Journal of general internal medicine
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Randomized Controlled Trial Comparative Study
The patient-doctor relationship and online social networks: results of a national survey.
The use of online social networks (OSNs) among physicians and physicians-in-training, the extent of patient-doctor interactions within OSNs, and attitudes among these groups toward use of OSNs is not well described. ⋯ Personal OSN use among physicians and physicians-in-training mirrors that of the general population. Patient-doctor interactions take place within OSNs, and are more typically initiated by patients than by physicians or physicians-in-training. A majority of respondents view these online interactions as ethically problematic.
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Use of bariatric surgery for severe obesity has increased dramatically. ⋯ Contemporary bariatric surgery appears to result in sustained weight reduction with acceptable costs but rigorous, longer-term (≥5 year) data are needed and a paucity of RCT data on mortality and obesity related comorbidity is evident. Procedure-specific variations in efficacy and risks exist and require further study to clarify the specific indications for and advantages of different procedures.
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Meta Analysis Comparative Study
Depression and medication adherence in the treatment of chronic diseases in the United States: a meta-analysis.
To conduct a meta-analysis of the association between depression and medication adherence among patients with chronic diseases. Poor medication adherence may result in worse outcomes and higher costs than if patients fully adhere to their medication regimens. ⋯ This analysis provides evidence that depression is associated with poor adherence to medication across a range of chronic diseases, and we find a new potential effect of adherence measurement type on this relationship. Although this study cannot assess causality, it supports the importance that must be placed on depression in studies that assess adherence and attempt to improve it.
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As the country turns toward implementation of the Patient Protection and Affordable Care Act, realizing the potential of reform will require significant transformation of the American system of health care delivery. To that end, the new law seeks to strengthen the nation's primary care foundation through enhanced reimbursement rates for providers and the use of innovative delivery models such as patient-centered medical homes. ⋯ If successfully implemented, the Affordable Care Act has the potential to realign incentives within the health system and create opportunities for providers to be rewarded for delivering high value, patient-centered primary care. Such a transformation could lead to better outcomes for patients, increase job satisfaction among physicians and encourage more sustainable levels of health spending for the nation.