Abstract:
OBJECTIVE:To assess the effect of a program that encourages teamwork between physicians and pharmacists on attempts to lower total cholesterol levels and to meet recommended goals proposed by the National Cholesterol Education Program (NCEP). DESIGN:A single-blind, randomized, controlled trial lasting 6 months. SETTING:An ambulatory primary care center. PATIENTS:A sample of 94 patients with total cholesterol levels of 240 mg/dL (6.2 mmol/L) or higher. INTERVENTION:Equal numbers of patients were randomly assigned to a control arm in which standard medical care was received and an intervention arm which implemented close interaction between physicians and pharmacists. MEASUREMENTS AND MAIN RESULTS:Absolute change in total cholesterol levels from baseline values and the percentage of patients who achieved an NCEP goal after 6 months of intervention were determined. The rate of success in achieving NCEP goals in the intervention arm was double the rate in the control arm (43% vs 21%, P < .05). Total cholesterol levels in the intervention arm declined 44 +/- 47 mg/dL (1.1 +/- 1.2 mmol/L) versus 13 +/- 51 mg/dL (0.3 +/- 1.3 mmol/L) in the control arm (p < .01). The effect of intervention on reducing total cholesterol levels was similar for men and women and did not appeared to be altered by age. The effect of intervention was greatest in patients with coronary heart disease (p < .01) followed by those without disease but with two or more coronary heart disease risk factors (p < .05). An effect of intervention was absent in patients without coronary heart disease and with fewer than two risk factors. CONCLUSIONS:Attempts to lower total cholesterol levels and achieve NCEP goals are likely to be more successful when combined with programs that include teamwork between physicians and pharmacists. Some programs, however, may be more successful for high-risk patients, for whom it is often easier to provide more aggressive therapies. Although altering adverse lipid profiles in lower-risk patients may be difficult, achieving optimal cholesterol levels could have an important impact on preventing movement to higher risk strata.
journal_name
J Gen Intern Medjournal_title
Journal of general internal medicineauthors
Bogden PE,Koontz LM,Williamson P,Abbott RDdoi
10.1007/s11606-006-5023-7subject
Has Abstractpub_date
1997-03-01 00:00:00pages
158-64issue
3eissn
0884-8734issn
1525-1497journal_volume
12pub_type
临床试验,杂志文章,随机对照试验abstract::Chronic eosinophilic pneumonia (CEP) is a rare interstitial lung disease characterized by subacute dyspnea, peripheral infiltrates on imaging, and pulmonary eosinophilia. We report a case of a 48-year-old man who presented to a "minute clinic" with cough and dyspnea. After improvement on a short course of steroids for...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-012-2316-x
更新日期:2013-07-01 00:00:00
abstract:OBJECTIVE:To compare the abilities of two methods for rapid detection of pyuria and three methods of urinalysis to predict significant bacteriuria in symptomatic ambulatory women. DESIGN:Prospective simultaneous comparison of the results of dipstick urinalysis, standard microscopic urinalysis, and hemocytometric cell ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02598002
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Despite the importance of professionalism, little is known about how burnout relates to professionalism among practicing physicians. OBJECTIVE:To evaluate the relationship between burnout and professional behaviors and cost-conscious attitudes. DESIGN AND PARTICIPANTS:Cross-sectional study in a national sa...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05376-x
更新日期:2020-05-01 00:00:00
abstract:BACKGROUND:Obesity and diabetes family history are the two strongest risk factors for type 2 diabetes (T2D). Prior work shows that an individual's obesity risk is associated with obesity in social contacts, but whether T2D risk follows similar patterns is unknown. OBJECTIVE:We aimed to estimate the relationship betwee...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3723-1
更新日期:2016-10-01 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:BACKGROUND:The 2016 presidential election and the controversial policy agenda of its victor have raised concerns about how the election may have impacted mental health. OBJECTIVE:Assess how mental health changed from before to after the November 2016 election and how trends differed in states that voted for Donald Tru...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06328-6
更新日期:2020-10-31 00:00:00
abstract:BACKGROUND:Racial and ethnic minority groups have lower levels of leisure-time physical activity (LTPA) than whites, but it is unclear how much of this is explained by differences in socioeconomic status and health. OBJECTIVE:To examine differences in LTPA, work-related physical activity (WRPA; heavy household chores ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1111/j.1525-1497.2005.40198.x
更新日期:2005-03-01 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:OBJECTIVES:To assess the prevalence and persistence of depression in patients with acute myocardial infarction (AMI) and the relationship between assessment modality and prevalence. DATA SOURCES:MEDLINE, Cochrane, CINAHL, PsycINFO, and EMBASE. REVIEW METHODS:A comprehensive search was conducted in March 2004 to ident...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1111/j.1525-1497.2005.00269.x
更新日期:2006-01-01 00:00:00
abstract:BACKGROUND:Many opioid-dependent patients do not receive care for addiction issues when hospitalized for other medical problems. Based on 3 years of clinical practice, we report the Transitional Opioid Program (TOP) experience using hospitalization as a "reachable moment" to identify and link opioid-dependent persons t...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1311-3
更新日期:2010-08-01 00:00:00
abstract:OBJECTIVE:The Veterans Affairs (VA) Quality Enhancement Research Initiative (QUERI) seeks to develop partnerships between VA health services researchers and clinical managers, with the goal of designing and evaluating interventions to improve the quality of VA health care. METHODS:In the present report we describe one...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-009-1155-x
更新日期:2010-01-01 00:00:00
