Annals of family medicine
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Annals of family medicine · Jan 2006
Community-based participatory research in practice-based research networks.
We wanted to describe community-based participatory research in practice-based research networks in the United States. ⋯ While perhaps not meeting the classical definition of CBPR, some PBRNs are involving community members and patients in their research. There is a wide spectrum of involvement by community members in PBRN research. Many PBRNs reported plans to involve community members in their research. We believe that community involvement will enhance PBRN research.
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Annals of family medicine · Jan 2006
Management of type 2 diabetes in the primary care setting: a practice-based research network study.
We wanted to describe how primary care clinicians care for patients with type 2 diabetes. ⋯ Only modest numbers of patients achieve established targets of diabetes control. Reengineering primary care practice may be necessary to substantially improve care.
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Annals of family medicine · Jan 2006
Encounters by patients with type 2 diabetes--complex and demanding: an observational study.
We wanted to examine the relationships between quality of diabetes care delivered, the type and length of encounter, and time to the next follow-up encounter. ⋯ Competing demands during primary care encounters require patient and physician to prioritize services delivered and defer indicated services to subsequent visits. Current models of patient care in primary care settings are inadequate to address the multitude of tasks facing clinicians, especially among patients with complex chronic illnesses. Innovative approaches and new models are needed to improve the quality of diabetes care.
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Annals of family medicine · Jan 2006
Randomized Controlled TrialEffects of enhanced depression treatment on diabetes self-care.
Among patients with diabetes, major depression is associated with more diabetic complications, lower medication adherence, and poorer self-care of diabetes. We reported earlier that enhanced depression care reduces depression symptoms but not hemoglobin A1c level. This study examined effects of depression interventions on self-management among depressed diabetic patients. ⋯ In general, diabetes self-management did not improve among the enhanced depression treatment group during a 12-month period, except for small between-group differences of limited clinical importance. Research needs to assess whether self-care interventions tailored for specific conditions, in addition to enhanced depression care, can achieve better diabetes and depression outcomes.