Journal of general internal medicine
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Comparative Study
Patients with multiple chronic conditions do not receive lower quality of preventive care.
The implications of measuring and rewarding performance for patients with multiple chronic conditions have not been explored empirically. ⋯ Diabetic patients with more chronic conditions may receive better quality of preventive care, partly due to their higher number of office-based physician visits.
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Prior data suggest that fatigue adversely affects patient safety and resident well-being. ACGME duty hour limitations were intended, in part, to reduce resident fatigue, but the factors that affect intern fatigue are unknown. ⋯ Simply decreasing the number of duty hours may be insufficient to reduce intern fatigue. Residency programs may need to incorporate programmatic changes to reduce stress, improve sleep quality, and foster teamwork in order to decrease intern fatigue and its deleterious consequences.
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Randomized Controlled Trial Comparative Study
A randomized controlled trial of team-based care: impact of physician-pharmacist collaboration on uncontrolled hypertension.
Evaluate the effectiveness of collaborative management of hypertension by primary care-pharmacist teams in community-based clinics. ⋯ Patients randomized to collaborative primary care-pharmacist hypertension management achieved significantly better blood pressure control compared to usual care with no difference in quality of life or satisfaction.
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In 2005 we published draft guidelines for reporting studies of quality improvement interventions as the initial step in a consensus process for development of a more definitive version. The current article contains the revised version, which we refer to as SQUIRE (Standards for QUality Improvement Reporting Excellence). We describe the consensus process, which included informal feedback, formal written commentaries, input from publication guideline developers, review of the literature on the epistemology of improvement and on methods for evaluating complex social programs, and a meeting of stakeholders for critical review of the guidelines' content and wording, followed by commentary on sequential versions from an expert consultant group. Finally, we examine major differences between SQUIRE and the initial draft, and consider limitations of and unresolved questions about SQUIRE; we also describe ancillary supporting documents and alternative versions under development, and plans for dissemination, testing, and further development of SQUIRE.
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Comparative Study
Correlates of sexual satisfaction among sexually active postmenopausal women in the Women's Health Initiative-Observational Study.
Satisfaction with sexual activity is important for health-related quality of life, but little is known about the sexual health of postmenopausal women. ⋯ Among postmenopausal women, the variables selected for examination yielded modest ability to discriminate between sexually satisfied and dissatisfied participants. Further study is necessary to better describe the cofactors associated with sexual satisfaction in postmenopausal women.