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https://www.readbyqxmd.com/read/28231615/what-do-older-people-experiencing-loneliness-think-about-primary-care-or-community-based-interventions-to-reduce-loneliness-a-qualitative-study-in-england
#1
Kalpa Kharicha, Steve Iliffe, Jill Manthorpe, Carolyn A Chew-Graham, Mima Cattan, Claire Goodman, Maggie Kirby-Barr, Janet H Whitehouse, Kate Walters
Loneliness in later life is a common problem with poor health outcomes. However, interventions to prevent or ameliorate loneliness have a weak evidence base. The views of older people experiencing or at risk of loneliness in the community are important in identifying features of potential support, but have been little studied. Twenty-eight community dwelling people, aged 65 and over who reported being 'lonely much of the time' or identified as lonely from the de Jong Gierveld six-item loneliness scale in a larger study, participated in in-depth interviews, between June 2013 and May 2014...
February 23, 2017: Health & Social Care in the Community
https://www.readbyqxmd.com/read/28231289/rehr-an-r-package-for-manipulating-and-analysing-electronic-health-record-data
#2
David A Springate, Rosa Parisi, Ivan Olier, David Reeves, Evangelos Kontopantelis
Research with structured Electronic Health Records (EHRs) is expanding as data becomes more accessible; analytic methods advance; and the scientific validity of such studies is increasingly accepted. However, data science methodology to enable the rapid searching/extraction, cleaning and analysis of these large, often complex, datasets is less well developed. In addition, commonly used software is inadequate, resulting in bottlenecks in research workflows and in obstacles to increased transparency and reproducibility of the research...
2017: PloS One
https://www.readbyqxmd.com/read/28231056/temporal-and-regional-variability-in-the-request-of-vitamin-d-from-general-practitioners-in-spain
#3
Maria Salinas, Maite López-Garrigós, Emilio Flores, Carlos Leiva-Salinas
BACKGROUND: Our main goal is to study the inter-practice regional variability and the temporal evolution in the request of 25-hydroxyvitamin D (25[OH]D) by general practitioners (GPs) in Spain. METHODS: Clinical laboratories in different autonomic communities (AACCs) were invited to report the number of 25(OH)D test requested by GPs during 2012 and 2014. The number of 25(OH)D requested per 1000 inhabitants and the index of variability were calculated, and compared between regions and time periods...
February 23, 2017: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/28230899/shared-care-across-the-interface-between-primary-and-specialty-care-in-management-of-long-term-conditions
#4
REVIEW
Susan M Smith, Gráinne Cousins, Barbara Clyne, Shane Allwright, Tom O'Dowd
BACKGROUND: Shared care has been used in the management of many chronic conditions with the assumption that it delivers better care than primary or specialty care alone; however, little is known about the effectiveness of shared care. OBJECTIVES: To determine the effectiveness of shared care health service interventions designed to improve the management of chronic disease across the primary/specialty care interface. This is an update of a previously published review...
February 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28230524/early-2016-17-vaccine-effectiveness-estimates-against-influenza-a-h3n2-i-move-multicentre-case-control-studies-at-primary-care-and-hospital-levels-in-europe
#5
Esther Kissling, Marc Rondy
We measured early 2016/17 season influenza vaccine effectiveness (IVE) against influenza A(H3N2) in Europe using multicentre case control studies at primary care and hospital levels. IVE at primary care level was 44.1%, 46.9% and 23.4% among 0-14, 15-64 and ≥ 65 year-olds, and 25.7% in the influenza vaccination target group. At hospital level, IVE was 2.5%, 7.9% and 2.4% among ≥ 65, 65-79 and ≥ 80 year-olds. As in previous seasons, we observed suboptimal IVE against influenza A(H3N2).
