Published in JAMA on October 09, 2002
Continuing Care Following Drug Abuse Treatment: Linkage With Primary Care (Linkage) | NCT01621711
Effectiveness of Shared Care Diabetes Management in Patients With Type 2 Diabetes | NCT04100278
Effectiveness of SCDM in Patients With Type 2 Diabetes (ESCDM) | NCT04259489
Prevalence of multimorbidity among adults seen in family practice. Ann Fam Med (2005) 9.01
Evidence on the Chronic Care Model in the new millennium. Health Aff (Millwood) (2009) 8.60
Initial lessons from the first national demonstration project on practice transformation to a patient-centered medical home. Ann Fam Med (2009) 6.49
Adoption, non-adoption, and abandonment of a personal electronic health record: case study of HealthSpace. BMJ (2010) 5.79
Physician and pharmacist collaboration to improve blood pressure control. Arch Intern Med (2009) 5.75
ADHD: clinical practice guideline for the diagnosis, evaluation, and treatment of attention-deficit/hyperactivity disorder in children and adolescents. Pediatrics (2011) 5.46
Comorbidity: implications for the importance of primary care in 'case' management. Ann Fam Med (2004) 5.16
A meta-analysis of interventions to improve care for chronic illnesses. Am J Manag Care (2005) 5.10
The break-even point: when medical advances are less important than improving the fidelity with which they are delivered. Ann Fam Med (2005) 3.84
Web-based collaborative care for type 2 diabetes: a pilot randomized trial. Diabetes Care (2008) 3.66
Risk communication in practice: the contribution of decision aids. BMJ (2003) 3.55
Effect of home blood pressure telemonitoring and pharmacist management on blood pressure control: a cluster randomized clinical trial. JAMA (2013) 3.55
The ambulatory long-block: an accreditation council for graduate medical education (ACGME) educational innovations project (EIP). J Gen Intern Med (2008) 3.51
Assessing the implementation of the chronic care model in quality improvement collaboratives. Health Serv Res (2005) 3.51
Patients' experience with a diabetes support programme based on an interactive electronic medical record: qualitative study. BMJ (2004) 3.44
Rethinking management of chronic diseases. BMJ (2004) 3.32
Clinical outcomes and adherence to medications measured by claims data in patients with diabetes. Diabetes Care (2004) 3.31
The future of general internal medicine. Report and recommendations from the Society of General Internal Medicine (SGIM) Task Force on the Domain of General Internal Medicine. J Gen Intern Med (2004) 3.19
Systematic review and meta-analysis of practice facilitation within primary care settings. Ann Fam Med (2012) 3.10
Overtreating chronic back pain: time to back off? J Am Board Fam Med (2009) 3.00
Children with medical complexity: an emerging population for clinical and research initiatives. Pediatrics (2011) 2.88
A qualitative study of GPs' attitudes to self-management of chronic disease. Br J Gen Pract (2006) 2.57
Practice-linked online personal health records for type 2 diabetes mellitus: a randomized controlled trial. Arch Intern Med (2008) 2.47
Methods for evaluating practice change toward a patient-centered medical home. Ann Fam Med (2010) 2.41
Chronic care management for dependence on alcohol and other drugs: the AHEAD randomized trial. JAMA (2013) 2.36
Tracking diabetes: New York City's A1C Registry. Milbank Q (2009) 2.34
Prevention of acute exacerbations of COPD: American College of Chest Physicians and Canadian Thoracic Society Guideline. Chest (2015) 2.32
A shared treatment decision-making approach between patients with chronic conditions and their clinicians: the case of diabetes. Health Expect (2006) 2.30
Chronic illness, comorbidities, and the need for medical generalism. Ann Fam Med (2004) 2.23
Improved outcomes in a quality improvement collaborative for pediatric inflammatory bowel disease. Pediatrics (2012) 2.16
The cost-effectiveness of improving diabetes care in U.S. federally qualified community health centers. Health Serv Res (2007) 2.09
Care for chronic diseases. BMJ (2002) 2.05
The chronic care model and diabetes management in US primary care settings: a systematic review. Prev Chronic Dis (2013) 2.05
The Vermont Diabetes Information System (VDIS): study design and subject recruitment for a cluster randomized trial of a decision support system in a regional sample of primary care practices. Clin Trials (2004) 2.05
Design and implementation of a web-based patient portal linked to an ambulatory care electronic health record: patient gateway for diabetes collaborative care. Diabetes Technol Ther (2006) 2.02
Challenges of change: a qualitative study of chronic care model implementation. Ann Fam Med (2006) 1.98
Integrated Theory of Health Behavior Change: background and intervention development. Clin Nurse Spec (2009) 1.94
Audit-based education lowers systolic blood pressure in chronic kidney disease: the Quality Improvement in CKD (QICKD) trial results. Kidney Int (2013) 1.90
