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Quality improvement in primary care

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https://www.readbyqxmd.com/read/28544780/spinal-metastatic-disease-a-review-of-the-role-of-the-multidisciplinary-team
#1
REVIEW
Mark Curtin, Robert P Piggott, Evelyn P Murphy, Sudarshan Munigangaiah, Joseph F Baker, John P McCabe, Aiden Devitt
Historically, a simple approach centered on palliation was applicable to the majority of patients with metastatic spinal disease. With advances in diagnosis and treatment, a more complicated algorithm has devolved requiring a multidisciplinary approach with institutional commitment and support. We performed a database review including pertinent articles exploring the multidisciplinary management of spinal metastatic disease. The wide variation in clinical presentation and tumor response to treatment necessitates a multidisciplinary approach that integrates the diagnosis and treatment of the cancer, symptom management, and rehabilitation for optimal care of patients with spinal metastases...
May 24, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28543716/an-atopic-dermatitis-management-algorithm-for-primary-care-providers-and-assessment-of-its-usefulness-as-a-clinical-tool
#2
Maria E Miyar, Megan Brown, Karina L Vivar, Kimberly Jablon, Christy Boscardin, Moise L Levy, Joyce M Teng, Erin F Mathes
BACKGROUND/OBJECTIVES: There is a lack of primary care provider (PCP) understanding of atopic dermatitis (AD) treatments and topical steroid use. We designed an AD management algorithm for pediatric PCPs. We hypothesized that the algorithm would improve pediatric PCPs' knowledge of AD diagnosis and management. METHODS: Pediatric primary care resident and attending physicians at three residency programs were invited to participate in an electronic AD algorithm survey that contained demographic and 19 knowledge-based questions...
May 25, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28543692/the-impact-of-resident-involvement-in-breast-reconstruction-surgery-outcomes-by-modality-an-analysis-of-4-500-cases
#3
Kevin T Jubbal, Anthony Echo, Aldona J Spiegel, Shayan A Izaddoost
BACKGROUND: The goal of this study was to determine the impact of resident involvement on various methods of breast reconstruction via an American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) retrospective analysis. METHODS: We performed a retrospective analysis of the ACS NSQIP database to identify patients undergoing breast reconstruction by free flap, implant, latissimus dorsi (LD), and transverse rectus abdominis myocutaneous (TRAM) flap reconstruction modalities...
May 24, 2017: Microsurgery
https://www.readbyqxmd.com/read/28543671/patient-centred-dietetic-care-from-the-perspectives-of-older-malnourished-patients
#4
E Hazzard, L Barone, M Mason, K Lambert, A McMahon
BACKGROUND: Governing organisations for health services currently recommend a patient-centred (PC) approach to practice for all health professions, including dietetics. For the vulnerable older malnourished patient, this approach needs to be prioritised to improve outcomes. The paucity of patient experience data likely limits evidence-based, patient-centred care (PCC) from being implemented effectively. The present study aimed to identify quality indicators of dietetic services from the perspectives of older malnourished patients to inform evidence-based PC dietetic care...
May 22, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28542622/meta-analysis-of-magnetic-resonance-imaging-accuracy-for-diagnosis-of-oral-cancer
#5
Marcelo Aldrighi Moreira, Luiza Silveira Lessa, Francieli Regina Bortoli, Abigail Lopes, Eduardo Picolo Xavier, Renan Antonio Ceretta, Fernanda Guglielmi Faustini Sônego, Cristiane Damiani Tomasi, Patricia Duarte Simões Pires, Luciane Bisognin Ceretta, Ingrid Dalira Schweigert Perry, Priscyla Waleska Simões
OBJECTIVE: To establish the diagnostic accuracy of magnetic resonance imaging (MRI) as an auxiliary means for the diagnosis of oral cancer through a systematic review and meta-analysis. METHODS: An exhaustive search of publications from 1986 to 2016 was performed of Medline, Embase and Cochrane (and related databases), including grey literature. Primary diagnostic accuracy studies that assessed oral cancer (target condition) using MRI (index test) were included...
