The American journal of medicine
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Both the incidence and prevalence of osteoarthritis increase with advancing age. Management of osteoarthritis in older adults focuses on reducing pain and other symptoms, minimizing functional limitation and disability from the disease, and avoiding the side effects associated with pharmacologic therapy. ⋯ We conclude that acetaminophen, when given at full doses of 4,000 mg/day, is more efficacious than placebo and has comparable efficacy to ibuprofen in the management of patients with osteoarthritis of the knee who have mild to moderate pain. Thus, acetaminophen merits a trial as initial therapy based on its cost-effectiveness and safety profile relative to NSAIDs.
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We examined whether physician factors, particularly financial productivity incentives, affect the provision of preventive care. ⋯ Our findings suggest that some financial productivity incentives may discourage the performance of certain forms of preventive care, specifically Pap smears and cholesterol screening. More studies are needed to examine the effects of financial incentives on the quality of care, and to examine whether quality improvement interventions or incentives based on quality improve the performance of preventive care.