The contribution of teleconsultation and videoconferencing to diabetes care: a systematic literature review. J Med Internet Res (2007) 1.90
Improving medical practice: a conceptual framework. Ann Fam Med (2007) 1.84
A national profile of caregiver challenges among more medically complex children with special health care needs. Arch Pediatr Adolesc Med (2011) 1.83
Bridging the inferential gap: the electronic health record and clinical evidence. Health Aff (Millwood) (2007) 1.81
Common elements in self-management of HIV and other chronic illnesses: an integrative framework. AIDS Care (2009) 1.81
Primary care in the United States. Innovations in primary care in the United States. BMJ (2003) 1.80
The Individual and Family Self-Management Theory: background and perspectives on context, process, and outcomes. Nurs Outlook (2009) 1.76
A four phase development model for integrated care services in the Netherlands. BMC Health Serv Res (2009) 1.75
Recovery capital as prospective predictor of sustained recovery, life satisfaction, and stress among former poly-substance users. Subst Use Misuse (2008) 1.73
Primary care practice transformation is hard work: insights from a 15-year developmental program of research. Med Care (2011) 1.72
Rethinking prevention in primary care: applying the chronic care model to address health risk behaviors. Milbank Q (2007) 1.70
Stakeholder validation of a model of readiness for transition to adult care. JAMA Pediatr (2013) 1.67
Patient-centered medical home and diabetes. Diabetes Care (2011) 1.66
Hospital-physician collaboration: landscape of economic integration and impact on clinical integration. Milbank Q (2008) 1.66
A meta-analysis of health status, health behaviors, and healthcare utilization outcomes of the Chronic Disease Self-Management Program. Prev Chronic Dis (2013) 1.66
Counseling African Americans to Control Hypertension: cluster-randomized clinical trial main effects. Circulation (2014) 1.65
Access to mobile communication technology and willingness to participate in automated telemedicine calls among chronically ill patients in Honduras. Telemed J E Health (2010) 1.65
The effects of guided care on the perceived quality of health care for multi-morbid older persons: 18-month outcomes from a cluster-randomized controlled trial. J Gen Intern Med (2009) 1.64
The cost consequences of improving diabetes care: the community health center experience. Jt Comm J Qual Patient Saf (2008) 1.62
Effects of a Web-based intervention for adults with chronic conditions on patient activation: online randomized controlled trial. J Med Internet Res (2012) 1.62
Patients' online access to their electronic health records and linked online services: a systematic interpretative review. BMJ Open (2014) 1.61
The hypertension team: the role of the pharmacist, nurse, and teamwork in hypertension therapy. J Clin Hypertens (Greenwich) (2011) 1.60
Optimizing practice through research: a new perspective to solve an old problem. Ann Fam Med (2008) 1.60
A primary care, multi-disciplinary disease management program for opioid-treated patients with chronic non-cancer pain and a high burden of psychiatric comorbidity. BMC Health Serv Res (2005) 1.58
A practical randomized trial to improve diabetes care. J Gen Intern Med (2004) 1.57
Assessing health centre systems for guiding improvement in diabetes care. BMC Health Serv Res (2005) 1.53
Assessing the evolution of primary healthcare organizations and their performance (2005-2010) in two regions of Québec province: Montréal and Montérégie. BMC Fam Pract (2010) 1.53
How can the practice nurse be more involved in the care of the chronically ill? The perspectives of GPs, patients and practice nurses. BMC Fam Pract (2006) 1.47
Where is the patient in diabetes performance measures? The case for including patient-centered and self-management measures. Diabetes Care (2008) 1.47
Two complementary personal medication management applications developed on a common platform: case report. J Med Internet Res (2011) 1.47
A comparison of phenotype definitions for diabetes mellitus. J Am Med Inform Assoc (2013) 1.47
Multidisciplinary group clinic appointments: the Self-Management and Care of Heart Failure (SMAC-HF) trial. Circ Heart Fail (2014) 1.46
A system-wide intervention to improve HIV testing in the Veterans Health Administration. J Gen Intern Med (2008) 1.46
Impact of generalist care managers on patients with diabetes. Health Serv Res (2005) 1.46
Challenges in diabetes management with particular reference to India. Int J Diabetes Dev Ctries (2009) 1.45
Recognizing the diverse roles of community health workers in the elimination of health disparities: from paid staff to volunteers. Ethn Dis (2010) 1.45
Being uninsured is bad for your health: can medical homes play a role in treating the uninsurance ailment? Ann Fam Med (2013) 1.45
