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https://www.readbyqxmd.com/read/29136390/assurance-of-myeloid-growth-factor-administration-in-an-infusion-center-pilot-quality-improvement-initiative
#1
Pamela Maree Ramirez, Barry Peterson, Christine Holtshopple, Kristina Borja, Vincent Torres, Lucille Valdivia-Peppers, Julio Harriague, Melanie D Joe
PURPOSE: Four incident reports involving missed doses of myeloid growth factors (MGFs) triggered the need for an outcome-driven initiative. From March 1, 2015, to February 29, 2016, at University of California Irvine Health Chao Infusion Center, 116 of 3,300 MGF doses were missed (3.52%), including pegfilgrastim, filgrastim, and sargramostim. We hypothesized that with the application of Lean Six Sigma methodology, we would achieve our primary objective of reducing the number of missed MGF doses to < 0...
November 14, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29130378/the-experiences-of-patients-with-advanced-cancer-and-caregivers-presenting-to-emergency-departments-a-qualitative-study
#2
Jennifer Philip, Cheryl Remedios, Sibilah Breen, Tracey Weiland, Lisa Willenberg, Mark Boughey, George Jelinek, Heather Lane, Claudia Marck, Jennifer Weil
BACKGROUND: Despite being a common event in the course of an advanced cancer illness, there is little understanding of patients' perceptions of hospital Emergency Department presentations. AIM: To explore the experiences and perceptions of Emergency Departments held by patients with advanced cancer and their informal caregivers. DESIGN: Cross-sectional study involving semi-structured interviews with advanced cancer patients and their informal caregivers...
October 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29130267/long-term-impact-of-a-postdischarge-community-health-worker-intervention-on-health-care-costs-in-a-safety-net-system
#3
Alison A Galbraith, David J Meyers, Dennis Ross-Degnan, Marguerite E Burns, Catherine E Vialle-Valentin, Marc R Larochelle, Sharon Touw, Fang Zhang, Meredith Rosenthal, Richard B Balaban
OBJECTIVE: Patient navigators (PNs) may represent a cost-effective strategy to improve transitional care and reduce hospital readmissions. We evaluated the impact of a PN intervention on health system costs in the 180 days after discharge for high-risk patients in a safety-net system. DATA SOURCE/SETTING: Primary and secondary data from an academic safety-net health system. STUDY DESIGN: We compared per-patient utilization and costs, overall and by age, for high-risk, medical service patients randomized to the PN intervention relative to usual care between October 2011 and April 2013...
December 2017: Health Services Research
https://www.readbyqxmd.com/read/29126138/-those-conversations-in-my-experience-don-t-go-well-a-qualitative-study-of-primary-care-provider-experiences-tapering-long-term-opioid-medications
#4
Laura C Kennedy, Ingrid A Binswanger, Shane R Mueller, Cari Levy, Daniel D Matlock, Susan L Calcaterra, Stephen Koester, Joseph W Frank
Objective: Given the risks of long-term opioid therapy, patients may benefit from tapering these medications. There is little evidence to guide providers' approach to this process. We explored primary care providers' experiences discussing and implementing opioid tapering with patients on long-term opioid therapy. Design: Qualitative study using six semistructured, in-person focus groups. Subjects: Primary care providers (N = 40). Setting: Six academically affiliated primary care clinics in university, urban safety net, and Veterans Health Administration medical centers in Colorado...
November 4, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29122906/safety-netting-versus-overtreatment-in-paediatrics-viral-infection-or-incomplete-kawasaki-disease
#5
Jennifer Michelle Charlesworth, Bernadette Power, Edina Moylett
Kawasaki disease (KD) is the most common systemic vasculitis of childhood. The following presentation of a 4-year-old Irish boy referred to a secondary care paediatric service from the community with prolonged fever, oral mucous membrane changes and painless blistering lesions of the hands and feet in the presence of elevated inflammatory markers serves as an opportunity to discuss the diagnostic criteria and treatment for KD and incomplete KD, an often missed diagnosis with significant paediatric morbidity outside an academic paediatric centre...