February 16, 2017: Euro Surveillance: Bulletin Européen sur les Maladies Transmissibles, European Communicable Disease Bulletin
https://www.readbyqxmd.com/read/28230459/estimated-cost-effectiveness-cost-benefit-and-risk-reduction-associated-with-an-endocrinologist-pharmacist-diabetes-intense-medical-management-tune-up-clinic
#6
Jan D Hirsch, Mark Bounthavong, Anisa Arjmand, David R Ha, Christine L Cadiz, Andrew Zimmerman, Heather Ourth, Anthony P Morreale, Steven V Edelman, Candis M Morello
BACKGROUND: In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230446/economic-impact-of-treatment-duration-and-persistence-with-basal-insulin-in-previously-insulin-naive-users
#7
Samaneh Kalirai, Ran Duan, Dongju Liu, Beverly L Reed
BACKGROUND: Although insulin is a well-established therapy that is associated with improved clinical outcomes, adherence and persistence with insulin regimens are poor in patients with type 2 diabetes mellitus (T2DM). Diabetes-related health care costs and the impact of insulin persistence patterns on these health care costs have been previously studied; however, these aspects of insulin therapy have limited data beyond the first year of use and have not been characterized among patients previously naive to basal insulin...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230438/the-influence-of-placements-on-adult-nursing-graduates-choice-of-first-post
#8
Mark Wareing, Renate Taylor, Aileen Wilson, Adrienne Sharples
BACKGROUND: This article presents findings from a study that sought to explore the extent to which clinical placements have an impact on nursing students' decisions regarding their first staff nurse post. Within the UK, nursing is facing a recruitment crisis with particular difficulty recruiting to areas such as primary care and care of older people. Transitioning into a new role is challenging in any occupation, but it is a particular problem in nursing where the realities of professional practice often differ from students' perception of the staff nurse role as shaped by their clinical placements...
February 23, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28230312/five-year-cost-effectiveness-of-patient-empowerment-programme-pep-for-type-2-diabetes-mellitus-in-primary-care
#9
J X Lian, Sarah M McGhee, C So, J Chau, Carlos Kh Wong, William Cw Wong, Cindy Lk Lam
This study evaluated the short-term cost-effectiveness of the Patient Empowerment Programme (PEP) for diabetes mellitus in Hong Kong. Propensity score matching was used to select a matched group of PEP and non-PEP subjects. A societal perspective was adopted to estimate the cost of PEP. The outcome measures were the cumulative incidence of all-cause mortality and diabetic complication over a five-year follow-up and the number needed to treat (NNT) to avoid one event. The incremental cost-effectiveness ratio (ICER) of cost per event avoided was calculated using the PEP cost per subject multiplied by the NNT...
February 23, 2017: Diabetes, Obesity & Metabolism
https://www.readbyqxmd.com/read/28229807/using-psychoeducation-and-role-induction-to-improve-completion-rates-in-cognitive-behavioural-therapy
#10
Jaime Delgadillo, Martin Groom
BACKGROUND: Pre-treatment role induction interventions have been suggested to potentially enhance attendance and clinical outcomes in psychotherapy. AIMS: This study aimed to evaluate the effects of a programme of three transdiagnostic seminars (TDS) for patients with common mental disorders accessing cognitive behavioural therapy (CBT) in primary care. TDS included CBT psychoeducation and role induction. METHOD: A random sample of patients (n = 49) participated in TDS followed by CBT (TDS+CBT) and they were compared with matched controls (n = 49) accessing usual CBT...
March 2017: Behavioural and Cognitive Psychotherapy
https://www.readbyqxmd.com/read/28229485/osteoporosis-related-health-services-utilization-following-first-hip-fracture-among-a-cohort-of-privately-insured-women-in-the-united-states-2008-2014-an-observational-study
#11
Catherine W Gillespie, Pamela E Morin
Timely identification and treatment of osteoporosis following hip fracture is recommended to mitigate future fracture risk, yet prior work has demonstrated a disconnect between evidence-based recommendations and real-world implementation. We sought to describe contemporary patterns of osteoporosis screening and initiation of pharmacotherapy following hip fracture based on medical and pharmacy claims in the OptumLabs™ Data Warehouse. From a national sample, we identified 8349 women aged 50+ years enrolled in private commercial or Medicare Advantage plans with no prior history of osteoporosis diagnosis, osteoporosis pharmacotherapy, or hip fracture who experienced a hip fracture between 2008 and 2013...
