Annals of family medicine
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Annals of family medicine · Jul 2006
Randomized Controlled TrialA controlled trial of methods for managing pain in primary care patients with or without co-occurring psychosocial problems.
Pain, a common reason for visits to primary care physicians, is often not well managed. The objective of this study was to determine the effectiveness of pain management interventions suitable for primary care physicians. ⋯ For patients with pain and psychosocial problems, telephone-based assistance resulted in significant, sustained benefit in pain and psychosocial problems.
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Annals of family medicine · Jul 2006
Care quality and implementation of the chronic care model: a quantitative study.
We wanted to test whether improvements in care quality were correlated with changes in the Chronic Care Model (CCM) in a large medical group that attempted to implement the CCM. ⋯ Despite implementation of the CCM and improvements in quality measures for 3 chronic diseases, there were few significant correlations between these changes. Showing such a relationship may require larger changes, a larger number of clinics, changes in other CCM elements, or a more-sensitive measurement tool.
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Annals of family medicine · Jul 2006
'Breaking it down': patient-clinician communication and prenatal care among African American women of low and higher literacy.
Low literacy has been associated with poor medical adherence, but its role in maternal care utilization has not been explored. ⋯ Women who had both low- and higher-literacy skills had high rates of poor prenatal care utilization and reported that communication with clinicians influenced their use of prenatal care. Improving the clarity of communication by breaking down information into simple parts should be a priority for prenatal clinicians.
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Annals of family medicine · Jul 2006
Challenges of change: a qualitative study of chronic care model implementation.
The Chronic Care Model (CCM) provides a conceptual framework for transforming health care for patients with chronic conditions; however, little is known about how to best design and implement its specifics. One large health care organization that tried to implement the CCM in primary care provided an opportunity to study these issues. ⋯ These findings highlight specific organizational challenges with health care transformation in the absence of a blueprint more specific than the CCM. Effective models of organizational change and detailed examples of proven, feasible care changes still need to be demonstrated if we are to transform care as called for by the Institute of Medicine.