Annals of family medicine
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Annals of family medicine · Mar 2017
Multicenter Study Pragmatic Clinical TrialCannabis and Young Users-A Brief Intervention to Reduce Their Consumption (CANABIC): A Cluster Randomized Controlled Trial in Primary Care.
Brief intervention to reduce cannabis is a promising technique that could be adapted for use in primary care, but it has not been well studied in this setting. We tested the efficacy of a brief intervention conducted by general practitioners among cannabis users aged 15 to 25 years. ⋯ Our findings suggest that a brief intervention conducted by general practitioners with French young cannabis users does not affect use overall. They do, however, strongly support use of brief intervention for younger users and for moderate users.
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Annals of family medicine · Sep 2016
Multicenter StudyDiscordance Between Drug Adherence as Reported by Patients and Drug Importance as Assessed by Physicians.
Among patients on long-term medical therapy, we compared (1) patient and physician assessments of drug adherence and of drug importance and (2) drug adherence reported by patients with drug importance as assessed by their physicians. ⋯ We found substantial discordance between patient and physician evaluations of drug adherence and drug importance. Nearly 20% of drugs considered important by physicians were not correctly taken by patients. These findings highlight the need for better patient-physician collaboration in drug treatment.
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Annals of family medicine · Sep 2016
Multicenter StudyPrimary Care Patient Experience with Naloxone Prescription.
Notwithstanding a paucity of data, prescription of the opioid antagonist naloxone to patients prescribed opioids is increasingly recommended in opioid stewardship guidelines. The aim of this study was to evaluate chronic pain patients' attitudes toward being offered a naloxone prescription and their experience with naloxone. ⋯ Primary care patients on opioids reported that receiving a prescription for naloxone was acceptable, the prescription reached patients who had not had access to naloxone, and having naloxone may be associated with beneficial changes in opioid use behaviors. Patients prescribed opioids may not interpret the terminology describing overdose to imply unintentional opioid poisoning.
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Annals of family medicine · Jul 2016
Randomized Controlled Trial Multicenter StudyA Randomized Clinical Trial of a Tailored Lifestyle Intervention for Obese, Sedentary, Primary Care Patients.
The aim of the study was to test a tailored lifestyle intervention for helping obese primary care patients achieve weight loss and increase physical activity. ⋯ A home-based tailored lifestyle intervention in obese, sedentary primary care patients was effective in promoting weight loss and increasing moderate to vigorous physical activity, with the effects peaking at 12 months but waning at 24 months.
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Annals of family medicine · Jul 2016
Multicenter StudyImproving the Diagnosis and Treatment of Urinary Tract Infection in Young Children in Primary Care: Results from the DUTY Prospective Diagnostic Cohort Study.
Up to 50% of urinary tract infections (UTIs) in young children are missed in primary care. Urine culture is essential for diagnosis, but urine collection is often difficult. Our aim was to derive and internally validate a 2-step clinical rule using (1) symptoms and signs to select children for urine collection; and (2) symptoms, signs, and dipstick testing to guide antibiotic treatment. ⋯ A clinical rule based on symptoms and signs is superior to clinician diagnosis and performs well for identifying young children for noninvasive urine sampling. Dipstick results add further diagnostic value for empiric antibiotic treatment.