Weight-related perceptions among patients and physicians: how well do physicians judge patients' motivation to lose weight?

Background: Prior studies suggest that patients and physicians have different perceptions and expectations surrounding weight; however, few studies have directly compared patients' and physicians' perspectives.

Objectives: (1) To measure the extent to which obese patients and their physicians have discrepant weight-related perceptions, and (2) to explore patient and physician characteristics that may influence patient-physician discrepancy in motivation to lose weight.

Design And Participants: Four hundred and fifty-six obese patients (302 females; mean age = 55.

Adequate initial antidepressant treatment among patients with chronic obstructive pulmonary disease in a cohort of depressed veterans.

Objective: Depression is common among patients with chronic obstructive pulmonary disease (COPD). Patients with COPD may be more likely to have inadequate treatment with antidepressant medications. We tested the hypothesis that depressed patients with COPD have lower odds of adequate duration of antidepressant therapy in the first 3 months of treatment compared to those without COPD.

The community initiative on depression: report from a multiphase work site depression intervention.

Objective: We sought to further understand depression, a common, disabling condition with considerable ramifications for the workplace, including higher costs, absenteeism, and reduced work performance.

Methods: A multidisciplinary health care coalition recently implemented a multiphase workplace depression initiative in Kansas City. We report results from its first phase, a 22-item, self-administered survey of depression knowledge and attitudes among employees of 13 large, local work sites.

The relationship of system-level quality improvement with quality of depression care.

Objective: To explore the relationship of systemwide continuous quality improvement (CQI) with depression care quality in the Veterans Health Administration (VHA).

Study Design: Observational study using data from 2 VHA studies.

Patients And Methods: The Depression Care Quality Study (DCQS) was a retrospective cohort study of depression care quality in the northeastern United States involving 12 678 patients cared for at 14 VHA facilities; it used guideline-based process measures (ie, dosage and duration adequacy).

Monitoring depression care: in search of an accurate quality indicator.

Background: Linking process and outcomes is critical to accurately estimating healthcare quality and quantifying its benefits.

Objectives: The objective of this study was to explore the relationship of guideline-based depression process measures with subsequent overall and psychiatric hospitalizations.

Research Design: This is a retrospective cohort study during which we used administrative and centralized pharmacy records for sample identification, derivation of guideline-based process measures (antidepressant dosage and duration adequacy), and subsequent hospitalization ascertainment.

Potentially inappropriate antiepileptic drugs for elderly patients with epilepsy.

Objectives: To describe prescribing patterns for older veterans with epilepsy, determine whether disparity exists between these patterns and clinical recommendations, and describe those at greatest risk of receiving potentially inappropriate antiepileptic drugs (AEDs).

Design: Retrospective administrative database analysis.

Setting: All outpatient facilities within the Department of Veterans Affairs (VA).

Measuring the quality of depression care in a large integrated health system.

Background: Guideline-based depression process measures provide a powerful way to monitor depression care and target areas needing improvement.

Objectives: To assess the adequacy of depression care in the Veterans Health Administration (VHA) using guideline-based process measures derived from administrative and centralized pharmacy records, and to identify patient and provider characteristics associated with adequate depression care.

Research Design: This is a cohort study of patients from 14 VHA hospitals in the Northeastern United States which relied on existing databases.