Journal of general internal medicine
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Editorial Comment
Vitamin D as a mediator of racial differences in blood pressure.
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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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Comparative Study
Use of an electronic patient portal among disadvantaged populations.
Electronic patient portals give patients access to information from their electronic health record and the ability to message their providers. These tools are becoming more widely used and are expected to promote patient engagement with health care. ⋯ We found good early rates of adoption and use of an electronic patient portal during the first 2 years of its deployment among a predominantly low-income population, especially among patients with chronic diseases. Disparities in access to and usage of the portal were evident but were smaller than those reported recently in other populations. Continued efforts will be needed to ensure that portals are usable for and used by disadvantaged groups so that all patients benefit equally from these technologies.
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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.