JAMA internal medicine
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JAMA internal medicine · Nov 2014
Randomized Controlled Trial Comparative StudyBrief intervention for patients with problematic drug use presenting in emergency departments: a randomized clinical trial.
Medical treatment settings such as emergency departments (EDs) present important opportunities to address problematic substance use. Currently, EDs do not typically intervene beyond acute medical stabilization. ⋯ In this sample of drug users seeking emergency medical treatment, a relatively robust brief intervention did not improve substance use outcomes. More work is needed to determine how drug use disorders may be addressed effectively in the ED.
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JAMA internal medicine · Oct 2014
Randomized Controlled TrialThe effect of information presentation on beliefs about the benefits of elective percutaneous coronary intervention.
For stable angina, the benefits of percutaneous coronary intervention (PCI) are limited to symptom relief, but patients often believe that PCI prevents myocardial infarction (MI). Whether presenting accurate information about the benefits of PCI would dispel these beliefs remains unknown. We hypothesized that explanatory information would be more effective for influencing volunteers' beliefs. ⋯ In the setting of mild, stable angina, most people assume PCI prevents MI and are likely to choose it. Explicit information can partially overcome that bias and influence decision making. Explanatory information was the most effective intervention in overcoming this bias.
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JAMA internal medicine · Aug 2014
Randomized Controlled Trial Comparative StudyComparative effectiveness of a multifaceted intervention to improve adherence to annual colorectal cancer screening in community health centers: a randomized clinical trial.
Colorectal cancer (CRC) screening rates are lower among Latinos and people living in poverty. Fecal occult blood testing (FOBT) is one recommended screening modality that may overcome cost and access barriers. However, the ability of FOBT to reduce CRC mortality depends on high rates of adherence to annual screening. ⋯ This intervention greatly increased adherence to annual CRC screening; most screenings were achieved without personal calls. It is possible to improve annual CRC screening for vulnerable populations with relatively low-cost strategies that are facilitated by health information technologies.
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JAMA internal medicine · Jun 2014
Randomized Controlled TrialCollaborative care for depression and anxiety disorders in patients with recent cardiac events: the Management of Sadness and Anxiety in Cardiology (MOSAIC) randomized clinical trial.
Depression and anxiety are associated with adverse cardiovascular outcomes in patients with recent acute cardiac events. There has been minimal study of collaborative care (CC) management models for mental health disorders in high-risk cardiac inpatients, and no prior CC intervention has simultaneously managed depression and anxiety disorders. ⋯ A novel telephone-based, low-intensity model to concurrently manage cardiac patients with depression and/or anxiety disorders was effective for improving mental health-related quality of life in a 24-week trial.