Family Physicians

Approach to sialadenitis

Rowan Hutchins — Tue, 26 Sep 2023 05:00:00 +0000

Date Added:

September 26, 2023

Journal/Publication:

Canadian Family Physician

Publisher:

College of Family Physicians of Canada

Publication Date:

August 1, 2023

Issue:

Volume:

Pages:

531-536

URL:

Approach to sialadenitis

Type:

Meta-analyses, Reviews, and Guidelines

DOI (1):

https://doi.org/10.46747/cfp.6908531

Keywords

sialadenitis

family medicine

Family Physicians

PMID (1):

37582587

MeSH

Diagnostic Imaging

Physical Examination

Sialadenitis* / diagnosis

Sialadenitis* / etiology

Sialadenitis* / therapy

A concise review of the diagnosis and management of sialadenitis. James W. Mold, MD, MPH

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Objective To provide family physicians with a practical evidence-based approach to the management of patients with sialadenitis.

Sources of information MEDLINE and PubMed databases were searched for English-language research on sialadenitis and other salivary gland disorders, as well as for relevant review articles and guidelines published between 1981 and 2021.

Main message Sialadenitis refers to inflammation or infection of the salivary glands and is a condition that can be caused by a broad range of processes including infectious, obstructive, and autoimmune. History and physical examination play important roles in directing management, while imaging is often useful to establish a diagnosis. Red flags such as suspected abscess formation, signs of respiratory obstruction, facial paresis, and fixation of a mass to underlying tissue should prompt urgent referral to head and neck surgery or a visit to the emergency department.

Conclusion Family physicians can play an important role in the diagnosis and management of sialadenitis. Prompt recognition and treatment of the condition can prevent the development of complications.

Sialadenitis is inflammation or infection of the salivary glands that can present acutely or chronically. Sialadenitis can cause serious discomfort in everyday activities such as chewing food. There are numerous pathologies that can cause sialadenitis, which are reviewed below.

Author/s:

Moore, Jonah, Simpson, Matthew T.W., Cohen, Natasha, Beyea, Jason A., Phillips, Timothy

Revising the advanced access model pillars: a multimethod study

Aubrey Delammermore — Sat, 24 Sep 2022 05:00:00 +0000

Date Added:

September 24, 2022

Journal/Publication:

CMAJOpn

Publisher:

CMA Impact Inc

Publication Date:

September 6, 2022

Issue:

Volume:

Pages:

E799-E806

URL:

Revising the advanced access model pillars: a multimethod study

Type:

Practice Management Research Results

Format:

Article

DOI (1):

10.9778/cmajo.20210314

Keywords

Family Physicians

social workers

referral and consultation

nurse practitioners

scheduling models

MeSH

primary health care

health services accessibility

access to information

Patient-Centered Care

Population Health

A highly conceptual report on the design and improvement of advance access scheduling models based upon research and clinical and administrative experience. James W. Mold, MD, MPH

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Background: The advanced access model was developed 20 years ago and has been implemented in several countries. We aimed to revise and operationalize the pillars and subpillars of the advanced access model based on its contemporary practice by professionals in primary health care.

Methods: This multimethod sequential study was informed by a literature review and an expert panel of provincial and local decision-makers, primary health care clinic members (family physicians, nurses and administrative staff), patients and researchers from the province of Quebec. Throughout the consultation process, participants were asked to develop a common vision of the pillars and subpillars that make up the advanced access model and to react to suggested definitions or content.

Results: The revised advanced access model is defined by 5 pillars, of which 2 were updated from the original model (“Appointment system” and “Interprofessional practice”), 1 was merged with a revised pillar (“Develop contingency plans” with “Planning of needs and supply”) and 1 underwent major transformations (“Backlog reduction” to “Continuous adjustment”). A new pillar concerning communication emerged from the consultation process. Subsequent steps for operationalizing definitions of subpillars confirmed the nature of the revised advanced access pillars and stabilized their content.

Interpretation: The overall consultation process resulted in a revised contemporary advanced access model, with strong consensus among participating experts. The revised model will be used to develop a reflective tool for primary health care professionals to evaluate their advanced access practice.

