This cross-sectional study compares patterns of end-of-life care and family-rated quality of care for patients in the Veterans Affairs health system dying with different serious illnesses.
This study identifies clinician characteristics associated with higher prostate-specific antigen (PSA) screening rates in older men with limited life expectancy, for whom there is guideline consensus that PSA screening should be avoided, and contrasts this with PSA screening in men with favorable life expectancy, for whom many guidelines still recommend individualized decision making.
This survey study of primary care physicians assessed perceived barriers to deintensifying treatment in patients with diabetes at risk for hypoglycemia.
This cohort study evaluates the deintensification of medication used for glucose and blood pressure control in individuals older than 70 years with diabetes mellitus and discusses the possibility for reducing overtreatment.
This observational study among a nationwide sample of patients reports that primary care provider turnover was associated with worse patient experiences of care but did not have a major effect on ambulatory care quality.
This randomized clinical trial of a stepped-care intervention for chronic pain resulted in statistically significant reductions in pain-related disability, pain interference, and pain severity in veterans with chronic musculoskeletal pain.
This cross-sectional, retrospective cohort study found that veterans who receive glucose test strips through both the Department of Veterans Affairs and Medicare use more strips and are more likely to overuse strips.
In a retrospective cohort study, Edwards et al characterize the association between enrollment in Home-Based Primary Care, a program operated by the Department of Veterans Affairs, and hospitalizations owing to an ambulatory care–sensitive condition among older veterans with diabetes mellitus. See the Invited Commentary by Federman and Soriano.
Kovesdy et al compare the outcomes associated with a treated systolic blood pressure of less than 120 mm Hg vs those associated with the currently recommended systolic blood pressure of less than 140 mm Hg in a national chronic kidney disease database of US veterans.
Nelson et al create an index that measures the extent of patient-centered medical home implementation, describe variation in implementation, and examine the association between the implementation index and key outcomes. See also the invited commentary by Baron.
Walling et al evaluate nonhospice supportive cancer care comprehensively in a national sample of veterans. See also the invited commentary by Aldridge and Meier.