February 23, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28229476/initial-medication-non-adherence-prevalence-and-predictive-factors-in-a-cohort-of-1-6-million-primary-care-patients
#12
I Aznar-Lou, A Fernández, M Gil-Girbau, M Fajó-Pascual, P Moreno-Peral, M T Peñarrubia-Maria, A Serrano-Blanco, A Sánchez-Niubó, M March-Pujol, A M Jové, M Rubio-Valera
INTRODUCTION: Adherence to medicines is vital in treating diseases. Initial medication non-adherence (IMNA) - defined as not obtaining a medication the first time it is prescribed - has been poorly explored. Previous studies show IMNA rates between 6 and 28% in Primary Care (PC). The aims of this study were to determine prevalence and predictive factors of IMNA in the most prescribed and expensive pharmacotherapeutic groups in the Catalan health system. METHODS: Retrospective, register-based cohort study which linked Catalan PC System (Spain) prescription and invoicing databases...
February 23, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28229264/diabetes-outcome-and-process-measures-among-patients-who-require-language-interpreter-services-in-minnesota-primary-care-practices
#13
Jane W Njeru, Deborah H Boehm, Debra J Jacobson, Laura M Guzman-Corrales, Chun Fan, Scott Shimotsu, Mark L Wieland
Immigrants and refugees are less likely to meet diabetes management goals than the general US population. Those with limited English proficiency (LEP) and who need interpreter services (IS) for health care encounters, maybe at higher risk for encountering barriers to optimal diabetes management, and while most receive diabetes care in primary care settings, little is known about the association between IS need and diabetes outcomes. This study aims to determine adherence with diabetes process and outcomes measures among LEP patients in primary care settings, and is a retrospective cohort study of patients with type II diabetes at two large primary care networks in Minnesota from January 1, 2012 through December 31, 2013...
February 22, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28229248/promoting-social-nurturance-and-positive-social-environments-to-reduce-obesity-in-high-risk-youth
#14
REVIEW
Dawn K Wilson, Allison M Sweeney, Heather Kitzman-Ulrich, Haylee Gause, Sara M St George
Nurturing environments within the context of families, schools, and communities all play an important role in enhancing youth's behavioral choices and health outcomes. The increasing prevalence rates of obesity among youth, especially among low income and ethnic minorities, highlight the need to develop effective and innovative intervention approaches that promote positive supportive environments across different contexts for at-risk youth. We propose that the integration of Social Cognitive Theory, Family Systems Theory, and Self-Determination Theory offers a useful framework for understanding how individual, family, and social-environmental-level factors contribute to the development of nurturing environments...
February 22, 2017: Clinical Child and Family Psychology Review
https://www.readbyqxmd.com/read/28229032/role-of-dual-energy-computed-tomography-imaging-in-the-diagnosis-of-gout
#15
REVIEW
Divya Jayakumar, Shiv T Sehra, Suneesh Anand, Gary W Stallings, Abhijeet Danve
Gout is a well-known inflammatory arthritis and affects four percent of the United States population. It results from the deposition of uric acid crystals in joints, tendons, bursae, and other surrounding tissues. Prevalence of gout has increased in the recent decade. Gout is usually seen in conjunction with other chronic comorbid conditions like cardiac disease, metabolic syndrome, and renal disease. The diagnosis of this inflammatory arthritis is confirmed by visualization of monosodium urate (MSU) crystals in the synovial fluid...