2017: PloS One
https://www.readbyqxmd.com/read/28542530/quality-of-nutrition-services-in-primary-health-care-facilities-implications-for-integrating-nutrition-into-the-health-system-in-bangladesh
#6
Sk Masum Billah, Kuntal Kumar Saha, Abdullah Nurus Salam Khan, Ashfaqul Haq Chowdhury, Sarah P Garnett, Shams El Arifeen, Purnima Menon
BACKGROUND: In 2011, the Bangladesh Government introduced the National Nutrition Services (NNS) by leveraging the existing health infrastructure to deliver nutrition services to pregnant woman and children. This study examined the quality of nutrition services provided during antenatal care (ANC) and management of sick children younger than five years. METHODS: Service delivery quality was assessed across three dimensions; structural readiness, process and outcome...
2017: PloS One
https://www.readbyqxmd.com/read/28540530/voice-outcomes-in-surgical-repair-of-zenker-s-diverticulum
#7
Stephen Schoeff, Michael Freeman, James Daniero
The purpose of the study was to define the impact of Zenker's diverticula on voice and potential benefit from repair. Retrospective chart review of prospectively collected data from eleven patients with a Zenker's diverticulum treated surgically in a tertiary care center from November 2014 through January 2016. The voice handicap index-10 (VHI-10) and eating assessment tool-10 (EAT-10) questionnaires were collected as part of pre- and post-operative evaluation, with an average post-operative follow-up of 69 days...
May 25, 2017: Dysphagia
https://www.readbyqxmd.com/read/28539693/quality-based-procedures-for-knee-replacement-hip-replacement-and-hip-fracture-physiotherapists-perceptions-of-adherence-barriers-and-facilitators
#8
Kirsti J E Reinikka, Denise Taylor, Sylvia Daniel, Stacey Burns-Hogan, Brittany DePass, Laura McGill, Michael McLeod, Susan Safadi, Sandy Veit
Purpose: This mixed-methods study examined the perceived barriers to and facilitators of implementing best-practice guidelines (BPGs) and adhering to provincial Quality-Based Procedures (QBPs) by Ontario physiotherapists working with patients after total knee replacement (TKR), total hip replacement (THR), and hip fracture (HF). Method: Using snowball sampling, 93 hospital and home care physiotherapists working with patients after TKR, THR, or HF completed a Web-based survey. A subset of these participated in follow-up semi-structured telephone interviews...
2017: Physiotherapy Canada. Physiothérapie Canada
https://www.readbyqxmd.com/read/28538939/quality-of-life-and-associated-characteristics-application-of-whoqol-bref-in-the-context-of-primary-health-care
#9
Celline Cardoso Almeida-Brasil, Micheline Rosa Silveira, Kátia Rodrigues Silva, Marina Guimarães Lima, Christina Danielli Coelho de Morais Faria, Claudia Lins Cardoso, Hans-Joachim Karl Menzel, Maria das Graças Braga Ceccato
This study aimed to identify the characteristics associated to quality of life (QOL) in users of four Basic Health Units (Unidades Básicas de Saúde, UBS) in Belo Horizonte, Minas Gerais. We conducted a cross-sectional study with 930 adult users enrolled in the selected UBS, using a questionnaire containing the WHOQOL-bref instrument and questions about sociodemographic characteristics, lifestyle and health conditions. Following descriptive analysis, we performed simple and multiple linear regression to evaluate the association between the exposure variables and the QOL domains...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28538934/availability-of-herbal-medicines-and-medicinal-plants-in-the-primary-health-facilities-of-the-state-of-s%C3%A3-o-paulo-southeast-brazil-results-from-the-national-program-for-access-and-quality-improvement-in-primary-care
#10
Maria do Carmo Gullaci Guimarães Caccia-Bava, Bianca Waléria Bertoni, Ana Maria Soares Pereira, Edson Zangiacomi Martinez
This study aims to describe the availability of herbal medicines and medicinal plants in the primary care facilities in the state of São Paulo, Southeast Brazil, from the results of the first cycle of the National Program for Access and Quality Improvement in Primary Care (PMAQ). The PMAQ uses a national cross-sectional multicenter design, with data from 4,249 health facilities distributed among 645 municipalities of the state of São Paulo. Of these facilities, 467 (11%) had herbal medicines and/or medicinal plants...
