Journal of general internal medicine
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Comparative Study
Use of a geriatric home visit experience to teach medical students the functional status assessment.
Functional status measures strongly predict hospital outcomes and mortality, yet teaching of these measures is often missing from medical schools' curricula. To address this deficiency, we developed a Geriatric Home-based Assessment (GHA) module for third-year medical students. The module was composed of a workshop and two to three home visits. ⋯ Our GHA module was effective in improving students' knowledge and proficiency in the functional status assessment. "Hands on" experiences like the GHA allow students to develop a solid foundation for assessing functional status and mobility.
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Comparative Study
Integrating buprenorphine treatment into office-based practice: a qualitative study.
Despite the availability and demonstrated effectiveness of office-based buprenorphine maintenance treatment (BMT), the systematic examination of physicians' attitudes towards this new medical practice has been largely neglected. ⋯ Addressing physicians' perceptions of facilitators and barriers to BMT is crucial to supporting the further expansion of BMT into primary care and office-based practices.
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Comparative Study
Readiness for the Patient-Centered Medical Home: structural capabilities of Massachusetts primary care practices.
The Patient-Centered Medical Home (PCMH), a popular model for primary care reorganization, includes several structural capabilities intended to enhance quality of care. The extent to which different types of primary care practices have adopted these capabilities has not been previously studied. ⋯ Larger and network-affiliated primary care practices are more likely than smaller, non-affiliated practices to have adopted several recommended capabilities. In order to achieve PCMH designation, smaller non-affiliated practices may require the greatest investments.
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Comparative Study
Patient experiences with coordination of care: the benefit of continuity and primary care physician as referral source.
Coordination across a patient's health needs and providers is important to improving the quality of care. ⋯ Facilitating visit continuity between the patient and PCP, and encouraging the use of the PCP as the referral source would likely enhance care coordination.
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Meta Analysis Comparative Study
Gabapentin versus tricyclic antidepressants for diabetic neuropathy and post-herpetic neuralgia: discrepancies between direct and indirect meta-analyses of randomized controlled trials.
Previous systematic reviews concluded that tricyclics antidepressants are superior to gabapentin for neuropathic pain, but were based on indirect comparisons from placebo-controlled trials. ⋯ Though direct evidence is limited, we found no difference in likelihood of achieving pain relief between gabapentin and tricyclic antidepressants for diabetic neuropathy and post-herpetic neuralgia. Indirect analyses that combine data from sets of trials conducted in different eras can be unreliable.