The relationship between neighborhood characteristics and self-rated health for adults with chronic conditions. Am J Public Health (2007) 1.45
Care quality and implementation of the chronic care model: a quantitative study. Ann Fam Med (2006) 1.44
Study protocol: national research partnership to improve primary health care performance and outcomes for Indigenous peoples. BMC Health Serv Res (2010) 1.43
Identification of asthmatic children using prescription data and diagnosis. Eur J Clin Pharmacol (2007) 1.43
Transforming medical professionalism to fit changing health needs. BMC Med (2009) 1.41
Online disease management of diabetes: engaging and motivating patients online with enhanced resources-diabetes (EMPOWER-D), a randomized controlled trial. J Am Med Inform Assoc (2012) 1.41
Improvement in the diagnostic evaluation of a positive fecal occult blood test in an integrated health care organization. Med Care (2008) 1.37
The case for chronic disease management for addiction. J Addict Med (2008) 1.36
The empirical foundations of telemedicine interventions for chronic disease management. Telemed J E Health (2014) 1.34
Organizational interventions employing principles of complexity science have improved outcomes for patients with Type II diabetes. Implement Sci (2007) 1.34
Getting in step: electronic health records and their role in care coordination. J Gen Intern Med (2010) 1.33
Organizational culture and physician satisfaction with dimensions of group practice. Health Serv Res (2007) 1.32
The Vermont diabetes information system: a cluster randomized trial of a population based decision support system. J Gen Intern Med (2009) 1.32
Applying the chronic care model to homeless veterans: effect of a population approach to primary care on utilization and clinical outcomes. Am J Public Health (2010) 1.32
Interval examination: the ambulatory long block. J Gen Intern Med (2010) 1.32
Web-based collaborative care for type 1 diabetes: a pilot randomized trial. Diabetes Technol Ther (2009) 1.31
How is shared decision-making defined among African-Americans with diabetes? Patient Educ Couns (2008) 1.30
Study protocol: Audit and Best Practice for Chronic Disease Extension (ABCDE) Project. BMC Health Serv Res (2008) 1.30
The complex web of health: relationships among chronic conditions, disability, and health services. Public Health Rep (2011) 1.30
Cardiac rehabilitation exercise and self-care for chronic heart failure. JACC Heart Fail (2013) 1.30
Persistence and determinants of statin therapy among middle-aged patients for primary and secondary prevention. Br J Clin Pharmacol (2005) 1.29
Adult obesity and office-based quality of care in the United States. Obesity (Silver Spring) (2009) 1.29
Cultural translation of interventions: diabetes care in American Samoa. Am J Public Health (2010) 1.29
Implementing and evaluating a regional strategy to improve testing rates in VA patients at risk for HIV, utilizing the QUERI process as a guiding framework: QUERI Series. Implement Sci (2008) 1.27
Improving primary care for patients with chronic illness: the chronic care model, Part 2. JAMA (2002) 19.28
Patient self-management of chronic disease in primary care. JAMA (2002) 17.35
Association of health literacy with diabetes outcomes. JAMA (2002) 14.21
Closing the loop: physician communication with diabetic patients who have low health literacy. Arch Intern Med (2003) 8.76
Evidence on the Chronic Care Model in the new millennium. Health Aff (Millwood) (2009) 8.60
Development and validation of the Patient Assessment of Chronic Illness Care (PACIC). Med Care (2005) 5.75
Improving timely access to primary care: case studies of the advanced access model. JAMA (2003) 5.36
Assessment of chronic illness care (ACIC): a practical tool to measure quality improvement. Health Serv Res (2002) 5.10
A lifeline for primary care. N Engl J Med (2009) 4.46
Electronic technology: a spark to revitalize primary care? JAMA (2003) 4.03
Effects of limited English proficiency and physician language on health care comprehension. J Gen Intern Med (2005) 3.84
Chronic illness management: what is the role of primary care?. Ann Intern Med (2003) 3.60
Building a virtual cancer research organization. J Natl Cancer Inst Monogr (2005) 3.60
Physician language ability and cultural competence. An exploratory study of communication with Spanish-speaking patients. J Gen Intern Med (2004) 3.46
Recommendations for intrauterine contraception: a randomized trial of the effects of patients' race/ethnicity and socioeconomic status. Am J Obstet Gynecol (2010) 3.18
Self-management aspects of the improving chronic illness care breakthrough series: implementation with diabetes and heart failure teams. Ann Behav Med (2002) 3.15
Are Time-Limited Grants Likely to Stimulate Sustained Growth in Primary Care Residency Training? A Study of the Primary Care Residency Expansion Program. Acad Med (2015) 2.59
