Family Medicine Research That Provides Compelling, Urgent Data to Improve Patient Care

Abstract

Herein is positive, mixed, and negative news-albeit all useful-on family medicine topics. The time to depression remission can be dramatically reduced. There is compelling evidence on how to improve medication reconciliation. There is a major underestimated determinant of the length of intrauterine device use. Data on the convoluted nature of the International Classification of Diseases, 10th Revision, transition could cause heart sink for doctors. Another article notes how family physicians can improve the usability of electronic health records by working with vendors. Targeting For patients with depression, it is not just remission that matters, but the time to reach remission. In a fascinating and important article, Garrison et al 1 find substantial differences in the amount of time it took to reach remission among patients with depression treated with collaborative care versus usual care. Much of the previous literature emphasizes remission itself as the primary outcome. This article provides dramatic results, that is, more than a year difference in time to remission for collaborative care patients compared with those without collaborative care. All were diagnosed with depression or dysthymia; all were treated with antidepressants. The Robert Graham Center also presents some useful data that are pertinent to the collaborative treatment of depression. While family physicians frequently work with nurse practitioners and/or physicians assistants, 2 the number of family physicians working directly in the office with behavioral specialists or psychiatrists is much lower at about one fifth of family physicians. To increase collaborative mental health care, these numbers need to increase. The recent Journal of the American Board of Family Medicine supplement on integrated care 3 provides related helpful information.Health literacy is known to be important in health outcomes. Health care providers often work to overcome literacy issues, but often without much guidance or certainty of improved outcomes. The Agency for Health care Research and Quality has a health literacy toolkit that Weiss et al 4 tested for medication reconciliation in 2 practices. The primary implemented items were not particularly time consuming, and the results were impressive: substantially more drug therapy problems were identified and revisions undertaken. For those not using the toolkit methods, it's time to start! In another persuasive report, Chang et al 5 findthat patients who initiate a discussion of intrauterine devices (IUDs) keep their IUDs much longer than do patients for whom the physician introduced the idea of an IUD. The difference among this population was more than a year! The physicianinitiated IUDs were removed at 6 months, on av-

Effect of family intervention on relapse rate of Chinese patients with alcohol-dependent

“…Research has shown that family support can improve the quality of life of patients with alcohol-induced mental disorders, reduce the occurrence of anxiety and depression, reduce the frequency of alcohol consumption, and reduce the occurrence and severity of mental symptoms ( 16 , 17 ). It can also improve patients’ ability to respond to adverse events, timely alleviate psychological crises, and fundamentally achieve the goal of eliminating bad drinking habits ( 18 ). However, there was no report on the effect of family intervention on the relapse rate of alcohol dependence in Chinese patients.…”