Journal of general internal medicine
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The care of patients with HIV is increasingly focused on outpatient chronic disease management. It is not known to what extent internal medicine residents in the US are currently being trained in or encouraged to provide primary care for this population of patients. ⋯ With a looming HIV workforce shortage, we believe that internal medicine programs should create educational experiences that will provide their residents with the skills and knowledge necessary to meet the healthcare needs of this population.
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Multicenter Study
Does screening for pain correspond to high quality care for veterans?
Routine numeric screening for pain is widely recommended, but its association with overall quality of pain care is unclear. ⋯ Despite routine pain screening in VA, providers seldom documented elements considered important to evaluation and treatment of pain. Improving pain care may require attention to all aspects of pain management, not just screening.
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Comparative Study
Using the Teamlet Model to improve chronic care in an academic primary care practice.
Team care can improve management of chronic conditions, but implementing a team approach in an academic primary care clinic presents unique challenges. ⋯ The Teamlet Model may improve chronic care in academic primary care practices.
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Randomized Controlled Trial
Predictors of adherence to nicotine gum and counseling among African-American light smokers.
A high proportion of African-American smokers are light smokers, and they experience low smoking cessation rates and disproportionately high tobacco-related morbidity; yet no studies have examined tobacco treatment adherence in this group. ⋯ Individual risk factors may influence adherence to nicotine gum and counseling. Improving psychological interventions and promoting adherence to counseling may increase overall smoking cessation success among African-American light smokers.
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With 1-2% of patients leaving the hospital against medical advice (AMA), the potential for these patients to suffer adverse health outcomes is of major concern. ⋯ Due to the higher risk of adverse outcomes, hospitals should target AMA patients for post-discharge interventions, such as phone follow-up, home visits, or mental health counseling to improve outcomes.