Journal of general internal medicine
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Randomized Controlled Trial
Blood Pressure Visit Intensification in Treatment (BP-Visit) Findings: a Pragmatic Stepped Wedge Cluster Randomized Trial.
Shortening time between office visits for patients with uncontrolled hypertension represents a potential strategy for improving blood pressure (BP). ⋯ www.ClinicalTrials.gov Identifier: NCT02164331.
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Randomized Controlled Trial
The Coordination Toolkit and Coaching Project: Cluster-Randomized Quality Improvement Initiative to Improve Patient Experience of Care Coordination.
Given persistent gaps in coordination of care for medically complex primary care patients, efficient strategies are needed to promote better care coordination. ⋯ Although coached clinics attempted more or more complex QI projects and used more tools than non-coached clinics, coaching provided no additional benefit versus the online toolkit alone in patient-reported outcomes.
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Randomized Controlled Trial
Computerized Relational Agent to Deliver Alcohol Brief Intervention and Referral to Treatment in Primary Care: a Randomized Clinical Trial.
Alcohol screening and brief intervention have demonstrated efficacy but limited effectiveness and implementation in real-world primary care settings. ⋯ The Relational Agent successfully provided brief intervention and referred many more patients to specialty care and was able to intervene with patients with less severe drinking without increasing primary care burden.
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Breast implant surgery for cosmetic or reconstructive purposes is becoming increasingly common. While the devices used are regulated and approved by the US Food and Drug Administration, all patients with breast implants require continued follow-up. ⋯ It is vital that treating clinicians are knowledgeable about the history of breast implants, routine screening guidelines, and the recent breast implant "hot topics"-breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), connective tissue disease, and breast implant illness. This paper will provide the necessary information for primary care providers to appropriately counsel patients with breast implants to maintain not only their trust, but also their health.
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The COVID-19 pandemic brought rapid changes to the work and personal lives of clinicians. ⋯ This large survey found the pandemic disproportionally impacted women, younger clinicians, and those whose caregiving responsibilities impacted their work. These results highlight the need for a holistic and targeted strategy for improving clinician well-being that addresses the needs of women, younger clinicians, and those with caregiving responsibilities.