Abstract:
OBJECTIVE:To evaluate whether training primary care clinicians in maintenance care for patients who have changed their drinking influences practice behavior. DESIGN:We randomized 15 physician and 3 mid-level clinicians in 2 primary care offices in a 2:1 design. The 12 intervention clinicians received a total of 2 (1/4) hours of training in the maintenance care of alcohol problems in remission, a booster session, study materials and chart-based prompts at eligible patients' visits. Six controls provided usual care. Screening forms in the waiting rooms identified eligible patients, defined as those who endorsed: 1 or more items on the CAGE questionnaire or that they had an alcohol problem in the past; that they have "made a change in their drinking and are trying to keep it that way"; and that they drank <15 (men) or <10 (women) drinks per week in the past month. Exit interviews with patients evaluated the clinician's actions during the visit. RESULTS:Of the 164 patients, 62% saw intervention clinicians. Compared with patients of control clinicians, intervention patients were more likely to report that their clinician asked about their alcohol history (odds ratio, 2.8; 95% confidence interval, 1.3, 5.8). Intervention clinicians who asked about the alcohol history were more likely to assess prior and planned alcohol treatment, assist through offers for prescriptions and treatment referral, and receive higher satisfaction ratings for the visit. CONCLUSIONS:Systemic prompts and training in the maintenance care of alcohol use disorders in remission might increase primary care clinicians' inquiries about the alcohol history as well as appropriate assessment and intervention after an initial inquiry.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Friedmann PD,Rose J,Hayaki J,Ramsey S,Charuvastra A,Dubé C,Herman D,Stein MDdoi
10.1111/j.1525-1497.2006.00611.xsubject
Has Abstractpub_date
2006-12-01 00:00:00pages
1269-75issue
12eissn
0884-8734issn
1525-1497pii
JGI611journal_volume
21pub_type
杂志文章,随机对照试验abstract:OBJECTIVE:To report rates of cost-related skipping of medications and other treatments, assess correlates of skipping, examine changes in skipping between 1998 and 2000, and identify factors associated with changes in skipping. DESIGN, SETTING, AND PARTICIPANTS:Cross-sectional and longitudinal analyses of surveys of a...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.0128.x
更新日期:2005-08-01 00:00:00
abstract:BACKGROUND:Heart disease is the leading cause of death for women in the United States, accounting for 24.5 % of all deaths among women. Earlier research has demonstrated racial/ethnic differences in prevalence of cardiovascular (CVD) risk factors. OBJECTIVE:To empirically examine the prevalence of CVD risk factors amo...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-012-2309-9
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:Addressing the epidemic of poor compliance with antihypertensive medications will require identifying factors associated with poor adherence, including modifiable psychosocial and behavioral characteristics of patients. DESIGN:Cross-sectional study, comparing measured utilization of antihypertensive prescrip...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.2002.00406.x
更新日期:2002-07-01 00:00:00
abstract:BACKGROUND:Entry into general internal medicine (GIM) has declined. The effect of the inpatient general medicine rotation on medical student career choices is uncertain. OBJECTIVE:To assess the effect of student satisfaction with the inpatient general medicine rotation on pursuit of a career in GIM. DESIGN:Multicente...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-1497.2006.00429.x
更新日期:2006-05-01 00:00:00
abstract::We conducted a telephone survey of patients in a university-based medical practice to determine if there was a difference across payer class in patients' willingness to have supervised housestaff physicians function as their primary care providers. Overall, commercial managed care patients were more likely to object t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:1998-05-01 00:00:00
abstract:BACKGROUND:Extension for Community Healthcare Outcomes (ECHO) and related models of medical tele-education are rapidly expanding; however, their effectiveness remains unclear. This systematic review examines the effectiveness of ECHO and ECHO-like medical tele-education models of healthcare delivery in terms of improve...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05291-1
更新日期:2019-12-01 00:00:00
abstract::In rare cases, pancytopenia results from hormonal deficiencies that arise in the setting of panhypopituitarism. Here we describe the unusual case of a 60-year-old man who presented with progressive fatigue and polyuria, and whose laboratory workup revealed a deficiency of the five hormones associated with the action o...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-014-3161-x
更新日期:2015-05-01 00:00:00
abstract:OBJECTIVE:African-American (black) and white individuals have been shown to differ in their desire for life-sustaining treatments and their use of living wills for end-of-life care, but the reasons for these differences are unclear. This study was designed to test the hypothesis that these ethnic differences exist beca...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600155
更新日期:1996-11-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-020-06235-w
更新日期:2020-12-01 00:00:00
abstract:BACKGROUND:Rates of substance use in rural areas are close to those of urban areas. While recent efforts have emphasized integrated care as a promising model for addressing workforce shortages in providing behavioral health services to those living in medically underserved regions, little is known on how substance use ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-015-3488-y
