Wednesday, January 6, 2016

Hypertension, Diabetes, Hyperlipidemia Resource: January 2016

Resources updated to support the January 2016 Guidelines discussion for new Family Medicine Residents:

Hypertension2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults
Additional Resources: 
American Family Physician: POEMsJNC 8 Report on Prevention, Evaluation and Treatment of Hypertension
AAFP: 2014 Hypertension Guideline Stands to Simplify Treatment, Says Expert

Hyperlipidemia2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
American Heart Association: CV Risk Calculator
AAFP: New Guidelines Propose Significant Shift in Cholesterol Management

Diabetes: American Diabetes Association: Standards of Medical Care in Diabetes—2015
(including the new Abridged Standards for Primary Care Providers)
American Association of Clinical Endocrinologists: AACE Comprehensive Diabetes Management Algorithm 2015
Additional Resources: 
National Diabetes Education Program2012 Diabetes Numbers at a Glance
CDC Diabetes Data & Trends

In addition, there are a number of "apps" that I think can be of use in clinic:

1) Agency for Healthcare Research & Quality: electronic Preventive Service Selector (ePSS)
2) Shots by STFM (Society or Teachers of Family Medicine)
3) American Heart Association/American College of Cardiology  ASCVD Risk Calculators (online)

ASCCP 2013 Consensus Guidelines on the Management of Women with Abnormal Cervical Cancer Screening Tests and Cancer Precursors

The 2013 guidelines from the American Society for Colposcopy and Cervical Pathology on how to deal with almost any abnormal Pap or HPV testing result can be found at:
http://www.asccp.org/Guidelines-2/Management-Guidelines-2

If you are the type of person who likes to skip right to the facts, you can find the PDF of the algorithms at:
http://www.asccp.org/Portals/9/docs/ASCCP%20Management%20Guidelines_August%202014.pdf

If you have questions on how to deal with abnormal cervical pathology/screening results, this is the place to start the search.

Thursday, October 1, 2015

Errata for my presentations at 2015 AAFP FMX!


My Big Blue Friend and I would like to make you aware of some corrections, additions and explanatory materials from my presentations on Diabetes at the 2015 Family Medicine Experience!  These were sessions CME031 & 032: Diabetes Update 2015: New Trends in an Old Disease.

Slide 31: ACOG Gestational Diabetes Recommendations:
Under the heading "Start medication if" the last line should read "-2-hour 120 mg/dL"

Slide 32: Prevent Diabetes STAT
The url listed no longer works (though it did in the past and remains in the STAT program handouts).  The working URL is: here 

Slide 61: DPP-4 Inhibitors:
Additional Information: on 8-28-15, the FDA issued a Drug Safety Communication noting that rare patients using DPP-4 inhibitors had experienced severe disabling joint pain.  The onset of pain occurred from one day to several years after starting the medication.  The pain usually resolved within one month of stopping the DPP-4i medication.

If you have any further recommendations or have discovered additional errors, please send them to me at peter.ziemkowski@gmail.com.

Thank you,
Pete

Monday, July 13, 2015

2015 Clinical Guideline Resources

Resources updated to support the 2015 Guidelines discussion for new Family Medicine Residents:


Hypertension2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults
Additional Resources: 
American Family Physician: POEMsJNC 8 Report on Prevention, Evaluation and Treatment of Hypertension
AAFP: 2014 Hypertension Guideline Stands to Simplify Treatment, Says Expert

Hyperlipidemia2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
American Heart Association: CV Risk Calculator
AAFP: New Guidelines Propose Significant Shift in Cholesterol Management

Diabetes: American Diabetes Association: Standards of Medical Care in Diabetes—2015
(including the new Abridged Standards for Primary Care Providers)
American Association of Clinical Endocrinologists: AACE Comprehensive Diabetes Management Algorithm 2015
Additional Resources: 
National Diabetes Education Program2012 Diabetes Numbers at a Glance
CDC Diabetes Data & Trends

