The Experts below are selected from a list of 252141 Experts worldwide ranked by ideXlab platform
Bruce Arroll - One of the best experts on this subject based on the ideXlab platform.
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physician patient Relationship and medication compliance a primary care investigation
Annals of Family Medicine, 2004Co-Authors: Ngaire Kerse, Stephen Buetow, Arch G Mainous, Gregory Young, Gregor Coster, Bruce ArrollAbstract:PURPOSE We assessed the Relationship between 4 attributes of the Physician-Patient Relationship and medication compliance. METHODS We conducted a waiting room survey of patients consulting 22 general practitioners in 14 randomly selected practices in Auckland, New Zealand (81% response rate). A total of 370 consecutive patients (75% response rate) completed survey instruments about 4 attributes of the Physician-Patient Relationship. Continuity of care (assessed from use of a usual physician, length of continuity, and perceived importance of continuity) and trust in the physician were ascertained before the consultation. After the consultation the Patient Enablement Index measured the physician’s ability to enable patients in self-care, and concordance between the patient and physician was measured by a 6-item inventory of perceived agreement about the presenting problem and management, were ascertained immediately after the consultation. Compliance with prescribed medication therapy was ascertained by telephone follow-up 4 days after the consultation. RESULTS Overall, 220 patients (61%) received a prescription, and 79% of these patients were taking the medication at follow-up. In a univariate analysis adjusted for clustering, only trust and Physician-Patient concordance were significantly related to compliance. In analysis further adjusted for health and demographic factors, Physician-Patient concordance was independently related to compliance (odds ratio = 1.34, 95% confidence interval, 1.04–1.72). CONCLUSIONS Primary care consultations with higher levels of patient-reported Physician-Patient concordance were associated with one-third greater medication compliance. An emphasis on understanding and facilitating agreement between physician and patient may benefit outcomes in primary care.
David Anthony - One of the best experts on this subject based on the ideXlab platform.
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untangling the web the impact of internet use on health care and the physician patient Relationship
Patient Education and Counseling, 2007Co-Authors: Hedy S Wald, Catherine Dube, David AnthonyAbstract:Abstract Objective The use of Web (i.e. Internet)-derived health information within the health care encounter is rapidly increasing. In this article, an extensive review of the complex effects and sometimes contradictory roles of the Web in regard to health care delivery and the physician–patient Relationship is presented. Methods A review of relevant literature was conducted, with key points integrated into a physician guide for effective interaction with Web-activated patients. Results An emerging consumerist model with “triangulation” of patient–Web–physician can be expected to significantly impact dynamics of the physician–patient Relationship. Potential advantages of Web-acquired information include helping patients make informed health care choices (with potential to decrease health care disparities), shared decision-making with a collaborative, teamwork approach, more efficient use of clinical time, augmenting of physician-provided information, online support groups, and/or access to patients’ own health information. Alternatively, factors such as misinformation due to highly variable quality of Web information, possible exacerbation of socioeconomic health disparities, and shifting of conventional notions of the physician–patient Relationship (“traditional” medical authority) present their own set of challenges for the health care provider. Conclusion A tangible guide to the integration of patients’ use of the Web within a medical practice is thus offered with recommended communication skills. Practice implications The “net-friendly” clinician can be effective by engendering a genuine partnership with patients, thus contributing to quality health care.
Ngaire Kerse - One of the best experts on this subject based on the ideXlab platform.
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physician patient Relationship and medication compliance a primary care investigation
Annals of Family Medicine, 2004Co-Authors: Ngaire Kerse, Stephen Buetow, Arch G Mainous, Gregory Young, Gregor Coster, Bruce ArrollAbstract:PURPOSE We assessed the Relationship between 4 attributes of the Physician-Patient Relationship and medication compliance. METHODS We conducted a waiting room survey of patients consulting 22 general practitioners in 14 randomly selected practices in Auckland, New Zealand (81% response rate). A total of 370 consecutive patients (75% response rate) completed survey instruments about 4 attributes of the Physician-Patient Relationship. Continuity of care (assessed from use of a usual physician, length of continuity, and perceived importance of continuity) and trust in the physician were ascertained before the consultation. After the consultation the Patient Enablement Index measured the physician’s ability to enable patients in self-care, and concordance between the patient and physician was measured by a 6-item inventory of perceived agreement about the presenting problem and management, were ascertained immediately after the consultation. Compliance with prescribed medication therapy was ascertained by telephone follow-up 4 days after the consultation. RESULTS Overall, 220 patients (61%) received a prescription, and 79% of these patients were taking the medication at follow-up. In a univariate analysis adjusted for clustering, only trust and Physician-Patient concordance were significantly related to compliance. In analysis further adjusted for health and demographic factors, Physician-Patient concordance was independently related to compliance (odds ratio = 1.34, 95% confidence interval, 1.04–1.72). CONCLUSIONS Primary care consultations with higher levels of patient-reported Physician-Patient concordance were associated with one-third greater medication compliance. An emphasis on understanding and facilitating agreement between physician and patient may benefit outcomes in primary care.
Roger Detels - One of the best experts on this subject based on the ideXlab platform.
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hiv aids patients medical and psychosocial needs in the era of haart a cross sectional study among hiv aids patients receiving haart in yunnan china
Aids Care-psychological and Socio-medical Aspects of Aids\ hiv, 2013Co-Authors: Yi Wen, Yun Shi, Chengqin Jiang, Roger DetelsAbstract:Since the launch of China's Free Antiretroviral Therapy (ART) Program in 2002, more than 100,000 HIV/AIDS patients have been treated with highly actively antiretroviral therapy (HAART). However, the current evaluation system for this program mainly focused on its medical outcomes. This study aims to evaluate the medical and psychosocial needs of HIV/AIDS patients after initiating HAART. A cross-sectional study was conducted among 499 HIV/AIDS patients who were currently being treated with HAART in three designated hospitals in Luxi City, Yunnan Province. A questionnaire was used to collect information about participants' demographic characteristics, perceived HIV-related stigma, Physician-Patient Relationship, quality of life, family functioning, etc. Patients' medical records in the National HIV Information System were linked with their questionnaire by their ART identification number. Patients on HAART who were infected with HIV through injection drug use and were current smokers typically had poorer physical health than other participants on HAART. Better financial status and better Physician-Patient Relationship were associated with both physical and psychological well-being. Family awareness of the patient's HIV status was negatively associated with the patient's psychological well-being. Higher levels of perceived HIV-related stigma were associated with poorer psychological health and poorer family functioning. This study emphasizes the importance of assuring a caring environment in China's AIDS treatment program and re-enforces the need to combat the stigma encountered with health providers and the public.
Tara L Kuther - One of the best experts on this subject based on the ideXlab platform.
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medical decision making and minors issues of consent and assent
Adolescence, 2003Co-Authors: Tara L KutherAbstract:The Physician-Patient Relationship has been described as an egalitarian partnership in which patients and physicians work together to make healthcare decisions. Although adults receive considerable encouragement to become active participants in medical decision-making, children and adolescents often have little voice in such decisions and are granted limited access to confidential medical care. After a brief discussion of legal perspectives on informed consent, the present review examines the developmental literature on children and adolescents' capacities to make medical decisions that are informed, voluntary, and rational. The purposes and benefits of assent are identified. Remaining questions of how to evaluate capacity and balance parental and minor autonomy are explored.