Articles: outcome.
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Journal of physiotherapy · Jan 2012
CommentTargeted physiotherapy treatment for low back pain based on clinical risk can improve clinical and economic outcomes when compared with current best practice.
Does a stratified primary care approach for patients with low back pain result in clinical and economic benefits when compared with current best practice? ⋯ A stratified management approach including a prognostic screening and treatment targeting, showed improved clinical and economic benefits when compared with current best practice.
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To examine whether self-reported treatments, workplace-oriented rehabilitation and change of occupation were associated with subsequent sickness absence and disability pension among long-term sick-listed for psychiatric disorders. ⋯ We found a pattern of poorer outcome of drug treatment and physiotherapy compared with other treatments (psychotherapy, workplace-oriented rehabilitation and complementary or alternative medicine) in terms of increased odds of sickness absence and disability pension. Workplace-oriented rehabilitation and/or change of occupation were associated with reduced odds of sick leave. Studies with a randomised controlled trial design are needed to examine the effect on sick leave of a workplace-oriented intervention.
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Vasc Health Risk Manag · Jan 2012
Patterns of warfarin use and subsequent outcomes in atrial fibrillation in primary care practices.
Warfarin is recommended for stroke prevention in high-risk patients with atrial fibrillation. However, it is often underutilized and inadequately managed in actual clinical practice. ⋯ Warfarin was underutilized in a substantial portion of eligible atrial fibrillation patients in these community-based practices. In addition, prolonged interruptions in anticoagulation were common in this population, and multiple interruptions were associated with over twice the risk of stroke when compared to those treated continuously.
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⋯ Practitioners can consider eccentric exercise as an initial intervention for AT, with the addition of laser therapy as appropriate. Shock wave therapy may represent an effective alternative. High-quality RCTs following CONSORT guidelines are required to further evaluate the efficacy of physical therapies and determine optimal clinical pathways for AT.
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Comment
Protocol-directed care in the ICU: making a future generation of intensivists less knowledgeable?
Prasad M, Holmboe ES, Lipner RS, Hess BJ, Christie JD, Bellamy SL, Rubenfeld GD, Kahn JM. Clinical Protocols and Trainee Knowledge About Mechanical Ventilation. JAMA. 2011; 306(9):935-941. PubMed PMID: 21900133 This is available on http://www.pubmed.gov ⋯ Among first-time ABIM Critical Care Medicine Certification Examination examinees, training in a high-intensity ventilator protocol environment compared with a low-intensity environment was not associated with worse performance on examination questions about mechanical ventilation management.