In addition, there are a number of "apps" that I think can be of use in clinic:

1) Agency for Healthcare Research & Quality: electronic Preventive Service Selector (ePSS)
2) Shots by STFM (Society or Teachers of Family Medicine)
3) American Heart Association/American College of Cardiology  ASCVD Risk Calculators (online)

Friday, October 24, 2014

Links for Computer Applications: AAFP Scientific Assembly 2014

Meaningful Use




         Stage 1

      13 required core objectives

      5 menu objectives (from list of 9)

     Total of 18 objectives

     http://www.healthit.gov/providers-professionals/step-5-achieve-meaningful-use-stage-1  

         Stage 2

      17 core objectives

      3 menu objectives (from list of 6)

      total of 20 objectives

     http://www.healthit.gov/providers-professionals/step-5-achieve-meaningful-use-stage-2  

 

EHR Selection & Implementation

        AAFP Center for Health Information Technology

        AAFP Health-IT Guides

    Selecting & Implementing an HER

     http://www.aafp.org/practice-management/health-it/product.html  

CDS Implementation Guides

        HealthIT.gov

    http://www.healthit.gov/policy-researchers-implementers/cds-implementation   

    How-to guides:

     Start with a Strong Foundation for CDS

     Assemble a CDS Implementation Team

     Plan for Successful CDS Development, Design, and Deployment 

     Roll Out Effective CDS Interventions

     Measure Effects and Refine CDS Interventions

Old Fashioned CDS System

        DiagnosisPro: http://en.diagnosispro.com/

Smartphone Apps

Reference

        All-in-one

    UpToDate: www.uptodate.com  

    ePocrates: www.epocrates.com  

    Medscape Mobile App: http://www.medscape.com/public/mobileapp  

Reference

        Leverage content

    Elsevier: ClinicalKey: www.clinicalkey.com  

    Skyscape: Omnio: www.omnio.com  

Drug Reference

        Lexicomp: www.lexi.com

        Micromedex: http://micromedex.com/mobile  

        Monthly Prescribing Reference:

    www.empr.com/app  

        Physician’s Drug Reference:

    Standalone or Omnio

    http://www.pdr.net/resources/mobilepdr/  

Tools

        PatientKeeper

    Patient lists

    Aggregate patient data

    Order entry

    Charge capture

    http://www.patientkeeper.com/mobile-platform/index.html  

Tools

        ePSS: electronic Preventative Services Selector

    AHRQ: http://epss.ahrq.gov/PDA/index.jsp  

        Shots by STFM:

    http://www.immunizationed.org/Shots-Mobile-App  

        ASCVD Risk Estimator: ACC/AHA

    http://www.cardiosource.org/Science-And-Quality/Practice-Guidelines-and-Quality-Standards/2013-Prevention-Guideline-Tools.aspx  

Tools

        VisualDx:

     Diagnosis search/differential builder

    http://www.visualdx.com/features/mobile-access

        MedCalc:

    http://medcalc.medserver.be/  

        Pregnancy wheel

     Huge range

Patient Health Apps

         Calorie counters

         Activity trackers

         Smoking Cessation:

     Smokefree.gov/apps-quitguide

         Patient Social Media:

     CaringBridge: www.caringbridge.org/  

         Exercise monitors

     Fitbit: www.fitbit.com

     Jawbone: www.jambone.com/up  

     Apple Watch: coming

         Sleep monitors

     Sleepbot: www.mysleepbot.com  

     Sleep Cycle: www.sleepcycle.com  


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Tuesday, April 22, 2014

Journal Club Resources

A good place to find Journal Club resources is the Centre for Evidence Based Medicine at Oxford: http://www.cebm.net/

There you can find a step-by-step introduction to the process of EBM, including tools such as the worksheets to appropriately evaluated each type of article.

If you have any trouble using this site, or finding the correct worksheet, please contact me by email.

Thanks,

Dr. Z