Annals of family medicine
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Annals of family medicine · Jul 2008
Randomized Controlled TrialIntegration of depression and hypertension treatment: a pilot, randomized controlled trial.
We wanted to examine whether integrating depression treatment into care for hypertension improved adherence to antidepressant and antihypertensive medications, depression outcomes, and blood pressure control among older primary care patients. ⋯ A pilot, randomized controlled trial integrating depression and hypertension treatment was successful in improving patient outcomes. Integrated interventions may be more feasible and effective in real-world practices, where there are competing demands for limited resources.
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Annals of family medicine · May 2008
The unsustainable US health care system: a blueprint for change.
As a family physician, I have become increasingly uncomfortable being associated with the US health care system. While shiny, new buildings go up each day, there is still little movement toward a model that will shore up the crumbling foundation. The current delivery system and financing structures are unsustainable. ⋯ In this essay, patient stories are woven into a narrative that highlights the magnitude of the problem at multiple levels of the system. My intent is not to compare stories, because we all have patients, friends, and family members who have been affected. The purpose of this essay is to encourage each reader to reflect on his or her own experiences and to present an imperative to lead change.
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Annals of family medicine · May 2008
Randomized Controlled TrialAbsolute cardiovascular disease risk and shared decision making in primary care: a randomized controlled trial.
We wanted to determine the effect of promoting the effective communication of absolute cardiovascular disease (CVD) risk and shared decision making through disseminating a simple decision aid for use in family practice consultations. ⋯ A simple transactional decision aid based on calculating absolute individual CVD risk and promoting shared decision making in CVD prevention can be disseminated through CME groups and may lead to higher patient satisfaction and involvement and less decisional regret, without negatively affecting global CVD risk.
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Previous research has documented that diabetes distress, defined as patient concerns about disease management, support, emotional burden, and access to care, is an important condition distinct from depression. We wanted to develop a brief diabetes distress screen instrument for use in clinical settings. ⋯ The DDS2 is a 2-item diabetes distress screening instrument asking respondents to rate on a 6-point scale the degree to which the following items caused distress: (1) feeling overwhelmed by the demands of living with diabetes, and (2) feeling that I am often failing with my diabetes regimen. The DDS17 can be administered to those who have positive findings on the DDS2 to define the content of distress and to direct intervention.