JAMA internal medicine
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JAMA internal medicine · Dec 2014
Randomized Controlled Trial Comparative StudyPrimary care-based buprenorphine taper vs maintenance therapy for prescription opioid dependence: a randomized clinical trial.
Prescription opioid dependence is increasing and creates a significant public health burden, but primary care physicians lack evidence-based guidelines to decide between tapering doses followed by discontinuation of buprenorphine hydrochloride and naloxone hydrochloride therapy (hereinafter referred to as buprenorphine therapy) or ongoing maintenance therapy. ⋯ Tapering is less efficacious than ongoing maintenance treatment in patients with prescription opioid dependence who receive buprenorphine therapy in primary care.
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JAMA internal medicine · Dec 2014
Attitudes of hospital leaders toward publicly reported measures of health care quality.
Public reporting of quality is considered a key strategy for stimulating improvement efforts at US hospitals; however, little is known about the attitudes of hospital leaders toward existing quality measures. ⋯ Hospital leaders indicated that the measures reported on the Hospital Compare website exert strong influence over local planning and improvement efforts. However, they expressed concerns about the clinical meaningfulness, unintended consequences, and methods of public reporting.