Browsing by Author "Mac Kinnon, Joyce L."

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    Adherence With Home Exercise Programs 1-6 Months After Discharge From Physical Therapy By Individuals Post-Stroke
    (2008-10-10T17:10:22Z) Miller, Kristine Kay; Mac Kinnon, Joyce L.; Porter, Rebecca Elaine; Riolo, Lisa
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    Hospital Readmission and the Timing of Postdischarge Outpatient Follow-up
    (2011-03-09) Kashiwagi, Deanne Tomie; Mac Kinnon, Joyce L.; Kirkland, Lisa; Mushi-Brunt, Christina R.
    Postdischarge follow-up appointments are widely thought to improve the safety of transition for patients moving from the hospital to home. They provide an opportunity for outpatient primary care providers to detect problems or failures of postdischarge care. Readmissions can be used to reflect the quality of postdischarge or transitional care. This study evaluated whether patients with an outpatient follow-up appointment scheduled with their primary care provider within five calendar days of discharge had fewer 30-day readmissions than those patients who had appointments scheduled six days or longer from discharge. No difference in readmission rate was detected between the two groups.
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    THE IMPACT OF FIBROMYALGIA ON RESOURCE USE IN THE UK PRIMARY CARE SETTING
    (2008-10-10T18:19:38Z) Le, Trong Kim; Mac Kinnon, Joyce L.; Bayliss, Amy J.; Schellhase, Ellen
    Fibromyalgia (FMS) is a complex, chronic condition involving persistent and widespread pain of unknown origin. FMS is sometimes mistaken as psychiatric in origin; however, the precise origin and cause of FMS is unknown (Klippel et al., 1998). Worldwide prevalence rates range from 0.18-12%, with 0.18% in the United Kingdom (UK) (Hughes et al., 2006), 2% in the United States (US) (Wolfe et al., 1997), and 12% in Spain (Carmona et al., 2001). In the UK, there is debate over the existence of FMS (Bohr, 1995), and the reluctance of a general practitioner (GP) to diagnose conditions that are poorly defined (Hughes et al., 2006). Primary symptoms of FMS include generalized muscular pain, multiple tender points, sleep disruption and excessive fatigue. Additional symptoms include headaches, memory and concentration problems, dizziness, numbness/tingling, itching, fluid retention, abdominal cramps or pelvic pain and diarrhea (Hudson et al., 1992). Clearly, these symptoms may have an immense impact on daily life, limiting an individual’s functioning and emotional well-being. FMS is associated with significant societal and health care costs. Patients with FMS may repeatedly present to the general practitioner with various symptoms before a definitive diagnosis of FMS is made. As a result, general practitioners may be more likely to diagnose FMS in patients who frequently present with symptoms related to FMS, while patients who meet the diagnostic criteria but who rarely present at the practice may be missed (Ehrlich, 2003). The condition is of unknown etiology, and this, together with the lack of verifiable diagnostic criteria (i.e. lab tests), has led some to speculate that the disease does not or is at best a surrogate marker for underlying psychosocial problems. As such, the very process of diagnosing a patient with FMS may exacerbate symptoms and lead to increased dependence on health care providers (Ehrlich, 2003). This study examined the diagnoses of FMS made in “real-life” clinical practice and recorded by general practitioners in a large primary care population in the UK.
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    A retrospective descriptive study of pain scores in the pre-diabetic patients on metformin
    (2015-07-01) Moore, Michele Nakamura; Mushi, Christina R.; Ang, Dennis C.; Mac Kinnon, Joyce L.; Sturek, Michael S.; Arnold, Brent L.
    Objectives: The purpose was to evaluate pain scores (SF-36 BPS) among pre-diabetic patients on metformin or placebo to determine if patients on metformin therapy report less pain (higher SF-36 BPS) than patients on placebo. Study design: A descriptive retrospective review of pain scores was conducted using secondary data analyses of the Diabetes Prevention Program (DPP) and Diabetes Prevention Program Outcomes Study (DPPOS) conducted from 1996 to 2008. Patients were randomly assigned to placebo, low (850 mg/day) or high dose (1700 mg/day) metformin groups. Pain scores using the SF-36 BPS standard version were taken before randomization and annually (year one through four). Results: Out of 3,819 patients that participated in the original study, 1,056 patients met the current study criteria. The metformin group included 506 patients and the placebo group included 550 patients. With an alpha level of 0.05 for all analyses, baseline pain scores between the metformin group and placebo group showed no significant difference. Year two showed significance between placebo and metformin pain scores (75.2 vs 78.6). All other years were not significant. Comparing low and high dose metformin and placebo groups, years one, two and three displayed significant differences in pain scores. In years one and two, the high dose metformin group reported less pain than the placebo group (80.7 vs 77.7; 80.1 vs 75.2) and the low dose metformin group (80.7 vs 71.8; 80.1 vs 68.6). In year three, the high dose metformin group had less pain than the low dose metformin group (78.4 vs 70.5).