Abstract:
PURPOSE:The aim of this study was to assess whether the quality of diabetes care differs among practices employing nurse-practitioners (NPs), physician's assistants (PAs), or neither, and which practice attributes contribute to any differences in care.
METHODS:This cross-sectional study of 46 family medicine practices from New Jersey and Pennsylvania measured adherence to American Diabetes Association diabetes guidelines via chart audits of 846 patients with diabetes. Practice characteristics were identified by staff surveys. Hierarchical models determined differences between practices with and without NPs or PAs.
RESULTS:Compared with practices employing PAs, practices employing NPs were more likely to measure hemoglobin A(1c) levels (66% vs 33%), lipid levels (80% vs 58%), and urinary microalbumin levels (32% vs 6%); to have treated for high lipid levels (77% vs 56%); and to have patients attain lipid targets (54% vs 37%) (P journal_name journal_title authors doi subject pub_date pages issue eissn issn pii journal_volume pub_type
abstract:BACKGROUND:We undertook a study to understand how women who are victims of intimate partner violence (IPV) want physicians to manage these abusive relationships in the primary care office. METHODS:Thirty-two mothers in IPV shelters or support groups in southwestern Ohio were interviewed to explore their abuse experien...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.74
更新日期:2004-05-01 00:00:00
abstract:PURPOSE:Adolescent mothers are at risk for rapidly becoming pregnant again and for depression, school dropout, and poor parenting. We evaluated the impact of a community-based home-visiting program on these outcomes and on linking the adolescents with primary care. METHODS:Pregnant adolescents aged 12 to 18 years, pre...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.629
更新日期:2007-05-01 00:00:00
abstract:PURPOSE:Primary care practices in the United Kingdom have received substantial financial rewards for achieving standards set out in the Quality and Outcomes Framework since April 2004. This article reviews the growing evidence for the impact of the framework on the quality of primary medical care. METHODS:Five hundred...
journal_title:Annals of family medicine
pub_type: 杂志文章,评审
doi:10.1370/afm.1377
更新日期:2012-09-01 00:00:00
abstract::When I began experiencing chest pain that was different from my usual heartburn symptoms, I denied I could possibly be having a heart attack, but chewed 4 baby aspirin just in case. Despite years of community education about the need to call 911 and seek immediate emergency care when experiencing signs and symptoms of...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2170
更新日期:2018-01-01 00:00:00
abstract:PURPOSE:Hot tea and coffee have been found to have antimicrobial properties. The purpose of this study was to determine whether the consumption of tea, coffee, or both is associated with less frequent nasal carriage of methicillin-resistant Staphylococcus aureus (MRSA). METHODS:We performed a secondary analysis of dat...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1262
更新日期:2011-07-01 00:00:00
abstract:PURPOSE:Although screening with fecal occult blood testing (FOBT) reduces colorectal cancer (CRC) mortality, its effectiveness may diminish if patients do not adhere with repeated screenings. Among patients who had previously engaged in FOBT screening, we assessed subsequent adherence with FOBT screening. METHODS:We a...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1133
更新日期:2010-09-01 00:00:00
abstract::POEMs (patient-oriented evidence that matters) are studies that address a relevant clinical question, demonstrate improved patient-oriented outcomes, and have the potential to change practice. For 20 years the authors of this article have reviewed more than 100 English language clinical journals monthly to identify PO...
journal_title:Annals of family medicine
pub_type: 历史文章,杂志文章,评审
doi:10.1370/afm.2288
更新日期:2018-09-01 00:00:00
abstract::Efforts to address the current fragmented US health care structure, including controversial federal reform, cannot succeed without a reinvigoration of community-centered health systems. A blueprint for systematic implementation of community services exists in the 1967 Folsom Report--calling for "communities of solutio...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1350
更新日期:2012-05-01 00:00:00
abstract:PURPOSE:Describe the duration of symptoms, proportion of parents seeking primary care consultations, and costs for respiratory tract infections (RTIs) of children in the community. METHODS:Community-based, online, prospective inception cohort study. General practitioners from socioeconomically diverse practices posted...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2327
更新日期:2019-01-01 00:00:00
abstract::During a night of severe pain and weakness, I found several plausible-sounding diagnoses online: occipital neuralgia, nerve damage, and meningitis. The next day, I consulted a physician who did not offer professional guidance; instead the physician suggested tests entirely based on my self-diagnoses. What resulted was...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2414
更新日期:2019-09-01 00:00:00
abstract:PURPOSE:The US Preventive Services Task Force (USPSTF) is authorized by the US government to review and disseminate the scientific evidence for clinical preventive services. The purpose of this study was to evaluate the alignment of Medicare preventive services coverage with the recommendations of the USPSTF before imp...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1194
更新日期:2011-01-01 00:00:00
abstract::Tobacco use, lack of physical activity and poor diet, and alcohol consumption are leading causes of death in the United States. We estimated screening and counseling rates by using a nationally representative sample of adults aged 35 years and older with a preventive care supplement to the 2014 Medical Expenditure Pan...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2363
更新日期:2019-03-01 00:00:00
abstract:PURPOSE:We undertook a study to identify distinct functional trajectories in the year before hospice, to determine how patients with these trajectories differ according to demographic characteristics and hospice diagnosis, and to evaluate the association between these trajectories and subsequent outcomes. METHODS:From...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1720
更新日期:2015-01-01 00:00:00
abstract:PURPOSE:We wanted to compare 2 screening instruments for problem drinking, the CAGE and a single question, assessing frequency of use, patient and clinician comfort, and patient engagement in change. METHODS:The study was a crossover, cluster-randomized clinical trial with 31 clinicians in Missouri and 13 in the Ameri...
