Two Dozen Curated Articles to Shape Primary Care Policy and Practice

A list of research articles compiled by PCC's Research Dissemination Workgroup

Welcome to PCC’s primary care research hub. This hub is a product of PCC’s Bridging the Gap in Primary Care Research project, which is designed to curate a small number of recent, seminal primary care articles and communicate them broadly. Our goal is to inform and shape the thinking of practice and policy leaders with respect to primary care clinical and health services research.  

PCC has assembled this set of 24 primary care health services research (HSR) and primary care patient-centered outcomes research/comparative effectiveness research (clinical) articles through the work of a Research Dissemination Workgroup (RDWG) and our research partner, the North American Primary Care Research Group (NAPCRG). The PCC selected 12 clinical and 12 health services research articles for the final list.

The 24 articles can be filtered based on the Shared Principles of Primary Care, which characterize advanced primary care, and by article type. You can click on the Shared Principle icons next to each article to read more about each principle. Click on the title of the article to go to the full abstract and a link to the original publication. Some of the articles require an academic credential or paid subscription to the journal in which they were published. You can search for free, full-text versions of the articles using pubmed. 

In addition to this central research hub page, selected articles will receive additional dissemination treatment through our quarterly Lunch and Learn discussions and other dissemination documents. You can access previous Lunch and Learn discussions and view the additional dissemination materials on the About the Project page. 

The overall project is funded by a Patient-Centered Outcomes Research Institute Eugene Washington PCORI Engagement Award (19760-PCPCC).

Accessible

Estimated Effect on Life Expectancy of Alleviating Primary Care Shortages in the United States

Annals of Internal Medicine | July 2021

Prior studies have reported that greater numbers of primary care physicians (PCPs) per population are associated with reduced population mortality, but the effect of increasing PCP density in areas of low density is poorly understood. ...

Accessible

Higher Medicare Spending On Imaging And Lab Services After Primary Care Physician Group Vertical Integration

Health Affairs | May 2021

This study highlights how the growing trend of vertical integration, combined with differences in Medicare payment between hospitals and nonhospital providers, leads to higher Medicare spending.

Comprehensive and Equitable

Primary Care Practices Providing a Broader Range of Services Have Lower Medicare Expenditures and Emergency Department Utilization

Journal of General Internal Medicine | March 2021

This article explores the shared principle of "comprehensiveness" and assesses the impact comprehensiveness has on medical expenditures and emergency department utilization. 

Accessible

Geographic variation in overscreening for colorectal, cervical, and breast cancer among older adults

JAMA Network Open | July 2020

National guidelines balance risks and benefits of population-level cancer screening among adults with average risk. Older adults are not recommended to receive routine screening, but many are overscreened. This study assesses the...

Accessible

A comparison of contemporary versus older studies of aspirin for primary prevention

Family Practice | June 2020

Recent aspirin trials have not shown similar benefits for primary prevention as older studies. This study compares benefits and harms of aspirin for primary prevention before and after widespread use of statins and colorectal cancer...

Accessible

Effects of antihypertensive medication reduction vs usual care on short-term blood pressure control in patients with hypertension aged 80 years and older: The OPTIMISE randomized clinical trial

JAMA Network | May 2020

Deprescribing of antihypertensive medications is recommended for some older patients with polypharmacy and multimorbidity when the benefits of continued treatment may not outweigh the harms. This study aimed to establish whether...

Comprehensive and Equitable

Home blood pressure monitoring in cases of clinical uncertainty to differentiate appropriate inaction from therapeutic inertia

Annals of Family Medicine | January 2020

Conventional clinic blood pressure (BP) measurements are routinely used for hypertension management and physician performance measures. We aimed to check home BP measurements after elevated conventional clinic BP measurements for which...

Person- & Family-Centered

Oseltamivir plus usual care versus usual care for influenza-like illness in primary care: an open-label, pragmatic, randomised controlled trial

The Lancet | January 2020

Primary care patients with influenza-like illness treated with oseltamivir recovered one day sooner on average than those managed by usual care alone. Older, sicker patients with comorbidities and longer previous symptom duration...

Accessible

Association of Primary Care Physician Supply with Population Mortality in the United States, 2005-2015

JAMA Internal Medicine | February 2019

What is the association between primary care physician density and population-level mortality?

Comprehensive and Equitable

Preventing colorectal cancer or early diagnosis: Which is best? A re-analysis of the U.S. preventative services task force evidence report

Preventive Medicine | January 2019

Flexible sigmoidoscopy (FS) is the only cancer screening test to lower the risk of death compared to usual care in randomized controlled trials (RCTs). We hypothesize that this unique death reduction is more attributable to prevention...