November 8, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/29119588/an-early-pregnancy-unit-in-the-united-states-an-effective-method-for-evaluating-first-trimester-pregnancy-complications
#6
Polina Rovner, Elaine Stickrath, Meredith Alston, Kirsten Lund
In the United Kingdom, early pregnancy assessment clinics have existed since the early 1990s and have become the reference standard for evaluating and treating women with first-trimester pregnancy complications. These units have now been established in many countries and have been found to be effective and efficient, saving money and unnecessary emergency department visits and hospital admissions. To our knowledge, no such model has been described in the United States. A PubMed search using a combination of "early pregnancy unit," "early pregnancy assessment clinic," and "United States," "U...
November 9, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/29117725/experiencing-financial-hardship-associated-with-medical-bills-and-its-effects-on-health-care-behavior-a-2-year-panel-study
#7
Sunha Choi
Using 2-year panel data, this study examined (1) whether experiencing financial hardship associated with out-of-pocket medical expenditures affected delaying/missing necessary health care in the following year; (2) whether such financial hardship mediated the effects of predisposing, enabling, and need characteristics on timely health care access (i.e., significant indirect effects); and (3)whether such mediating effects are different by chronic health status (i.e., moderated mediation) among U.S. adults. The 2011 National Health Interview Survey was linked to the 2012 Medical Expenditure Panel Survey...
November 1, 2017: Health Education & Behavior: the Official Publication of the Society for Public Health Education
https://www.readbyqxmd.com/read/29113840/extended-venous-thromboembolism-prophylaxis-after-radical-cystectomy-a-call-for-adherence-to-current-guidelines
#8
REVIEW
Zachary Klaassen, Karan Arora, Hanan Goldberg, Thenappan Chandrasekar, Christopher J D Wallis, Rashid K Sayyid, Neil E Fleshner, Antonio Finelli, Alexander Kutikov, Philippe D Violette, Girish S Kulkarni
PURPOSE: Radical cystectomy (RC) is an inherently morbid procedure. The purpose of this review is to assess the timing and incidence of venous thromboembolism (VTE), review current guideline recommendations, and provide evidence for considering extended VTE prophylaxis among all patients undergoing RC. MATERIALS AND METHODS: We conducted a PubMed search of available literature for RC and VTE, focusing on: incidence and timing, evidence supporting extended VTE prophylaxis (among RC and abdominal surgical oncology patients), current guideline recommendations, safety considerations, and direct oral anticoagulants...
November 4, 2017: Journal of Urology
https://www.readbyqxmd.com/read/29095554/patients-perceptions-of-their-doctors-notes-and-after-visit-summaries-a-mixed-methods-study-of-patients-at-safety-net-clinics
#9
Brittaney M Belyeu, Jared W Klein, Lisa M Reisch, Sue Peacock, Natalia V Oster, Joann G Elmore, Sara L Jackson
BACKGROUND: Patients are increasingly offered electronic access to their doctors' notes, and many consistently receive paper After-Visit Summaries. Specific feedback from patients about notes and summaries are lacking, particularly within safety-net settings. DESIGN: A mixed methods study SETTING AND PARTICIPANTS: Patients with poorly controlled diabetes attending two urban safety-net primary care clinics in Washington State. METHODS: Patients read their own most recent clinic note and After-Visit Summary, then completed a brief survey followed by a focus group discussion (3 groups in a large general medicine teaching clinic and 1 in an HIV/AIDS clinic) about their perceptions of the clinic note and After-Visit Summary...
November 2, 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/29084312/effect-of-patient-navigation-and-financial-incentives-on-smoking-cessation-among-primary-care-patients-at-an-urban-safety-net-hospital-a-randomized-clinical-trial
#10
Karen E Lasser, Lisa M Quintiliani, Ve Truong, Ziming Xuan, Jennifer Murillo, Cheryl Jean, Lori Pbert
Importance: While the proportion of adults who smoke cigarettes has declined substantially in the past decade, socioeconomic disparities in cigarette smoking remain. Few interventions have targeted low socioeconomic status (SES) and minority smokers in primary care settings. Objective: To evaluate a multicomponent intervention to promote smoking cessation among low-SES and minority smokers. Design, Setting, and Participants: For this prospective, unblinded, randomized clinical trial conducted between May 1, 2015, and September 4, 2017, adults 18 years and older who spoke English, smoked 10 or more cigarettes per day in the past week, were contemplating or preparing to quit smoking, and had a primary care clinician were recruited from general internal medicine and family medicine practices at 1 large safety-net hospital in Boston, Massachusetts...
