November/December 2004 Annals of Family Medicine tip sheet

are predominantly female, have three times as many office visits, diagnoses and medications, and have eight times as many hospital admissions. The authors suggest that better targeted patient education and referral to other support services may decrease the number of calls and utilization of health services among this group.

Improving Test Ordering in Primary Care: The Added Value of a Small-Group Quality Improvement Strategy Compared with Classic Feedback Only
By Wim Verstappen, M.D., Ph.D.
With the number of tests ordered by primary care physicians on the rise, Verstappen and colleagues find that small-group quality improvement meetings, which give physicians an opportunity to discuss their test ordering performance with colleagues on the basis of actual performance data, are effective at changing physician test-ordering behavior. They conclude that the current practice of merely sending written feedback reports to physicians does not have a significant impact on test-ordering behavior. They suggest that to be effective, feedback reports must be incorporated into a more ambitious continuous quality improvement program.

The Unexpected in Primary Care: A Multicenter Study on the Emergency of Unvoiced Patient Agenda
By Michael Peltenberg, M.D., F.A.A.F.P., et al
Collecting data from 2,243 patients in several European countries, researchers uncovered an "emerging agenda" in nearly one of every seven outpatient visits. The researchers describe an "emerging agenda" as unexpectedly revealed concerns or issues that were neither on the patient's list of items for discussion nor anticipated by the physician.

Lay Understanding of Familial Risk of Common Chronic Diseases: A Systematic Review and Synthesis of Qualitative Research
By Fiona M. Walter, M.A., M.Sc., F.R.C.G.P., et al
In a systematic review of 11 rese

Contact: Angela Lower
American Academy of Family Physicians

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