Team-Based and Collaborative

Effect of community health worker support on clinical outcomes of low-income patients across primary care facilities: a randomized clinical trial

JAMA Internal Medicine | December 2018

Addressing the social determinants of health has been difficult for health systems to operationalize. This article assesses a standardized intervention, Individualized Management for Patient-Centered Targets (IMPaCT), delivered by...

High-Value

Do Medical Homes Improve Quality of Care for Persons with Multiple Chronic Conditions?

Health Services Research | December 2018

This paper examines the association between medical home enrollment and receipt of recommended care for Medicaid beneficiaries with multiple chronic conditions (MCC).

Continuous

Higher Primary Care Physician Continuity is Associated With Lower Costs and Hospitalizations

Annals of Family Medicine | November 2018

Continuity of care is a defining characteristic of primary care associated with lower costs and improved health equity and care quality. However, we lack provider-level measures of primary care continuity amenable to value-based payment...

Person- & Family-Centered

PedHITSS: A screening tool to detect childhood abuse in clinical settings.

Family Medicine | November 2018

This study indicates that the Pediatric Hurt-Insult-Threaten-Scream-Sex (PedHITSS) screening tool performs as well as the Conflict Tactics Scale: Parent-Child Version (CTSPC) screening measure (CTSPC) in identifying and differentiating...

Team-Based and Collaborative

Evaluation of the Learning to Integrate Neighborhoods and Clinical Care Project: Findings from Implementing a New Lay Role into Primary Care Teams to Address Social Determinants of Health

The Permanente Journal | October 2018

Lay health workers have been used to addressing patients' social determinants of health through resource referral and goal setting in targeted populations. However, we know of no studies that evaluate this type of role for a general...

Accessible

Opportunistic screening for heart failure with natriuretic peptides in patients with atrial fibrillation: a meta-analysis of individual participant data of four screening studies

Heart (BMJ Journal) | August 2018

Heart failure (HF) often coexists in atrial fibrillation (AF) but is frequently unrecognized due to overlapping symptomatology. Furthermore, AF can cause elevated natriuretic peptide levels, impairing its diagnostic value for HF...

Coordinated and Integrated

A systematic review of chronic disease management interventions in primary care

BMC Family Practice | January 2018

Primary and community care are key settings for the effective management of long term conditions. We aimed to evaluate the pattern of health outcomes in chronic disease management interventions for adults with physical health problems...

Comprehensive and Equitable

Primary care physician perspectives about antipsychotics and other medications symptoms of dementia

Journal of the American Board of Family Medicine | January 2018

Guidelines, policies, and warnings have been applied to reduce the use of medications for behavioral and psychological symptoms of dementia (BPSD). Because of rare dangerous side effects, antipsychotics have been singled out in these...

Accessible

Patient-Centered Medical Home Implementation and Improved Chronic Disease Quality: A Longitudinal Observational Study

Health Services Research | November 2017

This study examines associations between clinics’ extent of patient-centered medical home (PCMH) implementation and improvements in chronic illness care quality. Veterans Health Administration primary care clinics with the most PCMH...

Team-Based and Collaborative

High Levels of Capitation Payments Needed to Shift Primary Care Toward Proactive Team and Nonvisit Care

Health Affairs | September 2017

Capitated payments in the form of fixed monthly payments to cover all of the costs associated with delivering primary care could encourage primary care practices to transform the way they deliver care.

Accessible

Glucose self-monitoring in non-insulin-treated patients with type 2 diabetes in primary care settings: A randomized trial

JAMA Internal Medicine | July 2017

Routine self-monitoring of blood glucose levels does not significantly improve hemoglobin A1c levels or health related quality of life for most patients with non–insulin-treated type 2 diabetes; patients and clinicians should...

Person- & Family-Centered

Physical Exercise for Late-Life Depression: Customizing an Intervention for Primary Care

Journal of the American Geriatrics Society | February 2017

This study identifies which individual- and context-related factors influence the translation into clinical practice interventions based on physical exercise (PE) as an adjunct to antidepressants (AD) for the treatment of late-life...

Person- & Family-Centered

The fit family challenge: A primary care childhood obesity pilot intervention

Journal of the American Board of Family Medicine | July 2016

Childhood obesity has increased dramatically over several decades, and the American Academy of Pediatrics has recommended primary care practices as ideal sites for the identification, education, and implementation of therapeutic...

Coordinated and Integrated

Patient Navigators Connecting Patients to Community Resources to Improve Diabetes Outcomes

Journal of the American Board of Family Medicine | January 2016

In this study researchers tested the feasibility and acceptability of telephone-based nonprofessional patient navigation to promote linkages between the primary care physician office and community programs for patients with or at risk...

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