Annals of family medicine
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Annals of family medicine · Jul 2019
Multicenter StudyTeam-Based Clinic Redesign of Opioid Medication Management in Primary Care: Effect on Opioid Prescribing.
Six key elements of opioid medication management redesign in primary care have been previously identified. Here, we examine the effect of implementing these Six Building Blocks on opioid-prescribing practices. ⋯ Efforts to redesign opioid medication management in primary care resulted in a significant decrease in opioid prescribing. Future research is needed to determine if these results are generalizable to other settings and to assess implications for patient-reported outcomes.
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Annals of family medicine · Jul 2019
Multicenter Study Pragmatic Clinical TrialAssociation Between Primary Care Practitioner Empathy and Risk of Cardiovascular Events and All-Cause Mortality Among Patients With Type 2 Diabetes: A Population-Based Prospective Cohort Study.
To examine the association between primary care practitioner (physician and nurse) empathy and incidence of cardiovascular disease (CVD) events and all-cause mortality among patients with type 2 diabetes. ⋯ Positive patient experiences of practitioner empathy in the year after diagnosis of type 2 diabetes may be associated with beneficial long-term clinical outcomes. Further work is needed to understand which aspects of patient perceptions of empathy might influence health outcomes and how to incorporate this understanding into the education and training of practitioners.
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Annals of family medicine · Jul 2019
Editorial Historical ArticleA Tribute to Kurt Stange and the First Seventeen Years.
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Annals of family medicine · Jul 2019
Association Between Metformin Initiation and Incident Dementia Among African American and White Veterans Health Administration Patients.
African American patients are more likely to experience cognitive decline after type 2 diabetes mellitus onset than white patients. Metformin use has been associated with a lower risk of dementia compared with sulfonylureas. Evidence for whether this association differs by race is sparse. ⋯ Metformin vs sulfonylurea initiation was associated with a substantially lower risk of dementia among younger African American patients. These results may point to a novel approach for reducing the risk of dementia in African Americans with type 2 diabetes mellitus.
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Annals of family medicine · Jul 2019
Multicenter Study Observational StudyA Structured Approach to Detecting and Treating Depression in Primary Care: VitalSign6 Project.
This report describes outcomes of an ongoing quality-improvement project (VitalSign6) in a large US metropolitan area to improve recognition, treatment, and outcomes of depressed patients in 16 primary care clinics (6 charity clinics, 6 federally qualified health care centers, 2 private clinics serving low-income populations, and 2 private clinics serving patients with either Medicare or private insurance). ⋯ Although remission rates are high in those with 3 or more follow-up visits after routine screening and treatment of depression, attrition from care is a significant issue adversely affecting outcomes.