May/June 2006 Annals of Family Medicine Tip Sheet

es, location of physician training and processes by which physicians determine and negotiate patient and family preferences regarding care.
A Cross-Cultural Study of Physician Treatment Decisions for Demented Nursing Home Patients Who Develop Pneumonia
By Margaret R. Helton, M.D., et al

Patients with familial hypercholesterolemia, a genetic disease characterized by high cholesterol and early cardiovascular disease, use a two-step process to develop a personal sense of vulnerability to coronary heart disease. In this qualitative study of 40 patients, participants first consulted their family history to assess their genetic and inherited risk and then negotiated a personal sense of vulnerability through comparisons between themselves and family members. Frich and colleagues assert that in order for physicians to individualize their clinical management of patients, they should determine the patient's understanding of their family history and their personal vulnerability.
Perceived Vulnerability to Heart Disease in Patients with Familial Hypercholesterolemia: A Qualitative Interview Study
By Jan C. Frich, M.D., M.Sc., et al

The use of inhaled corticosteroids (ICSs) for treatment of patients with moderate to severe chronic obstructive pulmonary disease (COPD) is effective in improving health outcomes. COPD is one of the leading causes of morbidity and mortality worldwide and the beneficial effect of ICS for treatment remains controversial. This systematic review finds that COPD patients treated with ICSs experienced 33 percent fewer exa

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American Academy of Family Physicians

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