Journal of general internal medicine
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Multicenter Study
Factors associated with frequency of emergency department visits for chronic obstructive pulmonary disease exacerbation.
Little is known about the factors associated with frequency of emergency department visits (FEDV) in chronic obstructive pulmonary disease (COPD) patients with recurrent exacerbations. ⋯ Our results suggest that both disease and health care-related factors were associated with FEDV in COPD exacerbation. Multidisciplinary efforts through primary care provider follow-up should be assessed to test the effects on reducing the high morbidity and cost of recurrent COPD exacerbations.
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Multicenter Study
Hypertensive patients' race, health beliefs, process of care, and medication adherence.
African Americans have higher rates of hypertension and worse blood pressure (BP) control than Whites, and poorer medication adherence may contribute to this phenomenon. We explored associations among patients' race, self-reported experiences with clinicians, attitudes and beliefs about hypertension, and ultimately, medication adherence, among a sample with no racial disparities in BP control, to determine what lessons we could learn from patients and providers in this setting. ⋯ When both physicians and patients take BP management seriously, disparities in BP adherence and control may be reduced.
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Multicenter Study
Alcohol consumption among older adults in primary care.
Alcohol misuse is a growing public health concern for older adults, particularly among primary care patients. ⋯ The majority of participants were nondrinkers; among alcohol users, at-risk drinkers did not differ significantly from moderate drinkers in their characteristics or for the 3 health parameters evaluated. In contrast, heavy drinking was associated with depression and anxiety and less social support, and heavy drinking combined with binge drinking was associated with depressive/anxiety symptoms and perceived poor health.
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Multicenter Study Comparative Study
Persistent depression affects adherence to secondary prevention behaviors after acute coronary syndromes.
The persistence of depressive symptoms after hospitalization is a strong risk factor for mortality after acute coronary syndromes (ACS). Poor adherence to secondary prevention behaviors may be a mediator of the relationship between depression and increased mortality. ⋯ Persistently depressed patients were less likely to adhere to behaviors that reduce the risk of recurrent ACS. Differences in adherence to these behaviors may explain in part why depression predicts mortality after ACS.
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Randomized Controlled Trial Multicenter Study Comparative Study
Cost-effectiveness of a disease management program for major depression in elderly primary care patients.
Major depression is common in older adults and is associated with increased health care costs. Depression often remains unrecognized in older adults, especially in primary care. ⋯ This disease management program for major depression in elderly primary care patients had no statistically significant relationship with clinical outcomes, costs, and cost-effectiveness. Therefore, based on these results, continuing usual care is recommended.