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Web-Based Patient Education

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53681. Economic and policy analysis of university-based drug "detailing". (PubMed)

Economic and policy analysis of university-based drug "detailing". The cost-effectiveness of quality assurance programs is often poorly documented, especially for innovative approaches. The authors analyzed the economic effects of an experimental educational outreach program designed to reduce inappropriate drug prescribing, based on a four-state randomized controlled trial (N = 435 physicians). Primary care physicians randomized into the face-to-face group were offered two individualized (...) educational sessions with clinical pharmacists, lasting an average of 18 minutes each, concerning optimal use of three drug groups that are often used inappropriately. After the program, expenditures for target drugs prescribed by these physicians to Medicaid patients decreased by 13%, compared with controls (P = 0.002); this effect was stable over three quarters. Implementation of this program for 10,000 physicians would lead to projected drug savings (to Medicaid only) of $2,050,000, compared

1986 Medical Care Controlled trial quality: uncertain

53682. A comparison of methods for increasing compliance within a general practitioner based screening project for colorectal cancer and the effect on practitioner workload. (Full text)

A comparison of methods for increasing compliance within a general practitioner based screening project for colorectal cancer and the effect on practitioner workload. Screening for colorectal cancer by testing for faecal occult blood (FOBT) is effective for early diagnosis, but the success of a screening programme also depends on compliance. The aims of this study were to assess the effect of health education on compliance and to assess any addition to general practitioner workload (...) that resulted. Altogether 3860 patients were recruited and randomly allocated to test or control group. The test group was further divided into subgroups, some of which received health education. Compliance with FOBT was 54.7% (210/384) in the subgroup receiving only the doctor's letter, which fell to 48.1% (743/1544) in the group receiving health education. General practitioner consultation rates were similar in test and control groups.

1988 Journal of epidemiology and community health Controlled trial quality: uncertain

53683. A randomized controlled trial assessing the impact of problem-based versus didactic teaching methods in CME. (PubMed)

A randomized controlled trial assessing the impact of problem-based versus didactic teaching methods in CME. A Continuing Medical Education short course was designed to examine the effect of presenting topics in three learning formats - traditional lectures, large-group, case discussions or small-group, problem-solving sessions, on knowledge and performance of family physicians. The physicians in the small group session rated the CME short course higher and performed better on one aspect (...) of patient management than the lecture or large group physicians but there were no other differences between groups on knowledge or physician performance.

1988 Research in medical education : proceedings of the ... annual Conference. Conference on Research in Medical Education Controlled trial quality: uncertain

53684. Effective control of hypercholesterolemia in children with dietary interventions based in pediatric practice. (PubMed)

with hypercholesterolemia (> 185 mg/dl) two interventions: one single or four multiple 90-min sessions of family-oriented nutritional education, based in pediatric practices. We examined total cholesterol, 3-day food records, height and weight, and in the multisession group high-density lipoprotein cholesterol and triglycerides at the beginning and at intervals of 8.5-9 and 21 to 33 weeks (single-session and multisession groups, respectively).Total cholesterol was lowered equally in both treatment groups over (...) Effective control of hypercholesterolemia in children with dietary interventions based in pediatric practice. Based on recent recommendations, the number of hypercholesterolemic children who would require dietary therapy could overwhelm current preventive pediatric cardiology resources. No previous studies have established the efficacy of such therapy in the pediatrician's office. The purpose of this study was to evaluate two programs of office-based therapy.We randomly assigned 295 children

1993 Preventive Medicine Controlled trial quality: uncertain

53685. The effects of a community-based pulmonary rehabilitation programme on exercise tolerance and quality of life: a randomized controlled trial. (PubMed)

The effects of a community-based pulmonary rehabilitation programme on exercise tolerance and quality of life: a randomized controlled trial. The present multicentre study evaluates the differences in efficacy between a 3 month rehabilitation programme including drug treatment, and a 3 month control period of drug treatment only, for asthmatic patients and patients with chronic obstructive pulmonary disease (COPD). The programme was run by physiotherapists in eight local practices, and included (...) exercise training, patient education, breathing retraining, evacuation of mucus, relaxation techniques, and recreational activities. In a randomized controlled trial with a cross-over design, the effects of rehabilitation were evaluated 3 and 6 months after baseline measurements in terms of exercise tolerance and quality of life (QOL). Exercise tolerance was assessed using submaximal cycle ergometer tests and 6 min walking tests. QOL was evaluated by means of the Chronic Respiratory Disease

1997 The European respiratory journal : official journal of the European Society for Clinical Respiratory Physiology Controlled trial quality: uncertain

