Abstract：
:Polypharmacy occurs when a medical regimen includes at least one unnecessary medication. Factors that contribute to this problem include: patient characteristics of increasing age, multiple medical problems, therapy expectations, and decisions to self-treat; physician factors such as excessive prescribing; and system problems of multiple providers and lack of a coordinating provider. Complications include increased adverse drug reactions and noncompliance, which can lead to increased hospitalization and associated costs. Polypharmacy can be avoided by patient education and sharing the decisions for making the treatment goals and plan. The medication regimen can be simplified by eliminating pharmacologic duplication, decreasing dosing frequency, and regular review of the drug regimen. The goal should be to prescribe the least complex drug regimen for the patient as possible, while considering the medical problems and symptoms and the cost of therapy.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Colley CA,Lucas LMdoi
10.1007/BF02600099subject
Has Abstractpub_date
1993-05-01 00:00:00pages
278-83issue
5eissn
0884-8734issn
1525-1497journal_volume
8pub_type
杂志文章,评审abstract：OBJECTIVE:To determine whether internists in the United States and China have different ideas and behaviors regarding informing patients of terminal diagnoses and HIV/AIDS, the role of the family in end-of-life decision making, and assisted suicide. DESIGN:Structured questionnaire of clinical vignettes followed by mul...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1999.06318.x
更新日期：1999-08-01 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:Pharmaceutical industry gifts to physicians are common and influence physician behavior. Little is known about patient beliefs about the prevalence of these gifts and how these beliefs may influence trust in physicians and the health care system. OBJECTIVE:To measure patient perceptions about the prevalence...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-011-1760-3
更新日期：2012-03-01 00:00:00
abstract：BACKGROUND:eConsult programs have been instituted to increase access to specialty expertise. Opt-in choice eConsult programs maintain primary care physician (PCP) autonomy to decide whether to utilize eConsults versus traditional specialty referrals, but little is known about how this intervention may impact PCP eConsu...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06101-9
更新日期：2020-11-01 00:00:00
abstract：OBJECTIVE:To evaluate the accuracy of a preliminary diagnosis based solely on patient history and physical examination in medical outpatients with abdominal or chest pain. DESIGN:Prospective observational study. SETTING:General medical outpatient clinic in a university teaching hospital. PARTICIPANTS:One hundred nin...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.1997.00083.x
更新日期：1997-08-01 00:00:00
abstract：:The community of health services researchers in general internal medicine has played an important role in affecting health policy at the national and state levels. Community-based participatory research (CBPR) offers health services researchers an opportunity to identify and address health policy questions at the loca...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-011-1878-3
更新日期：2011-12-01 00:00:00
abstract：BACKGROUND:National guidelines indicate that healthcare providers should routinely screen women of reproductive age for experience of intimate partner violence. We know little about intimate partner violence (IPV) screening and disclosure experience among women older than reproductive age. OBJECTIVE:To examine the per...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05947-3
更新日期：2020-09-01 00:00:00
abstract：OBJECTIVE:To determine whether selected socially rehabilitated former heroin addicts maintained on methadone can continue successful rehabilitation while maintained on methadone by primary care physicians rather than licensed clinics. This procedure has been termed "medical maintenance." DESIGN:Cohort study with 42-11...
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：OBJECTIVE:To examine experiences of older persons and their clinicians with shared decision making (SDM) and their willingness to use an SDM instrument. DESIGN:Qualitative focus group study. PARTICIPANTS:Four focus groups of 41 older persons and 2 focus groups of 11 clinicians, purposively sampled to encompass a rang...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2005.0114.x
更新日期：2005-07-01 00:00:00
abstract：BACKGROUND:Few data have evaluated the relationship between caregiving and cardiovascular disease (CVD) risk. OBJECTIVE:The purpose of this study was to determine the prevalence and predictors of caregiver strain and to evaluate the association between caregiving and CVD lifestyle and psychosocial risk factors among f...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-008-0852-1
更新日期：2009-01-01 00:00:00
abstract：BACKGROUND:Many patient education materials (PEMs) available on the internet are written at high school or college reading levels, rendering them inaccessible to the average US resident, who reads at or below an 8(th) grade level. Currently, electronic health record (EHR) providers partner with companies that produce P...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-012-2046-0
更新日期：2012-09-01 00:00:00
abstract：:To investigate the value of home urine glucose testing in assessing chronic diabetic glucose control, the authors compared patients' glycosuria patterns with their mean blood glucose (MBG) levels calculated from glycosylated hemoglobin (Hb Alc). One hundred and twenty-one patients who regularly checked their urines re...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/BF02596192
更新日期：1986-07-01 00:00:00
abstract：BACKGROUND:Studies using local samples suggest that racial minorities anticipate a greater preference for life-sustaining treatment when faced with a terminal illness. These studies are limited by size, representation, and insufficient exploration of sociocultural covariables. OBJECTIVE:To explore racial and ethnic di...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-009-0952-6
更新日期：2009-06-01 00:00:00
abstract：:Several population health big data projects have been initiated in the USA recently. These include the County Health Rankings & Roadmaps (CHR) initiated in 2010, the 500 Cities Project initiated in 2016, and the City Health Dashboard project initiated in 2017. Such projects provide data on a range of factors that dete...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05869-0
更新日期：2020-11-01 00:00:00
abstract：OBJECTIVE:Assess impact of a computer-based patient support system on quality of life in younger women with breast cancer, with particular emphasis on assisting the underserved. DESIGN:Randomized controlled trial conducted between 1995 and 1998. SETTING:Five sites: two teaching hospitals (Madison, Wis, and Chicago, I...
