Annals of family medicine
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Annals of family medicine · Nov 2006
Multicenter StudyConceptual models of treatment in depressed Hispanic patients.
Though patient variables are likely to play an important role in the undertreatment of depression, little is known of patients' perceptions of standard depression treatments. In an effort to understand their perspective, we investigated depressed Hispanic patients' perceptions of primary care treatments and the specific benefits associated with them. ⋯ Patients' perceptions of the specific efficacies of depression treatment did not match priorities implicit in current treatment guidelines. Such perceptions may play a key role in shaping patients' decisions to initiate and maintain treatment.
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Annals of family medicine · May 2005
Multicenter StudyEvaluation of a quality improvement collaborative in asthma care: does it improve processes and outcomes of care?
We wanted to examine whether a collaborative to improve asthma care influences process and outcomes of care in asthmatic adults. ⋯ The intervention was associated with improved process-of-care measures that have been linked with better outcomes. Patients benefited through increased satisfaction with communication. Follow-up of patients who participated in the intervention may have been too brief to be able to detect significant improvement in health-related outcomes.
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Annals of family medicine · Nov 2004
Randomized Controlled Trial Multicenter Study Clinical TrialImproving test ordering in primary care: the added value of a small-group quality improvement strategy compared with classic feedback only.
We wanted to evaluate the added value of small peer-group quality improvement meetings compared with simple feedback as a strategy to improve test-ordering behavior. Numbers of tests ordered by primary care physicians are increasing, and many of these tests seem to be unnecessary according to established, evidence-based guidelines. ⋯ Compared with only disseminating comparative feedback reports to primary care physicians, the new strategy of involving peer interaction and social influence improved the physicians' test-ordering behavior. To be effective, feedback needs to be integrated in an interactive, educational environment.
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Annals of family medicine · Sep 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialComfortably engaging: which approach to alcohol screening should we use?
We wanted to compare 2 screening instruments for problem drinking, the CAGE and a single question, assessing frequency of use, patient and clinician comfort, and patient engagement in change. ⋯ Clinicians and patients reported similar comfort with the CAGE questions and the single-question screening tools for problem drinking, and the 2 instruments were equal in their ability to engage the patient. In Missouri, the single question was more likely to be used.
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Annals of family medicine · Jul 2004
Multicenter StudyA string of mistakes: the importance of cascade analysis in describing, counting, and preventing medical errors.
Notions about the most common errors in medicine currently rest on conjecture and weak epidemiologic evidence. We sought to determine whether cascade analysis is of value in clarifying the epidemiology and causes of errors and whether physician reports are sensitive to the impact of errors on patients. ⋯ Cascade analysis of physicians' error reports is helpful in understanding the precipitant chain of events, but physicians provide incomplete information about how patients are affected. Miscommunication appears to play an important role in propagating diagnostic and treatment mistakes.