Journal of general internal medicine
-
Randomized Controlled Trial Comparative Study Clinical Trial
Practical methods to increase use of advance medical directives.
To compare the effectiveness of two means for increasing the use of advance medical directives: written materials only versus written materials and an educational videotape. ⋯ In an elderly population with a substantial baseline placement rate, mailing of written materials substantially increased placement of an advance directive in the medical record, but the addition of a videotape did not. Mailing the video did increase the use of treatment trials and made patients more aware of reasons not to use advance directives.
-
Randomized Controlled Trial Clinical Trial
Increasing breast and cervical cancer screening in low-income women.
To determine if women would have higher breast and cervical cancer screening rates if lay health advisers recommended screening and offered a convenient screening opportunity. ⋯ Breast and cervical cancer screening rates were improved in women attending non-primary-care outpatient clinics by using lay health advisers and a nurse practitioner to perform screening. The effect was strongest in women in greatest need of screening.
-
Randomized Controlled Trial Clinical Trial
Role of written advance directives in decision making: insights from qualitative and quantitative data.
To understand the role of written advance directives (ADs) in medical decision making through examination of qualitative and quantitative data sources. We specifically wanted to address whether physicians unilaterally disregard advance directives. ⋯ Our findings indicate that physicians are not unilaterally disregarding patients' ADs. Despite the patients' serious illnesses, family members and physicians did not see them as "absolutely, hopelessly ill." Hence, ADs were not considered applicable to the majority of these cases. Cases in which ADs had an impact evidenced open negotiation with a surrogate that yielded a transition in the goals of care.
-
Randomized Controlled Trial Clinical Trial
Intervention to increase mammography utilization in a public hospital.
To study the effects of three approaches to increasing utilization of screening mammography in a public hospital setting in Northwest Louisiana. ⋯ At 6 months there was at least a 30% increase in the mammography utilization rate in the group receiving the intervention designed in collaboration with patients as compared with those receiving the recommendation alone or recommendation with brochure. Giving patients an easy-to-read NCI brochure and a personal recommendation was no more effective than giving them a recommendation alone, suggesting that simply providing women in a public hospital with a low-literacy-level, culturally appropriate brochure is not sufficient to increase screening mammography rates. In a multivariate analysis, the only significant predictor of mammography use at 6 months was the custom-made intervention.
-
Randomized Controlled Trial Comparative Study Clinical Trial
Smoking cessation among inner-city African Americans using the nicotine transdermal patch.
To determine the efficacy of the transdermal nicotine patch for smoking cessation in inner-city African Americans. ⋯ The nicotine patch significantly improves short-term quit rates in inner-city African Americans who are interested in trying to quit smoking. Efforts should be made to reach underserved populations through smoking cessation programs, and to assist in maintaining abstinence.