Journal of general internal medicine
-
Randomized Controlled Trial Comparative Study
A comparison of web-based versus print-based decision AIDS for prostate cancer screening: participants' evaluation and utilization.
Patient decision aids facilitate informed decision making for medical tests and procedures that have uncertain benefits. ⋯ Decision aid use was independently influenced by race, education, and the decision aid medium, findings consistent with the 'digital divide.' These results suggest that when it is not possible to provide this age cohort with their preferred decision aid medium, print materials will be more highly used than web-based materials. Although there are many advantages to web-based decision aids, providing an option for print-based decision aids should be considered.
-
Randomized Controlled Trial Multicenter Study
Intensive blood pressure control, falls, and fractures in patients with type 2 diabetes: the ACCORD trial.
There are few rigorous studies to confirm or refute the commonly cited concern that control of blood pressure to lower thresholds may result in an increased risk of falls and fractures. ⋯ We conclude that intensive antihypertensive treatment that lowered mean systolic blood pressure to below 120 mmHg was not associated with an increased risk of falls or non-spine fractures in patients age 40 to 79 years with type 2 diabetes.
-
Randomized Controlled Trial
A randomized controlled pilot trial of the functional assessment screening tablet to engage patients at the point of care.
Healthcare providers play an important role in encouraging healthy behaviors and improving health-related quality of life (HRQoL). They are most effective when they partner with informed, engaged patients. ⋯ Providing patients with immediate, personalized, guideline-based feedback prior to the clinical encounter can increase patient-initiated discussions regarding mental HRQoL. Future work should test FAST-Feedback in a larger population and evaluate the impact on tobacco cessation, increased physical activity, and improvements in HRQoL.
-
Randomized Controlled Trial Comparative Study
E-cigarette versus nicotine inhaler: comparing the perceptions and experiences of inhaled nicotine devices.
Novel nicotine delivery products, such as electronic cigarettes (e-cigarettes), have dramatically grown in popularity despite limited data on safety and benefit. In contrast, the similar U.S. Food and Drug Administration (FDA)-approved nicotine inhaler is rarely utilized by smokers. Understanding this paradox could be helpful to determine the potential for e-cigarettes as an alternative to tobacco smoking. ⋯ The e-cigarette was more acceptable, provided more satisfaction, and had higher perceived benefit than the inhaler during this trial. E-cigarettes have the potential to be important nicotine delivery products owing to their high acceptance and perceived benefit, but more data are needed to evaluate their actual efficacy and safety. Providers should be aware of these issues, as patients will increasingly inquire about them.
-
Randomized Controlled Trial
The care transitions innovation (C-TraIn) for socioeconomically disadvantaged adults: results of a cluster randomized controlled trial.
Despite growing emphasis on transitional care to reduce costs and improve quality, few studies have examined transitional care improvements in socioeconomically disadvantaged adults. It is important to consider these patients separately as many are high-utilizers, have different needs, and may have different responses to interventions. ⋯ C-TraIn did not reduce 30-day inpatient readmissions or ED use; however, it improved transitional care quality.