更新日期:2016-02-01 00:00:00
abstract:OBJECTIVE:To assess a new technique for the detection of free pleural fluid. DESIGN:118 consecutive inpatients with radiologic evidence of free pleural fluid and a control group of 175 randomly selected inpatients were examined over a three-year period in a prospective blind study by auscultatory percussion (AP) for e...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02600204
更新日期:1994-02-01 00:00:00
abstract:IMPORTANCE:Sexual minority women with and at-risk for human immunodeficiency virus (HIV) may face increased risks of violence. OBJECTIVE:To understand the relationship between sexual minority status and violence; and how high-risk sex and substance use mediate that relationship among women with and at-risk for HIV. D...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-014-2832-y
更新日期:2014-08-01 00:00:00
abstract:BACKGROUND:To date, 38 states have enacted dense breast notification (DBN) laws mandating that mammogram reports include language informing women of risks related to dense breast tissue. OBJECTIVE:Nationally representative survey to assess the association between residing in a state with a DBN law and women's awarenes...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2020-07-01 00:00:00
abstract:OBJECTIVE:The objective of the study was to identify potential explanatory factors for racial differences in blood pressure (BP) control. DESIGN:The design of the study was a cross-sectional study PATIENTS/PARTICIPANTS:The study included 608 patients with hypertension who were either African American (50%) or white (...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-008-0547-7
更新日期:2008-05-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-006-0067-2
更新日期:2007-05-01 00:00:00
abstract:BACKGROUND:Medical students in the USA have negative perceptions of primary care careers, which are exacerbated by the hidden curriculum and medical school culture. Longitudinal integrated clerkships (LICs) have shown promise in ameliorating this situation by promoting student/preceptor continuity relationships and hel...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-018-4600-x
更新日期:2018-10-01 00:00:00
abstract:OBJECTIVE:To examine the impact of a nurse-coordinated intervention delivered to patients with non-insulin-dependent diabetes mellitus between office visits to primary care physicians. DESIGN:Randomized, controlled trial. SETTING:Veterans Affairs general medical clinic. PATIENTS:275 veterans who had NIDDM and were r...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1007/BF02600227
更新日期:1995-02-01 00:00:00
abstract:BACKGROUND:Increasing the use of electronic medical records (EMR) has been suggested as an important strategy for improving healthcare safety. OBJECTIVE:To sequentially measure, evaluate, and respond to safety culture and practice safety concerns following EMR implementation. DESIGN:Safety culture was assessed using ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-012-2153-y
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:1) To determine whether the frequencies of panic disorder (PD) and depression (DEP) in an emergency department (ED) population were comparable to those in other primary care groups; 2) to evaluate whether patients without the clinical diagnosis of acute cardiac ischemia (ACI) had higher frequencies of these d...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600087
更新日期:1993-05-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1525-1497.2004.30357.x
更新日期:2004-04-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2007-03-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600025
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Limitations in instrumental activities of daily living (IADL) hinder a person's ability to live independently in the community and self-manage their conditions, but its impact on hospital readmission has not been firmly established. OBJECTIVE:To test the importance of IADL dependency as a predictor of 30-da...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05982-0
更新日期:2020-10-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2011-12-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2020-12-01 00:00:00
abstract::This study is a cross-sectional descriptive survey of randomly selected primary care patients and physicians regarding patient, physician, and family roles in end-of-life decision making. The subjects included 329 adult outpatients and 272 practicing physicians. Physicians were more likely than patients to believe the...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1998.00008.x
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND:Process measures of healthcare quality are usually formulated as the number of patients who receive evidence-based treatment (numerator) divided by the number of patients in the target population (denominator). When the systems being evaluated can influence which patients are included in the denominator, it ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2016-04-01 00:00:00
abstract:BACKGROUND:Many medical schools have incorporated the Stages of Change Model into their curricula with specific application to tobacco cessation. OBJECTIVE:This study examined the extent to which medical students were prepared to provide stage-based interventions to treat nicotine dependence. DESIGN:Using a quasi-exp...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2007-02-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章
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更新日期:2010-05-01 00:00:00
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journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
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更新日期:2006-07-01 00:00:00