53686. Improving office-based physician's prevention practices for sexually transmitted diseases. (PubMed)

of physicians of the combined intervention group reported an increase in counseling patients about reducing risky sexual behavior compared with 53% of the group receiving only educational materials and 42% of the control group (P < or = 0.001).Mailed educational materials combined with an office visit by a simulated patient instructor for role-play and feedback on clinical performance increased the frequency of office-based physicians' risk assessment and risk reduction counseling of patients for sexually (...) Improving office-based physician's prevention practices for sexually transmitted diseases. To determine whether office-based interventions increase primary care physicians' risk assessment of and counseling practices for patients regarding sexually transmitted diseases and the human immunodeficiency virus (HIV).Randomized controlled clinical trial.Washington, D.C., Metropolitan Statistical Area.Office-based primary care physicians (family or general practice, internal medicine, and obstetrics

1994 Annals of internal medicine Controlled trial quality: uncertain

53687. Randomised controlled trial of general practice based asthma clinics. (PubMed)

Randomised controlled trial of general practice based asthma clinics. To compare the effects on asthma morbidity of asthma clinics based in general practice with standard general practice care.A randomised controlled trial in eight general practices. Patients, general practitioners and outcomes assessors were not blinded to treatment allocation.195 patients with asthma aged 5-64 years; 191 completed the trial.Three asthma clinic sessions over six months involving nurse counselling, education (...) about asthma management, spirometry and consultation with the general practitioner.Patients reporting days lost from work or school, number of days lost, the presence of morning or nocturnal asthma symptoms, use of an action plan, medication use, current smoking, hospitalisation, and emergency visits.Asthma clinics were associated with a greater reduction in nocturnal symptoms, an increase in the ownership of peak flow meters and an increase in the number of patients commencing or resuming smoking

1999 The Medical journal of Australia Controlled trial quality: uncertain

53688. The effect of a peak flow-based action plan in the prevention of exacerbations of asthma. (PubMed)

subjects were recruited after attending an emergency department or a clinic for urgent treatment of asthma.All subjects received evaluation and education for asthma before being randomly allocated to receive no action plan, a symptom-based action plan, or a peak flowmeter and a peak flow-based action plan.Subjects were assessed by questionnaire at 3 and 6 months after enrollment with questions relating to their asthma control and their need for urgent treatment or hospital admission for asthma.At 6 (...) months after enrollment, although all three intervention groups experienced improvement in their asthma control, there was a striking reduction in emergency department visits for asthma only in the peak flow-based action plan group (p=0.006). No significant difference in emergency visits was apparent between the symptom-based action plan and no action plan groups.We conclude that a peak flow-based action plan is effective, at least in the short term, in protecting patients with asthma against severe

1997 Chest Controlled trial quality: uncertain

53689. Home-based management can achieve intensification cost-effectively in type I diabetes. (PubMed)

Home-based management can achieve intensification cost-effectively in type I diabetes. Newly diagnosed insulin-dependent diabetic children are most often admitted to hospital for education and insulin management and subsequently followed in outpatient clinics or office settings. However, most could be managed at home, given adequate family and health care team support and subsequent follow-up facilitated by home-based nursing intervention. We conducted a randomized trial of clinical (...) , psychosocial, and cost effects of home-based management in a 2-year follow-up study of newly diagnosed diabetic children.Sixty three patients were randomly assigned to traditional hospitalization and outpatient follow-up (hospital-based group) or home management (home-based group). Treatment differences between the two groups consisted of duration of initial hospital stay, site and timing of initial teaching, and nature and extent of subsequent nursing follow-up. Metabolic control was assessed by means

1999 Pediatrics Controlled trial quality: uncertain

53690. The effect of a multifaceted physician office-based intervention on older women's mammography use. (PubMed)

. The multifaceted intervention incorporated patient education, physician reminders, and audit-with-feedbackBiennial mammography rates. Patient adherence to physician mammography referral was evaluated in a restricted cohort of women selected from the intervention sample.The mammography rate for the intervention sample increased from 62.7% (baseline) to 73.1% (follow-up), (P<.001), whereas the control sample's rate remained essentially unchanged (68.3 to 69.5%), (P = .34). The intervention patients were 48% more (...) The effect of a multifaceted physician office-based intervention on older women's mammography use. In response to identified low mammography use among older women in three geographic areas in Connecticut, a physician office-based mammography intervention was initiated under the Health Care Financing Administration's Health Care Quality Improvement Program.To evaluate the intervention's impact on older women's mammography use.A quasi-experimental design comparing mammography rates for women

