Abstract:
BACKGROUND:The rapid increase of antibiotic resistance poses a significant threat to human health. Overuse of antibiotics has been linked to rates of antibiotic resistance. This study assessed the utility of two common interventions--1) practice profiling and feedback and 2) patient education materials--implemented to decrease antibiotic prescribing for pediatric upper respiratory infections (URIs). METHODS:Based on Medicaid regions in Kentucky, primary care physicians managing pediatric respiratory infections in Medicaid were randomized into four groups. Groups received either 1) performance feedback only, 2) patient education materials only, 3) both feedback and education materials, or 4) no intervention. Participating physicians had their antibiotic prescribing assessed for the period of July 1, 1996, to November 30, 1997, with an intervention in June 1997. The study included 216 physicians and 124,092 episodes of care. RESULTS:All groups increased in proportion of episodes with antibiotics between the pre-intervention and post-intervention periods. Prescribing in the patient education group and the patient education and feedback group increased at a significantly lower rate than in the control group. Physicians did not change their coding of illness to justify antibiotics after the intervention, and there was no significant generalization of effect of the pediatric intervention on prescribing for adult URIs. CONCLUSIONS:These interventions demonstrate little if any impact on promoting appropriate antibiotic prescribing. Antibiotic prescribing for viral respiratory infections continues to increase, suggesting concomitant increases in antibiotic resistance.
journal_name
Fam Medjournal_title
Family medicineauthors
Mainous AG 3rd,Hueston WJ,Love MM,Evans ME,Finger Rsubject
Has Abstractpub_date
2000-01-01 00:00:00pages
22-9issue
1eissn
0742-3225issn
1938-3800journal_volume
32pub_type
临床试验,杂志文章,随机对照试验相关文献
FAMILY MEDICINE文献大全abstract:BACKGROUND:Since before Hippocrates, case reports have provided a rich resource for teaching and research in medicine. Case reports are published by many prominent journals--more than 140,000 case reports are indexed in MEDLINE from 1996 to present--and a number of narrative guidelines for the preparation of case repor...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2000-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Pharmacist inclusion in patient-centered medical home (PCMH) teams has been shown to benefit both patients and practices. However, pharmacists' inclusion on these teams is not widespread, partly because the work they do is not well known. The Successful Collaborative Relationships to Improve P...
journal_title:Family medicine
pub_type: 杂志文章
doi:10.22454/FamMed.2018.391124
更新日期:2018-09-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:As the opioid crisis worsens across the United States, the factors that impact physician training in management of substance use disorders become more relevant. A thorough understanding of these factors is necessary for family medicine residency programs to inform their own residency curricula...
journal_title:Family medicine
pub_type: 杂志文章
doi:10.22454/FamMed.2020.373152
更新日期:2020-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Schools of medicine in the United States may overstate the placement of their graduates in primary care. The purpose of this project was to determine the magnitude by which primary care output is overestimated by commonly used metrics and identify a more accurate method for predicting actual p...
journal_title:Family medicine
pub_type: 杂志文章
doi:10.22454/FamMed.2020.785068
更新日期:2020-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Physician workforce projections fuel interest in addressing the shortage of family physicians. Copious research has investigated personality as a variable influencing specialty intention. Medical school rural longitudinal integrated clerkships (LICs) nurture interest in family medicine. This s...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2015-03-01 00:00:00
abstract::Publication in scientific journals is required for academic promotion at universities. It is also the method by which most family medicine faculty members disseminate their scholarly work, establish a reputation in their field, and develop a clinical, teaching, or scholarly expertise. Publications are able to reach a ...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2010-04-01 00:00:00
abstract:BACKGROUND:Although American Sign Language (ASL) is the third most commonly used primary language in the United States, physicians are often not adequately prepared for the challenges of conducting an interview with a deafpatient who signs. METHODS:A search of MEDLINE and PsychINFO databases for research on physician-...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2002-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Repair of perineal birth trauma is one of the most common surgical techniques in pregnancy care. Because of the three-dimensional nature of the required repair, students and residents often have difficulty learning this procedure. METHODS:We developed a new method to teach learners the repair...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1996-02-01 00:00:00
abstract:OBJECTIVE:Our objective was to describe primary care patients' perceptions of informed and shared decision making about cancer screening tests in a diverse sample. METHODS:We administered a 33-item survey to 467 women and 257 men aged 50 years and older from seven practices in a family medicine practice-based research...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2010-06-01 00:00:00
abstract::Family physicians frequently see children and parents when they are adjusting to marital separation. This study examined how well child adjustment at school could be determined from an assessment of interspousal relations, maternal functioning, and child perception variables. Teachers evaluated adaptive functioning, s...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1990-03-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:There has been a significant reduction in the number of family physicians who provide pregnancy care. This study examines the effects of an educational intervention at a university-based family practice residency. The intervention was designed to increase the number of graduates who include pr...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2003-03-01 00:00:00
abstract::Biomedical reductionism, the unwritten theory underlying the practice of medicine, is being supplanted by the biopsychosocial model. The explanatory power of the biopsychosocial model, however, is hampered by an inadequate mechanism to account for the social production of disease. We examine diabetes in the Marshall I...
