Abstract:
PURPOSE:This review summarizes the evidence regarding the efficacy of adjuvant steroids for pain reduction in acute pharyngitis. METHODS:We searched for randomized controlled trials, using MEDLINE, EMBASE, and the Cochrane Database of Systematic Reviews, published between 1966 and December 2008. Two reviewers assessed the quality of each retrieved article and summarized the data. RESULTS:Our review found 8 relevant randomized controlled trials (RCTs) with a total of 806 patients. There were 5 RCTs with adult patients and 3 with children. All RCTs found a statistically significant faster reduction of pain or complete pain relief from steroid use compared with placebo. The trials used different steroids (dexamethasone, betamethasone, prednisone), and most participants had received antibiotics at least initially. Analgesic medication, such as acetaminophen, was allowed in all studies, but this factor was not always controlled. No serious adverse side effects were reported. CONCLUSIONS:Steroids are effective in relieving pain in acute pharyngitis. Although no serious adverse effects were observed, the benefits have to be balanced with possible adverse drug effects. There are safe and effective over-the-counter medications to relieve throat pain. Most patients received concomitant antibiotics; however, reducing the prescription of antibiotics for generally benign upper respiratory tract infection is a public health goal. We therefore recommend further studies to establish both the safety of steroids without antibiotic coverage and the additional benefits of steroids when used with regular administration of over-the-counter analgesic medications.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Korb K,Scherer M,Chenot JFdoi
10.1370/afm.1038subject
Has Abstractpub_date
2010-01-01 00:00:00pages
58-63issue
1eissn
1544-1709issn
1544-1717pii
8/1/58journal_volume
8pub_type
杂志文章,评审abstract:PURPOSE:In primary care, the involvement of health care assistants (HCAs) in clinical depression management is an innovative approach. Little is known, however, about how HCAs experience their new tasks. We wanted to describe the perceptions and experiences of HCAs who provided case management to patients with depressi...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1037
更新日期:2009-11-01 00:00:00
abstract:PURPOSE:Recent national guidelines encourage a trial of labor after cesarean (TOLAC) as a means of increasing vaginal births after cesarean (VBACs) and decreasing the high US cesarean birth rate and its consequences (2010 National Institute of Health Consensus Statement and American College of Obstetricians and Gynecol...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1403
更新日期:2012-11-01 00:00:00
abstract:PURPOSE:In screening for type 2 diabetes, guidelines recommend targeting high-risk individuals. Our objectives were to assess the yield of opportunistic targeted screening for type 2 diabetes in primary care and to assess the diagnostic value of various risk factors. METHODS:In 11 family practices (total practice popu...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.997
更新日期:2009-09-01 00:00:00
abstract:PURPOSE:Potentially inappropriate prescribing (PIP) is a common yet preventable medical error among older persons in primary care. It is uncertain whether PIP produces adverse outcomes in this population, however. We conducted a systematic review with meta-analysis to pool the adverse outcomes of PIP specific to primar...
journal_title:Annals of family medicine
pub_type: 杂志文章,meta分析
doi:10.1370/afm.2373
更新日期:2019-05-01 00:00:00
abstract:PURPOSE:We undertook a study to examine the impact of experiences shared between patient and physician and the value patients place on continuity of care. METHODS:Data on 4,454 patients collected in The Direct Observation of Primary Care (DOPC) study conducted between October 1994 and August 1995 were analyzed to asse...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.84
更新日期:2004-09-01 00:00:00
abstract:PURPOSE:Overtreatment of screen-detected localized prostate cancer (LPC) is an important public health concern, since the survival benefit of aggressive treatment (surgery or radiation) has not been well established. We investigated the survival expectations of patients who had LPC with and without their chosen treatme...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1926
更新日期:2016-05-01 00:00:00
abstract::Although primary care, including family medicine, recognizes different types of clinician-patient interaction, I argue that only interactions characterized by coprovision define care. By coprovision I mean that clinicians and patients each provide the expertise in health care that they have the capacity to contribute ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.342
更新日期:2005-11-01 00:00:00
abstract:PURPOSE:Self-harm is a public health problem that requires a better understanding of mortality risk. We undertook a study to examine premature mortality in a nationally representative cohort of primary care patients who had harmed themselves. METHODS:During 2001-2013, a total of 385 general practices in England contri...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2054
更新日期:2017-05-01 00:00:00
abstract:PURPOSE:This study was conducted to document current immunization practices by family physicians. METHODS:In 2008 the American Academy of Family Physicians (AAFP) conducted a survey among a random sample of 2,000 of its members who reported spending 80% or more of their time in direct patient care. The survey consiste...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1185
更新日期:2010-11-01 00:00:00
abstract:PURPOSE:Few studies have attempted to link patients' beliefs about racism in the health care system with how they use and experience health care. METHODS:Using telephone survey data from a national sample of 1,479 whites, 1,189 African Americans, and 983 Latinos, we explored patients' beliefs about racism, their prefe...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.282
更新日期:2005-03-01 00:00:00
abstract:PURPOSE:Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2171
更新日期:2018-01-01 00:00:00
