1 40 2 Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. URL Address <a href="http://doi.org/10.1097/00124743-200010000-00004" target="_blank" rel="noreferrer noopener">http://doi.org/10.1097/00124743-200010000-00004</a> Rights Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s). Pages 258-265 Issue 5 Volume 6 Search for Full-text Locate full-text within NEOMED Library's e-journal collections <p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Guidelines for monitoring of NSAIDS - Who listened? Publisher An entity responsible for making the resource available Jcr-Journal of Clinical Rheumatology Date A point or period of time associated with an event in the lifecycle of the resource 2000 2000-10 Subject The topic of the resource complications; drugs; guidelines; laboratory monitoring; nonsteroidal antiinflammatory drugs; Rheumatology Creator An entity primarily responsible for making the resource Rothenberg R J; Holcomb J P Description An account of the resource The side effects of nonsteroidal anti-inflammatory drugs (NSAID) include problems involving peptic ulceration, renal function, and. liver disease. Publications have stressed the need to monitor patients for these problems and the rheumatology community across the country has echoed these concerns in continuing education activities to physicians over the years. The American College of Rheumatology (ACR) disseminated recommendations for nonsteroidal anti-inflammatory drugs (NSAID) monitoring in rheumatoid arthritis (RA) patients. We used this as an example of expert opinion for monitoring of NSAID and compared it with the frequency of monitoring by primary care physicians using NSAID for various diseases. We asked whether the rheumatology community's efforts were successful over time to enhance NSAID monitoring by primary care physicians. Physicians across the United States, using a computerized medical record, allowed data to be extracted from their medical practices. Dates of NSAID prescriptions and laboratory test monitoring for any diagnosis were analyzed. Those tests included a CBC, hepatic panel, and renal tests. The frequency of baseline tests performed within 3 months before starting a NSAID by internists was 30% compared with 6% by family practitioners in private practice and 1% in academic family practice centers before publication of the ACR guideline. After dissemination of the guidelines in 1996, the frequency of baseline testing by these groups was lower. Follow-up monitoring within 3 months of starting a NSAID was also low (24, 3, and 2% respectively) and did not improve after ACR guideline publication. Publication and dissemination of the ACR guidelines, and other efforts, did not improve rates of monitoring. The rheumatology community needs to re-evaluate the effectiveness of programs that teach safe use of rheumatologic medications by primary care physicians. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1097/00124743-200010000-00004" target="_blank" rel="noreferrer noopener">10.1097/00124743-200010000-00004</a> Format The file format, physical medium, or dimensions of the resource Journal Article 2000 complications Drugs guidelines Holcomb J P Jcr-Journal of Clinical Rheumatology Journal Article laboratory monitoring nonsteroidal antiinflammatory drugs Rheumatology Rothenberg R J Text A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text. URL Address <a href="http://doi.org/10.1385/jcd:5:4:375" target="_blank" rel="noreferrer noopener">http://doi.org/10.1385/jcd:5:4:375</a> Rights Article information provided for research and reference use only. All rights are retained by the journal listed under publisher and/or the creator(s). Pages 375-381 Issue 4 Volume 5 Search for Full-text Locate full-text within NEOMED Library's e-journal collections <p>Users with a NEOMED Library login can search for full-text journal articles at the following url: <a href="https://libraryguides.neomed.edu/home">https://libraryguides.neomed.edu/home</a></p> Dublin Core The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/. Title A name given to the resource Physician treatment of osteoporosis in response to heel ultrasound bone mineral density reports Publisher An entity responsible for making the resource available Journal of Clinical Densitometry Date A point or period of time associated with an event in the lifecycle of the resource 2002 2002 Subject The topic of the resource treatment; osteoporosis; management; Endocrinology & Metabolism; classification; postmenopausal women; quantitative ultrasound; bone density report; densitometry; heel ultrasound; hip fracture Creator An entity primarily responsible for making the resource Boyd J L; Holcomb J P; Rothenberg R J Description An account of the resource Optimal information that should be included in ultrasound (US) heel bone mineral density (BMD) reports is not known. If additional information about further evaluation of patients with low heel BMD were included in reports, would responses for treatment improve? We screened people at health fairs using the Sahara heel US machine. For those with a T-score of less than or equal to -1.0, letters were sent to their primary care physician notifying them of the result. Physicians were randomly assigned to (1) a standard letter, which recommended central bone density screening (dual X-ray absorptiometry [DXA]) and treatment if the BMD was low; or (2) an extended letter, which also outlined treatment strategies based on recommended subsequent central DXA scan results for a T-score of <-1.50 and also if < -2.00. The extended letter only increased the frequency of DXA testing from 30.1 to 37.2% (not a significant increase). Of 88 people with heel BMD: less than or equal to -1.00 and not previously on any treatment, 25 of 45 (56%) were treated (calcium, estrogens, bisphosphonates, or calcitonin or a combination) after physicians received a standard letter and 30 of 43 (70%) after an extended letter (one-sided p = 0.084). Of people with T less than or equal to -1.9, and initially taking nothing more than calcium, 5 of 36 (13.9%) received additional treatment after physicians received a standard letter vs 9 of 41 (22.0%) after an extended letter (one-sided p = 0.180). For those with T less than or equal to -1.0 because of the screen 25 of 197 (12.7%) received additional treatment. One hundred forty-six of 194 (75%) individuals and received treatment with calcium or other medications, and 74 of 173 (43%) of individuals before screening and 141 of 195 (72%) after physicians received letters took calcium. Physicians regarded calcium alone as adequate treatment in many cases. There was no marked increase in treatment when additional information was provided to physicians regarding evaluation and treatment for low US heel BMD results. Identifier An unambiguous reference to the resource within a given context <a href="http://doi.org/10.1385/jcd:5:4:375" target="_blank" rel="noreferrer noopener">10.1385/jcd:5:4:375</a> Format The file format, physical medium, or dimensions of the resource Journal Article or Conference Abstract Publication 2002 bone density report Boyd J L classification Densitometry Endocrinology & Metabolism heel ultrasound hip fracture Holcomb J P Journal Article or Conference Abstract Publication Journal of Clinical Densitometry Management Osteoporosis postmenopausal women quantitative ultrasound Rothenberg R J Treatment