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Diabetics in nursing home

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https://www.readbyqxmd.com/read/28801438/associations-between-polypharmacy-and-treatment-intensity-for-hypertension-and-diabetes-a-cross-sectional-study-of-nursing-home-patients-in-british-columbia-canada
#1
Rita McCracken, James McCormack, Margaret J McGregor, Sabrina T Wong, Scott Garrison
OBJECTIVES: Describe nursing home polypharmacy prevalence in the context of prescribing for diabetes and hypertension and determine possible associations between lower surrogate markers for treated hypertension and diabetes (overtreatment) and polypharmacy. DESIGN: Cross-sectional study. SETTING: 6 nursing homes in British Columbia, Canada. PARTICIPANTS: 214 patients residing in one of the selected facilities during data collection period...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28764876/determinants-of-potentially-inappropriate-medication-use-in-long-term-and-acute-care-settings-a-systematic-review
#2
REVIEW
Stephanie K Nothelle, Ritu Sharma, Allison H Oakes, Madeline Jackson, Jodi B Segal
BACKGROUND: Potentially inappropriate medications (PIMs) are widely used in institutionalized older adults, yet the key determinants that drive their use are incompletely characterized. METHODS: We systematically searched published literature within MEDLINE and Embase from January 1998 to March 2017. We searched for studies conducted in the United States that described determinants of PIM use in adults ≥60 years of age in a nursing home or residential care facility, in the emergency department (ED), or in the hospital...
July 29, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28759685/association-between-extending-carefirst-s-medical-home-program-to-medicare-patients-and-quality-of-care-utilization-and-spending
#3
G Greg Peterson, Kristin Lowe Geonnotti, Lauren Hula, Timothy Day, Laura Blue, Keith Kranker, Boyd Gilman, Kate Stewart, Sheila Hoag, Lorenzo Moreno
Importance: CareFirst, the largest commercial insurer in the mid-Atlantic Region of the United States, runs a medical home program focusing on financial incentives for primary care practices and care coordination for high-risk patients. From 2013 to 2015, CareFirst extended the program to Medicare fee-for-service (FFS) beneficiaries in participating practices. If the model extension improved quality while reducing spending, the Centers for Medicare and Medicaid Services could expand the program to Medicare beneficiaries broadly...
July 31, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28689471/the-scope-pc-instrument-for-assessing-patient-safety-culture-in-primary-care-a-psychometric-evaluation
#4
Melissa Desmedt, Jochen Bergs, Benjamin Willaert, Annemie Vlayen, Johan Hellings, Ward Schrooten, Neree Claes, Dominique Vandijck
INTRODUCTION: Primary healthcare differs from hospitals in terms of - inter alia - organisational structure. Therefore, patient safety culture could differ between these settings. Various instruments have been developed to measure collective attitudes of personnel within a primary healthcare organisation. However, the number of valid and reliable instruments is limited. OBJECTIVES: Psychometric properties of the SCOPE-Primary Care instrument were tested to examine the instrument's applicability in home care services in Belgium...
July 9, 2017: Acta Clinica Belgica
https://www.readbyqxmd.com/read/28676291/metformin-safety-warnings-and-diabetes-drug-prescribing-patterns-for-older-nursing-home-residents
#5
Andrew R Zullo, David D Dore, Roee Gutman, Vincent Mor, Carlos A Alvarez, Robert J Smith
OBJECTIVE: Diabetes mellitus is common in US nursing homes (NHs), and the mainstay treatment, metformin, has US Food and Drug Administration (FDA) boxed warnings indicating safety concerns in those with advanced age, heart failure, or renal disease. Little is known about treatment selection in this setting, especially for metformin. We quantified the determinants of initiating sulfonylureas over metformin with the aim of understanding the impact of FDA-labeled boxed warnings in older NH residents...
July 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28672282/increasing-incidence-of-multiply-recurrent-clostridium-difficile-infection-in-the-united-states-a-cohort-study
#6
Gene K Ma, Colleen M Brensinger, Qufei Wu, James D Lewis
Background: Clostridium difficile infection (CDI), the most common health care-associated infection, often recurs. Fecal microbiota transplantation is increasingly used to treat multiply recurrent CDI (mrCDI). Objective: To determine whether the incidence of mrCDI is increasing in proportion to CDI and to identify risk factors for mrCDI. Design: Retrospective cohort study. Setting: United States. Participants: 38 911 718 commercially insured patients in the OptumInsight Clinformatics Database, of whom 45 341 developed CDI...
August 1, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28663023/epidemiological-trends-and-direct-costs-of-diabetes-in-a-northern-italy-area-2012-health-administrative-records-analysis-lht-n-20-verona
#7
J Demurtas, N Alba, G Rigon, M V Nesoti, C Bovo, A Vaona
OBJECTIVE: This analysis estimates type 1 and type 2 diabetes direct costs in 2012, in terms of hospital care, outpatient visits, diagnostics and medications, in a local healthcare trust in Northern Italy (ULSS n.20 Verona). METHODS: The Johns Hopkins Adjusted Clinical Group (ACG(®)) System was used to analyze data, including hospital discharges, emergency room admissions, medical encounter records, disease registries, copayment exemptions, home care services, psychiatric services, rehabilitation services, and medications...
