Content of Ambulatory Internal Medicine Practice in an Academic Army Medical Center and an Army Community Hospital

Johnson, James E.; Pinholt, Ellen M.; Jenkins, Terry R.; Carpenter, John L.

doi:10.1093/milmed/153.1.21

Cited by 26 publications

(10 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Subjects were recruited in the spring of 1992 from the General Internal Medicine Clinic at Walter Reed Army Medical Center, a 750-bed military teaching hospital with an outpatient case mix similar to that of other teaching hospitals. 5 All patients receiving care in the clinic over a 4-week period were asked to complete a questionnaire. The questionnaire collected basic demographic information and asked questions related to current advancedirective planning such as whether previous discussions with health care providers had occurred or whether advance directives had been completed.…”

Section: Methodsmentioning

confidence: 99%

Increasing the use of advance directives in medical outpatients

et al. 1997

View full text Add to dashboard Cite

show abstract

Section: Methodsmentioning

confidence: 99%

Increasing the use of advance directives in medical outpatients

et al. 1997

View full text Add to dashboard Cite

show abstract

“…Housestaff are divided into four “firms,” each consisting of three interns, three junior residents, and three senior residents. New patients are assigned in random fashion to any one of the four firms; the patient demographics and case mix of the firms are similar to each other 34 as well as to civilian patient populations 35 . Each firm has two assigned clinic sessions per week, during which only housestaff from that firm see patients.…”

Section: Methodsmentioning

confidence: 99%

Reducing Polypharmacy in the Elderly

Kroenke¹,

Pinholt²

1990

J American Geriatrics Society

Self Cite

119

View full text Add to dashboard Cite

A prospective, controlled trial to reduce polypharmacy in patients 65 years or older was carried out in the residents' clinic of a teaching hospital. Of 272 elderly patients surveyed, 89 (33%) were taking five or more prescription drugs. Recommendations to discontinue medications or to simplify regimens were formulated for 79 polypharmacy patients. Compared to 41 controls, the 38 patients whose physicians were informed of the recommended changes demonstrated a small but significant reduction in the mean number of drugs, the complexity, and the cost of their regimens. Physicians complied with eight (100%) of eight recommendations to simplify a dosage schedule, eight (62%) of 13 recommendations to substitute a new drug for the old one, and only eight (40%) of 20 recommendations to stop a medication (P = .04). Noncompliance usually resulted from patient refusal or from medications being prescribed by another provider. Whereas feedback to the primary physician is beneficial, more substantial reductions in outpatient polypharmacy may require overcoming patient barriers and limiting the number of prescribing physicians.

show abstract

“…The demo¬ graphics and case mix ofthe BAMC pop¬ ulation are similar to those seen in civilian practice. 1,5 Over six three-day periods, all pa¬ tients seen in the two adult primarycare clinics at the BAMC were asked to complete a one-page questionnaire. The internal medicine clinic provides longi¬ tudinal care for adults with chronic med-ical problems, while the acute-care clin¬ ic provides care on a walk-in basis for minor illnesses.…”

Section: Methodsmentioning

confidence: 99%

Chronic Fatigue in Primary Care

Kroenke¹

1988

JAMA

301

View full text Add to dashboard Cite

Although fatigue is one of the most common complaints in ambulatory care, research has been minimal. Of the 1159 consecutive patients surveyed in two adult primary-care clinics, 276 (24%) indicated that fatigue was a major problem. Fatigue was more prevalent in women than in men (28% vs 19%). Extensive clinical, laboratory, psychometric, and functional data were gathered for 102 fatigued patients and 26 controls. Laboratory testing was not useful in detecting unsuspected medical conditions or in determining the cause of fatigue. Depression or somatic anxiety or both were suggested by screening psychometric instruments in 82 fatigued patients (80%) compared with three controls (12%). Global dysfunction was marked, as reported by patients on the Sickness Impact Profile. The mean score on the Sickness Impact Profile of 11.3 for fatigued patients is similar to that reported for patients with major medical illnesses. After one year of follow-up, only 29 fatigued patients (28%) had improved. The high prevalence, persistence, and functional consequences of fatigue mandate a search for effective therapy.

show abstract

Content of Ambulatory Internal Medicine Practice in an Academic Army Medical Center and an Army Community Hospital

Cited by 26 publications

References 0 publications

Increasing the use of advance directives in medical outpatients

Increasing the use of advance directives in medical outpatients

Reducing Polypharmacy in the Elderly

Chronic Fatigue in Primary Care

Contact Info

Product

Resources

About