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 (50%) and who received primary care in Durham, NC. MEASUREMENTS AND MAIN RESULTS:Baseline data were obtained from the Take Control of Your Blood pressure study and included clinical, demographic, and psychosocial variables potentially related to clinic BP measures. African Americans were more likely than whites to have inadequate baseline clinic BP control as defined as greater than or equal to 140/90 mmHg (49% versus 34%; unadjusted odds ratio [OR] 1.8; 95% confidence interval [CI] 1.3-2.5). Among factors that may explain this disparity, being older, reporting hypertension medication nonadherence, reporting a hypertension diagnosis for more than 5 years, reporting high levels of stress, being worried about hypertension, and reporting an increased number of medication side effects were related to inadequate BP control. In adjusted analyses, African Americans continue to have poor BP control relative to whites; the magnitude of the association was reduced (OR = 1.5; 95% CI 1.0-2.1). Medication nonadherence, worries about hypertension, and older age (>70) continued to be related to poor BP control. CONCLUSIONS:In this sample of hypertensive patients, there were a number of factors associated with poor BP control that partially explained the observed racial disparity in hypertension control including age, medication nonadherence, and worry about BP. Medication nonadherence is of particular interest because it is a potentially modifiable factor that might be used to reduce the racial disparity in BP control.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Bosworth HB,Powers B,Grubber JM,Thorpe CT,Olsen MK,Orr M,Oddone EZdoi
10.1007/s11606-008-0547-7subject
Has Abstractpub_date
2008-05-01 00:00:00pages
692-8issue
5eissn
0884-8734issn
1525-1497journal_volume
23pub_type
杂志文章,多中心研究abstract::Elderly veterans who visit our Veterans Affairs (VA) Medical Center primary care clinic often mention they are enrolled in HMOs. Approximately 20% of patients hospitalized at our facility report health insurance coverage. Of 1,000 hospitalizations during a 6-month period in which veterans reported insurance coverage, ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1046/j.1525-1497.1997.012004247.x
更新日期:1997-04-01 00:00:00
abstract::Anti-N-methyl-D-aspartate receptor (anti-NMDA-R) encephalitis is an immune-mediated syndrome that remains under-recognized despite a growing body of literature. This syndrome has been predominantly described in young females with a constellation of symptoms, including personality changes, autonomic dysfunction and neu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-011-1641-9
更新日期:2011-07-01 00:00:00
abstract:OBJECTIVE:Examine patterns of alcohol use disorder (AUD) medication use and identify factors associated with prescription fill among commercially insured individuals with an index AUD visit. DESIGN:Using 2008-2018 claims data from a large national insurer, estimate days to first AUD medication using cause-specific haz...
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abstract:BACKGROUND:There is growing interest in developing systems to overcome barriers for acquiring and interpreting family health histories in primary care. OBJECTIVE:To examine the capacity of three different electronic portals to collect family history from patients and deposit valid data in an electronic health record (...
journal_title:Journal of general internal medicine
pub_type: 临床试验,杂志文章,多中心研究
doi:10.1007/s11606-013-2442-0
更新日期:2013-12-01 00:00:00
abstract:BACKGROUND:The many challenges in health care today create a special need for great leadership. However, traditional criteria for physicians' advancement to leadership positions often regard academic and/or clinical accomplishments rather than the distinctive competencies needed to lead. Furthermore, physicians' traini...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-009-1007-8
更新日期:2009-07-01 00:00:00
abstract::There is reason for pessimism about the incorporation of prevention into medical education. In addition to what might be called the standard reasons for resistance to prevention, there are at least three other structural barriers: the destabilization of the health care system, the loss of interest in careers in primar...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600854
更新日期:1990-09-01 00:00:00
abstract:BACKGROUND:Leaders play a crucial role in implementing and sustaining changes in clinical practice, yet there is limited evidence on the strategies to engage them in team problem solving and communication. OBJECTIVE:Examine the impact of an intervention focused on facilitating leadership during daily huddles on optimi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06487-6
更新日期:2021-01-26 00:00:00
abstract::Electronic health records (EHRs) provide benefits for patients, physicians, and clinical teams, but also raise ethical questions. Navigating how to provide care in the digital age requires an assessment of the impact of the EHR on patient care and the patient-physician relationship. EHRs should facilitate patient care...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-017-4030-1
更新日期:2017-08-01 00:00:00
abstract:OBJECTIVE:To assess the relationship between gender, background, and brief training and physicians' detection of and treatment for woman abuse. DESIGN:Quasi-experimental and correlational designs, plus control for background factors. SETTING:Two residency training programs: general internal medicine and family practi...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599714
更新日期:1993-11-01 00:00:00
abstract:PURPOSE:To compare the effects of three methods of values clarification (VCM): balance sheet; rating and ranking; and a discrete choice experiment (DCE) on decision-making about colorectal cancer (CRC) screening among adults in the US and Australia. METHODS:Using online panels managed by a survey research organization...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-013-2701-0
更新日期:2014-03-01 00:00:00
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...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1111/j.1525-1497.2006.00611.x
更新日期:2006-12-01 00:00:00
abstract:OBJECTIVE:We examined the clinical utility of supplementing type 2 diabetes mellitus (DM) risk counseling with DM genetic test results and counseling. RESEARCH DESIGN AND METHODS:In this randomized controlled trial, non-diabetic overweight/obese veteran outpatients aged 21 to 65 years received DM risk estimates for li...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-015-3315-5
更新日期:2015-11-01 00:00:00
abstract::The fourth-year medicine clerkship was restructured at one of four sites. Teams consisting of one attending physician and three students cared for eight new patients per week. The overall experience of the restructured clerkship was rated significantly more positively than the experiences at all other sites and the te...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600292
更新日期:1993-01-01 00:00:00
