Journal of general internal medicine
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Randomized Controlled Trial Comparative Study Pragmatic Clinical Trial
Effects of a Transitional Care Practice for a Vulnerable Population: a Pragmatic, Randomized Comparative Effectiveness Trial.
There is limited experimental evidence on transitional care interventions beyond 30 days post-discharge and in vulnerable populations. ⋯ Among patients randomized to a patient-centered transitional care intervention, there was no significant reduction in 90-day probability of death or additional hospital encounters. However, there were significant decreases in measures of inpatient admissions over 180 days.
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Multicenter Study Pragmatic Clinical Trial
"Get Ready and Empowered About Treatment" (GREAT) Study: a Pragmatic Randomized Controlled Trial of Activation in Persons Living with HIV.
Little is known about strategies to improve patient activation, particularly among persons living with HIV (PLWH). ⋯ The patient activation intervention modestly improved several domains related to patient empowerment; effects on patient activation were largest among those with the lowest levels of baseline patient activation.
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Multicenter Study Observational Study
Changes in Physical Health After Supported Housing: Results from the Collaborative Initiative to End Chronic Homelessness.
The permanent supported housing model is known to improve housing outcomes, but there has been sparse research on the effects of supported housing on physical health. Various organizations including the National Academy of Sciences have called for research in this area. ⋯ Entry into supported housing with linked primary care services was not associated with improvements in physical HRQOL. Improvement in other medical outcome measures was not specifically associated with improved housing status.
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Studies of interventions to reduce low-value care are increasingly common. However, little is known about how the effects of such interventions are measured. ⋯ Most published studies focused on reductions in utilization rather than on clinically meaningful measures (e.g., improvements in appropriateness, patient-reported outcomes) or unintended consequences. Investigators should systematically incorporate more clinically meaningful measures into their study designs, and sponsors should develop standardized guidance for the evaluation of interventions to reduce low-value care.