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https://www.readbyqxmd.com/read/29784698/aspects-of-multicomponent-integrated-care-promote-sustained-improvement-in-surrogate-clinical-outcomes-a-systematic-review-and-meta-analysis
#1
REVIEW
Lee Ling Lim, Eric S H Lau, Alice P S Kong, Melanie J Davies, Naomi S Levitt, Björn Eliasson, Carlos A Aguilar-Salinas, Guang Ning, Yutaka Seino, Wing Yee So, Margaret McGill, Graham D Ogle, Trevor J Orchard, Philip Clarke, Rury R Holman, Edward W Gregg, Juan José Gagliardino, Juliana C N Chan
OBJECTIVE: The implementation of the Chronic Care Model (CCM) improves health care quality. We examined the sustained effectiveness of multicomponent integrated care in type 2 diabetes. RESEARCH DESIGN AND METHODS: We searched PubMed and Ovid MEDLINE (January 2000-August 2016) and identified randomized controlled trials comprising two or more quality improvement strategies from two or more domains (health system, health care providers, or patients) lasting ≥12 months with one or more clinical outcomes...
June 2018: Diabetes Care
https://www.readbyqxmd.com/read/29783981/implementing-integrated-services-for-people-with-epilepsy-in-primary-care-in-ethiopia-a-qualitative-study
#2
Raquel Catalao, Tigist Eshetu, Ruth Tsigebrhan, Girmay Medhin, Abebaw Fekadu, Charlotte Hanlon
BACKGROUND: In order to tackle the considerable treatment gap for epilepsy in many low- and middle-income countries (LMICs), a task sharing model is recommended whereby care is integrated into primary health services. However, there are limited data on implementation and impact of such services in LMICs. Our study aimed to explore the perspectives of service users and caregivers on the accessibility, experience and perceived impact of epilepsy treatment received in a task-shared model in a rural district of Ethiopia...
May 21, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29781688/-he-should-feel-your-pain-patient-insights-on-patient-provider-communication-in-rwanda
#3
Vincent K Cubaka, Michael Schriver, Janvier B Kayitare, Phil Cotton, Helle T Maindal, Laetitia Nyirazinyoye, Per Kallestrup
BACKGROUND:  Patient-provider communication is an interpersonal interaction between a patient and a health care provider. OBJECTIVE:  This study explored patients' communication preferences and perceptions on what factors influence the patient-provider communication in primary health care settings in Rwanda. METHODS:  In-depth semi-structured interviews with 15 individuals including 8 with limited literacy. A thematic inductive analysis was used...
April 16, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29780285/collaborative-youth-mental-health-service-users-immigration-poverty-and-family-environment
#4
Lucie Nadeau, Vanessa Lecompte, Janique Johnson-Lafleur, Annie Pontbriand, Cécile Rousseau
Background: This article examines the association between immigration, poverty and family environment, and the emotional and behavioral problems reported by youth and their family receiving mental health (MH) services within a collaborative care model in a multiethnic neighborhood. Method: Participants in this study were 140 parent-child dyads that are part of an ongoing longitudinal project looking at the association between individual, familial, social and organizational factors, and outcomes of youth receiving MH services in local health and social service organizations in the Montreal area...
May 2018: Child and Adolescent Mental Health
https://www.readbyqxmd.com/read/29774442/integrated-models-of-care-for-individuals-with-opioid-use-disorder-how-do-we-prevent-hiv-and-hcv
#5
REVIEW
Katherine M Rich, Joshua Bia, Frederick L Altice, Judith Feinberg
PURPOSE OF REVIEW: To describe models of integrated and co-located care for opioid use disorder (OUD), hepatitis C (HCV), and HIV. RECENT FINDINGS: The design and scale-up of multidisciplinary care models that engage, retain, and treat individuals with HIV, HCV, and OUD are critical to preventing continued spread of HIV and HCV. We identified 17 models within primary care (N = 3), HIV specialty care (N = 5), opioid treatment programs (N = 6), transitional clinics (N = 2), and community-based harm reduction programs (N = 1), as well as two emerging models...
