The American journal of medicine
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Randomized Controlled Trial Multicenter Study
Use of a decision aid to improve treatment decisions in osteoporosis: the osteoporosis choice randomized trial.
Poor adherence to therapy, perhaps related to unaddressed patient preferences, limits the effectiveness of osteoporosis treatment in at-risk women. A parallel patient-level randomized trial in primary care practices was performed. ⋯ A decision aid improved the quality of clinical decisions about bisphosphonate therapy in at-risk postmenopausal women, did not affect start rates, and may have improved adherence.
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Randomized Controlled Trial Multicenter Study Comparative Study
Immunosuppressive therapy with oral prednisone to prevent restenosis after PCI. A multicenter randomized trial.
Prednisone at immunosuppressive doses after stenting has shown remarkable efficacy in reducing ischemic recurrences in nondiabetic patients with high post-procedural levels of C-reactive protein; the study aim was to compare the clinical outcome obtained in a control group of patients treated with bare metal stents versus 2 other study groups--bare metal stent plus oral prednisone or drug eluting stents--assuming similar optimal adjunctive medical treatment. ⋯ Compared with bare metal stents alone, prednisone treatment after bare metal stents or drug-eluting stent implantation result in a better event-free survival at 1 year.
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Randomized Controlled Trial
Racial differences in two self-management hypertension interventions.
Only one half of Americans have their blood pressure controlled, and there are significant racial differences in blood pressure control. The goal of this study was to examine the effectiveness of 2 patient-directed interventions designed to improve blood pressure control within white and non-white subgroups (African Americans, 49%). ⋯ Combined home blood pressure monitoring and a tailored behavioral phone intervention seem to be particularly effective for improving blood pressure in non-white patients.
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Randomized Controlled Trial Multicenter Study
Randomized trial of a warfarin communication protocol for nursing homes: an SBAR-based approach.
More than 1.6 million Americans currently reside in nursing homes. As many as 12% of them receive long-term anticoagulant therapy with warfarin. Prior research has demonstrated compelling evidence of safety problems with warfarin therapy in this setting, often associated with suboptimal communication between nursing home staff and prescribing physicians. ⋯ Facilitated telephone communication between nurses and physicians using the SBAR approach modestly improves the quality of warfarin management for nursing home residents.
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Randomized Controlled Trial Comparative Study
The effectiveness of outpatient appointment reminder systems in reducing no-show rates.
Patients who do not keep physician appointments (no-shows) represent a significant loss to healthcare providers. For patients, the cost includes their dissatisfaction and reduced quality of care. An automated telephone appointment reminder system may decrease the no-show rate. Understanding characteristics of patients who miss their appointments will aid in the formulation of interventions to reduce no-show rates. ⋯ A clinic staff reminder was significantly more effective in lowering the no-show rate compared with an automated appointment reminder system.