Abstract:
PURPOSE:We hypothesized that antibiotic overuse for acute cough illness (ACI) is in part due to a mismatch between patients' expectations and the natural history of ACI. METHODS:We performed a population-based random digit dialing survey of 493 adults in Georgia to determine their expectations regarding the duration of ACI. We also performed a systematic review of observational studies and the placebo or untreated control groups of randomized controlled trials to determine the duration of ACI from the published medical literature. We included studies of otherwise healthy adults with undifferentiated ACI, no clear bacterial cause, data on at least 1 cough outcome, and at least 1 week of follow-up. RESULTS:The mean duration of cough in the published literature was 17.8 days. Survey respondents reported a median duration of 5 to 7 days and a mean duration of 7.2 to 9.3 days depending on the specific scenario. Patients expecting a longer duration of illness were more likely to be white, female, and have self-reported asthma or chronic lung disease. Independent predictors of the belief that antibiotics are always helpful included nonwhite race (OR = 1.82, 95% CI, 1.14-2.92), some college education or less (OR = 2.08, 95% CI, 1.26-3.45), and previous antibiotics for ACI (OR = 2.20, 95% CI, 1.34-3.55). CONCLUSIONS:There is a mismatch between patients' expectations regarding the duration of ACI and the actual duration based on the best available evidence. Efforts to reduce inappropriate antibiotic use should target this discrepancy.
journal_name
Ann Fam Medjournal_title
Annals of family medicineauthors
Ebell MH,Lundgren J,Youngpairoj Sdoi
10.1370/afm.1430subject
Has Abstractpub_date
2013-01-01 00:00:00pages
5-13issue
1eissn
1544-1709issn
1544-1717pii
11/1/5journal_volume
11pub_type
杂志文章,评审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::Patient-choice cesarean delivery is increasing in the United States. The American College of Obstetricians and Gynecologists supports this option, citing ethical premises of autonomy and informed consent, despite a lack of evidence for its safety. This increase in patient-choice cesarean delivery occurs during a time ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.537
更新日期:2006-05-01 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:PURPOSE:We wanted to explore the context of help seeking for reproductive and nonreproductive health concerns by urban adolescent girls. METHODS:We undertook a qualitative study using in-depth interviews of African American and Latina girls (n = 22) aged 13 to 19 years attending public high schools in the Bronx, NY. ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.124
更新日期:2004-11-01 00:00:00
abstract::I had intended to spend our spring break week in Montana with my kids and my dad, going to parks and museums together. Instead, I spent the week in the hospital, helping my dad make end-of-life choices and learning more about the importance of communication in health care settings and the preciousness of close relatio...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1908
更新日期:2016-05-01 00:00:00
abstract:PURPOSE:Results of case management designed for patients with dementia and their caregivers in community-based primary health care (CBPHC) were inconsistent. Our objective was to identify the relationships between key outcomes of case management and barriers to implementation. METHODS:We conducted a systematic mixed s...
journal_title:Annals of family medicine
pub_type: 杂志文章,评审
doi:10.1370/afm.1677
更新日期:2014-09-01 00:00:00
abstract::William Osler is quoted as saying, "Nothing will sustain you more potently than the power to recognize in your humdrum routine, as perhaps it may be thought, the true poetry of life-the poetry of the commonplace, of the plain, toil-worn woman, with their loves and their joys, their sorrows and their griefs."(1) A fami...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1622
更新日期:2014-05-01 00:00:00
abstract:PURPOSE:Postpartum depression is common but inadequately recognized and undertreated. Continuing depressive symptoms are associated with adverse outcomes for the woman, her infant, and family. We wanted to determine the effect of a practice-based training program for screening, diagnosis, and management of depression i...
journal_title:Annals of family medicine
pub_type: 杂志文章,随机对照试验
doi:10.1370/afm.1418
更新日期:2012-07-01 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:Up to 50% of urinary tract infections (UTIs) in young children are missed in primary care. Urine culture is essential for diagnosis, but urine collection is often difficult. Our aim was to derive and internally validate a 2-step clinical rule using (1) symptoms and signs to select children for urine collection;...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.1954
更新日期:2016-07-01 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: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: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:The Seventh Report of the Joint National Commission (JNC 7) on High Blood Pressure established prehypertension (120 to 139 mm Hg systolic or 80 to 89 mm Hg diastolic) as a new risk category. We aim to determine the risk of major cardiovascular events associated with blood pressure in the prehypertensive range i...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.312
更新日期:2005-07-01 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
abstract:PURPOSE:The purpose of this study was to assess patient and practice outcomes after introducing the Asthma APGAR (Activities, Persistent, triGGers, Asthma medications, Response to therapy) tools into primary care practices. METHODS:We used a pragmatic cluster-randomized controlled design in 18 US family medicine and p...
journal_title:Annals of family medicine
pub_type: 杂志文章,多中心研究
doi:10.1370/afm.2179
更新日期:2018-03-01 00:00:00
abstract:PURPOSE:There is currently too few endoscopists to enact a national colorectal cancer screening program with colonoscopy. Primary care physicians could play an important role in filling this shortage by offering screening colonoscopy in their practice. The purpose of this study was to examine the safety and effectivene...
journal_title:Annals of family medicine
pub_type: 杂志文章,meta分析,评审
doi:10.1370/afm.939
更新日期:2009-01-01 00:00:00
abstract:PURPOSE:Avoidable hospitalizations due to adverse drug events and high-risk prescribing are common in older people. Primary care physicians prescribe most on-going medicines. Deprescribing has long been essential to best prescribing practice. We sought to explore the views of primary care physicians on the barriers and...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2094
更新日期:2017-07-01 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:Automated office blood pressure monitoring during 30 minutes (OBP30) may reduce overtreatment of patients with white-coat hypertension in primary health care. OBP30 results approximate those of ambulatory blood pressure monitoring, but OBP30 is much more convenient. In this study, we compared OBP30 with routine...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2041
更新日期:2017-03-01 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:PURPOSE:The purpose of this study was to characterize graduates of family medicine (FM) residencies from 1994 to 2017 and determine whether they continue to practice family medicine after residency. METHOD:We sampled physicians who completed FM residency training from 1994-2017 using 2017 American Medical Association ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.2535
更新日期:2020-07-01 00:00:00
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::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: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:We aimed to advance the internal and external validity of research by sharing our empirical experience and recommendations for systematically reporting contextual factors. METHODS:Fourteen teams conducting research on primary care practice transformation retrospectively considered contextual factors important ...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.1549
更新日期:2013-05-01 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:BACKGROUND:Recognizing fundamental flaws in the fragmented US health care systems and the potential of an integrative, generalist approach, the leadership of 7 national family medicine organizations initiated the Future of Family Medicine (FFM) project in 2002. The goal of the project was to develop a strategy to trans...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.130
更新日期:2004-03-01 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:Most new mothers return to work soon after childbirth. A need exists to reexamine the definition of postpartum health and evaluate employed women's recovery from childbirth in association with such factors as delivery type and breastfeeding. METHODS:Using a prospective cohort design, we recruited Minnesota wom...
journal_title:Annals of family medicine
pub_type: 杂志文章
doi:10.1370/afm.519
更新日期:2006-03-01 00:00:00