Personal Satisfaction

ntroduction: Growing evidence documents strong associations between volunteering and favorable health and well-being outcomes. However, epidemiological studies have not evaluated whether changes in volunteering are associated with subsequent health and well-being outcomes.

Methods: Data were from 12,998 participants in the Health and Retirement Study-a large, diverse, prospective, and nationally representative cohort of U.S. adults aged >50 years. Using multiple logistic, linear, and generalized linear regression models, this study evaluated if changes in volunteering (between t0, 2006/2008 and t1, 2010/2012) were associated with 34 indicators of physical health, health behaviors, and psychosocial well-being (in t2, 2014/2016). Models adjusted for sociodemographics, physical health, health behaviors, psychosocial factors, and personality, as well as volunteering and all outcomes in the prebaseline wave (t0, 2006/2008). Results accounted for multiple testing and data were analyzed in 2019.

Results: During the 4-year follow-up period, participants who volunteered ≥100 hours/year (versus 0 hours/year) had a reduced risk of mortality and physical functioning limitations, higher physical activity, and better psychosocial outcomes (higher: positive affect, optimism, and purpose in life; lower: depressive symptoms, hopelessness, loneliness, and infrequent contact with friends). Volunteering was not associated with other physical health outcomes (diabetes, hypertension, stroke, cancer, heart disease, lung disease, arthritis, overweight/obesity, cognitive impairment, and chronic pain), health behaviors (binge drinking, smoking, and sleep problems), or psychosocial outcomes (life satisfaction, mastery, health/financial mastery, depression, negative affect, perceived constraints, and contact with other family/children).

Conclusions: With further research, volunteering is an activity that physicians might suggest to their willing and able patients as a way of simultaneously enhancing health and society.

Author/s:

Kim, E.S., Whillans, A.V., Lee, M.T., Chen, Y., VanderWeele, T.J.

Efficacy of Intra-Articular Hypertonic Dextrose (Prolotherapy) for Knee Osteoarthritis: A Randomized Controlled Trial

Brian Desmarais — Wed, 13 May 2020 23:54:05 +0000

Date Added:

May 13, 2020

Journal/Publication:

Annals of Family Medicine

Publication Date:

May 1, 2020

Issue:

Volume:

Pages:

235-242

URL:

Efficacy of Intra-Articular Hypertonic Dextrose (Prolotherapy) for Knee Osteoarthritis: A Randomized Controlled Trial

Type:

Clinical Research Results

Format:

Article

DOI (1):

10.1370/afm.2520

MeSH

Personal Satisfaction

In this relatively small RCT, prolotherapy was more effective than saline injections for relieving pain and improving function in patients with OA of the knee at 4, 6, and 12 months. James W. Mold, MD, MPH

Commercial full text (fees may apply)

View

Purpose: To test the efficacy of intra-articular hypertonic dextrose prolotherapy (DPT) vs normal saline (NS) injection for knee osteoarthritis (KOA).

Methods: A single-center, parallel-group, blinded, randomized controlled trial was conducted at a university primary care clinic in Hong Kong. Patients with KOA (n = 76) were randomly allocated (1:1) to DPT or NS groups for injections at weeks 0, 4, 8, and 16. The primary outcome was the Western Ontario McMaster University Osteoarthritis Index (WOMAC; 0-100 points) pain score. The secondary outcomes were the WOMAC composite, function and stiffness scores; objectively assessed physical function test results; visual analogue scale (VAS) for knee pain; and EuroQol-5D score. All outcomes were evaluated at baseline and at 16, 26, and 52 weeks using linear mixed model.

