WEDNESDAY, Nov. 11 (HealthDay News) -- Expanded use of lower level clinical personnel, such as medical assistants (MAs), in primary care can enhance patient care but only if the clinical personnel are trained and integrated into the practice culture, according to a pair of studies in the November/December issue of the Annals of Family Medicine.

In one study, Robert L. Ferrer, M.D., of the University of Texas Health Science Center at San Antonio, and colleagues conducted a study in which 864 patients were screened by MAs for smoking, drinking, inactivity and unhealthy diet, then sent on to their primary care clinician either with or without the MA's assessment. Patients whose MA assessments were sent on were referred to intervention programs more than those whose assessments were not sent on (67.4 versus 21.8 percent). However, the success rates for improved behaviors were judged similar (21.7 versus 16.9 percent).

In another study, Jochen Gensichen, M.D., of Friedrich-Schiller-University in Jena, Germany, and colleagues interviewed 26 health care assistants (HCAs) who monitored patients with depression by telephone. A majority of HCAs said their patient interactions provided personal and professional satisfaction and interested them in improving patient-communication skills. On the downside, the HCAs cited the stresses of interacting with depressed patients and their increased workload.

"Engaging more primary care team members to address risk behaviors improved referral rates. More extensive medical assistant training, changes in practice culture, and sustained behavioral interventions will be necessary to improve risk behavior outcomes," Ferrer and colleagues conclude.

Abstract - Ferrer
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Abstract - Gensichen
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