More than a score: a qualitative study of ancillary benefits of performance measurement.

Background: Prior research has examined clinical effects of performance measurement systems. To the extent that non-clinical effects have been researched, the focus has been on negative unintended consequences. Yet, these same systems may also have ancillary benefits for patients and providers--that is, benefits that extend beyond improvements on clinical measures.

Unintended consequences of implementing a national performance measurement system into local practice.

Background: Although benefits of performance measurement (PM) systems have been well documented, there is little research on negative unintended consequences of performance measurement systems in primary care. To optimize PM systems, a better understanding is needed of the types of negative unintended consequences that occur and of their causal antecedents.

Objectives: (1) Identify unintended negative consequences of PM systems for patients.

Multicenter, double-blind, placebo-controlled crossover study to assess the acute prokinetic efficacy of nizatidine-controlled release (150 and 300 mg) in patients with gastroesophageal reflux disease.

Introduction: The aim of the study is to test whether nizatidine delivered via a unique bimodal pulsatile-controlled release system, nizatidine controlled release (CR), accelerates gastric emptying in patients with gastroesophageal reflux disease (GERD).

Methods: Combined data were analyzed on 39 patients with delayed gastric emptying (DGE) from 2 studies (n = 84) assessing the prokinetic effect of nizatidine CR. A single-blind placebo baseline was followed by double-blind nizatidine CR (150 and 300 mg) in randomized sequence, 2 to 5 days apart.

Pharmacotherapy plus endoscopic intervention is more effective than pharmacotherapy or endoscopy alone in the secondary prevention of esophageal variceal bleeding: a meta-analysis of randomized, controlled trials.

Background: Previous clinical trials on the treatment of esophageal variceal bleeding yielded mixed results regarding the efficacy of endoscopic procedures compared with pharmacotherapy only.

Objective: To compare the efficacy of endoscopic procedures with that of pharmacotherapy in the prevention of mortality and rebleeding.

Design And Setting: A systematic literature review was performed to identify randomized, controlled trials of the efficacy of pharmacotherapy and endoscopic therapy.

Prolonging the return visit interval in primary care.

Purpose: Extending the scheduled return visit interval has been suggested as one means to improve clinic access to the provider. However, prolonging the return visit interval may affect quality of care if prevention measures and chronic disease management receive less attention as clinic visits become less frequent. The purpose of this study was to determine whether a comprehensive education program could encourage providers to lengthen their return visit interval without compromising performance on key quality indicators.