Journal of general internal medicine
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Randomized Controlled Trial Multicenter Study
Effectiveness of Shared Decision-making for Diabetes Prevention: 12-Month Results from the Prediabetes Informed Decision and Education (PRIDE) Trial.
Intensive lifestyle change (e.g., the Diabetes Prevention Program) and metformin reduce type 2 diabetes risk among patients with prediabetes. However, real-world uptake remains low. Shared decision-making (SDM) may increase awareness and help patients select and follow through with informed options for diabetes prevention that are aligned with their preferences. ⋯ A prediabetes SDM intervention led by pharmacists increased patient engagement in evidence-based options for diabetes prevention and was associated with significantly greater uptake of DPP and/or metformin at 4 months and weight loss at 12 months. Prediabetes SDM may be a promising approach to enhance prevention efforts among patients at increased risk.
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Multicenter Study
Primary Care-Based Staff Ideas for Implementing a Mammography Decision Aid for Women 75+: a Qualitative Study.
We previously developed a pamphlet decision aid (DA) on mammography screening for women ≥ 75 years. However, implementing DAs in primary care may be challenging and may require support from non-physician healthcare team members. ⋯ Participants felt that as long as use of the mammography DA for women ≥ 75 years was supported by clinicians, it would be feasible to implement with minimal refinements to existing healthcare system processes.
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Multicenter Study
Variation in Patient Experience Across the Clinic Day: a Multilevel Assessment of Four Primary Care Practices.
Patient satisfaction with healthcare is associated with clinical outcomes, provider satisfaction, and success of healthcare organizations. As the clinic day progresses, provider fatigue, deterioration with communication within the care team, and appointment spillover may decrease patient experience. ⋯ In primary care, appointment time of day is associated with patient-reported experience.
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Multicenter Study
Intimate Partner Violence Screening Programs in the Veterans Health Administration: Informing Scale-up of Successful Practices.
Screening women for intimate partner violence (IPV) is increasingly expected in primary care, consistent with clinical prevention guidelines (e.g., United States Preventive Services Task Force). Yet, little is known about real-world implementation of clinical practices or contextual factors impacting IPV screening program success. This study identified successful clinical practices, and barriers to and facilitators of IPV screening program implementation in the Veterans Health Administration (VHA). ⋯ Findings advance national efforts by highlighting successful clinical practices for IPV screening programs and informing strategies useful for enhancing their implementation within and beyond the VHA, ultimately improving services and women's health.
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Multicenter Study
The Care Transitions Measure-3 Is Only Weakly Associated with Post-discharge Outcomes: a Retrospective Cohort Study in 48,384 Albertans.
The National Quality Forum endorsed a 3-item Care Transitions Measure (CTM-3), part of the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey, for evaluating hospital care transitions performance. ⋯ The CTM-3 score is influenced by baseline patient and hospital factors, is not associated with 30-day post-discharge outcomes, and is only weakly associated with 3- and 12-month outcomes. These findings suggest that the CTM-3 score is not a good performance measure for the quality of transitional care.