Annals of family medicine
-
Annals of family medicine · May 2012
Randomized Controlled Trial Comparative StudyHealthy Steps trial: pedometer-based advice and physical activity for low-active older adults.
We compared the effectiveness of 2 physical activity prescriptions delivered in primary care--the standard time-based Green Prescription and a pedometer step-based Green Prescription--on physical activity, body mass index (BMI), blood pressure, and quality of life in low-active older adults. ⋯ Pedometer use resulted in a greater increase in leisure walking without any impact on overall activity level. All participants increased physical activity, and on average, their blood pressure decreased over 12 months, although the clinical relevance is unknown.
-
Annals of family medicine · May 2012
Review Meta AnalysisIntranasal corticosteroids in management of acute sinusitis: a systematic review and meta-analysis.
Acute sinusitis is a common condition in ambulatory care, where it is frequently treated with antibiotics, despite little evidence of their benefit. Intranasal corticosteroids might relieve symptoms; however, evidence for this benefit is currently unclear. We performed a systematic review and meta-analysis of the effects of intranasal corticosteroids on the symptoms of acute sinusitis. ⋯ Intranasal corticosteroids offer a small therapeutic benefit in acute sinusitis, which may be greater with high doses and with courses of 21 days' duration. Further trials are needed in antibiotic-naïve patients.
-
Annals of family medicine · May 2012
Randomized Controlled Trial Comparative StudyTypical electronic health record use in primary care practices and the quality of diabetes care.
Recent efforts to encourage meaningful use of electronic health records (EHRs) assume that widespread adoption will improve the quality of ambulatory care, especially for complex clinical conditions such as diabetes. Cross-sectional studies of typical uses of commercially available ambulatory EHRs provide conflicting evidence for an association between EHR use and improved care, and effects of longer-term EHR use in community-based primary care settings on the quality of care are not well understood. ⋯ Consistent use of an EHR over 3 years does not ensure successful use for improving the quality of diabetes care. Ongoing efforts to encourage adoption and meaningful use of EHRs in primary care should focus on ensuring that use succeeds in improving care. These efforts will need to include provision of assistance to longer-term EHR users.
-
Annals of family medicine · May 2012
Randomized Controlled TrialHealth coaching to improve hypertension treatment in a low-income, minority population.
Poor blood pressure control is common in the United States. We conducted a study to determine whether health coaching with home titration of antihypertensive medications can improve blood pressure control compared with health coaching alone in a low-income, predominantly minority population. ⋯ Blood pressure control in a low-income, minority population can be improved by teaching patients to monitor their blood pressure at home and having nonprofessional health coaches assist patients, in particular, by counseling them on medication adherence. The improved blood pressure control can be achieved while reducing the time spent by physicians.