Annals of family medicine
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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 · Mar 2015
Estimating the residency expansion required to avoid projected primary care physician shortages by 2035.
The purpose of this study was to calculate the projected primary care physician shortage, determine the amount and composition of residency growth needed, and estimate the impact of retirement age and panel size changes. ⋯ To eliminate projected shortages in 2035, primary care residency production must increase by 21% compared with current production. Delivery models that shift toward smaller ratios of population to primary care physicians may substantially increase the shortage.
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Annals of family medicine · Jan 2015
Review Meta AnalysisEffectiveness of psychological treatments for depressive disorders in primary care: systematic review and meta-analysis.
We performed a systematic review of the currently available evidence on whether psychological treatments are effective for treating depressed primary care patients in comparison with usual care or placebo, taking the type of therapy and its delivery mode into account. ⋯ There is evidence that psychological treatments are effective in depressed primary care patients. For CBT approaches, substantial evidence suggests that interventions that are less resource intensive might have effects similar to more intense treatments.
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Annals of family medicine · Jan 2015
Review Meta AnalysisEfficacy and acceptability of pharmacological treatments for depressive disorders in primary care: systematic review and network meta-analysis.
The purpose of this study was to investigate whether antidepressants are more effective than placebo in the primary care setting, and whether there are differences between substance classes regarding efficacy and acceptability. ⋯ Compared with other drugs, TCAs and SSRIs have the most solid evidence base for being effective in the primary care setting, but the effect size compared with placebo is relatively small. Further agents (hypericum, rMAO-As, SNRI, NRI, NaSSAs, SARI) showed some positive results, but limitations of the currently available evidence makes a clear recommendation on their place in clinical practice difficult.