Acute hospital admissions of hospice patients.

Background And Methods: Research into acute hospital admissions (AHAs) of hospice patients is relatively underdeveloped. The goal of this study, based on the electronic health records (EHR) of a large Midwestern hospice service over a 3-year period, was to identify characteristics of new hospice patients that are associated with an increased risk of later AHAs.

Results: Our study of a large and undifferentiated hospice population revealed several important new findings regarding AHA.

The statistical validity of nursing home survey findings.

Objectives: The Medicare nursing home survey is a high-stakes process whose findings greatly affect nursing homes, their current and potential residents, and the communities they serve. Therefore, survey findings must achieve high validity. This study looked at the validity of one key assessment made during a nursing home survey: the observation of the rate of errors in administration of medications to residents (med-pass).

Do family physicians fail to provide triptans for patients with migraine?

While continuing to improve recognition of migraine in your patient population, pay particular attention to the adherence rate among those for whom you have prescribed a triptan. Ask patients who discontinue triptan therapy why they made that decision. Besides adverse effects from the agent, reasons may include medication cost, influence of comorbidities, or triptan interaction with medications you may not have known about.

Student treatment on clerkships based on their specialty interests.

Background: Student clerkship experiences may suffer if teachers are not sympathetic to students' clinical interests.

Purpose: In this study, we quantified these experiences, compared reports of primary care and focused specialty students, and identified clerkships and teachers that posed special problems.

Methods: Students starting their 4th year at 6 schools completed a survey.

Do residents want automated external defibrillators in their retirement home?

Purpose: The administration of a continuing care retirement community (CCRC), while weighing practical and ethical questions surrounding installation of automated external defibrillators (AEDs), wanted to consider resident opinions. No databased studies on this subject were found.

Design And Methods: After an information session about AEDs, CCRC residents were surveyed concerning their opinions on AED installation, their beliefs and concerns regarding AEDs, their advance directive status, and their demographic characteristics.

Patient satisfaction with migraine management by family physicians.

Over 70% of the estimated 5 million office visits per year for migraine headache are to family physicians. Both the number of visits and proportion of migraine patients seeking medical care are increasing rapidly. Patient satisfaction with migraine care by primary care physicians is reported to be low but most data are obtained from patients referred to subspecialists or entered in clinical trials.

Treatment of medical students during clerkships based on their stated career interests.

Background: Clerkship students often face questions from teachers about their career interests and may perceive that their responses change their clerkship experiences significantly.

Purpose: To explore student experiences with "career interest" inquiries and how responses may influence clerkship experiences.

Methods: A qualitative study of 4th-year medical students by use of focus groups, whose experienced facilitators used a structured interview protocol.

Evidence-based medicine knowledge, attitudes, and skills of community faculty.

Context: As medical schools turn to community physicians for ambulatory care teaching, assessing the preparation of these faculty in principles of evidence-based medicine (EBM) becomes important.

Objective: To determine the knowledge and attitudes of community faculty concerning EBM and their use of EBM in patient care and teaching.

Design: Cross-sectional survey conducted from January to March of 2000.