Effective clinical practice : ECP
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Randomized Controlled Trial Clinical Trial
Can evidence change the rate of back surgery? A randomized trial of community-based education.
Timely adoption of clinical practice guidelines is more likely to happen when the guidelines are used in combination with adjuvant educational strategies that address social as well as rational influences. ⋯ We were able to use scientific evidence to engender voluntary change in back pain practice patterns across entire communities.
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Randomized Controlled Trial Clinical Trial
Reducing emergency visits in older adults with chronic illness. A randomized, controlled trial of group visits.
Emergency department utilization by chronically ill older adults may be an important sentinel event signifying a breakdown in care coordination. A primary care group visit (i.e., several patients meeting together with the provider at the same time) may reduce fragmentation of care and subsequent emergency department utilization. ⋯ Monthly group visits reduce emergency department utilization for chronically ill older adults.
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Randomized Controlled Trial Clinical Trial
Telephone care as an adjunct to routine medical follow-up. A negative randomized trial.
In 1992, a randomized trial at one outpatient clinic demonstrated that making telephone appointments part of routine medical follow-up could save money and reduce hospitalization. ⋯ Telephone care had little effect in this study. Instead of providing a way to maintain contact with patients without requiring them to appear in clinic frequently, telephone appointments became simply an additional service.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Enhanced access to primary care for patients with congestive heart failure. Veterans Affairs Cooperative Study Group on Primary Care and Hospital Readmission.
To determine whether enhanced access to primary care affects the diagnostic evaluation, pharmacologic management, or health outcomes of patients hospitalized with congestive heart failure (CHF). ⋯ Compliance with recommended CHF testing and treatment guidelines was equally high in both study groups. Enhanced access to primary care did not improve patients' self-reported health status and was associated with more frequent hospitalizations.