2000 Journal of the American Geriatrics Society Controlled trial quality: uncertain

53691. Early findings from a community-based, cluster-randomized, controlled oral cancer screening trial in Kerala, India. The Trivandrum Oral Cancer Screening Study Group. (PubMed)

for treatment. Data on oral cancer incidence, stage distribution, survival, and mortality in the study groups are obtained by record linkage with the Trivandrum population-based cancer registry and municipal death registration systems.There were 59,894 eligible subjects in the intervention group and 54,707 in the control group; 31.4% of the former group reported no tobacco or alcohol habits, compared with 44.1% of the latter. The distribution of age, education, occupation, income, and socioeconomic status (...) Early findings from a community-based, cluster-randomized, controlled oral cancer screening trial in Kerala, India. The Trivandrum Oral Cancer Screening Study Group. Oral cancer satisfies the criteria for a suitable disease for screening, and oral visual inspection is a suitable test for oral cancer screening. The efficacy of screening in reducing mortality from oral cancer has not yet been evaluated. The authors describe a cluster-randomized, controlled oral cancer screening trial in southern

2000 Cancer Controlled trial quality: uncertain

53692. Assessing the impact of pediatric-based development services on infants, families, and clinicians: challenges to evaluating the Health Steps Program. (PubMed)

Assessing the impact of pediatric-based development services on infants, families, and clinicians: challenges to evaluating the Health Steps Program. Begun in 1996, the Healthy Steps for Young Children Program (HS) is a new model of pediatric practice that incorporates child development specialists and enhanced developmental services for families of young children. HS is for all families, not just those at high-risk. It is expected to strengthen parents' knowledge, attitudes, and behaviors (...) . It describes the evaluation design and characteristics of the HS sites and sample for the evaluation.The evaluation is following a cohort of children from birth to age 3 at 15 evaluation sites across the country. The sites represent a range of organizational practice settings that include group practices, hospital-based clinics, and health maintenance organization pediatric clinics. The evaluation design relies on 2 comparison strategies. At 6 randomization design sites, 400 children were randomized

2000 Pediatrics Controlled trial quality: uncertain

53693. A clinic-based mammography intervention targeting inner-city women. (PubMed)

participation.A clinic-based program incorporating physician education, provider prompts, patient education materials, and appointment reminders and emphasizing nursing involvement can facilitate adherence to breast cancer screening guidelines among inner-city women. (...) for mammography) during the study period were enrolled in the trial (n = 314).The intervention program emphasized nursing involvement and included physician education, provider prompts, use of audiovisual and printed patient education materials, transportation assistance in the form of bus passes, preappointment telephone or postcard reminders, and rescheduling assistance. Control firm women received usual care.Mammography completion within 8 weeks of clinic visits was significantly higher among intervention

1999 Journal of General Internal Medicine Controlled trial quality: uncertain

53694. Brief physician advice for alcohol problems in older adults: a randomized community-based trial. (PubMed)

drinkers. Twenty-four community-based primary care practices in Wisconsin (43 family physicians and internists) participated in the trial. Of the 6073 patients screened, 105 men and 53 women met inclusion criteria and were randomized into a control group (n = 71) or an intervention group (n = 87). Intervention group patients received two 10- to 15-minute physician-delivered counseling sessions that included advice, education, and contracting using a scripted workbook. A total of 146 patients (92.4 (...) Brief physician advice for alcohol problems in older adults: a randomized community-based trial. Alcohol use in older adults is common. It is associated with depression, hypertension, diabetes, drug interactions, accidents, and increased rates of emergency department visits and hospitalizations.A controlled clinical trial (Project GOAL--Guiding Older Adult Lifestyles) tested the efficacy of brief physician advice in reducing the alcohol use and use of health care services of older adult problem

1999 Journal of Family Practice Controlled trial quality: uncertain

53695. Handwashing compliance by health care workers: The impact of introducing an accessible, alcohol-based hand antiseptic. (PubMed)

Handwashing compliance by health care workers: The impact of introducing an accessible, alcohol-based hand antiseptic. Under routine hospital conditions handwashing compliance of health care workers including nurses, physicians, and others (eg, physical therapists and radiologic technicians) is unacceptably low.To investigate the efficacy of an education/ feedback intervention and patient awareness program (cognitive approach) on handwashing compliance of health care workers; and to compare (...) the acceptance of a new and increasingly accessible alcohol-based waterless hand disinfectant (technical approach) with the standard sink/soap combination.A 6-month, prospective, observational study.One medical intensive care unit (ICU), 1 cardiac surgery ICU, and 1 general medical ward located in a 728-bed, tertiary care, teaching facility.Medical caregivers in each of the above settings.Implementation of an education/ feedback intervention program (6 in-service sessions per each ICU) and patient awareness

