Journal of general internal medicine
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Randomized Controlled Trial Comparative Study
Electronic versus dictated hospital discharge summaries: a randomized controlled trial.
Patient care transitions are periods of enhanced risk. Discharge summaries have been used to communicate essential information between hospital-based physicians and primary care physicians (PCPs), and may reduce rates of adverse events after discharge. ⋯ An EDS program can be used by housestaff to more easily create hospital discharge summaries, and there was no difference in PCP satisfaction.
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Randomized Controlled Trial Comparative Study
Disclosing medical errors to patients: it's not what you say, it's what they hear.
There is consensus that patients should be told if they are injured by medical care. However, there is little information on how they react to different methods of disclosure. ⋯ Patients will probably respond more favorably to physicians who apologize and accept responsibility for medical errors than those who do not apologize or give ambiguous responses. Patient perceptions of what is said may be more important than what is actually said. Desire to sue may not be affected despite a full apology and acceptance of responsibility.
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Randomized Controlled Trial Multicenter Study Comparative Study
The effect of patient race and blood pressure control on patient-physician communication.
Racial disparities in hypertension control contribute to higher rates of cardiovascular mortality among blacks. Patient-physician communication quality is associated with better health outcomes, including blood pressure (BP) control. Both race/ethnicity and BP control may adversely affect communication. ⋯ This study reveals that patient race is associated with the quality of patient-physician communication to a greater extent than BP control. Interventions that improve patient-physician communication should be tested as a strategy to reduce racial disparities in hypertension care and outcomes.
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Comparative Study
Are opioid dependence and methadone maintenance treatment (MMT) documented in the medical record? A patient safety issue.
Opioid-dependent patients often have co-occurring chronic illnesses requiring medications that interact with methadone. Methadone maintenance treatment (MMT) is typically provided separately from medical care. Hence, coordination of medical care and substance use treatment is important to preserve patient safety. ⋯ Among patients receiving MMT and medical care at different sites, documentation of opioid dependence and MMT in the medical record occurs for the majority, but is missing in a substantial number of patients. Most of these patients are prescribed medications that potentially interact with methadone. This study highlights opportunities for improved coordination between medical care and MMT.
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This review examines the results of randomized controlled trials in which behavioral weight loss interventions, used alone or with pharmacotherapy, were provided in primary care settings. ⋯ Current evidence does not support the use of low- to moderate-intensity physician counseling for obesity, by itself, to achieve clinically meaningful weight loss. PCP counseling plus pharmacotherapy, or intensive counseling (from a dietitian or nurse) plus meal replacements may help patients achieve this goal. Further research is needed on different models of managing obesity in primary care practice.