Journal of general internal medicine
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Randomized Controlled Trial
A randomized controlled pilot trial of the functional assessment screening tablet to engage patients at the point of care.
Healthcare providers play an important role in encouraging healthy behaviors and improving health-related quality of life (HRQoL). They are most effective when they partner with informed, engaged patients. ⋯ Providing patients with immediate, personalized, guideline-based feedback prior to the clinical encounter can increase patient-initiated discussions regarding mental HRQoL. Future work should test FAST-Feedback in a larger population and evaluate the impact on tobacco cessation, increased physical activity, and improvements in HRQoL.
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Comparative Study Observational Study
Comparing patient outcomes of academician-preceptors, hospitalist-preceptors, and hospitalists on internal medicine services in an academic medical center.
Patient outcomes with hospitalist care have been studied in many settings, yet little is known about how hospitalist care interacts with trainee care to affect patient outcomes in teaching hospitals. ⋯ Preceptor-led medicine services were associated with more readmissions within 30 days, shorter lengths of stay, and lower index admission-associated costs. However, when considering cumulative hospitalization costs, patients discharged by academician-preceptors incurred the highest cost and hospitalist-preceptors incurred the lowest cost.
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Little is known about older women's experience with a benign breast biopsy. ⋯ The high psychological burden of a benign breast biopsy among older women significantly diminishes with time but does not completely resolve. To reduce this burden, older women need more information about undergoing a breast biopsy.
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Observational Study
Chronic opioid therapy urine drug testing in primary care: prevalence and predictors of aberrant results.
Urine drug tests (UDTs) are recommended for patients on chronic opioid therapy (COT). Knowledge of the risk factors for aberrant UDT results could help optimize their use. ⋯ In this primary care setting, results were aberrant for 30% of UDTs of COT patients, largely because of prescribed opioid non-detection and THC. Aberrant results of almost all types were more likely among patients under the age of 45. Other risk factors varied across aberrancies, but commonly included current smoking and prior substance use disorder diagnosis.
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Interpersonal care (IPC) is increasingly emphasized as health care systems focus on implementing patient-centered care. Language barriers may be a particularly important influence on IPC ratings among rural Spanish-speaking Latinos. ⋯ This study provides evidence that language concordance is independently associated with high IPC scores in rural Latino adults with diabetes. Moreover, this study suggests that language concordance may contribute to improved participation diabetes self-care activities.