January 20, 2017: Curēus
https://www.readbyqxmd.com/read/28228902/mri-diagnosis-of-herpes-simplex-encephalitis-in-an-elderly-man-with-nonspecific-symptoms
#16
Benjamin J Croll, Zachary M Dillon, Kevin R Weaver, Marna Rayl Greenberg
A 78-year-old male presented to the Emergency Department complaining of a 1-week onset of increasing fatigue and anorexia. The patient was previously well but had a history of depression, chronic diarrhea, and hypertension. His examination was remarkable for mild fever (100.1°F). He had no acute neurologic deficits. The patient felt better after intravenous fluids and was discharged to follow-up with the primary care provider. With no resolution of symptoms and new memory loss, the patient's primary care doctor ordered an MRI which revealed abnormal signal/patchy enhancement of the left temporal lobe indicative (pathognomonic) of herpes simplex encephalitis...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28228694/survey-of-primary-contact-medical-and-chiropractic-clinicians-on-self-reported-knowledge-and-recognition-of-mild-traumatic-brain-injuries-a-pilot-study
#17
David N Taylor, Frank J Ponce, Stephen J Dyess
OBJECTIVE: The purpose of this study was to assess the self-reported knowledge of concussion recognition and treatment with first-contact family medical and chiropractic practitioners by means of a pilot study of the need, construct validity, and feasibility for further investigation of mild traumatic brain injury (MTBI) knowledge base. METHODS: Two hundred forty-eight practicing chiropractic and 120 medical physicians in the south and northeastern sections of the United States were contacted by e-mail, telephone, and postal mail to answer an 18-item survey on knowledge, diagnosis, and common practice with respect to traumatic brain injury patients...
March 2017: Journal of Chiropractic Medicine
https://www.readbyqxmd.com/read/28228660/estimating-the-economic-consequences-of-an-increased-medication-adherence-due-to-a-potential-improvement-in-the-inhaler-technique-with-spiromax-%C3%A2-compared-with-turbuhaler-%C3%A2-in-patients-with-moderate-to-severe-chronic-obstructive-pulmonary-disease-in-spain
#18
Josep Darbà, Gabriela Ramírez, Juan L García-Rivero, Sagrario Mayoralas, José Francisco Pascual, Diego Vargas, Adi Bijedic
OBJECTIVE: The objective of this study was to estimate the economic impact of the introduction of DuoResp(®) Spiromax(®), budesonide/formoterol fixed-dose combination (FDC), focusing on an increase in medication adherence due to an enhancement of the inhalation technique for the treatment of COPD patients in Spain and 5 regions including Andalusia, Catalonia, Galicia, Madrid, and Valencia. METHODS: A 4-year budget impact model was developed for the time period of 2015-2018...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28228380/off-label-indications-for-antidepressants-in-primary-care-descriptive-study-of-prescriptions-from-an-indication-based-electronic-prescribing-system
#19
Jenna Wong, Aude Motulsky, Michal Abrahamowicz, Tewodros Eguale, David L Buckeridge, Robyn Tamblyn
Objective To examine off-label indications for antidepressants in primary care and determine the level of scientific support for off-label prescribing.Design Descriptive study of antidepressant prescriptions written by primary care physicians using an indication based electronic prescribing system.Setting Primary care practices in and around two major urban centres in Quebec, Canada.Participants Patients aged 18 years or older who visited a study physician between 1 January 2003 and 30 September 2015 and were prescribed an antidepressant through the electronic prescribing system...
February 21, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28228370/enhancing-doctors-competencies-in-communication-with-and-activation-of-older-patients-the-promoting-active-aging-practa-computer-based-intervention-study
#20
Dorota Wlodarczyk, Joanna Chylińska, Magdalena Lazarewicz, Marta Rzadkiewicz, Mariusz Jaworski, Miroslawa Adamus, Gørill Haugan, Monica Lillefjell, Geir Arild Espnes
BACKGROUND: Demographic changes over the past decades call for the promotion of health and disease prevention for older patients, as well as strategies to enhance their independence, productivity, and quality of life. OBJECTIVE: Our objective was to examine the effects of a computer-based educational intervention designed for general practitioners (GPs) to promote active aging. METHODS: The Promoting Active Aging (PRACTA) study consisted of a baseline questionnaire, implementation of an intervention, and a follow-up questionnaire that was administered 1 month after the intervention...
February 22, 2017: Journal of Medical Internet Research
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