July/August 2005 Annals of Family Medicine tip sheet

to be done beyond clinical practices to work with patients on making healthy lifestyle changes.
Prehypertension and Cardiovascular Morbity
By Heather Liszka, M.D., et al
Prehypertension, Patient Outcomes, and the Knowledge Base of Family Medicine
By Lee Green, M.D., M.P.H.

Many persistently high users of primary care appear to be over-serviced but underserved, with underlying problems that can be better addressed by a non-medical approach. Analyzing outpatient visits of approximately 58,000 people to primary care physicians in a Midwestern city, the study finds that a small proportion of patients (2 percent) consume a large proportion of primary care visits (18 percent). Among these persistently high-use patients were a substantial number of patients with unstable chronic medical conditions who are candidates for disease management efforts. There also were a number of patients with illnesses involving both the mind and body who could benefit from psychosocial support. Nonmedical approaches, the authors assert, might better address these patients' underlying needs than our current medical system, which focuses on alleviating physical symptoms.
Predicting Persistently High Primary Care Use
By James M. Naessens, M.P.H., et al

Analyzing data from a 5-year longitudinal study of 122 diabetic adults, researchers found that the use of electronic medical records (EMR) did not lead to improved clinical outcomes. While EMR use was associated with an increased frequency of testing for long-term blood glucose control and bad cholesterol levels, it did not improve glucose control among diabetic patients, which is a predictor of future risk of complications and increased health care costs. The data suggests that despite substantia

Contact: Kristin Robinson
American Academy of Family Physicians

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