May 17, 2018: Current HIV/AIDS Reports
https://www.readbyqxmd.com/read/29771160/effects-of-an-intervention-program-for-pomoting-ethical-practices-among-pediatric-nurses
#6
Naomi Matsumori
The Japanese nursing education system only requires a general nursing qualification. After graduation, many Japanese nurses work within pediatric departments where they receive specialized training in pediatric care. An intervention program for promoting ethical nursing practices among patients and their families was implemented for pediatric nurses with 0-5 years pediatric nursing experience. The objective of this study was to clarify changes in nurses' recognition and behaviors, as well as the intervention's post-initiation durability...
May 17, 2018: Comprehensive Child and Adolescent Nursing
https://www.readbyqxmd.com/read/29763657/a-mhealth-based-care-model-for-improving-hypertension-control-in-stroke-survivors-pilot-rct
#7
Kamakshi Lakshminarayan, Sarah Westberg, Carin Northuis, Candace C Fuller, Farah Ikramuddin, Mustapha Ezzeddine, Julie Scherber, Stuart Speedie
PURPOSE: Hypertension (HTN) is significantly under-treated in stroke survivors. We examined usability and efficacy of a mHealth -based care model for improving post-stroke HTN control (Funding: AHRQ R21HS021794). METHODS: We used a RCT design. Planned study duration was 90 days. Intervention arm (IA) participants measured their BP daily using a smart phone and wireless BP monitor. This was transmitted automatically to the study database. Investigators (Physician + PharmD) made bi-weekly medication adjustments to achieve the BP goal...
May 12, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29759260/a-call-to-bridge-across-silos-during-care-transitions
#8
Fatima Sheikh, Evelyn Gathecha, Michele Bellantoni, Colleen Christmas, Justin P Lafreniere, Alicia I Arbaje
BACKGROUND: Older adults with complex medical conditions are vulnerable during care transitions. Poor care transitions can lead to poor patient outcomes and frequent readmissions to the hospital. FACTORS CONTRIBUTING TO SUBOPTIMAL CARE TRANSITIONS: Key factors related to ineffective care transitions, which can lead to suboptimal patient outcomes, include poor cross-site communication and collaboration; lack of awareness of patient wishes, abilities, and goals of care; and incomplete medication reconciliation...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29759257/developing-a-medical-scribe-program-at-an-academic-hospital-the-hennepin-county-medical-center-experience
#9
Marc L Martel, Brian H Imdieke, Kayla M Holm, Sara Poplau, William G Heegaard, Jon L Pryor, Mark Linzer
BACKGROUND: Medical scribes are frequently incorporated into the patient care model to improve provider efficiency and enable providers to refocus their attention to the patient rather than the electronic health record (EHR). The medical scribe program was based on four pillars (objectives): (1) provider satisfaction, (2) standardized documentation, (3) documentation components for risk adjustment, and (4) revenue enhancement. METHODS: The medical scribe program was deployed in nine non-resident-supported clinics (internal medicine, ophthalmology, orthopedics, hematology/oncology, urology), with the medical scribes (who have no clinical duties) supporting both physicians and advanced practice providers (nurse practitioners and physician assistants)...
May 2018: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/29758130/pediatric-heart-transplantation-at-adult-specialty-centers-in-the-us-a-multicenter-registry-analysis
#10
Son Q Duong, Johnathan G Yabes, Jeffery J Teuteberg, Diana A Shellmer, Brian Feingold
Recent OPTN bylaw revisions mandate US transplant programs have an "approved pediatric component" in order to perform heart transplantation (HT) in patients <18 years old. The impact of this change on adolescents, a group known to be at high-risk for graft loss and nonadherence, is unknown. We studied all US pediatric (age <18 years) HT from 2000-2015 to compare graft survival between centers organized primarily for adult versus pediatric care. Centers were designated as pediatric- or adult-specialty care according to the ratio of pediatric:adult HT performed and minimum age of HT (pediatric-specialty defined as ratio>0...
