Journal of general internal medicine
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To determine patient and provider characteristics associated with increased risk of nondetection of mental health problems by primary care physicians. ⋯ Patients' race, gender, and coexisting medical conditions affected physician awareness of mental health problems. Strategies to improve detection of mental health problems among African Americans, Hispanics, and men should be explored and evaluated.
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Comparative Study
Blood cholesterol screening influence of fasting state on cholesterol results and management decisions.
To compare fasting and nonfasting total and high-density lipoprotein (HDL) cholesterol values in adults and to determine how closely classification into risk groups for coronary heart disease based on nonfasting blood tests compares with classification based on fasting studies. ⋯ Screening nonfasting adults for total and HDL cholesterol is appropriate for making decisions about primary prevention of coronary heart disease.
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Randomized Controlled Trial Clinical Trial
Randomized trial of case-finding for depression in elderly primary care patients.
To determine the effect of case-finding for depression on frequency of depression diagnoses, prescriptions for antidepressant medications, prevalence of depression, and health care utilization during 2 years of follow-up in elderly primary care patients. ⋯ We were unable to demonstrate any benefit from case-finding for depression during 2 years of follow-up in elderly primary care patients. Studies are needed to determine whether case-finding combined with more intensive patient education and follow-up will improve outcomes of primary care patients with depression.
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To assess the effects of depressive symptoms on asthma patients' reports of functional status and health-related quality of life. ⋯ Nearly half of asthma patients in this study had a positive screen for depressive symptoms. Asthma patients with more depressive symptoms reported worse health-related quality of life than asthma patients with similar disease activity but fewer depressive symptoms. Given the new emphasis on functional status and health-related quality of life measured by disease-specific and general health scales, we conclude that psychological status indicators should also be considered when patient-derived measures are used to assess outcomes in asthma.
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To identify and describe general internal medicine teaching units and their educational activities. ⋯ General internal medicine teaching units surveyed contributed substantial faculty effort, much of it unfunded and located off-campus, to training medical students, residents, and fellows. A majority of their graduating residents chose generalist careers.