Results: Randomization produced similar groups. The WOMAC pain score at 52 weeks showed a difference-in-difference estimate of -10.34 (95% CI, -19.20 to -1.49, P = 0.022) points. A similar favorable effect was shown on the difference-in-difference estimate on WOMAC function score of -9.55 (95% CI, -17.72 to -1.39, P = 0.022), WOMAC composite score of -9.65 (95% CI, -17.77 to -1.53, P = 0.020), VAS pain intensity score of -10.98 (95% CI, -21.36 to -0.61, P = 0.038), and EuroQol-5D VAS score of 8.64 (95% CI, 1.36 to 5.92, P = 0.020). No adverse events were reported.

Conclusion: Intra-articular dextrose prolotherapy injections reduced pain, improved function and quality of life in patients with KOA compared with blinded saline injections. The procedure is straightforward and safe; the adherence and satisfaction were high.

Keywords: intra-articular hypertonic dextrose; knee osteoarthritis; normal saline; prolotherapy; randomized clinical trial.

Author/s:

Sit, R.W.S., Wu, R.W., Reeves, K.D., Chan, D.C.C., Yip, B.H.K., Chung, V.C.H., Wong, S.

Powering-Up Primary Care Teams: Advanced Team Care With In-Room Support

John Bayhi — Thu, 18 Jul 2019 19:58:52 +0000

Date Added:

July 18, 2019

Journal/Publication:

Annals of Family Medicine

Publisher:

Annals of Family Medicine, Inc

Publication Date:

July 1, 2019

Issue:

Volume:

Pages:

367-371

URL:

Powering-Up Primary Care Teams: Advanced Team Care With In-Room Support

Type:

Practice Management Reviews and Guidelines, Practice Management Research Results

Format:

Article

DOI (1):

10.1370/afm.2422

Keywords

primary care

primary care teams

PMID (1):

31285215

MeSH

primary health care

physicians

allied health personnel

Personal Satisfaction

A description of an enhanced team-based model of primary care and its impact on practice revenue and joy in practice. James W. Mold, MD, MPH

Free full text

View

Primary care teams are underpowered. Teams do not maximally redistribute team functions when clinicians are diverted from activities where they add the most value. This commentary describes "advanced team care with in-room support" as a way to "power-up" primary care teams. In this core team model, each clinician is paired with 2 or 3 highly trained medical assistants or nurses-care team coordinators (CTCs). Early evidence suggests that this model is more satisfying to clinicians, staff, and patients and is financially sustainable. Yet its spread has been hobbled by several misguided beliefs, such as that the physician can and should do most tasks, that technology replaces people, that health care is a transactional endeavor more than a therapeutic relationship, that regulation is the main lever by which to advance quality, and that the principal way to increase net revenue is to reduce overhead. A shift in mindset is needed to energize primary care.

Author/s:

Christine A, Bodenheimer, Thomas

Ten tips for advancing a culture of improvement in primary care

Brian Desmarais — Thu, 20 Jun 2019 13:12:16 +0000

Date Added:

June 20, 2019

Journal/Publication:

BMJ Quality and Safety

Publication Date:

October 31, 2018

URL:

Ten tips for advancing a culture of improvement in primary care

Type:

Practice Management Research Results

Format:

Article

DOI (1):

10.1136/bmjqs-2018-008451

Keywords

MeSH

Personal Satisfaction

Based upon their successful improvement efforts, this academic family practice identified 10 keys to success. James W. Mold, MD, MPH

Free full text

View

Embracing practice-based quality improvement (QI) represents one way for clinicians to improve the care they provide to patients while also improving their own professional satisfaction. But engaging in care redesign is challenging for clinicians. In this article, we describe our experience over the last 7 years transforming the care delivered in our large primary care practice. We reflect on our journey and offer 10 tipsto healthcare leaders seeking to advance a culture of improvement. Our organisation has developed a cadre of QI leaders, tracks a range of performance measures and has demonstrated sustained improvements in important areas of patient care. Success has required deep engagement with both patients and clinicians, a long-term vision, and requisite patience.

Author/s:

Kiran, T., 'Ramji, N.', Derocher, M.B., Girdhari, R., Davie, S., Lam-Antoniades M.