How health care systems can begin to address the challenge of limited literacy. J Gen Intern Med (2006) 2.46
Integrating abortion training into family medicine residency programs. Fam Med (2007) 2.39
Shared decision making and the experience of partnership in primary care. Ann Fam Med (2006) 2.25
Self-management: Enabling and empowering patients living with cancer as a chronic illness. CA Cancer J Clin (2011) 2.24
System-based participatory research in health care: an approach for sustainable translational research and quality improvement. Ann Fam Med (2010) 2.24
Chronic illness, comorbidities, and the need for medical generalism. Ann Fam Med (2004) 2.23
A descriptive analysis of abortion training in family medicine residency programs. Fam Med (2007) 2.23
Risk of heart failure in breast cancer patients after anthracycline and trastuzumab treatment: a retrospective cohort study. J Natl Cancer Inst (2012) 2.21
Cross-cultural education in U.S. medical schools: development of an assessment tool. Acad Med (2003) 2.21
The effect of health insurance on medical care utilization and implications for insurance expansion: a review of the literature. Med Care Res Rev (2005) 2.11
Estimating a reasonable patient panel size for primary care physicians with team-based task delegation. Ann Fam Med (2012) 2.10
Care for chronic diseases. BMJ (2002) 2.05
Effects of provider practice on functional independence in older adults. J Am Geriatr Soc (2004) 1.97
Understanding high-quality cancer care: a summary of expert perspectives. Cancer (2008) 1.97
Comprehensive health care for people infected with HIV in developing countries. BMJ (2002) 1.81
The 10 building blocks of high-performing primary care. Ann Fam Med (2014) 1.75
Racial differences in tumor stage and survival for colorectal cancer in an insured population. Cancer (2007) 1.71
Women in medicine: a four-nation comparison. J Am Med Womens Assoc (2002) 1.71
Treatment adjustment and medication adherence for complex patients with diabetes, heart disease, and depression: a randomized controlled trial. Ann Fam Med (2012) 1.61
Untangling practice redesign from disease management: how do we best care for the chronically ill? Annu Rev Public Health (2009) 1.61
Transform residency training in chronic illness care -- now. Acad Med (2006) 1.60
No exit: an evaluation of measures of physician attrition. Health Serv Res (2004) 1.59
Primary care delivery is associated with greater physician experience and improved survival among persons with AIDS. J Gen Intern Med (2003) 1.56
Quality of integrated chronic care measured by patient survey: identification, selection and application of most appropriate instruments. Health Expect (2009) 1.55
Community exercise program use and changes in healthcare costs for older adults. Am J Prev Med (2003) 1.50
Impact of the University of California, Los Angeles/Charles R. Drew University Medical Education Program on medical students' intentions to practice in underserved areas. Acad Med (2005) 1.48
Specialists, technology, and newborns--too much of a good thing. N Engl J Med (2002) 1.45
Does having more physicians lead to better health system performance? JAMA (2008) 1.45
Primary care, generalism, public good: déjà vu? Again! Ann Intern Med (2005) 1.45
Practice profile. A safety-net system gains efficiencies through 'eReferrals' to specialists. Health Aff (Millwood) (2010) 1.42
Multipayer patient-centered medical home implementation guided by the chronic care model. Jt Comm J Qual Patient Saf (2011) 1.41
The primary care extension program: a catalyst for change. Ann Fam Med (2013) 1.34
A multisite randomized trial of the effects of physician education and organizational change in chronic-asthma care: health outcomes of the Pediatric Asthma Care Patient Outcomes Research Team II Study. Arch Pediatr Adolesc Med (2004) 1.30
Chronic disease care. BMJ (2004) 1.28
Effect of part-time practice on patient outcomes. J Gen Intern Med (2003) 1.25
Applying depression-specific change concepts in a collaborative breakthrough series. Jt Comm J Qual Patient Saf (2005) 1.23
Measuring and improving performance in multicenter research consortia. J Natl Cancer Inst Monogr (2005) 1.23
Improving modern cancer care through information technology. Am J Prev Med (2011) 1.19
Are continuity of care and teamwork incompatible? Med Care (2007) 1.17
The role of medical education in reducing health care disparities: the first ten years of the UCLA/Drew Medical Education Program. J Gen Intern Med (2007) 1.16
High quality care for people with chronic diseases. BMJ (2005) 1.15
Integrating community health centers into organized delivery systems can improve access to subspecialty care. Health Aff (Millwood) (2012) 1.15
Outcomes of a community-based dissemination of the health enhancement program. J Am Geriatr Soc (2002) 1.11
Deconstructing heart failure disease management. Ann Intern Med (2004) 1.11