October 30, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29081664/impact-of-prior-therapies-on-everolimus-activity-an-exploratory-analysis-of-radiant-4
#11
Roberto Buzzoni, Carlo Carnaghi, Jonathan Strosberg, Nicola Fazio, Simron Singh, Fabian Herbst, Antonia Ridolfi, Marianne E Pavel, Edward M Wolin, Juan W Valle, Do-Youn Oh, James C Yao, Rodney Pommier
BACKGROUND: Recently, everolimus was shown to improve median progression-free survival (PFS) by 7.1 months in patients with advanced, progressive, well-differentiated, nonfunctional neuroendocrine tumors (NET) of lung or gastrointestinal (GI) tract compared with placebo (HR, 0.48; 95% CI, 0.35-0.67; P<0.00001) in the Phase III, RADIANT-4 study. This post hoc analysis evaluates the impact of prior therapies (somatostatin analogs [SSA], chemotherapy, and radiotherapy) on everolimus activity...
2017: OncoTargets and Therapy
https://www.readbyqxmd.com/read/29078730/barriers-to-engagement-in-collaborative-care-treatment-of-uncontrolled-diabetes-in-a-safety-net-clinic
#12
Brittaney Belyeu, Lydia Chwastiak, Joan Russo, Meghan Kiefer, Kathy Mertens, Lisa Chew, Sara L Jackson
Purpose The purpose of the study was to evaluate patient factors associated with nonengagement in a Diabetes Collaborative Care Team (DCCT) program in a safety-net clinic. Methods The first 18 months of a multidisciplinary care, team-based diabetes care management program in a safety-net primary care clinic were studied. Nonengagement was defined as fewer than 2 visits with a team member during the 18 months of the program. Patients who did not engage in the program were compared with those who did engage on demographics, comorbid medical and psychiatric diagnoses, and cardiovascular risk factors, using univariate and multivariable analyses...
December 2017: Diabetes Educator
https://www.readbyqxmd.com/read/29072773/effect-of-hospital-safety-net-designation-on-treatment-use-and-survival-in-hepatocellular-carcinoma
#13
Ali A Mokdad, Caitlin C Murphy, Sandi L Pruitt, John C Mansour, Jorge A Marrero, Amit G Singal, Adam C Yopp
BACKGROUND: Racial/ethnic minorities with hepatocellular carcinoma (HCC) have worse survival than non-Hispanic whites. Comparing patient outcomes across health care delivery systems can identify biological and care delivery mechanisms contributing to this disparity. We compared presentation, treatment, and survival of HCC patients treated at safety net hospitals (SNHs) and non-SNHs. METHODS: Patients diagnosed with HCC from 2001 to 2012 were identified in the Texas Cancer Registry...
October 26, 2017: Cancer
https://www.readbyqxmd.com/read/29059424/hiv-care-initiation-a-teachable-moment-for-smoking-cessation
#14
Damon J Vidrine, Summer G Frank, Micah J Savin, Andrew J Waters, Yisheng Li, Sixia Chen, Faith E Fletcher, Roberto C Arduino, Ellen R Gritz
Introduction: Tobacco use among persons living with HIV represents an important risk factor for poor treatment outcomes, morbidity, and mortality. Thus, efforts designed to inform the development of appropriate smoking cessation programs for this population remains a public health priority. To address this need, a study was conducted to longitudinally assess the relationship between intention to quit smoking and cessation over the 12 month period following initiation of HIV care. Methods: Patients initiating HIV care at a large inner city safety net clinic were enrolled (n=378) in a 12-month prospective study...
September 25, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/29059413/the-time-varying-relations-between-risk-factors-and-smoking-before-and-after-a-quit-attempt
#15
Matthew D Koslovsky, Emily T Hébert, Michael D Swartz, Wenyaw Chan, Luis Leon-Novelo, Anna V Wilkinson, Darla E Kendzor, Michael S Businelle
Introduction: Intensive longitudinal data (ILD) collected with ecological momentary assessments (EMAs) can provide a rich resource for understanding the relations between risk factors and smoking in the time surrounding a cessation attempt. Methods: Participants (N=142) were smokers seeking treatment at a safety-net hospital smoking cessation clinic who were randomly assigned to receive standard clinic care (i.e., counseling and cessation medications) or standard care plus small financial incentives for biochemically confirmed smoking abstinence...