abstract::Starfield and colleagues have suggested four overarching attributes of good primary care: "first-contact access for each need; long-term person- (not disease) focused care; comprehensive care for most health needs; and coordinated care when it must be sought elsewhere." As this series on reinventing primary care highl...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-016-3945-2
更新日期:2017-04-01 00:00:00
abstract:BACKGROUND:The transition from pediatric to adult care is a critical period for young adults with childhood-onset conditions. General internists are tasked with participating in the care of this vulnerable population. Existing guidelines regarding transition do not fully address structural or organizational characteris...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究
doi:10.1007/s11606-019-05226-w
更新日期:2019-10-01 00:00:00
abstract::This report examines alternative methods of paying for clinical preventive care services. First, the extent of coverage of preventive health care services in public and private health insurance plans is reviewed. Included in this review are Medicare, Medicaid, health maintenance organizations, and private health insur...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600851
更新日期:1990-09-01 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::Opioid dependence is largely an undertreated medical condition in the United States. The introduction of buprenorphine has created the potential to expand access to and use of opioid agonist treatment in generalist settings. Physicians, however, often have limited training and experience providing this type of care. S...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-010-1377-y
更新日期:2010-09-01 00:00:00
abstract:OBJECTIVE:To determine the relevance of the initial certifying examination to the practice of internal medicine and the suitability of items used in initial certification for recertification. DESIGN:Using a matrix-sampling approach, items from the 1991 Certifying Examination were assigned to two sets of judges: direct...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02599989
更新日期:1993-02-01 00:00:00
abstract::Attempts to explain the high cost of care in teaching hospitals have yielded conflicting results. This study was conducted to compare hospital charges and lengths of stay for two groups of patients: one cared for by a resident team and the other cared for by attending physicians. The study was conducted at a universit...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02602350
更新日期:1989-03-01 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: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::Hospitalists are well poised to serve in key leadership roles and in frontline care in particular when facing a pandemic such as the SARS-CoV-2 (COVID-19) infection. Much of the disaster planning in hospitals around the country addresses overcrowded emergency departments and decompressing these locations; however, in ...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-020-05952-6
更新日期:2020-09-01 00:00:00
abstract:BACKGROUND:We sought to examine the relationship between literacy and heart failure-related quality of life (HFQOL), and to explore whether literacy-related differences in knowledge, self-efficacy and/or self-care behavior explained the relationship. METHODS:We recruited patients with symptomatic heart failure (HF) fr...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1007/s11606-011-1668-y
更新日期:2011-09-01 00:00:00
abstract:BACKGROUND:While studies have been published in the last 30 years that examine the effect of charge display during physician decision-making, no analysis or synthesis of these studies has been conducted. OBJECTIVE:We aimed to determine the type and quality of charge display studies that have been published; to synthes...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,评审
doi:10.1007/s11606-015-3226-5
更新日期:2015-06-01 00:00:00
abstract:OBJECTIVE:To determine whether a Bayesian method of lung scan (LS) reporting could influence the management of patients with suspected pulmonary embolism (PE). DESIGN:1) A descriptive study of the diagnostic process for suspected PE using the new reporting method; 2) a non-experimental evaluation of the reporting meth...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02600392
更新日期:1990-07-01 00:00:00
abstract:OBJECTIVE:Internet and other interactive technology-based programs offer great potential for practical, effective, and cost-efficient diabetes self-management (DSM) programs capable of reaching large numbers of patients. This study evaluated minimal and moderate support versions of an Internet-based diabetes self-manag...
journal_title:Journal of general internal medicine
pub_type: 杂志文章,随机对照试验
doi:10.1007/s11606-010-1480-0
更新日期:2010-12-01 00:00:00
abstract::The study examined the relative contribution of caregivers' conduct and physical conditions of the hospital setting to patients' global satisfaction with health care, while controlling for self-assessed health status. The study was performed in the Soroka Medical Center, which is the only inpatient facility for a popu...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02598274
更新日期:1996-05-01 00:00:00
abstract:BACKGROUND:The case presentation is a fundamental activity used in both patient care and trainee education, partly due to feedback from supervisor to trainee. Although feedback in medical education is well studied, prior studies have not focused on the perceptions of feedback by Internal Medicine supervisors and traine...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-019-05134-z
更新日期:2019-10-01 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 determine whether there are differences between men and women patients who have chronic fatigue syndrome (CFS) and, if so, to ascertain whether a gender-related pattern exists. DESIGN:A descriptive study of demographic, clinical, and psychosocial measures, the results of which were prospectively collected...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/BF02629522
更新日期:1994-07-01 00:00:00
abstract:BACKGROUND:Network meta-analysis (NMA) is a popular tool to compare multiple treatments in medical research. It is frequently implemented via Bayesian methods. The prior choice of between-study heterogeneity is critical in Bayesian NMAs. This study evaluates the impact of different priors for heterogeneity on NMA resul...
journal_title:Journal of general internal medicine
pub_type: 杂志文章
doi:10.1007/s11606-020-06357-1
更新日期:2021-01-05 00:00:00