Journal of general internal medicine
-
Randomized Controlled Trial Comparative Study
Quality of care for cardiovascular disease-related conditions in patients with and without mental disorders.
We compared the quality of care for cardiovascular disease (CVD)-related risk factors for patients diagnosed with and without mental disorders. ⋯ Quality of care for major chronic conditions associated with premature CVD-related mortality is suboptimal for VA patients with SMI, especially for procedures requiring care by a specialist.
-
Randomized Controlled Trial Comparative Study
The impact of consumer-directed health plans and patient socioeconomic status on physician recommendations for colorectal cancer screening.
Consumer-directed health plans are increasingly common, yet little is known about their impact on physician decision-making and preventive service use. ⋯ Patient SES and deductible-level affect physician recommendations for preventive care. Coverage of preventive services and funds in medical savings accounts may help to mitigate the impact of high-deductibles and SES on inappropriate recommendations.
-
Randomized Controlled Trial
The impact of perceived treatment assignment on smoking cessation outcomes among African-American smokers.
The double-blind placebo-controlled design is commonly considered the gold standard in research methodology; however, subject expectation bias could subvert blinding. ⋯ Results support previous research that expectation bias associated with judgment of treatment assignment is a strong predictor of outcome and confirms this relationship in a smoking cessation trial using bupropion SR among African-American smokers.
-
Randomized Controlled Trial Multicenter Study
Does outpatient telephone coaching add to hospital quality improvement following hospitalization for acute coronary syndrome?
Telephone counseling in chronic disease self-management is increasing, but has not been tested in studies that control for quality of medical care. ⋯ Telephone coaching post-hospitalization for ACS was modestly effective in accomplishing short-term, but not long-term life-style behavior change. Previous positive results shown in primary care did not transfer to free-standing telephone counseling as an adjunct to care following hospitalization.
-
Randomized Controlled Trial Multicenter Study
Using a pocket card to improve end-of-life care on internal medicine clinical teaching units: a cluster-randomized controlled trial.
End-of-life care is suboptimally taught in undergraduate and postgraduate education in Canada. Previous interventions to improve residents' knowledge and comfort have involved lengthy comprehensive educational modules or dedicated palliative care rotations. ⋯ Our pocket card is a feasible, economical, and educational intervention that improves resident comfort level and knowledge in delivering end-of-life care on CTUs.