abstract:BACKGROUND:Despite high rates of post-deployment psychosocial problems in Iraq and Afghanistan veterans, mental health and social services are under-utilized. OBJECTIVE:To evaluate whether a Department of Veterans Affairs (VA) integrated care (IC) clinic (established in April 2007), offering an initial three-part prim...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-011-1746-1
更新日期:2011-10-01 00:00:00
abstract::Impaired hearing, so common among older people, often has disastrous consequences. The infirmity, too frequently concealed or unknown by the patient, is invisible to others. Disability and frustration can be lessened considerably by greater awareness on the part of medical and lay people about various helpful measures...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596426
更新日期:1986-11-01 00:00:00
abstract:STUDY OBJECTIVE:To determine the efficacy of a comprehensive, one-month psychosocial training program for first-year medical residents. DESIGN:Nonrandomized, controlled study with immediate pre/post evaluation. Limited evaluation of some residents was also conducted an average of 15 months after teaching. SETTING:Com...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02598223
更新日期:1991-11-01 00:00:00
abstract:BACKGROUND:It is assumed that the performance of more senior residents is superior to that of interns, but this has not been assessed objectively. OBJECTIVE:To determine whether adherence to national guidelines for outpatient preventive health services differs by year of residency training. DESIGN:Cross-sectional stu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.0158.x
更新日期:2005-09-01 00:00:00
abstract:BACKGROUND:As the Veterans Health Administration (VHA) reorganizes providers into the patient-centered medical home, questions remain whether this model of care can demonstrate improved patient outcomes and cost savings. OBJECTIVE:We measured adoption of medical home features by VHA primary care clinics prior to wides...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-013-2405-5
更新日期:2013-09-01 00:00:00
abstract::Research into health literacy and shared decision-making has largely developed along parallel, but distinct lines over the past two decades. There is little evidence that the concepts and related practice have intersected except in the most functional way, for example, to simplify shared decision-making tools by impro...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-05912-0
更新日期:2020-05-29 00:00:00
abstract::To meet the demand by residents and to provide knowledge and skills important to the developing physician, global health (GH) training opportunities are increasingly being developed by United States (U.S.) residency training programs. However, many residency programs face common challenges of developing GH curricula, ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
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更新日期:2017-05-01 00:00:00
abstract:OBJECTIVE:To determine the impact of prospective payment by diagnosis-related groups (DRGs) on length of stay in the hospital, ambulatory status, and level of post-hospital care needed for patients hospitalized with hip fracture. DESIGN:Retrospective chart review of a consecutive series of cases before and after the r...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599687
更新日期:1989-09-01 00:00:00
abstract:BACKGROUND:In response to proposed federal legislation, the Accreditation Council for Graduate Medical Education limited resident work-hours in July 2003. The cost may be substantial but, if successful, the reform might lower preventable adverse event costs in hospital and after discharge. OBJECTIVES:This study sought...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.0133.x
更新日期:2005-10-01 00:00:00
abstract:BACKGROUND:Physician opinion can influence the prospects for health care reform, yet there are few recent data on physician views on reform proposals or access to medical care in the United States. OBJECTIVE:To assess physician views on financing options for expanding health care coverage and on access to health care....
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-0916-x
更新日期:2009-04-01 00:00:00
abstract:BACKGROUND:For adults who stutter, communication difficulties can impact many spheres of life. Previous studies have not examined how stuttering might impact patient's experiences with the medical system. OBJECTIVE:Our objective was to understand the range and depth of experiences with the medical system among adults ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-015-3302-x
更新日期:2015-11-01 00:00:00
abstract:BACKGROUND:Little is known regarding the prevalence or risk factors for non-comprehension and non-compliance with discharge instructions among older adults. OBJECTIVE:To quantify the prevalence of non-comprehension and non-compliance with discharge instructions and to identify associated patient characteristics. RESE...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-014-2956-0
更新日期:2014-11-01 00:00:00
abstract:BACKGROUND:Stigma is associated with depression treatment, however, whether stigma differs between depression treatment modalities is not known, nor have racial differences in depression treatment stigma been fully explored. OBJECTIVE:To measure stigma for four depression treatments and estimate its association with t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-007-0276-3
更新日期:2007-09-01 00:00:00
abstract::Emergency readmissions among patients discharged from the medical service of an acute-care teaching hospital were analyzed. Using the multivariate technique of recursive partitioning, the authors developed and validated a model to predict readmission based on diagnoses and other clinical factors. Of the 4,769 patients...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02596366
更新日期:1987-11-01 00:00:00
abstract:BACKGROUND:Primary care providers (PCPs) vary in skills to effectively treat depression. Key features of evidence-based collaborative care models (CCMs) include the availability of depression care managers (DCMs) and mental health specialists (MHSs) in primary care. Little is known, however, about the relationships bet...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-014-2807-z
更新日期:2014-07-01 00:00:00
abstract:OBJECTIVE:To explore the effect of race on primary care quality and satisfaction among women in the Department of Veterans Affairs (VA). METHODS:We used a mail survey to measure primary care quality and satisfaction. We focused on 4 primary care domains: patient preference for provider, interpersonal communication, ac...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2006.00517.x
更新日期:2006-10-01 00:00:00
abstract::To train more generalist physicians, structural changes must be made along the continuum of medical education. Future generalists require in-depth exposure to primary care practice, with substantive experience in the longitudinal management of patient panels and the opportunity to work with successful generalist role ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/BF02598115
更新日期:1994-04-01 00:00:00