abstract:PURPOSE:The purpose of this study was to examine the association between the prevalence of both diabetes-concordant and diabetes-discordant conditions and the quality of diabetes care at the family practice level in England. We hypothesized that the prevalence of concordant (or discordant) conditions would be associate...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1848
更新日期:2015-11-01 00:00:00
abstract:PURPOSE:The purpose of this study was to determine the relationship between the number of patients under a primary care physician's care (panel size) and primary care quality indicators. METHODS:We conducted a cross-sectional, population-based study of fee-for-service and capitated interprofessional and non-interprofe...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1864
更新日期:2016-01-01 00:00:00
abstract::Two voices tell the story of an evolving doctor-patient relationship. Seizures are the first indication of squamous cell lung cancer metastatic to the brain. Both doctor and patient describe the course of the illness, treatment, and remarkable recovery, each from his own perspective. The patient describes how the canc...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.9
更新日期:2003-05-01 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: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:PURPOSE:Targeted interventions to reduce the risk and increase the early detection of melanoma have the potential to save lives. We aimed to assess the effect of such an intervention on patient prevention behavior. METHODS:We conducted a pilot clustered randomized controlled trial, comparing a targeted screening and e...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1600
更新日期:2014-01-01 00:00:00
abstract:PURPOSE:Peer health coaches offer a potential model for extending the capacity of primary care practices to provide self-management support for patients with diabetes. We conducted a randomized controlled trial to test whether clinic-based peer health coaching, compared with usual care, improves glycemic control for lo...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1443
更新日期:2013-03-01 00:00:00
abstract:PURPOSE:To address doubts regarding National Lung Screening Trial (NLST) generalizability, we analyzed over 6,000 lung cancer screenings (LCSs) within a community health system. METHODS:Our LCS program included 10 sites, 7 hospitals (2 non-university tertiary care, 5 community) and 3 free-standing imaging centers. Pri...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2519
更新日期:2020-05-01 00:00:00
abstract:PURPOSE:Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physician...
journal_title:Annals of family medicine
pub_type: 杂志文章,评审
doi:10.1370/afm.2230
更新日期:2018-05-01 00:00:00
abstract:PURPOSE:Bacterial pathogens are assumed to cause an illness course different from that of nonbacterial causes of acute cough, but evidence is lacking. We evaluated the disease course of lower respiratory tract infection (LRTI) with a bacterial cause in adults with acute cough. METHODS:We conducted a secondary analysis...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1370/afm.1974
更新日期:2016-11-01 00:00:00
abstract:PURPOSE:Shared medical appointments (SMAs) are becoming popular, but little is known about their association with patient experience in primary care. We performed an exploratory analysis examining overall satisfaction and patient-centered care experiences across key domains of the patient-centered medical home among pa...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1660
更新日期:2014-07-01 00:00:00
abstract::The American Board of Family Medicine routinely surveys its Diplomates in each national graduating cohort 3 years out of training. These data were used to characterize early career family physicians whose services include management of pregnancy and prescribing buprenorphine. A total of 261 (5.1%) respondents both pro...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2504
更新日期:2020-03-01 00:00:00
abstract:PURPOSE:Knowledge about the ways patients perceive their vulnerability to disease is important for communication with patients about risk and preventive health measures. This interview study aimed to explore how patients with a diagnosis of heterozygous familial hypercholesterolemia understand and perceive their vulner...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.529
更新日期:2006-05-01 00:00:00
abstract:BACKGROUND:Clinicians are faced with a plethora of guidelines. To rate guidelines, they can select from a number of evaluation tools, most of which are long and difficult to apply. The goal of this project was to develop a simple, easy-to-use checklist for clinicians to use to identify trustworthy, relevant, and useful...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2119
更新日期:2017-09-01 00:00:00
abstract:PURPOSE:Practice transformation is the cornerstone of the future of family medicine and health care reform, but little is known about how the process occurs. We sought to develop and test a model of the natural history of practice transformation. METHODS:We developed an outcomes-based model of how a practice moves thr...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1497
更新日期:2013-05-01 00:00:00
abstract:PURPOSE:Previous studies suggest that the highest-risk patients value accessible, coordinated primary care that they perceive to be of high technical quality. We have limited understanding, however, of how low-income, chronically ill patients and the staff who care for them experience each individual step in the primar...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.1808
更新日期:2015-07-01 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:PURPOSE:We wanted to estimate excess risk of in-hospital mortality associated with medical injuries identified using an injury surveillance system, after controlling for risk of death resulting from comorbidities. METHODS:The Wisconsin Medical Injuries Prevention Program (WMIPP) screening criteria were used to identif...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.553
更新日期:2006-09-01 00:00:00
abstract:PURPOSE:The explosion of evidence in the last decade supporting the role of spirituality in whole-person patient care has prompted proposals for a move to a biopsychosocial-spiritual model for health. Making this paradigm shift in today's multicultural societies poses many challenges, however. This article presents 2 t...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.864
更新日期:2008-09-01 00:00:00