Timely access is a cornerstone of strong primary health care and a key component of a patient-centred medical home for ensuring population health.1 Numerous innovations have been implemented to improve timely access,2 with one of the most recommended around the world being the advanced access model, also called open access.2,3 Based on greater accessibility linked with patients’ relational and informational continuity with a primary health care professional or team, the advanced access model aims to ensure that patients obtain access to health care services at a time and date convenient for them when needed, regardless of the urgency of the demand.4 Originally developed in the United States in the early 2000s, advanced access is defined by Murray and Berwick as having 5 pillars: balance supply and demand, reduce the backlog of previously scheduled appointments, review the appointment system, integrate interprofessional practice and develop contingency plans.5,6 Several scientific papers on the foundations of advanced access have been published over the past 20 years, and its benefits have been reported in many countries, including the US, the United Kingdom and Canada.6–9

Over the last 2 decades, primary health care practice has evolved to increase interdisciplinarity in clinical teams. Thus, the need for a model that incorporates new practices and professionals has necessitated development of an updated advanced access model. Furthermore, advanced access was originally developed in a context that prioritized implementing a new way of doing, with less emphasis on the ongoing practice and sustainability of the model.10,11 However, changes in primary health care practice require revisions to the advanced access model to adapt it to the contemporary context.

In this study, we redefine the pillars and subpillars of the advanced access model by integrating an interdisciplinary team–based focus, while considering the integration of primary health care professionals, such as nurse practitioners, registered nurses, social workers and other allied professionals, in primary health care practices. The objective of this study was to revise and operationalize the pillars and subpillars of the advanced access model.

Author/s:

Breton, M., Gaboury, I., Beaulieu, C., Sasseville, M., Hudon, C., Malham, S. A., Duhoux, A., Rodrigues, I., Haggerty, J.

Revising the advanced access model pillars: a multimethod study

Aubrey Delammermore — Sat, 24 Sep 2022 05:00:00 +0000

Date Added:

September 24, 2022

Journal/Publication:

CMAJOpn

Publisher:

CMA Impact Inc

Publication Date:

September 6, 2022

Issue:

Volume:

Pages:

E799-E806

URL:

Revising the advanced access model pillars: a multimethod study

Type:

Practice Management Research Results

Format:

Article

DOI (1):

10.9778/cmajo.20210314

Keywords

Family Physicians

social workers

referral and consultation

nurse practitioners

scheduling models

MeSH

primary health care

health services accessibility

access to information

Patient-Centered Care

Population Health

A highly conceptual report on the design and improvement of advance access scheduling models based upon research and clinical and administrative experience. James W. Mold, MD, MPH

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Author/s:

Breton, M., Gaboury, I., Beaulieu, C., Sasseville, M., Hudon, C., Malham, S. A., Duhoux, A., Rodrigues, I., Haggerty, J.

Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency

Devin Evans — Fri, 26 Feb 2021 06:00:00 +0000

Date Added:

February 26, 2021

Journal/Publication:

Journal of the American Board of Family Medicine

Publication Date:

January 31, 2021

Issue:

Volume:

Pages:

216-223

URL:

Sudden Sensorineural Hearing Loss: A Diagnostic and Therapeutic Emergency

Type:

Meta-analyses, Reviews, and Guidelines

Format:

Article

DOI (1):

10.3122/jabfm.2021.01.200199

Keywords

Audiology

clinical decision-making

Conductive Hearing Loss

PMID (1):

33452100

MeSH

physicians, family

Hearing Loss, Sudden

Hearing Loss, Sensorineural

Otolaryngology

Medicine

primary health care

A summary for primary care clinicians of the recently updated ENT guidelines for evaluation and management of sudden acute hearing loss. James W. Mold, MD, MPH

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The family physician's role in recognizing and managing sudden sensorineural hearing loss (SSNHL) is crucial. A recently updated otolaryngologic clinical practice guideline has been released for this emergency syndrome, but dissemination is limited to a specialty journal. As a result, the guidelines may not be widely available in the primary care setting where patients often present. We provide this focused review to clarify and disseminate SSNHL guidelines for the frontline family physician.

Author/s:

Prince, Andrew D.P., Stucken, Emily Z.