Journal of general internal medicine
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Multicenter Study Comparative Study
Prevalence of practice system tools for improving depression care among primary care clinics: the DIAMOND initiative.
Practice system tools improve chronic disease care, but are generally lacking for the care of depression in most primary care settings. ⋯ Few practice system tools are in place for improving depression care in Minnesota primary care clinics, and these are less well-developed than general chronic disease practice systems. Future research should focus on demonstrating whether implementing these tools for depression care results in much-needed improvements in care for patients with depression.
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Multicenter Study Comparative Study
Low use of opioid risk reduction strategies in primary care even for high risk patients with chronic pain.
Experts recommend close oversight of patients receiving opioid analgesics for chronic non-cancer pain (CNCP), especially those at increased risk of misuse. We hypothesized that physicians employ opioid risk reduction strategies more frequently in higher risk patients. ⋯ Primary care physicians' adoption of opioid risk reduction strategies is limited, even among patients at increased risk of misuse.
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Comparative Study
Healthcare consumers' attitudes towards physician and personal use of health information exchange.
Health information exchange (HIE), the electronic transmission of patient medical information across healthcare institutions, is on the forefront of the national agenda for healthcare reform. As healthcare consumers are critical participants in HIE, understanding their attitudes toward HIE is essential. ⋯ Consumer outreach to gain further support for ongoing personal and physician HIE efforts is needed and should address consumer security concerns and potential disparities in HIE acceptance and use.
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Randomized Controlled Trial Multicenter Study Comparative Study
Relationship between literacy, knowledge, self-care behaviors, and heart failure-related quality of life among patients with heart failure.
We sought to examine the relationship between literacy and heart failure-related quality of life (HFQOL), and to explore whether literacy-related differences in knowledge, self-efficacy and/or self-care behavior explained the relationship. ⋯ Low literacy was associated with worse HFQOL and lower HF-related knowledge, self-efficacy, and self-care behaviors, but differences in knowledge, self-efficacy and self-care did not explain the relationship between low literacy and worse HFQOL.
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The debate over use of artificial nutrition and hydration (ANH) in terminal illness, including advanced dementia, remains contentious despite extensive ethical and empirical investigation. ⋯ Patients' interests could be better protected through remedial action at both the individual and the policy levels.