May 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28538261/physical-activity-and-sleep-quality-in-breast-cancer-survivors-a-randomized-trial
#11
Laura Q Rogers, Kerry S Courneya, Robert A Oster, Philip M Anton, Randall S Robbs, Andres Forero, Edward McAuley
PURPOSE: Data from large randomized controlled trials confirming sleep quality improvements with aerobic physical activity have heretofore been lacking for post-primary treatment breast cancer survivors. Our primary purpose for this report was to determine the effects of a physical activity behavior change intervention, previously reported to significantly increase physical activity behavior, on sleep quality in post-primary treatment breast cancer survivors. METHODS: Post-primary treatment breast cancer survivors (n=222) were randomized to a 3-month physical activity behavior change intervention (BEAT Cancer) or usual care...
May 20, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28536899/effect-of-educating-the-primary-care-physician-about-headache-to-help-reduce-trivial-referrals-and-improve-the-number-and-quality-of-substantial-referrals-that-truly-need-subspecialty-headache-medicine-care
#12
REVIEW
Robert Cowan, Meredith Barad
Technology is likely to play an increasingly important role in the delivery of healthcare as the disparity between provider availability/expertise and patient numbers/needs increases. This article is intended to lend insight into the ways in which technology can facilitate the evaluation of patients with headache disorders and improve the ongoing monitoring of disease progression and response to therapy, following proper diagnosis. While it is not possible to prognosticate the impact of technologies not yet available, the article addresses potential novel usage of currently existing technology to standardize intake, expedite evaluations, ensure adequate history and documentation, and monitoring of patient care...
July 2017: Current Treatment Options in Neurology
https://www.readbyqxmd.com/read/28536094/using-beta-version-mhealth-technology-for-team-based-care-management-to-support-stroke-prevention-an-assessment-of-utility-and-challenges
#13
Magaly Ramirez, Shinyi Wu, Gery Ryan, Amytis Towfighi, Barbara G Vickrey
BACKGROUND: Beta versions of health information technology tools are needed in service delivery models with health care and community partnerships to confirm the key components and to assess the performance of the tools and their impact on users. We developed a care management technology (CMT) for use by community health workers (CHWs) and care managers (CMs) working collaboratively to improve risk factor control among recent stroke survivors. The CMT was expected to enhance the efficiency and effectiveness of the CHW-CM team...
May 23, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28536088/the-use-of-text-messaging-to-improve-the-hospital-to-community-transition-in-acute-coronary-syndrome-patients-txt2prevent-intervention-development-and-pilot-randomized-controlled-trial-protocol
#14
Emily S Ross, Brodie M Sakakibara, Martha H Mackay, David Gt Whitehurst, Joel Singer, Mustafa Toma, Kitty K Corbett, Harriette Gc Van Spall, Kimberly Rutherford, Bobby Gheorghiu, Jillianne Code, Scott A Lear
BACKGROUND: Acute coronary syndrome, including acute myocardial infarction (AMI), is one of the leading causes for hospitalization, with AMI 30-day readmission rates around 20%. Supporting patient information needs and increasing adherence to recommended self-management behaviors during transition from hospital to home has the potential to improve patient outcomes. Text messages have been effective in other interventions and may be suitable to provide support to patients during this transition period...