October 4, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/29059279/wealth-associated-disparities-in-death-and-disability-in-the-united-states-and-england
#16
Lena K Makaroun, Rebecca T Brown, L Grisell Diaz-Ramirez, Cyrus Ahalt, W John Boscardin, Sean Lang-Brown, Sei Lee
Importance: Low income has been associated with poor health outcomes. Owing to retirement, wealth may be a better marker of financial resources among older adults. Objective: To determine the association of wealth with mortality and disability among older adults in the United States and England. Design, Setting, and Participants: The US Health and Retirement Study (HRS) and English Longitudinal Study of Aging (ELSA) are nationally representative cohorts of community-dwelling older adults...
October 23, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29056371/preventive-service-use-among-people-with-and-without-serious-mental-illnesses
#17
Bobbi Jo H Yarborough, Nancy A Perrin, Scott P Stumbo, John Muench, Carla A Green
INTRODUCTION: People with serious mental illnesses experience excess morbidity and premature mortality resulting from preventable conditions. The goal was to examine disparities in preventive care that might account for poor health outcomes. METHODS: In this retrospective cohort study, adults (N=803,276) served by Kaiser Permanente Northwest and federally qualified health centers/safety-net community health clinics were categorized into five groups: schizophrenia spectrum disorders, bipolar disorders/affective psychoses, anxiety disorders, nonpsychotic unipolar depression, and reference groups with no evidence of these specific mental illnesses...
October 11, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29055770/implementation-of-a-multidisciplinary-team-based-model-to-treat-chronic-hepatitis-c-in-the-primary-care-setting-lessons-learned
#18
Randi Sokol, Jessica Early, Amanda Barner, Sarah Gottfried, Richard Gumpert, Lorky Libaridian, Virginia Morrison, Alexandra Santamaria, Linda Shipton
Hepatitis C virus (HCV) is the most common blood-borne virus in the U.S., and its incidence continues to rise. With approval of direct-acting antiviral medications, treatment for Chronic Hepatitis C (CHC) has become highly efficacious with a minimal side effect profile. Primary care physicians are well-positioned to address this increased demand, yet most do not feel comfortable treating CHC. In this case report, we describe implementation of a multidisciplinary team-based approach for treating CHC at multiple primary care sites across a large safety net health system...
October 18, 2017: Healthcare
https://www.readbyqxmd.com/read/29055056/everolimus-in-advanced-progressive-well-differentiated-non-functional-neuroendocrine-tumors-radiant-4-lung-subgroup-analysis
#19
Nicola Fazio, Roberto Buzzoni, Gianfranco Delle Fave, Margot E Tesselaar, Edward Wolin, Eric Van Cutsem, Paolo Tomassetti, Jonathan Strosberg, Maurizio Voi, Lida Bubuteishvili-Pacaud, Antonia Ridolfi, Fabian Herbst, Jiri Tomasek, Simron Singh, Marianne Pavel, Matthew H Kulke, Juan W Valle, James C Yao
In the phase III RADIANT-4 study, everolimus improved median progression-free survival (PFS) by 7.1 months in patients with advanced, progressive, well-differentiated (grade 1 or grade 2), non-functional lung or gastrointestinal neuroendocrine tumors (NETs) vs placebo (hazard ratio, 0.48; 95% confidence interval [CI], 0.35-0.67; P < .00001). This exploratory analysis reports the outcomes of the subgroup of patients with lung NETs. In RADIANT-4, patients were randomized (2:1) to everolimus 10 mg/d or placebo, both with best supportive care...
October 21, 2017: Cancer Science
https://www.readbyqxmd.com/read/29052175/african-americans-with-cirrhosis-are-less-likely-to-receive-endoscopic-variceal-screening-within-one-year-of-cirrhosis-diagnosis
#20
Ann Robinson, Hesam Tavakoli, Benny Liu, Taft Bhuket, Ramsey Cheung, Robert J Wong
BACKGROUND: Esophageal variceal hemorrhage is a complication of cirrhosis that carries high mortality, and can be reduced with timely endoscopic variceal screening and treatment. AIM: We aim to evaluate overall rates of and disparities in receipt of endoscopic variceal screening among an ethnically diverse urban safety-net hospital. METHODS: All consecutive adults with cirrhosis (7/1/2014 to 12/31/2015) were retrospectively evaluated to determine the rates of receiving esophageal variceal screening within 6 months and within 1 year after cirrhosis diagnosis...
October 19, 2017: Journal of Racial and Ethnic Health Disparities
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