Archives of internal medicine
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Randomized Controlled Trial
The diabetes mellitus medication choice decision aid: a randomized trial.
Patient involvement in the choice of antihyperglycemic agents could improve adherence and optimize glycemic control in patients with type 2 diabetes mellitus. ⋯ An innovative decision aid effectively involved patients with type 2 diabetes mellitus in decisions about their medications but did not improve adherence or HbA(1c) levels. Trial Registration clinicaltrials.gov Identifier: NCT00388050.
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Randomized Controlled Trial
Clinicians' assessments of electronic medication safety alerts in ambulatory care.
While electronic prescribing (e-prescribing) systems with drug interaction and allergy alerts promise to improve medication safety in ambulatory care, clinicians often override these safety features. We undertook a study of respondents' satisfaction with e-prescribing systems, their perceptions of alerts, and their perceptions of behavior changes resulting from alerts. ⋯ Although clinicians were critical of the quality of e-prescribing alerts, alerts may lead to clinically significant modifications in patient management not readily apparent based on "acceptance" rates.
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Acute exacerbations of chronic obstructive pulmonary disease (AECOPDs) often require hospitalization, may necessitate mechanical ventilation, and can be fatal. We sought to develop a simple risk score to determine its severity. ⋯ A simple risk class based on clinical variables easily obtained at presentation predicts mortality and need for mechanical ventilation. It may facilitate the triage and care of patients with AECOPD.
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To define whether elderly patients hospitalized with community-acquired pneumonia (CAP) had better outcomes if they were treated with empirical antimicrobial therapy adherent to the 2007 Infectious Diseases Society of America (IDSA)/American Thoracic Society (ATS) guidelines for CAP. ⋯ Implementation of national guidelines at the local hospital level will improve not only mortality and LOS of elderly patients hospitalized with CAP but also time to clinical stability.