J Am Board Fam Med
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Randomized Controlled Trial Multicenter Study Comparative Study
Outcomes of acupuncture for chronic pain in urban primary care.
The purpose of this study was to describe outcomes of the Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) trial, testing acupuncture as an adjunct to usual treatment for chronic pain in urban health centers. ⋯ Referred primary care patients experienced high levels of pain and pain-related disability. Weekly acupuncture was associated with short-term improvements in pain and quality of life.
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Randomized Controlled Trial
Association of speculum lubrication with pain and Papanicolaou test accuracy.
To determine the effects of lubrication of the vaginal speculum before insertion during a Papanicolaou test on perceived pain and quality of the cytology specimen. ⋯ During the collection of Papanicolaou test specimens, lubrication of the vaginal speculum with a small amount of K-Y Jelly (a water-soluble lubricant gel) decreases the pain associated with insertion of the vaginal speculum among postmenopausal women without obscuring the cytological interpretation of conventional or liquid-based cytology. In women of reproductive age, lubrication of the speculum with K-Y Jelly does not cause a meaningful effect with respect to perceived pain.
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Randomized Controlled Trial
A randomized controlled trial of a tailored primary care program to reverse excessive alcohol consumption.
To assess the effects of a tailored, multifaceted intervention in primary care on the level of patients' alcohol consumption and to investigate which patient and organizational factors determine a reduction in alcohol consumption. ⋯ Our results suggest that the intervention has been counterproductive because the proportion of patients reducing their levels of alcohol consumption to low-risk levels was lower in the intervention group compared with the control group. Furthermore, our study demonstrated that patients' attitudes toward alcohol use are an important determinant of the success of the program. Therefore, future research should focus on the effectiveness of methods to change patients' attitudes.
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Randomized Controlled Trial
Azithromycin for bronchial asthma in adults: an effectiveness trial.
Macrolides have antimicrobial and anti-inflammatory properties that may be useful in the treatment of chronic asthma. ⋯ Adults with asthma who were randomized to azithromycin did not show statistically significant improvement in asthma outcomes, although the study was underpowered to detect clinical improvement in 15% (number needed to treat = 7). Adults with severe persistent asthma who elected OL treatment documented clinical improvements in asthma symptoms, AQL, and asthma control that persisted after completion of OL azithromycin (number needed to treat = 2).
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Randomized Controlled Trial Comparative Study
Patient-centered care is associated with decreased health care utilization.
This article uses an interactional analysis instrument to characterize patient-centered care in the primary care setting and to examine its relationship with health care utilization. ⋯ Patient-centered care was associated with decreased utilization of health care services and lower total annual charges. Reduced annual medical care charges may be an important outcome of medical visits that are patient-centered.