Annals of family medicine
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Annals of family medicine · Jan 2011
Randomized Controlled TrialImpact of EHR-based clinical decision support on adherence to guidelines for patients on NSAIDs: a randomized controlled trial.
Electronic health records (EHRs) with clinical decision support hold promise for improving quality of care, but their impact on management of chronic conditions has been mixed. This study examined the impact of EHR-based clinical decision support on adherence to guidelines for reducing gastrointestinal complications in primary care patients on nonsteroidal anti-inflammatory drugs (NSAIDs). ⋯ This study showed only a small impact of EHR-based clinical decision support for high-risk patients on NSAIDs in primary care offices. These results add to the growing literature about the complexity of EHR-based clinical decision support for improving quality of care.
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Annals of family medicine · Jan 2011
Randomized Controlled TrialImpact of electronic health record clinical decision support on diabetes care: a randomized trial.
We wanted to assess the impact of an electronic health record-based diabetes clinical decision support system on control of hemoglobin A(1c) (glycated hemoglobin), blood pressure, and low-density lipoprotein (LDL) cholesterol levels in adults with diabetes. ⋯ EHR-based diabetes clinical decision support significantly improved glucose control and some aspects of blood pressure control in adults with type 2 diabetes.
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Annals of family medicine · Jan 2011
Randomized Controlled TrialEffect of preventive messages tailored to family history on health behaviors: the Family Healthware Impact Trial.
We wanted to determine the impact of automated family history assessment and tailored messages for coronary heart disease, stroke, diabetes, colorectal, breast, and ovarian cancer on preventive behaviors compared with a standard preventive message. ⋯ Messages tailored to an individual's familial risk for 6 common diseases modestly increased self-reported physical activity and fruit and vegetable intake but reduced the likelihood of receiving cholesterol screening.
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Annals of family medicine · Jul 2010
Randomized Controlled TrialPhysician satisfaction with chronic care processes: a cluster-randomized trial of guided care.
Chronically ill older patients with multiple conditions are challenging to care for, and new models of care for this population are needed. This study evaluates the effect of the Guided Care model on primary care physicians' impressions of processes of care for chronically ill older patients. ⋯ Based on physician report, Guided Care provides important benefits to physicians by improving communication with chronically ill older patients and their families and in physicians' knowledge of their patients' clinical conditions.
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Annals of family medicine · May 2010
Randomized Controlled Trial Clinical TrialHome-based activity program for older people with depressive symptoms: DeLLITE--a randomized controlled trial.
We wanted to assess the effectiveness of a home-based physical activity program, the Depression in Late Life Intervention Trial of Exercise (DeLLITE), in improving function, quality of life, and mood in older people with depressive symptoms. ⋯ The DeLLITE activity program improved mood and quality of life for older people with depressive symptoms as much as the effect of social visits. Future social and activity interventions should be tested against a true usual care control.