journal_title：Journal of general internal medicine
pub_type： 临床试验,杂志文章,多中心研究,随机对照试验
doi：10.1046/j.1525-1497.2001.016007435.x
更新日期：2001-07-01 00:00:00
abstract：OBJECTIVE:To assess whether newer antipsychotic medications are associated with weight gain and development of diabetes. DESIGN:Retrospective cohort study. SETTING:Data from a comprehensive electronic medical record serving an urban public hospital and a citywide network of mental health clinics. PATIENTS/PARTICIPAN...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2004.40126.x
更新日期：2004-12-01 00:00:00
abstract：BACKGROUND:Obese women experience higher postmenopausal breast cancer risk, morbidity, and mortality and may be less likely to undergo mammography. OBJECTIVES:To quantify the relationship between body weight and mammography in white and black women. DATA SOURCES AND REVIEW METHODS:We identified original articles eval...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,meta分析,评审
doi：10.1007/s11606-009-0939-3
更新日期：2009-05-01 00:00:00
abstract：BACKGROUND:Computerized physician order entry and clinical decision support systems are electronic prescribing strategies that are increasingly used to improve patient safety. Previous reviews show limited effect on patient outcomes. Our objective was to assess the impact of electronic prescribing strategies on medicat...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,meta分析
doi：10.1007/s11606-019-05236-8
更新日期：2019-10-01 00:00:00
abstract：BACKGROUND:Despite significant investment in colorectal cancer (CRC) screening, 40% of US adults are not up-to-date. Commitment devices, which are psychologically tailored approaches to enforce health goals, may be an effective method to increase CRC screening. OBJECTIVE:Compare the effectiveness of a commitment devic...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-06392-y
更新日期：2021-01-20 00:00:00
abstract：BACKGROUND:Quite often medical students or novice residents have difficulty in ruling out diseases even though they are quite unlikely and, due to this difficulty, such students and novice residents unnecessarily repeat laboratory or imaging tests. OBJECTIVE:To explore whether or not a carefully designed short trainin...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1111/j.1525-1497.2004.30257.x
更新日期：2004-05-01 00:00:00
abstract：BACKGROUND:Approximately 25 million people in the USA are limited English proficient (LEP). When LEP patients receive care from physicians who are truly language concordant, some evidence show that language disparities are reduced, but others demonstrate worse outcomes. We conducted a systematic review of the literatur...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-04847-5
更新日期：2019-08-01 00:00:00
abstract：BACKGROUND:Social connectedness exerts strong influences on health, including major depression and suicide. A major component of social connectedness is having individual relationships with close supports, romantic partners, and other trusted members of one's social network. OBJECTIVE:The objective of this study was t...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-020-05692-7
更新日期：2020-07-01 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
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
abstract：BACKGROUND:Heterogeneity of existing physician burnout studies impairs analyses of longitudinal trends, geographic distribution, and organizational factors impacting physician burnout. The Department of Veterans Affairs (VA) is one of the largest integrated healthcare systems in the USA, offering a unique opportunity t...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05582-7
更新日期：2020-05-01 00:00:00
abstract：OBJECTIVE:To examine the characteristics and outcomes of physician-referred weight management patients relative to self-referred patients. DESIGN:Review of clinic records of all individuals contacting a weight control program during a 2-year period with follow-up throughout consecutive levels of treatment (i.e., enrol...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1046/j.1525-1497.2002.11028.x
更新日期：2002-08-01 00:00:00
abstract：INTRODUCTION:Obesity stigma is common in our society, and a general stigma towards obesity has also been documented in physicians. We hypothesized that physician respect for patients would be lower in patients with higher body mass index (BMI). METHODS:We analyzed data from the baseline visit of 40 physicians and 238 ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章,随机对照试验
doi：10.1007/s11606-009-1104-8
更新日期：2009-11-01 00:00:00
abstract：BACKGROUND:Approximately 20% of patients with atherosclerotic cardiovascular disease (ASCVD) suffer from depression. OBJECTIVE:To compare healthcare expenditures and utilization, healthcare-related quality of life, and patient-centered outcomes among ASCVD patients, based on their risk for depression (among those with...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-019-05325-8
更新日期：2019-11-01 00:00:00
abstract：BACKGROUND:Identifying potential mechanisms that link depressed mood with worse health behaviors is important given the prevalence of depressed mood in patients with coronary heart disease (CHD) and its relationship with subsequent mortality. Perceived health competence is an individual's confidence in his/her ability ...
journal_title：Journal of general internal medicine
pub_type： 杂志文章
doi：10.1007/s11606-018-4767-1
更新日期：2019-07-01 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