June 26, 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28599947/an-elderly-man-with-pancreatic-neuroendocrine-tumor-and-a-cavitary-right-upper-lobe-lung-mass
#8
Palla DeSilva, Adarsha Selvachandra, Jennifer Kanaan, Debapriya Datta
An elderly man presented to the ED from a nursing care facility after transient loss of consciousness. Three weeks previously, the patient had been diagnosed with a high-grade pancreatic neuroendocrine tumor (NET) with metastases to the liver after being hospitalized for weakness. A chest radiograph at that time had revealed a right upper lobe mass that was presumed to represent a metastatic lesion (Fig 1); CT of the chest demonstrated similar findings (Fig 2). The patient had recovered consciousness on arrival to the ED and was diagnosed clinically as having had a syncopal episode from dehydration due to poor intake...
June 2017: Chest
https://www.readbyqxmd.com/read/28539088/prescription-patterns-and-disease-control-in-type-2-diabetes-mellitus-patients-in-nursing-home-and-home-care-settings-a-retrospective-analysis-in-germany
#9
Karel Kostev, Timo Rockel, Louis Jacob
AIM: The aim of this study was to analyze prescription patterns and disease control in patients with type 2 diabetes mellitus (T2DM) in nursing home and home care settings in Germany. METHODS: The present study is based on data from the Disease Analyzer database (QuintilesIMS). Patients with an initial diagnosis of T2DM and documented HbA1c values between January 2011 and December 2015 were included in the analysis. The index date corresponded to the last documented HbA1c value...
May 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28533166/risk-factors-for-30-day-mortality-in-patients-with-methicillin-resistant-staphylococcus-aureus-bloodstream-infections
#10
Pedro Ayau, Ana C Bardossy, Guillermo Sanchez, Ricardo Ortiz, Daniela Moreno, Pamela Hartman, Khulood Rizvi, Tyler C Prentiss, Mary B Perri, Meredith Mahan, Vanthida Huang, Katherine Reyes, Marcus J Zervos
OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are a major health care problem accounting for a large percentage of nosocomial infections. The aim of this study was to identify risk factors associated with 30-day mortality in patients with MRSA BSI. METHODS: This was a retrospective study performed in Southeast Michigan. Over a 9- year period, a total of 1,168 patients were identified with MRSA BSI. Patient demographics and clinical data were retrieved and evaluated using electronic medical health records...
August 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28506258/health-care-waste-management-in-community-based-care-experiences-of-community-health-workers-in-low-resource-communities-in-south-africa
#11
Lydia Hangulu, Olagoke Akintola
BACKGROUND: In South Africa, community health workers (CHWs) working in community-based care (CBC) programmes provide care to patients most of whom are living with HIV/AIDS and tuberculosis (TB). Although studies have shown that the caregiving activities provided by the CHWs generate health care waste (HCW), there is limited information about the experiences of CHWs on health care waste management (HCWM) in CBC. This study explored HCWM in CBC in Durban, South Africa from the perspectives CHWs...
May 15, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28455179/nonelective-primary-total-hip-arthroplasty-the-effect-of-discharge-destination-on-postdischarge-outcomes
#12
Chirag K Shah, Aakash Keswani, Debbie Chi, Alex Sher, Karl M Koenig, Calin S Moucha
BACKGROUND: Medicare has enacted a mandatory bundled payment program for primary total joint arthroplasty that includes nonelective primary total hip arthroplasty (THA). Efficient postacute care management has been identified as an opportunity to improve value for patients. We aimed to identify risk factors for and compare rates of complications by discharge destination and then use those factors to risk-stratify non-elective THA patients. METHODS: Patients who underwent nonelective primary THA from 2011 to 2014 were identified in the American College of Surgeons National Surgical Quality Improvement Program database and categorized into those discharged to skilled nursing facility or inpatient rehabilitation facility vs home self-managed/home health (HHH)...
March 30, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28451747/-community-acquired-urinary-tract-infections-association-with-risk-factors-changes-in-causative-organisms-and-resistance-over-time
#13
B Ubrig, M Böhme, A Merklinghaus, F Wagenlehner
BACKGROUND: Published studies on community-acquired urinary tract infections (UTI) often do not link microbiological findings with clinical risk factors and patient data. MATERIALS AND METHODS: We retrospectively correlated clinical findings of all patients with UTI of a urological outpatient clinic with the respective microbiological analysis of their urine samples over 2 periods of time: (A: 2005-2006 and B: 2011-2012). Patients were stratified to the following risk groups: uncomplicated cystitis, diabetes mellitus type 2, nursing home resident, prostatitis/epidydimitis, permanent catheter...