2000 Archives of internal medicine Controlled trial quality: uncertain

53696. Responses of older adults to theory-based nutrition newsletters. (PubMed)

to participate in a home-based educational intervention using a patient list generated from a rural tertiary care hospital database, Geisinger Medical Center in Danville, Pa.Five nutrition newsletters designed using the nutrition communication model and adult learning theory principles were mailed biweekly. Telephone interviews followed each of the 5 newsletters 10 to 14 days after distribution.Nutrition knowledge and interest, food behavior related to dietary fat, and stages of change for dietary fat (...) Responses of older adults to theory-based nutrition newsletters. To evaluate the effect of a theory-based newsletter on knowledge, attitude, and behavior change in older adults.Pretest-posttest, random assignment, and treatment-control design with 2 treatment groups: 1 that received newsletters only and 1 that received newsletters with follow-up telephone interviews. Control group completed pretest-posttest surveys only.Four hundred eighty men and women, aged 60 to 74 years, were recruited

2000 Journal of the American Dietetic Association Controlled trial quality: uncertain

53697. Generalizability of trial results based on randomized versus nonrandomized allocation of OME infants to ventilation tubes or watchful waiting. (PubMed)

Generalizability of trial results based on randomized versus nonrandomized allocation of OME infants to ventilation tubes or watchful waiting. The objective was to study the generalizability of trial results by comparing randomized patients to eligible but nonrandomized patients who received the same management. Implementation of trial results is only justifiable when the results can be generalized to the total domain population. The design was a multicentre randomized controlled trial (...) on the effect of early screening and treatment with ventilation tubes on infants with otitis media with effusion. Randomized (n = 187) and nonrandomized eligible patients (n = 133) were followed up. The study population comprised children who were detected by auditory screening at the age of 9-12 months and who were subsequently diagnosed with persistent bilateral otitis media with effusion for 4-6 months. A significant difference was found in the distribution of some prognostic factors: more randomized

2001 Journal of Clinical Epidemiology Controlled trial quality: uncertain

53698. The diabetes network internet-based physical activity intervention: a randomized pilot study. (PubMed)

The diabetes network internet-based physical activity intervention: a randomized pilot study. Because of other competing priorities, physical activity (PA) is seldom addressed in a consistent way in either primary care or diabetes education. This 8-week pilot study evaluated the short-term benefits of an Internet-based supplement to usual care that focused on providing support for sedentary patients with type 2 diabetes to increase their PA levels.A total of 78 type 2 diabetic patients (53 (...) program use.Internet-based self-management interventions for PA and other regimen areas have great potential to enhance the care of diabetes and other chronic conditions. We conclude that greater attention should be focused on methods to sustain involvement with Internet-based intervention health promotion programs over time.

2001 Diabetes Care Controlled trial quality: uncertain

53699. The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial. (PubMed)

The efficacy of home based progressive strength training in older adults with knee osteoarthritis: a randomized controlled trial. To test the effects of a high intensity home-based progressive strength training program on the clinical signs and symptoms of osteoarthritis (OA) of the knee.Forty-six community dwelling patients, aged 55 years or older with knee pain and radiographic evidence of knee OA, were randomized to a 4 month home based progressive strength training program or a nutrition (...) education program (attention control). Thirty-eight patients completed the trial with an adherence of 84% to the intervention and 65% to the attention control. The primary outcome was the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index pain and physical function subscales. Secondary outcomes included clinical knee examination, muscle strength, physical performance measures, and questionnaires to measure quality of life variables.Patients in the strength training group who

2001 The Journal of rheumatology Controlled trial quality: predicted high

53700. A randomized trial of hierarchical counseling in a short, clinic-based intervention to reduce the risk of sexually transmitted diseases in women. (PubMed)

A randomized trial of hierarchical counseling in a short, clinic-based intervention to reduce the risk of sexually transmitted diseases in women. Effective public health interventions to reduce the incidence of sexually transmitted disease (STD), including HIV, among women are urgently needed.A randomized trial among STD clinic patients of two types of counseling regarding methods to reduce disease transmission: a 'hierarchical' message (HP), with counseling on male condoms, female condoms (...) , diaphragms, cervical caps, and spermicides (three formulations) and a single method message (SM) covering male condoms only or female condoms only. For this analysis, 1591 subjects received one of three educational messages at the central public STD clinic in Philadelphia. Disease incidence data for up to 6 months following the index visit were extracted from the clinic's electronic database. The primary outcome was STD reinfection: laboratory-confirmed trichomonas infection and/or clinical diagnoses

2000 AIDS Controlled trial quality: uncertain

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