Abstract:
:The management of older patients with chronic medical conditions dominates medical practice. Cardiovascular disease (CVD) and diabetes mellitus type 2 (DM) in patients aged 65 and older have reached epidemic proportions. Using elements of the Chronic Care Model (CCM), a quality improvement project was undertaken to restructure the Geriatric Ambulatory Practice at Boston Medical Center, Boston's safety net hospital, to improve the quality of care for CVD and diabetes mellitus. Two hundred eighty-three eligible patients who had CVD, DM, or both were identified. The 39-month project period was divided into a 12-month baseline period and three follow-up periods. The multifaceted intervention consisted of development of a disease registry that centralized clinical information, implementation of an electronic medical record, patient education, physician education regarding evidence-based guidelines, feedback of provider-specific and practice data to physicians, and implementation of a foot examination protocol. Clinical measures included glycosylated hemoglobin, a diabetic foot examination, lipid profile, and blood pressure measurement. These were collected at baseline and at each patient visit for the entire project period. The average age of all patients was 76; 64% were female, 64% were African American, 72% had Medicare, and 22% had state subsidized medical insurance. Patients in all disease groups showed significant improvement in all clinical measures over time, independent of the frequency of visits. Using the CCM as a quality improvement framework can improve clinical measures for older urban minority populations with CVD and DM.
journal_name
J Am Geriatr Socjournal_title
Journal of the American Geriatrics Societyauthors
Caruso LB,Clough-Gorr KM,Silliman RAdoi
10.1111/j.1532-5415.2007.01320.xsubject
Has Abstractpub_date
2007-10-01 00:00:00pages
1656-62issue
10eissn
0002-8614issn
1532-5415pii
JGS1320journal_volume
55pub_type
杂志文章abstract:OBJECTIVES:To identify patterns and predictors of antithrombotic use and to evaluate the appropriateness of antithrombotic therapy for stroke prophylaxis in institutionalized elderly patients with atrial fibrillation. DESIGN:Retrospective study. SETTING:Seventeen long-term care institutions in Edmonton, Alberta. SUB...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2004.52117.x
更新日期:2004-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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abstract::Two concurrent studies of geriatric outpatients who received diagnoses of depression were conducted. In the first, patients were treated with one of two tricyclic antidepressants or with a placebo. In the second, patients were assigned to groups receiving either psychodynamic group therapy or cognitive-behavioral grou...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1982.tb01987.x
更新日期:1982-11-01 00:00:00
abstract:OBJECTIVES:Factors specifically affecting compliance with continuous positive airway pressure (CPAP) in older patients with obstructive sleep apnea (OSA) have not been described. The purpose of this study is to determine which factors are associated with compliance and noncompliance in older patients, a growing segment...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.49238.x
更新日期:2001-09-01 00:00:00
abstract:OBJECTIVE:To study the association of two well known risk factors for breast cancer and the association of knowledge of those risk factors with mammography utilization. DESIGN:Cross sectional: two independent random telephone surveys. SETTING:Two Northeastern metropolitan communities surveyed in 1987 and in 1989. PA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1992.tb01848.x
更新日期:1992-08-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
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更新日期:2002-07-01 00:00:00
abstract:OBJECTIVE:To describe a broad range of physical disability by examining the association between a four-level measure of disability, based on self-report of difficulty in performing functional activities, and previously identified risk factors for disability. DESIGN:Cross-sectional. SETTING:Community-based. PARTICIPA...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1996.tb04065.x
更新日期:1996-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1994.tb01760.x
更新日期:1994-03-01 00:00:00
abstract:OBJECTIVE:To compare characteristics, healthcare use, and costs of care of veterans in the rapidly expanding Veterans Health Administration (VHA) medical foster home (MFH) with those of three other VHA long-term care (LTC) programs. DESIGN:Descriptive, unmatched study. SETTING:VHA MFHs, home-based primary care (HBPC)...
journal_title:Journal of the American Geriatrics Society
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doi:10.1111/jgs.14517
更新日期:2016-12-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1999.tb02991.x
更新日期:1999-03-01 00:00:00
abstract::To prevent falls effectively, one must first understand the underlying reasons. Although environmental factors are sometimes to blame, the fundamental cause is a decline in postural control which is partly age-related and partly due to pathologic changes in the central nervous system. Dizziness is a common complaint a...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1980.tb01125.x
更新日期:1980-11-01 00:00:00
abstract:OBJECTIVES:To investigate whether anticholinergic burden scores from nine published anticholinergic scales are associated with adverse health outcomes, including hospital admissions, hospitalizations for falls, hospital length of stay (LOS), and more visits to general practitioners (GPs). DESIGN:Pharmacoepidemiologica...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.13206
更新日期:2015-01-01 00:00:00
abstract:OBJECTIVES:To determine to what extent demographic, social support, socioeconomic, geographic, medical, and End-of-Life (EOL) planning factors explain racial and ethnic variation in Medicare spending during the last 6 months of life. DESIGN:Retrospective cohort study. SETTING:Health and Retirement Study (HRS). PARTI...
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pub_type: 杂志文章
doi:10.1111/jgs.14263
更新日期:2016-09-01 00:00:00
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pub_type: 杂志文章,meta分析,评审
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更新日期:2004-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
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更新日期:2007-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2008.01770.x
更新日期:2008-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1046/j.1532-5415.2001.4911234.x
更新日期:2001-11-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/j.1532-5415.1992.tb01860.x
更新日期:1992-08-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1985.tb04619.x
更新日期:1985-08-01 00:00:00
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pub_type: 杂志文章,随机对照试验
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更新日期:2016-06-01 00:00:00
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pub_type: 杂志文章
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更新日期:2019-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:2005-02-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
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doi:10.1111/j.1532-5415.2004.52517.x
更新日期:2004-11-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1981.tb01236.x
更新日期:1981-02-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,多中心研究
doi:10.1111/j.1532-5415.2004.52300.x
更新日期:2004-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
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更新日期:1998-03-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/jgs.12313
更新日期:2013-07-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.2005.53202.x
更新日期:2005-04-01 00:00:00
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journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章,评审
doi:10.1111/jgs.12522
更新日期:2013-11-01 00:00:00
abstract:OBJECTIVE:The purpose of this study was to examine physical activity and the predictors of physical activity and exercise among nursing home residents. DESIGN:Population study. PARTICIPANTS:The sample (n = 190) was obtained by selecting every man and every second women from the entire nursing home population (n = 346...
journal_title:Journal of the American Geriatrics Society
pub_type: 杂志文章
doi:10.1111/j.1532-5415.1994.tb06593.x
更新日期:1994-09-01 00:00:00