J Am Board Fam Med
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Multicenter Study Comparative Study Observational Study
Risk-adjusted comparison of blood pressure and low-density lipoprotein (LDL) noncontrol in primary care offices.
Population-level control of modifiable cardiovascular disease (CVD) risk factors is suboptimal. The objectives of this study were (1) to demonstrate the use of electronically downloaded electronic health record (EHR) data to assess guideline concordance in a large cohort of primary care patients, (2) to provide a contemporary assessment of blood pressure (BP) and low-density lipoprotein (LDL) noncontrol in primary care, and (3) to demonstrate the effect of risk adjustment of rates of noncontrol of BP and LDL for differences in patient mix on these clinic-level performance measures. ⋯ We demonstrated that the use of electronic collection of data from a large cohort of patients from fee-for-service primary care clinics is feasible for the audit of and feedback on BP and LDL noncontrol. Rates of noncontrol for most clinics are substantially higher than those achievable. Risk adjustment of noncontrol rates results in a rank-order of clinics very different from that achieved with nonadjusted data.
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Randomized Controlled Trial Multicenter Study Comparative Study
Outcomes of acupuncture for chronic pain in urban primary care.
The purpose of this study was to describe outcomes of the Acupuncture to Decrease Disparities in Outcomes of Pain Treatment (ADDOPT) trial, testing acupuncture as an adjunct to usual treatment for chronic pain in urban health centers. ⋯ Referred primary care patients experienced high levels of pain and pain-related disability. Weekly acupuncture was associated with short-term improvements in pain and quality of life.
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Randomized Controlled Trial Multicenter Study
Validation of the Insomnia Severity Index in primary care.
Although insomnia is a prevalent complaint with significant consequences on quality of life, health, and health care utilization, it often remains undiagnosed and untreated in primary care settings. Brief, reliable, and valid instruments are needed to facilitate screening for insomnia in general practice. This study examined psychometric indices of the Insomnia Severity Index (ISI) to identify individuals with clinically significant insomnia in primary care settings. ⋯ These findings suggest that the ISI is a valid screening instrument for detecting insomnia among patients consulting in primary care settings.
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Randomized Controlled Trial Multicenter Study
Five-year trend in hydrogenated vegetable oil consumption among northern Iranian families.
The main aim of this study was to assess the trends in hydrogenated vegetable oil (HVO) consumption and some related factors among northern Iranian families from 2006 to 2010. ⋯ HVO consumption decreased during the 5-year study (2006 to 2010), but HVO is still used extensively in northern Iran. Preventive early intervention strategies are needed to target uneducated and poor families, with an emphasis on the Sisstanish ethnic group, to increase awareness about the negative consequences of HVO consumption.
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Multicenter Study
Chronic abdominal wall pain misdiagnosed as functional abdominal pain.
The abdominal wall is often neglected as a cause of chronic abdominal pain. The aim of this study was to identify chronic abdominal wall pain syndromes, such as anterior cutaneous nerve entrapment syndrome (ACNES), in a patient population diagnosed with functional abdominal pain, including irritable bowel syndrome, using a validated 18-item questionnaire as an identification tool. ⋯ A clinically relevant portion of patients previously diagnosed with functional abdominal pain syndrome in a primary care environment suffers from an abdominal wall pain syndrome such as ACNES.