Annals of family medicine
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Annals of family medicine · May 2004
Randomized Controlled Trial Clinical TrialPatient pain in primary care: factors that influence physician diagnosis.
The accurate recognition of patient pain is a crucial, but sometimes difficult, task in medical care. This study explored factors related to the physician's diagnosis of pain in primary care patients. ⋯ The diagnosis of pain is influenced by the severity of patient pain, patient gender, and physician practice style. If the routine use of pain assessment tools is found to be effective in improving physician recognition and treatment of patients' pain, then application of these tools in patient care settings should be encouraged.
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Annals of family medicine · May 2004
ReviewWhat can family physicians offer patients with carpal tunnel syndrome other than surgery? A systematic review of nonsurgical management.
We undertook a literature review to produce evidence-based recommendations for nonsurgical family physician management of carpal tunnel syndrome (CTS). ⋯ For those who are not able to get surgery or for those who do not want surgery, there are some conservative modalities that can be tried. These modalities include ones for which there is good evidence. It would be reasonable to try some of the techniques with less evidence if the better ones are not successful. Reconsideration of surgery must always be kept in mind to avoid permanent nerve damage.
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Annals of family medicine · May 2004
Referral of patients to specialists: factors affecting choice of specialist by primary care physicians.
We wanted to determine the importance of factors in primary care physicians' choice of specialist when referring patients and to compare importance ratings by physicians' race and sex. ⋯ Primary care physicians serving adults consider several factors to be of major importance when choosing a specialist. The importance of patient convenience, previous experience with the specialist, specialist board certification, and insurance coverage accepted by specialist varied by physicians' race and sex. A better understanding of factors important to a diverse physician workforce may help to improve the referral process.
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Annals of family medicine · Mar 2004
Management of patients with hepatitis C in a community population: diagnosis, discussions, and decisions to treat.
Chronic hepatitis C, a treatable condition caused by the hepatitis C virus (HCV), can be found in almost all primary care and community practices. The rate of hepatitis C treatment is low, however. This study explores the frequency of hepatitis C treatment, documented discussions of treatment consideration, and the reasons treatment may not be offered in a community population. ⋯ In this community population, hepatitis C treatment was discussed with the majority of patients with a diagnosis of hepatitis C; however, the actual treatment rate was low. Many opportunities exist for treating more patients for HCV infection, particularly those found during emergency care and chemical dependency treatment. In addition, generalists' recognition and treatment of potentially reversible contraindications to hepatitis C therapy could greatly increase the number of treatment candidates.
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Annals of family medicine · Mar 2004
A community-oriented primary care demonstration project: refining interventions for cardiovascular disease and diabetes.
We describe a community-oriented primary care project that implemented all 5 steps of the formal model. Data are presented on cardiac risk factors, protective behaviors, health locus of control, and stage of readiness for change in an African American community. We discuss the use of these data to refine our health promotion interventions. ⋯ This study documents low rates of physical activity and healthy dietary patterns and describes recent interventions to address environmental barriers to behavior change. The association between powerful others locus of control and specific cardiac risk factors has prompted a greater emphasis on developing faith-based interventions and renewing physician-counseling efforts. Stage of readiness for change findings have prompted strategies to disseminate existing diet and physical activity recommendations more effectively.