May 14, 2018: American Journal of Transplantation
https://www.readbyqxmd.com/read/29758122/association-of-gestational-weight-gain-with-prenatal-care-model
#11
Michelle A Kominiarek, Elizabeth Lucio Gray, Heidi Vyhmeister, William Grobman, Melissa Simon
INTRODUCTION: The objective of this study was to compare gestational weight gain (GWG) among women in group and traditional prenatal care. METHODS: This is a retrospective cohort study of women who received prenatal care between 2011 and 2015 in a setting in which low-risk women had the option of group prenatal care. Women with height and initial and final weight were eligible. Women who chose group prenatal care were compared with women who chose traditional prenatal care and gave birth during the same study period...
May 14, 2018: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/29756588/toward-a-shared-care-model-of-relapsing-remitting-multiple-sclerosis-role-of-the-primary-care-practitioner
#12
Jiwon Oh, Marie-Sarah Gagné-Brosseau, Melanie Guenette, Catherine Larochelle, François Lemieux, Suresh Menon, Sarah A Morrow, Laurence Poliquin-Lasnier, Chantal Roy-Hewitson, Carolina Rush, Anne-Marie Trudelle, Paul S Giacomini
The objective of this study was to develop a shared-care model to enable primary-care physicians to participate more fully in meeting the complex, multidisciplinary healthcare needs of patients with multiple sclerosis (MS). DESIGN: The design consisted of development of consensus recommendations and a shared-care algorithm. PARTICIPANTS: A working group of 11 Canadian neurologists involved in the management of patients with MS were included in this study. MAIN MESSAGE: The clinical management of patients with multiple sclerosis is increasing in complexity as new disease-modifying therapies (DMTs) become available, and ongoing safety monitoring is required...
May 2018: Canadian Journal of Neurological Sciences. le Journal Canadien des Sciences Neurologiques
https://www.readbyqxmd.com/read/29756557/barriers-to-end-of-life-discussions-among-hematologists-a-qualitative-study
#13
Chloé Prod'homme, Dominique Jacquemin, Licia Touzet, Regis Aubry, Serge Daneault, Laurent Knoops
BACKGROUND: Integrated palliative care is correlated with earlier end-of-life discussion and improved quality of life. Patients with haematological malignancies are far less likely to receive care from specialist palliative or hospice services compared to other cancers. AIM: The main goal of this study was to determine hematologists' barriers to end-of-life discussions when potentially fatal hematological malignancies recur. DESIGN: Qualitative grounded theory study using individual interviews...
May 2018: Palliative Medicine
https://www.readbyqxmd.com/read/29756527/when-will-telemedicine-appear-in-the-icu
#14
Mark V Avdalovic, James P Marcin
As our population ages and the demand for high-level intensive care unit (ICU) services increase, the ICU physician supply continues to lag. In addition, hospitals, physician groups, and patients are demanding rapid access for the highest level of expertise in the care of critically ill patients. Telemedicine in the ICU combined with remote patient monitoring has been increasingly touted as a model of care to increase efficiencies and quality of care. Telemedicine in the ICU provides the potential to connect critically ill patients to sophisticated specialty care on a 24/7 basis, even for those hospitalized in rural locations where access to timely specialty consultations are uncommon...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29754755/patients-should-define-value-in-health-care-a-conceptual-framework
#15
REVIEW
Robin N Kamal, Sarah E Lindsay, Sara L Eppler
The main tenet of value-based health care is delivering high-quality care that is centered on the patient, improving health, and minimizing cost. Collaborative decision-making frameworks have been developed to help facilitate delivering care based on patient preferences (patient-centered care). The current value-based health care model, however, focuses on improving population health and overlooks the individuality of patients and their preferences for care. We highlight the importance of eliciting patient preferences in collaborative decision making and describe a conceptual framework that incorporates individual patients' preferences when defining value...
