Showing papers by "Seth A. Berkowitz published in 2012"
TL;DR: Physician skills such as communication, professionalism, behavior change, and self-care are not innate abilities, but teachable and learnable skills which can benefit patients and can be done effectively with case management and telemonitoring strategies.
Abstract: PURPOSE OF REVIEW Behavioral medicine is a vast field with an ever-increasing knowledge base. We review important findings over the last 18 months. RECENT FINDINGS We organized advances in behavioral medicine into four main topic areas: the doctor and patient, health-related behavior, integration of behavioral medicine in primary care, and teaching and assessing behavioral medicine competencies in primary care. Section I reviews research on difficult encounters, delivering bad and sad news, and physician well being. Section II examines improvements in the treatment of obesity and tobacco abuse, as well as interventions which boost adherence. Section III discusses advancements in care management and collaborative care in the USA and resource-constrained settings. Finally, section IV deals with teaching and assessing communication skills, behavior change, and professionalism. SUMMARY Physician skills such as communication, professionalism, behavior change, and self-care are not innate abilities, but teachable and learnable skills. Collaborative care and the integration of behavioral medicine with care for other conditions can benefit patients, and can be done effectively with case management and telemonitoring strategies. Future behavioral medicine research should include evaluation of implementation strategies so that we may incorporate principles of behavioral medicine more widely into clinical practice.
15 citations
TL;DR: In patients both with and without a personal history of depression, having a vicarious experience (family and friend, respectively) with depression is associated with a more favorable attitude towards antidepressant medications.
Abstract: Author(s): Berkowitz, Seth A; Bell, Robert A; Kravitz, Richard L; Feldman, Mitchell D | Abstract: PurposeDepression is common in primary care but often under-treated. Personal experiences with depression can affect adherence to therapy, but the effect of vicarious experience is unstudied. We sought to evaluate the association between a patient's vicarious experiences with depression (those of friends or family) and treatment preferences for depressive symptoms.MethodsWe sampled 1054 English and/or Spanish speaking adult subjects from July through December 2008, randomly selected from the 2008 California Behavioral Risk Factor Survey System, regarding depressive symptoms and treatment preferences. We then constructed a unidimensional scale using item analysis that reflects attitudes about antidepressant pharmacotherapy. This became the dependent variable in linear regression analyses to examine the association between vicarious experiences and treatment preferences for depressive symptoms.ResultsOur sample was 68% female, 91% white, and 13% Hispanic. Age ranged from 18-94 years. Mean PHQ-9 score was 4.3; 14.5% of respondents had a PHQ-9 score g9.0, consistent with active depressive symptoms. Analyses controlling for current depression symptoms and socio-demographic factors found that in patients both with (coefficient 1.08, p = 0.03) and without (coefficient 0.77, p = 0.03) a personal history of depression, having a vicarious experience (family and friend, respectively) with depression is associated with a more favorable attitude towards antidepressant medications.ConclusionsPatients with vicarious experiences of depression express more acceptance of pharmacotherapy. Conversely, patients lacking vicarious experiences of depression have more negative attitudes towards antidepressants. When discussing treatment with patients, clinicians should inquire about vicarious experiences of depression. This information may identify patients at greater risk for non-adherence and lead to more tailored patient-specific education about treatment.
14 citations
TL;DR: It is clear that interventions that can successfully elicit behavior change to prevent and manage disease are needed.
Abstract: M OTIVATING BEHAVIORAL CHANGE HAS become a core competency for clinicians and a major priority for the health care system as chronic disease management and disease prevention encompass an increasing proportion of clinical medicine. Nonadherence to treatment programs represents an important barrier to successful chronic disease management and is associated with significant morbidity, mortality, and preventable health care costs across a wide variety of conditions. Clearly, we need interventions that can successfully elicit behavior change to prevent and manage disease. But how successful are the current strategies?
10 citations
1 citations