June 2017: Der Urologe. Ausg. A
https://www.readbyqxmd.com/read/28413415/effects-of-nursing-home-residency-on-diabetes-care-in-individuals-with-dementia-an-explorative-analysis-based-on-german-claims-data
#14
Larissa Schwarzkopf, Rolf Holle, Michaela Schunk
AIMS: This claims data-based study compares the intensity of diabetes care in community dwellers and nursing home residents with dementia. METHODS: Delivery of diabetes-related medical examinations (DRMEs) was compared via logistic regression in 1,604 community dwellers and 1,010 nursing home residents with dementia. The intra-individual effect of nursing home transfer was evaluated within mixed models. RESULTS: Delivery of DRMEs decreases with increasing care dependency, with more community-living individuals receiving DRMEs...
January 2017: Dementia and Geriatric Cognitive Disorders Extra
https://www.readbyqxmd.com/read/28371686/investigating-the-management-of-diabetes-in-nursing-homes-using-a-mixed-methods-approach
#15
L Hurley, M O'Donnell, R O'Caoimh, S F Dinneen
AIMS: As populations age there is an increased demand for nursing home (NH) care and a parallel increase in the prevalence of diabetes. Despite this, there is growing evidence that the management of diabetes in NHs is suboptimal. The reasons for this are complex and poorly understood. This study aimed to identify the current level of diabetes care in NHs using a mixed methods approach. METHODS: The nursing managers at all 44 NHs in County Galway in the West of Ireland were invited to participate...
March 21, 2017: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/28346573/assessment-of-glycemic-control-in-nursing-home-residents-with-diabetes
#16
F Retornaz, M Grino, L Mari, C Oliver
OBJECTIVE: To describe glycemic control in nursing home residents with diabetes and to evaluate the relevance of HbA1c in the detection of hypoglycemia risk. DESIGN AND METHODS: Diabetes treatment, geriatric assessment, blood capillary glucose (n= 24,682), and HbA1c were collected from medical charts of 236 southern France nursing home residents during a 4-month period. Glycemic control was divided into four categories: tight, fair, and moderate or severe chronic hyperglycemia using the High Blood Glucose Index or the analysis of blood glucose frequency distribution...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28345527/prevalence-and-factors-promoting-the-occurrence-of-vitamin-d-deficiency-in-the-elderly
#17
REVIEW
Magdalena Wyskida, Katarzyna Wieczorowska-Tobis, Jerzy Chudek
Vitamin D deficiency affects a large part of the population of elderly people, especially women, who live in moderate climate countries due to a reduced amount of vitamin D in the diet (small sea fish consumption) and reduced content of 7-dehydrocholesterol, which causes decreased skin synthesis. The lowest seasonal concentration of 25(OH)D3 is usually observed during winter and spring. Sun exposure influences 25(OH)D3 concentration more strongly in men than in women. Sociodemographic factors that increase the risk of vitamin D deficiency in the elderly include poor environmental conditions, low economic status, lower educational level, drug exposure (smoking), reduced physical activity, overall poor health and obesity, which causes reduced skin exposure to sunlight...
March 13, 2017: Postȩpy Higieny i Medycyny Doświadczalnej
https://www.readbyqxmd.com/read/28341615/design-and-usability-of-a-heart-failure-mhealth-system-a-pilot-study
#18
Nagla Alnosayan, Samir Chatterjee, Ala Alluhaidan, Edward Lee, Linda Houston Feenstra
BACKGROUND: Despite the advances in mobile health (mHealth) systems, little is known about patients' and providers' experiences using a new mHealth system design. OBJECTIVE: This study aimed to understand challenges and provide design considerations for a personalized mHealth system that could effectively support heart failure (HF) patients after they transition into the home environment. METHODS: Following exploratory interviews with nurses and preventive care physicians, an mHealth system was developed...
March 24, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28291156/experience-of-home-telehealth-technology-in-older-patients-with-diabetes
#19
Chi-Ping Chang, Ting-Ting Lee, Mary Etta Mills
The incidence of diabetes, a common chronic disease among older adults, is increasing annually. The lack of blood glucose regulation can result in severe diabetes-related complications and substantial healthcare costs, making self-care programs specific to this population especially important. Combined with reduced numbers of healthcare professionals, the integration of healthcare and information technology and the older adults' adoption of telehealth services have become increasingly important. This study used a qualitative method to interview 18 older study participants who used a telehealth service...
March 14, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28261758/the-impact-of-severe-obesity-on-healthcare-resource-utilisation-in-spain
#20
Olga Espallardo, Rafael Busutil, Antonio Torres, Néboa Zozaya, Renata Villoro, Álvaro Hidalgo-Vega
BACKGROUND: Obesity is not only a health problem but also a source of increased monetary expenditures. The objectives of this study were to analyse the use of healthcare resources in the Spanish adult population with class II obesity and above (BMI ≥35 kg/m(2)) and to compare it with other BMI groups. METHOD: We used the Spanish National Health Survey, a longitudinal population-based survey (n = 18,682), to analyse healthcare resource utilisation by BMI groups...
August 2017: Obesity Surgery
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