky, and colleagues quantified the nationwide decrease in primary care visits and increase in telehealth utilization during the pandemic and explored whether certain groups of patients were disproportionately affected. Analysis included 1.65 million patients (8.83 million visits) seen at 408 practices.

The researchers found that during the pandemic, there were decreases of 7 percent in total volume and 17 percent for in-person visit volume, yielding a 10 percent telehealth conversion ratio. The greatest decreases in visit volume were seen among pediatric patients (−24 percent), Asian patients (−11 percent), and those with more comorbidities (−9 percent). Hispanic or Latino patients (17 percent) and patients living in urban areas (12 percent) had highest telehealth usage.

"These variations [in telehealth utilization] have implications not only for the long-term consequences of the COVID-19 pandemic, but also for planners seeking to ready the primary care delivery system for any future systematic disruptions and to mitigate any potential exacerbation of existing disparities," the authors write.

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Patient-family physician language concordance is associated with a lower risk for adverse outcomes, according to a study published online June 3 in BMJ Public Health.

Michael Reaume, M.D., from the University of Manitoba Max Rady College of Medicine in Winnipeg, Canada, and colleagues used data from 497,227 home care recipients to examine whether patient-family physician language concordance in a primary care setting is associated with lower rates of hospital-based health care utilization and mortality.

The researchers found that those who received language-concordant primary care experienced significantly fewer emergency department visits (53.1 versus 57.5 percent), fewer hospitalizations (35.0 versus 37.6 percent), and lower mortality (14.4 versus 16.6 percent) compared with non-English, non-French speakers who received language-discordant primary care. Non-English, non-French speakers had lower risks for emergency department visits (adjusted hazard ratio [aHR], 0.91), hospitalizations (aHR, 0.94), and death (aHR, 0.87) when they received language-concordant primary care. Language of family physician did not impact the risk for experiencing an emergency department visit, hospitalization, or death for francophones.

"Optimizing the delivery of language-concordant care could potentially result in significant decreases in the use of acute health care services and mortality at the population level," the authors write.

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