Journal of general internal medicine
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Homicide is the leading cause of death in African-American men aged 15-34 years, yet physicians rarely discuss homicide prevention with patients. The authors propose that physicians have a role in preventing homicide similar to their role in other preventive medicine issues. ⋯ While being treated for unrelated problems at a walk-in ambulatory clinic, 53 African-American men patients received brief counseling by the physician about six preventive medicine topics, including firearms. A postvisit interview demonstrated that the discussion of firearms was well received and recalled more than any other preventive medicine issue discussed.
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To evaluate the incidence and preventability of adverse drug events (ADEs) and to determine the yield of several strategies for identifying them. ⋯ The authors conclude that ADEs are not infrequent, often preventable, and usually caused by physician decisions. In this study, solicited reporting by nurses and pharmacists was inferior to chart review for identifying ADEs, but was effective for identifying potential ADEs. Optimal prevention strategies should cover many types of drugs and target physicians' ordering practices.
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1) To determine whether the frequencies of panic disorder (PD) and depression (DEP) in an emergency department (ED) population were comparable to those in other primary care groups; 2) to evaluate whether patients without the clinical diagnosis of acute cardiac ischemia (ACI) had higher frequencies of these disorders; and 3) to identify characteristic clinical findings in patients with PD or DEP. ⋯ This study suggests that approximately one in three patients presenting to the ED with acute pain has symptoms consistent with a psychiatric disorder. These disorders occur frequently in both those with and those without acute cardiac ischemia, and clinical variables may help identify these frequent ED utilizers.
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To determine whether the protective effects of seat belt use on acute injury are followed by corresponding reductions in outpatient health care utilization. ⋯ Seat belt use does not result in lower utilization of follow-up outpatient services in the year following injury. However, the beneficial effects on acute care utilization more than offset the marginal effects on subsequent medical services utilization.
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To compare nurse practitioner (NP) and physician rates of breast and cervical cancer screening among poor, elderly black women. ⋯ Use of a NP to deliver same-day screening is an effective strategy to target poor, elderly black women for breast and cervical cancer screening. However, even with the substantial increases in rates obtained with the NP intervention, screening in this vulnerable population remains below nationally targeted levels.