Success in the Achieving CARdiovascular Excellence in Colorado (A CARE) Home Blood Pressure Monitoring Program: A Report from the Shared Networks of Colorado Ambulatory Practices and Partners (SNOCAP).

Background: Blood pressure (BP) control among primary care patients with hypertension is suboptimal. Home BP monitoring (HBPM) has been shown to be effective but is underused.

Methods: This study was a quasi-experimental evaluation of the impact of the A CARE HBPM program on hypertension control.

Health Promotion Text Messaging Preferences and Acceptability Among the Medically Underserved.

The Colorado Healthy Heart Solutions program uses community health workers to provide health promotion and navigation services for participants in medically underserved, predominantly rural areas who are at risk for developing cardiovascular disease. A text messaging program designed to increase participant engagement and adherence to lifestyle changes was pilot tested with English- and Spanish-speaking participants. Preimplementation focus groups with participants informed the development of text messages that were used in a 6-week pilot program.

Effects of clinical pathways for common outpatient infections on antibiotic prescribing.

Background: Antibiotic overuse in the primary care setting is common. Our objective was to evaluate the effect of a clinical pathway-based intervention on antibiotic use.

Methods: Eight primary care clinics were randomized to receive clinical pathways for upper respiratory infection, acute bronchitis, acute rhinosinusitis, pharyngitis, acute otitis media, urinary tract infection, skin infections, and pneumonia and patient education materials (study group) versus no intervention (control group).

An assessment of the Hawthorne Effect in practice-based research.

Background: Practical studies in real-world settings may be particularly vulnerable to unintended effects on intervention outcomes, including what is commonly known as the Hawthorne Effect. This phenomenon suggests that study subjects' behavior or study results are altered by the subjects' awareness that they are being studied or that they received additional attention. This is especially a concern when subjects are not blinded to randomization or when they participate in studies with observational components.

Improving the management of skin and soft tissue infections in primary care: a report from State Networks of Colorado Ambulatory Practices and Partners (SNOCAP-USA) and the Distributed Ambulatory Research in Therapeutics Network (DARTNet).

Background: Purulent skin and soft tissue infections (SSTIs) requiring medical attention are often managed in primary care. The prevalence of SSTIs caused by community-acquired Methicillin-resistant Staphylococcus aureus (CA-MRSA) has been increasing rapidly, including in otherwise healthy individuals. The Centers for Disease Control and Prevention (CDC) issued guidelines to improve the management of SSTIs in primary care.

What keeps patients from adhering to a home blood pressure program?

Background: Home blood pressure monitoring (HBPM) predicts cardiovascular risk and increases hypertension control. Non-participation in HBPM is prevalent and decreases the potential benefit.

Methods: Telephone surveys were conducted with a random quota sample of non-participants in a HBPM program, which supplied a complimentary automated blood pressure cuff and utilized a centralized reporting system.

Facilitating patient self-management through telephony and web technologies in seasonal influenza.

Purpose: The aim of this project was to develop and test information technology implementations that could assist patients with influenza self-management in primary care settings. Although testing was conducted in the context of seasonal influenza, the project aimed to develop a blueprint that primary care practices could use in an influenza pandemic.

Methods: Four primary care practice-based research networks (PBRNs) systematically designed, implemented, tailored and tested a tiered patient self-management technology model in 12 primary care practices during the peak of the 2007 to 2008 influenza season.

Do OTC remedies relieve cough in acute URIs?

Dextromethorphan (DM) for adults and honey for children provide some relief. DM may modestly decrease cough in adults compared with placebo. The data supporting zinc for the common cold are mixed.

Does regular exercise reduce the pain and stiffness of osteoarthritis?

Exercise helps reduce the pain, but it's unclear whether it helps with stiffness. Exercise moderately reduces pain in elderly patients with osteoarthritis and has a small effect on reducing self-reported disability. No studies have evaluated the effect of exercise on stiffness.