Annals of family medicine
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Annals of family medicine · Aug 2015
Randomized Controlled TrialPuentes hacia una mejor vida (Bridges to a Better Life): Outcome of a Diabetes Control Peer Support Intervention.
Peer support can promote diabetes control, yet research on feasible and effective peer support models is lacking. This randomized controlled trial tested a volunteer-based model of peer support for diabetes control. ⋯ Given the modest changes we observed, combined with other evidence for peer support to promote diabetes control, additional research is needed on how to modify the system of care to increase the level of peer support delivered by volunteers.
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Annals of family medicine · Mar 2015
Randomized Controlled TrialHealth coaching by medical assistants to improve control of diabetes, hypertension, and hyperlipidemia in low-income patients: a randomized controlled trial.
Health coaching by medical assistants could be a financially viable model for providing self-management support in primary care if its effectiveness were demonstrated. We investigated whether in-clinic health coaching by medical assistants improves control of cardiovascular and metabolic risk factors when compared with usual care. ⋯ Medical assistants serving as in-clinic health coaches improved control of hemoglobin A1c and LDL levels, but not blood pressure, compared with usual care. Our results highlight the need to understand the relationship between patients' clinical conditions, interventions, and the contextual features of implementation.
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Annals of family medicine · Mar 2015
Randomized Controlled Trial Pragmatic Clinical TrialLong-term effect of population screening for diabetes on cardiovascular morbidity, self-rated health, and health behavior.
There is limited trial evidence concerning the long-term effects of screening for type 2 diabetes on population morbidity. We examined the effect of a population-based diabetes screening program on cardiovascular morbidity, self-rated health, and health-related behaviors. ⋯ Invitation to screening for type 2 diabetes appears to have limited impact on population levels of cardiovascular morbidity, self-rated health status, and health behavior after 7 years.
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Annals of family medicine · Sep 2014
Randomized Controlled Trial Multicenter Study Comparative StudyTreatment of forefoot problems in older people: a randomized clinical trial comparing podiatric treatment with standardized shoe advice.
Consultations for forefoot pain are frequent in primary care, but scientific support of treatment options is scarce. The purpose of this study is to investigate the effect of podiatric treatment vs standardized advice on proper shoe characteristics and fit of shoes by means of an information leaflet for people aged 50 years and older with forefoot pain in primary care. ⋯ This study found that shoe advice provided to patients consulting their general practitioner for forefoot pain and symptom relief resulted in outcomes similar to treatment outcomes in patients consulting a podiatrist. Based on these results, primary care physicians should be cautious when referring a patient to a podiatrist; instead, they should start by providing advice on proper characteristics and fit of shoes.
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Annals of family medicine · Jul 2014
Randomized Controlled TrialElectronic health records for intervention research: a cluster randomized trial to reduce antibiotic prescribing in primary care (eCRT study).
This study aimed to implement a point-of-care cluster randomized trial using electronic health records. We evaluated the effectiveness of electronically delivered decision support tools at reducing antibiotic prescribing for respiratory tract infections in primary care. ⋯ Cluster randomized trials may be implemented efficiently in large samples from routine care settings by using primary care electronic health records. Future studies should develop and test multicomponent methods for remotely delivered intervention.