May 10, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29754670/knowledge-to-action-rationale-and-design-of-the-patient-centered-care-transitions-in-heart-failure-pact-hf-stepped-wedge-cluster-randomized-trial
#16
Harriette G C Van Spall, Shun Fu Lee, Feng Xie, Dennis T Ko, Lehana Thabane, Quazi Ibrahim, Peter R Mitoff, Michael Heffernan, Manish Maingi, Michael C Tjandrawidjaja, Mohammad I Zia, Mohamed Panju, Richard Perez, Kim D Simek, Liane Porepa, Ian D Graham, R Brian Haynes, Dilys Haughton, Stuart J Connolly
INTRODUCTION: Heart Failure (HF) is a common cause of hospitalization in older adults. The transition from hospital to home is high-risk, and gaps in transitional care can increase the risk of re-hospitalization and death. Combining health care services supported by meta-analyses, we designed the PACT-HF transitional care model. METHODS: Adopting an integrated Knowledge Translation (iKT) approach in which decision-makers and clinicians are partners in research, we implement and test the effectiveness of PACT-HF among patients hospitalized for HF...
May 2018: American Heart Journal
https://www.readbyqxmd.com/read/29749302/integrated-accountable-care-for-medicaid-expansion-enrollees-a-comparative-evaluation-of-hennepin-health
#17
Katherine D Vickery, Nathan D Shippee, Jeremiah Menk, Ross Owen, David M Vock, Peter Bodurtha, Dana Soderlund, Rodney A Hayward, Matthew M Davis, John Connett, Mark Linzer
Hennepin Health, a Medicaid accountable care organization, began serving early expansion enrollees (very low-income childless adults) in 2012. It uses an integrated care model to address social and behavioral needs. We compared health care utilization in Hennepin Health with other Medicaid managed care in the same area from 2012 to 2014, controlling for demographics, chronic conditions, and enrollment patterns. Homelessness and substance use were higher in Hennepin Health. Overall adjusted results showed Hennepin Health had 52% more emergency department visits and 11% more primary care visits than comparators...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29749288/changes-in-quality-of-life-among-enrollees-in-hennepin-health-a-medicaid-expansion-aco
#18
Katherine D Vickery, Nathan D Shippee, Laura M Guzman-Corrales, Cindy Cain, Sarah Turcotte Manser, Tom Walton, Jessica Richards, Mark Linzer
Despite limited program evaluations of Medicaid accountable care organizations (ACOs), no studies have examined if cost-saving goals negatively affect quality of life and health care experiences of low-income enrollees. The Hennepin Health ACO uses an integrated care model to address the physical, behavioral, and social needs of Medicaid expansion enrollees. As part of a larger evaluation, we conducted semistructured interviews with 35 primary care using Hennepin Health members enrolled for 2 or more years...
May 1, 2018: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29747964/applying-the-chronic-care-model-to-prenatal-care-patient-activation-productive-interactions-and-prenatal-outcomes
#19
Christy J W Ledford, Kerry P Sadler, Jeremy T Jackson, Jasmyne J Womack, Heather A Rider, Angela B Seehusen
OBJECTIVE: To demonstrate how the chronic care model can be applied in prenatal care. METHODS: This study was conducted through analysis of data generated in the women's health and family medicine departments of one community hospital and two medical centers across three states (Georgia, Nevada, and Virginia). 159 low-risk obstetric patients were monitored throughout their pregnancy for patient activation and biometric measures including: blood pressure at each appointment, baby's gestational age at birth, and mode of delivery...
April 30, 2018: Patient Education and Counseling
https://www.readbyqxmd.com/read/29747764/-genetics-diagnosis-and-characteristics-of-trisomy-21
#20
Aimé Ravel
Trisomy 21 remains relevant today. As patients' life expectancy increases, medical monitoring shows the importance of screening for associated complications such as epilepsy and sleep apnoea. For caregivers, it constitutes a care model for intellectually disabled people notably with regard to anxiety, poor expression of pain and family suffering. Scientific advances raise hope of progress in therapeutic practices.
May 2018: Soins. Pédiatrie, Puériculture
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