Annals of family medicine
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Annals of family medicine · Jul 2010
Randomized Controlled TrialPhysician satisfaction with chronic care processes: a cluster-randomized trial of guided care.
Chronically ill older patients with multiple conditions are challenging to care for, and new models of care for this population are needed. This study evaluates the effect of the Guided Care model on primary care physicians' impressions of processes of care for chronically ill older patients. ⋯ Based on physician report, Guided Care provides important benefits to physicians by improving communication with chronically ill older patients and their families and in physicians' knowledge of their patients' clinical conditions.
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Annals of family medicine · May 2010
Randomized Controlled Trial Clinical TrialHome-based activity program for older people with depressive symptoms: DeLLITE--a randomized controlled trial.
We wanted to assess the effectiveness of a home-based physical activity program, the Depression in Late Life Intervention Trial of Exercise (DeLLITE), in improving function, quality of life, and mood in older people with depressive symptoms. ⋯ The DeLLITE activity program improved mood and quality of life for older people with depressive symptoms as much as the effect of social visits. Future social and activity interventions should be tested against a true usual care control.
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Annals of family medicine · Mar 2010
Randomized Controlled TrialPoint-of-care C-reactive protein testing and antibiotic prescribing for respiratory tract infections: a randomized controlled trial.
Antibiotics are only beneficial for subgroups of patients with acute lower respiratory tract infections (LRTI) and rhinosinusitis in family practice, yet overprescribing for these conditions is common. C-reactive protein (CRP) point-of-care testing and delayed prescribing are useful strategies to reduce antibiotic prescribing, but both have limitations. We evaluated the effect of CRP assistance in antibiotic prescribing strategies-including delayed prescribing-in the management of LRTI and rhinosinusitis. ⋯ CRP point-of-care testing to assist in prescribing decisions, including delayed prescribing, for LRTI and rhinosinusitis may be a useful strategy to decrease antibiotic use and increase patient satisfaction without compromising patient recovery.
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Annals of family medicine · Jan 2010
Randomized Controlled TrialSuicide inquiry in primary care: creating context, inquiring, and following up.
We wanted to describe the vocabulary and narrative context of primary care physicians' inquiries about suicide. ⋯ Although most suicide inquiries by primary care physicians are sensitive, clear, and supportive, some language is used that may inhibit suicide disclosure. Some physician responses may unintentionally reinforce patients for remaining silent about their risk. This study will inform future research in the development of quality improvement interventions to support primary care physicians in making clear, appropriate, and sensitive inquires about suicide.
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Annals of family medicine · Nov 2009
Randomized Controlled TrialA medical assistant-based program to promote healthy behaviors in primary care.
Most primary care patients have at least 1 major behavioral risk: smoking, risky drinking, low physical activity, or unhealthy diet. We studied the effectiveness of a medical assistant-based program to identify and refer patients with risk behaviors to appropriate interventions. ⋯ 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.