Measure Accurately, Act Rapidly, and Partner With Patients (MAP) improves hypertension control in medically underserved patients: Care Coordination Institute and American Medical Association Hypertension Control Project Pilot Study results.

Measure Accurately, Act Rapidly, and Partner With Patients (MAP) is an evidence-based protocol implemented to improve hypertension control in a clinic for underserved patients (49.9% Medicaid and 50.2% black). Patients with hypertension seen during the year before intervention and with at least one visit during the 6-month intervention (N = 714) were included. If initial attended blood pressure (BP; standard aneroid manometer) was ≥140/≥90 mm Hg, unattended automated office BP was measured in triplicate and averaged (Measure Accurately) using an Omron HEM-907XL. When automated office BP was ≥140/≥90 mm Hg, Act Rapidly included intensification of antihypertensive medications, assessed by therapeutic inertia. Partner With Patients included BP self-monitoring, reducing pill burden, and minimizing medication costs, which was assessed by systolic BP change per therapeutic intensification. Between baseline and the last study visit, BP control to <140/<90 mm Hg increased from 61.2% to 89.9% (P < .0001). MAP rapidly and significantly improved hypertension control in medically underserved patients, largely as a result of measuring BP accurately and partnering with patients.

Promoting resident scholarship through a statewide symposium.

BACKGROUND AND OBJECTIVES: Literature on integration and assessment of a research curriculum into family medicine residency training programs is limited. The objectives of this paper are to describe the development, implementation, and evaluation of a state-wide resident scholarship symposium. METHODS: In 2003, the South Carolina Area Health Education Consortium (SC AHEC) and residency program directors developed an annual resident scholarship symposium. Abstracts are submitted in the categories of case presentation, quality improvement, or clinical research. Subsequently, two half days are devoted to residents' presentation of their research, which is evaluated by a panel of three judges, and awards are given in each category. RESULTS: A total of 238 residents have presented 176 research projects. Fifteen projects have been presented during the Annual Spring Conference of the Society of Teachers of Family Medicine (STFM), seven projects have been presented during the Annual Meeting of the North American Primary Care Research Group (NAPCRG), and nine projects have been published in peer-reviewed journals. Resident evaluations have rated the conference overall as good to outstanding. CONCLUSIONS: A state-wide symposium has provided family medicine residents an opportunity to present their scholarly works to a larger audience and is associated with resident projects that have been presented or published on a national level.

Congenital infections and preconception counseling.

Given the risks of congenital infections, the frequent occurrence of unintended pregnancy, and the lack of prenatal care in the first trimester, physicians should seek opportunities to discuss immunizations and disease prevention with women of childbearing age. Discussions of the following topics would be beneficial: 1. Encourage women to seek medical care at the first missed period. 2. Discuss safe sex and abstinence for prevention of sexually transmitted diseases. (See "Clinical Prevention Guidelines" in the CDC's 1998 Guidelines for Treatment of Sexually Transmitted Diseases.) 3. Encourage early medical care for vaginal discharge, pelvic pain, or possible exposure to sexually transmitted diseases. 4. Encourage good handwashing, especially before and after handling food or changing diapers. 5. Encourage the use of universal precautions when exposed to body fluids or blood. 6. Educate the patient on the importance of cooking food thoroughly and avoiding raw meat and unpasteurized dairy products. 7. Ensure vaccination against hepatitis B, rubella, and varicella.