journal_title:Annals of family medicine
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1370/afm.83
更新日期:2004-09-01 00:00:00
abstract:PURPOSE:Medicine is traditionally considered a healing profession, but it has neither an operational definition of healing nor an explanation of its mechanisms beyond the physiological processes related to curing. The objective of this study was to determine a definition of healing that operationalizes its mechanisms a...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.313
更新日期:2005-05-01 00:00:00
abstract::We sought to describe the proportion of patients in contact with a primary care physician, as well as the total number of primary care contacts over a 2-year period, using the 2002-2017 Medical Expenditure Panel Survey. The rate of any contact with a primary care physician for patients in the population decreased by 2...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2631
更新日期:2021-01-01 00:00:00
abstract:PURPOSE:We wanted to obtain perspectives of mothers and daughters on facilitators of and barriers to with adolescent girls' timely access to risk-appropriate reproductive care. METHODS:We conducted 5 separate focus groups with Latina and black mothers and their adolescent daughters. All participants resided in impover...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.601
更新日期:2006-11-01 00:00:00
abstract:PURPOSE:In 30 small, independent primary care practices, we examined the association between clinician-reported use of elements of the Chronic Care Model (CCM) and diabetic patients' hemoglobin A(1c) (HbA(1c)) and lipid levels and self-reported receipt of care. METHODS:Ninety clinicians (60 physicians, 17 nurse-practi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.610
更新日期:2007-01-01 00:00:00
abstract::In the United States, stable health insurance coverage is associated with improved health outcomes. A lack of insurance is associated with premature death from preventable causes. Although primary care clinicians are often in a position to see firsthand the impact that being uninsured has on patients, most ambulatory ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1541
更新日期:2013-09-01 00:00:00
abstract:PURPOSE:Qualitative research projects often involve the collaborative efforts of a research team. Challenges inherent in teamwork include changes in membership and differences in analytical style, philosophy, training, experience, and skill. This article discusses teamwork issues and tools and techniques used to improv...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.290
更新日期:2005-07-01 00:00:00
abstract:PURPOSE:Our goal was to monitor the progress of 3 Healthy People 2010 (HP2010) objectives encouraging self-management education and clinician counseling for weight loss and physical activity among adults with doctor-diagnosed arthritis. METHODS:Using the national 2002 and 2006 National Health Interview Survey (NHIS) a...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1210
更新日期:2011-03-01 00:00:00
abstract:PURPOSE:Practice transformation in primary care is a movement toward data-driven redesign of care, patient-centered care delivery, and practitioner activation. A critical requirement for achieving practice transformation is availability of tools to engage practices. METHODS:A total of 48 practices with 109 practice si...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2382
更新日期:2019-08-12 00:00:00
abstract:PURPOSE:This report describes outcomes of an ongoing quality-improvement project (VitalSign6) in a large US metropolitan area to improve recognition, treatment, and outcomes of depressed patients in 16 primary care clinics (6 charity clinics, 6 federally qualified health care centers, 2 private clinics serving low-inco...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2418
更新日期:2019-07-01 00:00:00
abstract::PURPOSE We examined how the closure of a large safety-net hospital in Los Angeles County, California, affected local primary care physicians. METHODS We conducted semistructured interviews with 42 primary care physicians who practiced in both underserved and nonunderserved settings in Los Angeles County. Two investiga...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1317
更新日期:2011-11-01 00:00:00
abstract:PURPOSE:In 2004, we undertook a consultation with Canadian primary health care experts to define the attributes that should be evaluated in predominant and proposed models of primary health care in the Canadian context. METHOD:Twenty persons considered to be experts in primary health care or recommended by at least 2 ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.682
更新日期:2007-07-01 00:00:00
abstract:PURPOSE:We wanted to describe family physicians' use of information from an electronic knowledge resource for answering clinical questions, and their perception of subsequent patient health outcomes; and to estimate the number needed to benefit from information (NNBI), defined as the number of patients for whom clinica...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1565
更新日期:2013-11-01 00:00:00
abstract:PURPOSE:Despite the benefits of well-child care visits, up to one-half of these visits are missed. Little is known about why children miss them, so we undertook a qualitative study to elucidate these factors. METHODS:We interviewed 17 caregivers whose children had missed well-child visits and 6 clinicians, focusing on...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2466
更新日期:2020-01-01 00:00:00
abstract:BACKGROUND:Notions about the most common errors in medicine currently rest on conjecture and weak epidemiologic evidence. We sought to determine whether cascade analysis is of value in clarifying the epidemiology and causes of errors and whether physician reports are sensitive to the impact of errors on patients. METH...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.126
更新日期:2004-07-01 00:00:00
abstract:PURPOSE:Little is known about the impact of pay-for-performance incentives on health care disparities. We examined ethnic disparities in the management of hypertension among patients with and without cardiovascular comorbidities after the implementation of a major pay-for-performance incentive scheme in UK primary care...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.907
更新日期:2008-11-01 00:00:00
abstract:PURPOSE:There is a shortage of rural primary care personnel with expertise in team care for patients with common mental disorders. Building the workforce for this population is a national priority. We investigated the feasibility of regular systematic case reviews through telepsychiatric consultation, within collaborat...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2561
更新日期:2020-09-01 00:00:00