May 23, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28535360/posttransplant-lymphoproliferative-disorder-otolaryngological-manifestations-and-management
#15
Richard Heyes, Donald W Northfelt, David G Lott
Objective Posttransplant lymphoproliferative disorder (PTLD) is a unifying term for a spectrum of lymphoid expansion entities brought about by immunosuppression and is strongly associated with Epstein-Barr virus (EBV). Otolaryngological findings tend to present early in the clinical course; therefore, disease awareness among otolaryngologists is of utmost importance. This review synthesizes the body of literature pertaining to PTLD involving the head and neck, summarizes contemporary management, and highlights areas for future research...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28535331/computer-and-mobile-technology-interventions-for-self-management-in-chronic-obstructive-pulmonary-disease
#16
REVIEW
Catherine McCabe, Margaret McCann, Anne Marie Brady
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction due to an abnormal inflammatory response of the lungs to noxious particles or gases, for example, cigarette smoke. The pattern of care for people with moderate to very severe COPD often involves regular lengthy hospital admissions, which result in high healthcare costs and an undesirable effect on quality of life. Research over the past decade has focused on innovative methods for developing enabling and assistive technologies that facilitate patient self-management...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28535154/randomised-controlled-trial-of-early-prophylactic-feeding-vs-standard-care-in-patients-with-head-and-neck-cancer
#17
Teresa E Brown, Merrilyn D Banks, Brett G M Hughes, Charles Y Lin, Lizbeth M Kenny, Judith D Bauer
BACKGROUND: Weight loss remains significant in patients with head and neck cancer, despite prophylactic gastrostomy and intensive dietary counseling. The aim of this study was to improve outcomes utilising an early nutrition intervention. METHODS: Patients with head and neck cancer at a tertiary hospital in Australia referred for prophylactic gastrostomy prior to curative intent treatment were eligible for this single centre randomised controlled trial. Exclusions included severe malnutrition or dysphagia...
May 23, 2017: British Journal of Cancer
https://www.readbyqxmd.com/read/28535109/intranasal-steroid-use-for-otitis-media-with-effusion-ongoing-opportunities-for-quality-improvement
#18
David E Wang, Derek J Lam, Angela M Bellmunt, Richard M Rosenfeld, Allison K Ikeda, Jennifer J Shin
Objectives Our objectives were (1) to assess patterns of intranasal steroid administration when otitis media with effusion (OME) has been diagnosed in children, (2) to investigate whether usage varies according to visit setting, and (3) to determine if practice gaps are such that quality improvement could be tracked. Study Design Cross-sectional analysis of an administrative database. Subjects and Methods National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005 to 2012; univariate, multivariate, and stratified analyses of intranasal steroid usage were performed...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28533106/trans-sectoral-care-of-geriatric-cancer-patients-based-on-comprehensive-geriatric-assessment-and-patient-reported-quality-of-life-results-of-a-multicenter-study-to-develop-and-pilot-test-a-patient-centered-interdisciplinary-care-concept-for-geriatric-oncology
#19
Heike Schmidt, Stephanie Boese, Katharina Lampe, Karin Jordan, Eckhard Fiedler, Ursula Müller-Werdan, Andreas Wienke, Dirk Vordermark
OBJECTIVES: For older patients with cancer the maintenance of independence, functionality and health-related quality of life (HRQOL) is of great importance. Aiming to maintain HRQOL of older patients with cancer we developed an interdisciplinary care program based on comprehensive geriatric assessment (CGA) and patient-reported HRQOL comprising tailored supportive measures and telephone-based counseling during 6month aftercare. MATERIALS AND METHODS: Pilot-testing of the intervention took place in three centers at the University Hospital Halle to examine feasibility, acceptance and potential benefit...
May 19, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28532739/quality-of-missing-data-reporting-and-handling-in-palliative-care-trials-demonstrates-that-further-development-of-the-consort-missing-data-reporting-guidance-is-required-a-systematic-review
#20
Jamilla A Hussain, Martin Bland, Dean Langan, Miriam J Johnson, David C Currow, Ian R White
OBJECTIVES: Assess (i) the quality of reporting and handling missing data in palliative care trials against current guidance, (ii) whether there are differences in the reporting of criteria specified by the CONSORT 2010 statement compared to those not specified, (iii) the association of the reporting of missing data with journal impact factor and CONSORT endorsement status. STUDY DESIGN AND SETTING: Systematic review of palliative care randomised controlled trials...
May 19, 2017: Journal of Clinical Epidemiology
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