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acpjournals.org

view the latest content from the annals of internal medicine, annals of internal medicine: clinical cases, and archived articles from the acp journal club (now a monthly feature in annals of internal medicine).

acponline.org

official site of the american college of physicians. acp provides advocacy, practice tools, clinical guidance, cme and moc for internal medicine and more.

annalsofglobalhealth.org

annals of global health is a peer-reviewed, fully open access, online journal dedicated to publishing high quality articles dedicated to all aspects of global health. the journal's mission is to advance global health, promote research, and foster the prevention and treatment of disease worldwide. its goals are to improve the health and well-being of all people, advance health equity, and promote wise stewardship of the earth's environment. the latest journal impact factor is 2.90. annals of global health is supported by the program for global public health and the common good at boston college. it was founded in 1934 by the icahn school of medicine at mount sinai as the mount sinai journal of medicine. it is a partner journal of the consortium of universities for global health.  from time to time, annals of global health publishes special collections, a series of articles organized around a common theme in global health. recent special collections have included "local evidence and strategies in addressing ncds non-communicable diseases in tanzania", "universal health coverage through integrated care", and "the minderoo-monaco commission on plastics and human health". global health workers interested in developing a special collection are strongly encouraged to contact the managing editor in advance to discuss the project.

annfammed.org

PURPOSE Unlike in many community-based settings, benzodiazepine (BZD) prescribing to older veterans has decreased. We sought to identify health care system strategies associated with greater facility-level reductions in BZD prescribing to older adults. METHODS We completed an explanatory sequential mixed methods study of health care facilities in the Veterans Health Administration (N = 140). Among veterans aged ≥75 years receiving long-term BZD treatment, we stratified facilities into relatively high and low performance on the basis of the reduction in average daily dose of prescribed BZD from October 1, 2015 to June 30, 2017. We then interviewed key facility informants (n = 21) who led local BZD reduction efforts (champions), representing 11 high-performing and 6 low-performing facilities. RESULTS Across all facilities, the age-adjusted facility-level average daily dose in October 2015 began at 1.34 lorazepam-equivalent mg/d (SD 0.17); the average rate of decrease was −0.27 mg/d (SD 0.09) per year. All facilities interviewed, regardless of performance, used passive strategies primarily consisting of education regarding appropriate prescribing, alternatives, and identifying potential patients for discontinuation. In contrast, champions at high-performing facilities described leveraging ≥1 active strategies that included individualized recommendations, administrative barriers to prescribing, and performance measures to incentivize clinicians. CONCLUSIONS Initiatives to reduce BZD prescribing to older adults that are primarily limited to passive strategies, such as education and patient identification, might have limited success. Clinicians might benefit from additional recommendations, support, and incentives to modify prescribing practices.

wolterskluwer.com

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nyas.org

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jmsh.ac.in

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