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L A Becker

Publications and source records attributed to L A Becker.

43 records · Page 3Linked to original sources
PubMed1979

Digoxin-prescribing. Mostly good news.

We examined digoxin-prescribing in 47,000 prescriptions written predominantly by physicians in a large family medicine practice. Two hundred fifty-four patients received 511 digoxin prescriptions. Dose adjustments for age (16% decrease in patients older than 64 years), for renal disease (33% decrease), and for atrial fibrillation (39% increase) followed good prescribing practices. Appropriately lower loading doses were used for digitalization. However, despite continuing concern over the bioavailability of generic digoxin tablets, less than 40% of digoxin prescriptions in this study were written for the innovator's brand-name product (Lanoxin).

Adult↗
PubMed1979

Low back pain in family practice: a case control study.

Eighty-three women between the ages of 25 and 44 years who presented with low back pain during a one-year period were compared with a control group of women matched by age and socioeconomic status. The patients with low back pain presented a larger number of problems to their family physicians during the course of the year, but there were no significant differences noted in the prevalence of symptoms of anxiety and depression during their visits, or in the number of psychological problems presented by the two groups, or in the number of psychoactive medications received for problems other than low back pain. The results suggest that low back pain patients may represent a group who more readily present their symptoms to physicians but that they are no more likely to have psychological problems than similar patients who do not have low back pain.

Adult↗
PubMedDate not supplied

Ecological analysis of an intervention study of smoking cessation in medical practices.

This study began as an investigation of the feasibility of a brief, multifaceted primary care smoking cessation intervention in two primary care medical settings. When the investigators experienced a series of problems and setbacks in implementing the protocol in both settings, they turned their attention to the ecological disturbances created in the health care settings when outside researchers intervened. This paper analyzes the interaction patterns that complicated the research enterprise, particularly the triangles among the research team, the nurses, and the physicians. It also describes steps taken by the research team to deal with these ecological/systems problems. The authors raise these issues to help other researchers who encounter similar problems in community-based research, problems which are rarely discussed in the research literature.

Cooperative Behavior↗
PubMedDate not supplied

Pelvic inflammatory disease in primary care.

The Ambulatory Sentinel Practice Network (ASPN) conducted an observational study of pelvic inflammatory disease (PID) in the primary care setting. During 14 months from 1982 to 1983, 38 practices in 16 states and two Canadian provinces reported 384 first visits for patients with PID. PID, as diagnosed by the clinicians in ASPN, was less severe than other published clinical descriptions of PID. Fewer patients had fever, palpable adnexal masses, and extensive tenderness than reported in other series. Although 43% of patients met published recommendations for hospitalization, the clinicians hospitalized only 9% on the initial visit, similar to the hospitalization rate by office gynecologists in a national study. Whether this management represented optimal care in the primary care setting is unknown. If office based physicians in the United States admitted to the hospital all PID patients who met current recommendations for hospitalization, the added annual cost could exceed $1.2 billion. Given both the serious clinical consequences of PID and the enormous financial implications of different clinical strategies, there is a compelling need to investigate the diagnosis and management of PID in primary care.

Adult↗