Ira B Wilson

..Nurse practitioners (NPs) and physician assistants (PAs) are primary care providers for patients with HIV in some clinics, but little is known about the quality of care that they provide...

..To determine whether a selected set of indicators can represent a single overall quality construct...

..To report rates of cost-related skipping of medications and other treatments, assess correlates of skipping, examine changes in skipping between 1998 and 2000, and identify factors associated with changes in skipping...

..Understanding and improving the quality of medication management is particularly important in the context of the Medicare prescription drug benefit that took effect last January 2006...

..Research that identifies relationships between the components (active ingredients) of an intervention and the outcomes of care will benefit future intervention strategies and contribute to improved and efficient care...

..The changing nature of HIV care has important implications for the types of physicians that can best care for patients with HIV infection...

..We examined differences in care received by HIV-infected women and men in a national sample of Ryan White CARE Act-funded clinics and explored the influence of clinic characteristics on care quality...

..We sought to assess the relationship between specialty training and expertise and the quality of care delivered to patients with HIV infection...

..We conclude that dose timing is also an important determinant of successful ART, and should be considered as an additional dimension to overall adherence...

..In an era marked by substantial national investment in quality monitoring, measures of these elements of care are notably absent from the nation's portfolio of quality indicators...

..Difficult-to-treat subgroups may benefit from pharmacists' care...

..In this prospective cohort study, we determined the relationship between human immunodeficiency virus (HIV) RNA load and body weight in patients with HIV infection...

..To determine the relationship between incident depression symptoms and suboptimal adherence to HIV highly active antiretroviral therapy (HAART)...

..CONCLUSION: In 1996 there were wide variations in rates of HAART use by site of care. Low-volume sites that do not specialize in HIV care should take measures to ensure that HIV expertise is available to their patients...

..Multi-institution collaborative quality improvement programs are a well-established and broadly applicable quality improvement strategy, but there is little systematic assessment their effectiveness...

..Providing education or experience-based exercises or ensuring that clinicians have adequate time to deal with complex problems might result in better attitudes and higher quality of care...

..Mean CD4 count rose by 90 cells/microl and declined by 9 cells/microl among intervention and control subjects, respectively. EDM feedback as a counseling tool appears promising for management of HIV and other chronic diseases...

..We evaluated insulin resistance (IR) in an HIV-infected cohort and compared our results with those of the National Health and Nutrition Examination Survey III (NHANES III)...

..Physicians' limited knowledge of patients' antiretroviral adherence may reduce their ability to perform effective adherence counseling...

..We discuss MMA's potential to improve quality and the need to monitor performance...

..The effect of depression on dietary intake has not, to our knowledge, been examined in persons with HIV infection...

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..Serum creatinine level may underestimate the prevalence of CKD in subjects with decreased lean body mass or liver disease. Level of serum cystatin C, an alternative kidney function marker, is independent of lean body mass...

..Good screeners for depression can also be good severity instruments. Exploiting screeners as severity instruments can significantly reduce response burden without sacrificing performance...

..Little information exists to inform beneficiaries' choices between the traditional fee-for-service (FFS) Medicare program and an HMO...

..With erosion of state and private sources of prescription benefits expected, the findings speak to the need for a national policy solution...

..We sought to assess whether participation in a quality-improvement collaborative changed care processes, systems, and organization of outpatient human immunodeficiency virus (HIV) clinics...

..We evaluated the association of host factors, disease severity, and ART to changes in total body bone mineral density (total BMD) over time in HIV-infected men (n = 283) and women (n = 96)...

..Here, we examine the relationship between inhaler-specific out-of-pocket costs and CRN in CPD...

..We conclude that 1-month recall periods may be more accurate than 3- or 7-day periods, and that items that ask respondents to rate their adherence may be more accurate than those that ask about frequencies or percents...

..In addition, our data suggest that it is critical to investigate and incorporate patients' belief systems about antiretroviral therapy into adherence discussions, and to identify and treat mental disorders...

..To compare oxandrolone (OX) or strength training with nutrition alone (NA) for AIDS wasting...

..We conclude with key questions for future research and methodologic recommendations...

..Partnerships between the allopathic and traditional/complementary health sectors in research, policy, and practice are essential in building comprehensive HIV/AIDS treatment strategies...

..Even among poorly educated, nongay male patients with insecure housing, rates of ingested CAM use were substantial. Physicians should routinely ask about ingested CAM therapy use and become knowledgeable about potential hazards...

..Little is known about HIV patients' care experiences...

..These potential benefits of requesting modifications need to be weighed against the possible risks of workplace disclosure...

..Even when HAART is being administered, clinicians should remain vigilant regarding weight loss, oral symptoms, and trouble swallowing...

..To develop and implement a method to evaluate the quality of medical interpretation in a pediatric outpatient setting and explore the patterns and correlates of errors and failures in translation...

..Researchers need valid methods to assess whether patients are taking their antidepressant medications. Two important sources of data on drug exposure are patients' self-reports and pharmacy claims...

..74). In conclusion, megestrol acetate therapy and oxandrolone therapy have similar effects on body weight and composition and are safe and well-tolerated during HAART...

..To assess the association of specialty training and experience in the care of HIV disease with HIV-specific knowledge, referral patterns, and HIV-related education activities...

..Though responses correlated with VL, single-item measures had higher correlations. Future studies should compare single-item questions to objective measures...

..For adherent patients, these adverse effects of HAART on PF are likely to be outweighed by the positive effects that HAART exerts through lowering VL and increasing CD4 counts...

..Despite near ubiquity of mobile phone technology in resource-limited settings, individual level collection of healthcare data presents challenges. Further research is needed for effective training and incentive methods...

..Throughput improvements occasioned by the hospitalist program with high baseline occupancy levels are substantial and tend to favor a hospitalist program...

..HIV care and service providers and policy makers in China responsible for HIV treatment should be aware of these important barriers to adherence...

..Investigators, clinicians, and health plans that want a DSM-IV-based depression screener can choose from among these three instruments, with known tradeoffs in sensitivity, respondent burden, and readability...

..It can be frustrating for doctors to discuss uncovered services with their patients, but open communication is necessary for shared decision making and to improve coverage decisions...

..We sought to assess which patient, physician, and organizational factors are related to voluntary physician switching among human immunodeficiency virus (HIV)-infected patients...

..Less is known about how physician gender and gender concordance affect care for chronic illnesses, including HIV...

..These findings indicate both advantages and disadvantages to having multiple clinicians. More effort should be devoted to facilitating coordination when multiple clinicians provide care...

..Current HIV treatment guidelines recommend delaying antiretroviral therapy for nonadherent patients, which some fear may disproportionately affect certain populations and contribute to disparities in care...

..Specifically, the three items reported here can be used to produce a reliable summary measure of physicians' manipulation of reimbursement rules to help patients obtain care that physicians perceive as necessary...

..Studies of such characteristics should report the organizational level reliability of the measures used...

..While this work focuses on adherence with ARVs for HIV disease, the GMIAS has been designed to be easily generalizable to other conditions and research problems in MD-PT communication. ..

..Third, because of the Tufts University Sackler School MS/PhD Program in Clinical Research there is an existing, successful training infrastructure that provides both trainees and junior faculty the opportunity to learn research skills. ..