journal_title:Family medicine
pub_type: 杂志文章,评审
doi:
更新日期:2001-10-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Physicians are sometimes poor at observing patient confidentiality. Medical students have access to patients and their medical records, but there is little known about how well students respect patients' confidentiality. Our objective was to study how medical students deal with confidential pa...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2009-05-01 00:00:00
abstract:BACKGROUND:Family-oriented care and sociocultural awareness are core competency objectives in behavioral science education. Nevertheless, teaching "family" and "culture" in ways that are meaningful and useful to residents can be a challenging task for family medicine educators. METHODS:We describe a block rotation tha...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1993-07-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Continuity of care is one of the presumed advantages of longitudinal residencies. However, it is not clear how well such residencies provide continuity of care, and, further, there is no recognized acceptable rate of good continuity. We compared traditional and longitudinal residencies to dete...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2001-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Diabetes requires substantial ongoing medical management and use of monitoring tests. However, physicians' performance of these tests is often suboptimal. This study explored primary care physicians' management of diabetes in the context of both planned diabetes visits and acute visits for con...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2001-09-01 00:00:00
abstract:INTRODUCTION:Since abortion has become a focus of increased public attention, it is important to assess family physicians' attitudes and scope of training regarding this outpatient procedure. METHODS:Residents and faculty at eight southern California family practice residency programs were surveyed about their views o...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:BACKGROUND:Colorectal cancer (CRC) is the second leading cause of cancer-related deaths in the United States, with African Americans having the highest incidence and mortality of all racial and ethnic groups. CRC screening is widely recommended but remains underused, especially in minority populations. This study's pur...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2005-05-01 00:00:00
abstract::Approximately 25,000 recorded visits between primary care physicians and adults aged 25 and older in the 1985 National Ambulatory Medical Care Survey were analyzed to study the relationship between patient age and selected process measures of the physician-patient encounter. Multiple presenting complaints and visit di...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1991-01-01 00:00:00
abstract::Increasing the quality and quantity of geriatric medicine training for family practice residents is a particular challenge for community-based programs. With support from the John A. Hartford Foundation of New York City, the American Academy of Family Physicians (AAFP) implemented in 1995 a multi-part project to impro...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2003-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:This study determined the perceived characteristics of family practice residency training programs that produce a high percentage of graduates who provide maternity care. METHODS:We surveyed a Delphi panel of 28 family practice maternity care experts. RESULTS:Consensus was reached after the ...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1997-11-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:As part of an initiative to promote the education of generalist physicians at the University of North Carolina, a series of meetings were held over a 12-month period between generalist senior faculty and faculty from a range of departments in the School of Medicine and other health professions...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1997-05-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Community-oriented primary care (COPC) is considered an attractive concept by many but has had limited implementation due to a lack of practical methodology. An important step in COPC is assessment of a community's health status, using health indicators as one means of assessment. Currently, t...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Clinicians in community health centers find it difficult to balance the demands of increased productivity and effective teaching. We hypothesized that precepting third-year students would decrease clinical productivity and that many elements related to the quality of the learning experience (e...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1998-02-01 00:00:00
abstract:BACKGROUND:Little is known regarding the dynamics of elderly persons' participation in health promotion programs. We studied factors influencing the participation of 337 sedentary elderly persons in an exercise promotion session. All study participants were members of a health maintenance organization. METHODS:Baselin...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1992-11-01 00:00:00
abstract::Type A behavior is characterized by status insecurity, hyperaggressiveness, free-floating hostility, time urgency, and self-destructive tendencies. In this cross-sectional study, a sample of 72 married couples from a family practice residency patient population completed self-administered questionnaires assessing the ...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1987-11-01 00:00:00
abstract::Previous studies have demonstrated that maternity care by family physicians can produce statistically similar outcomes to obstetric management in some communities. Obstetrical and perinatal literature suggest that those specialties may be able to decrease rural neonatal mortality. However, family practice literature h...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:1990-07-01 00:00:00
abstract::The family physician is the physician generalist who takes professional responsibility for the comprehensive care of unselected patients with undifferentiated problems and who is committed to the person regardless of age, gender, illness, or organ system. The clinical specialty of family practice is patient centered, ...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2001-04-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:More effective diabetes care is desperately needed, especially for ethnic minority populations. Provider cultural competence promises to be an important means for reducing disparities in outcomes for patients with diabetes. The objectives of this study were to understand the role of cultural c...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2013-06-01 00:00:00
abstract:BACKGROUND AND OBJECTIVES:Discrepancy in care of diabetes between racial and ethnic minority groups and Caucasians is well documented in America. System-based practices have been shown to improve quality of care outcomes. We implemented a disease registry and management system proven successful in a suburban practice n...
journal_title:Family medicine
pub_type: 杂志文章
doi:
更新日期:2010-10-01 00:00:00