Case-based audit and feedback around a decision aid improved antibiotic choice and duration for uncomplicated cystitis in primary care clinics.

Objectives: The objective of our study was to evaluate the impact of a multifaceted stewardship intervention on adherence to the evidence-based practice guidelines on treatment of uncomplicated cystitis in primary care. We hypothesised that our intervention would increase guideline adherence in terms of antibiotic choice and duration of treatment.

Design: A preintervention and postintervention comparison with a contemporaneous control group was performed.

Qualitative Analysis of Primary Care Provider Prescribing Decisions for Urinary Tract Infections.

Inappropriate choices and durations of therapy for urinary tract infections (UTI) are a common and widespread problem. In this qualitative study, we sought to understand why primary care providers (PCPs) choose certain antibiotics or durations of treatment and the sources of information they rely upon to guide antibiotic-prescribing decisions. We conducted semi-structured interviews with 18 PCPs in two family medicine clinics focused on antibiotic-prescribing decisions for UTIs.

Less workup, longer treatment, but no clinical benefit observed in women with diabetes and acute cystitis.

Aims: There is a lack of evidence on the optimal approach for treating acute cystitis in women with diabetes. We performed an outpatient database study to compare management of women with and without diabetes and to assess the effect of treatment duration on early and late recurrence.

Methods: We used the EPIC Clarity database (electronic medical record system) to identify all female patients aged ≥18years with acute cystitis in two family medicine clinics and a urology department.

Cognitive behavior therapy for late-life generalized anxiety disorder delivered by lay and expert providers has lasting benefits.

Objective: Peaceful Living, a cognitive-behavioral treatment (CBT) for late-life generalized anxiety disorder (GAD), produced positive outcomes in GAD severity, anxiety, depression, insomnia, and mental health quality of life relative to usual care with treatment delivered by either bachelor-level lay providers (BLPs) or PhD-level expert providers (PLPs). We examined long-term maintenance of gains during 12 months following CBT for patients in this trial who received the intervention delivered by BLPs and PLPs and completed post-treatment assessments.

Methods: Participants were 112 older adults (mean age, 66.

Lay providers can deliver effective cognitive behavior therapy for older adults with generalized anxiety disorder: a randomized trial.

Background: The Institute of Medicine recommends developing a broader workforce of mental health providers, including nontraditional providers, to expand services for older adults. Cognitive behavior therapy (CBT) is effective for late-life generalized anxiety disorder (GAD), but no study has examined outcomes with delivery by lay providers working under the supervision of licensed providers. The current study examined the effects of CBT delivered by lay, bachelor-level providers (BLP) relative to Ph.

Treating late-life generalized anxiety disorder in primary care: an effectiveness pilot study.

To increase the sustainability of cognitive behavior therapy (CBT) in primary care for late-life anxiety, we incorporated nonexpert counselors, options for telephone meetings, and integration with primary care clinicians. This open trial examines the feasibility, satisfaction, and clinical outcomes of CBT delivered by experienced and nonexperienced counselors for older adults with generalized anxiety disorder (GAD). Clinical outcomes assessed worry (Penn State Worry Questionnaire), GAD (Generalized Anxiety Disorder Severity Scale), and anxiety (Beck Anxiety Inventory and Structured Interview Guide for Hamilton Anxiety Scale).