Twelve evidence-based principles for implementing self-management support in primary care. Jt Comm J Qual Patient Saf (2010) 1.10
Impact of Title VII training programs on community health center staffing and national health service corps participation. Ann Fam Med (2008) 1.10
Effective teamwork and quality of care. Med Care (2004) 1.09
Clinical and sociodemographic factors associated with colon surveillance among patients with a history of colorectal cancer. Gastrointest Endosc (2004) 1.09
Women's preferences for contraceptive counseling and decision making. Contraception (2012) 1.08
Access to Spanish-speaking physicians in California: supply, insurance, or both. J Am Board Fam Pract (2004) 1.08
Trends in physician participation in Medicaid. The California experience. J Ambul Care Manage (2003) 1.08
Developing measures of educational change for academic health care teams implementing the chronic care model in teaching practices. J Gen Intern Med (2010) 1.07
Educational and individual factors associated with positive change in and reaffirmation of medical students' intention to practice in underserved areas. Acad Med (2014) 1.06
Medical student, physician, and public perceptions of health care disparities. Fam Med (2004) 1.05
Accuracy and complexities of using automated clinical data for capturing chemotherapy administrations: implications for future research. Med Care (2009) 1.03
Physician organization and care management in California: from cottage to Kaiser. Health Aff (Millwood) (2004) 1.03
Diffusion of aromatase inhibitors for breast cancer therapy between 1996 and 2003 in the Cancer Research Network. Breast Cancer Res Treat (2007) 1.02
Foreign versus domestic education of physicians for the United States: a case study of physicians of South Asian ethnicity in California. J Health Care Poor Underserved (2007) 1.02
A state-level application of the chronic illness breakthrough series: results from two collaboratives on diabetes in Washington State. Jt Comm J Qual Saf (2004) 1.02
Performance of claims-based algorithms for identifying heart failure and cardiomyopathy among patients diagnosed with breast cancer. Med Care (2014) 1.01
The emerging primary care workforce: preliminary observations from the primary care team: learning from effective ambulatory practices project. Acad Med (2013) 1.01
Is the use of benzodiazepines associated with incident disability? J Am Geriatr Soc (2002) 1.00
Practice-level effects of interventions to improve asthma care in primary care settings: the Pediatric Asthma Care Patient Outcomes Research Team. Health Serv Res (2005) 1.00
Medical liability insurance as a barrier to the provision of abortion services in family medicine. Am J Public Health (2008) 1.00
A comparison of how generalists and fellowship-trained geriatricians provide "geriatric" care. J Am Geriatr Soc (2008) 0.98
The association among specialty, race, ethnicity, and practice location among California physicians in diverse specialties. J Natl Med Assoc (2012) 0.98
An oncology nurse navigator program designed to eliminate gaps in early cancer care. Clin J Oncol Nurs (2013) 0.97
Quality of care for patients with type 2 diabetes mellitus in the Netherlands and the United States: a comparison of two quality improvement programs. Health Serv Res (2004) 0.96
Specialty choice and practice location of physician alumni of University of California premedical postbaccalaureate programs. Acad Med (2012) 0.95
Effect of socioeconomic factors on long-term mortality in men with clinically localized prostate cancer. Urology (2009) 0.95
Patient perceptions of integrated care: confused by the term, clear on the concept. Int J Integr Care (2013) 0.94
Team structure and culture are associated with lower burnout in primary care. J Am Board Fam Med (2014) 0.93
Strengthening primary care with better transfer of information. CMAJ (2008) 0.93
The safety net medical home initiative: transforming care for vulnerable populations. Med Care (2014) 0.92
The multi-stakeholder movement for primary care renewal and reform. Health Aff (Millwood) (2010) 0.92
The future of generalism in medicine. Ann Intern Med (2005) 0.91
How leaky is the health career pipeline? Minority student achievement in college gateway courses. Acad Med (2009) 0.91
Do physicians with self-reported non-English fluency practice in linguistically disadvantaged communities? J Gen Intern Med (2010) 0.90
Integrating public health and primary care systems: potential strategies from an IOM report. JAMA (2012) 0.90
The effect of patient gynecologic history on clinician contraceptive counseling. Contraception (2010) 0.90
Group medical visits for low-income women with chronic disease: a feasibility study. J Womens Health (Larchmt) (2004) 0.87
Perspectives of cancer survivors on the role of different healthcare providers in an integrated delivery system. J Cancer Surviv (2013) 0.87