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Quality improvement in primary care

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https://www.readbyqxmd.com/read/28645890/tailored-communication-within-mobile-apps-for-diabetes-self-management-a-systematic-review
#1
Heidi Holmen, Astrid Klopstad Wahl, Milada Cvancarova Småstuen, Lis Ribu
BACKGROUND: The prevalence of diabetes is increasing and with the requirements for self-management and risk of late complications, it remains a challenge for the individual and society. Patients can benefit from support from health care personnel in their self-management, and the traditional communication between patients and health care personnel is changing. Smartphones and apps offer a unique platform for communication, but apps with integrated health care personnel communication based on patient data are yet to be investigated to provide evidence of possible effects...
June 23, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28645260/within-class-differences-in-cancer-risk-for-sulfonylurea-treatments-in-patients-with-type-2-diabetes-zodiac-55-a-study-protocol
#2
Dennis Schrijnders, Geertruida H de Bock, Sebastiaan T Houweling, Kornelis J J van Hateren, Klaas H Groenier, Jeffrey A Johnson, Henk J G Bilo, Nanne Kleefstra, Gijs W D Landman
BACKGROUND: Patients with type 2 diabetes (T2D) are at increased risk for developing cancer. As approximately 8% of the world's population is living with T2D, even a slight increase in cancer risk could result in an enormous impact on the number of persons developing cancer. In addition, several glucose lowering drug classes for treating patients with T2D have been associated with a difference in risk of cancer overall, and especially for obesity related cancers. In what way and to what degree cancer risk is modified by the use of different sulfonylureas (SU) is unclear...
June 23, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28645203/neurosurgical-randomized-controlled-trials-distance-travelled
#3
Tej D Azad, Anand Veeravagu, Vaishali Mittal, Rogelio Esparza, Eli Johnson, John P A Ioannidis, Gerald A Grant
BACKGROUND: The evidence base for many neurosurgical procedures has been limited. We performed a comprehensive and systematic analysis of study design, quality of reporting, and trial results of neurosurgical randomized controlled trials (RCTs). OBJECTIVE: To systematically assess the design and quality characteristics of neurosurgical RCTs. METHODS: From January 1961 to June 2016, RCTs with >5 patients assessing any 1 neurosurgical procedure against another procedure, nonsurgical treatment, or no treatment were retrieved from MEDLINE, Scopus, and Cochrane Library...
June 21, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28645191/how-effective-is-algorithm-guided-treatment-for-depressed-inpatients-results-from-the-randomized-controlled-multicenter-german-algorithm-project-3-trial
#4
Mazda Adli, Katja Wiethoff, Thomas C Baghai, Robert Fisher, Florian Seemüller, Gregor Laakmann, Peter Brieger, Joachim Cordes, Jaroslav Malevani, Gerd Laux, Iris Hauth, Hans-Jürgen Möller, Klaus-Thomas Kronmüller, Michael N Smolka, Peter Schlattmann, Maximilian Berger, Roland Ricken, Thomas J Stamm, Andreas Heinz, Michael Bauer
Background: Treatment algorithms are are considered as key to improve outcomes by enhancing the quality of care. This is the first randomized controlled study to evalutate the clinical effect of algorithm-guided treatment in inpatients with major depressive disorder (MDD). Methods: Inpatients, aged 18-70 years with MDD from 10 German psychiatric departments were randomized to 5 different treatment arms (from 2000 to 2005), three of which were standardized stepwise drug treatment algorithms (ALGO)...
June 22, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28644698/sleep-disturbance-after-hospitalization-and-critical-illness-a-systematic-review
#5
Marcus T Altman, Melissa P Knauert, Margaret A Pisani
BACKGROUND: Sleep disturbance during intensive care unit (ICU) admission is common and severe. Sleep disturbance has been observed in survivors of critical illness even after transfer out of the ICU. Not only is sleep important to overall health and well-being, but patients after critical illness are also in a physiologically vulnerable state. Understanding how sleep disturbance impacts recovery from critical illness after hospital discharge is therefore clinically meaningful. OBJECTIVE: This systematic review aimed to summarize studies that identify the prevalence of and risk factors for sleep disturbance after hospital discharge for critical illness survivors...
June 23, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28644316/a-multicenter-evaluation-of-adherence-to-4-major-elements-of-the-baveno-guidelines-and-outcomes-for-patients-with-acute-variceal-hemorrhage
#6
Elliot B Tapper, Jennifer Friderici, Zachary A Borman, Jacob Alexander, Alan Bonder, Nabiha Nuruzzaman, Sheryl Ramdass, Rony Ghaoui
GOALS: To determine the rate of and outcomes associated with guideline adherence in the care of acute variceal hemorrhage (AVH). BACKGROUND: Four major elements of high-quality care for AVH defined by the Baveno consensus (VI) include timely endoscopy (≤12 h), antibiotics, and somatostatin analogs before endoscopy and band ligation as primary therapy for esophageal varices. STUDY: We retrospectively evaluated 239 consecutive admissions of 211 patients with AVH admitted to 2 centers in Massachusetts from 2010 to 2015...
June 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28643212/the-role-of-primary-health-care-in-hepatitis-b-testing-and-management-a-case-study
#7
Jacqueline A Richmond, Joe Sasadeusz, Meredith Temple-Smith
Hepatitis B is a complex disease requiring lifelong management. Infection is linked to birth in high prevalence regions including Africa and Asia. Best practice guidelines identify who to test for hepatitis B, however, a significant proportion of Australians with hepatitis B have not been diagnosed, and are subsequently at risk of serious morbidity and mortality. This study sought to address the gap between current and optimal hepatitis B testing in a primary care clinic with a likely high population of undiagnosed hepatitis B...
June 22, 2017: Journal of Community Health
https://www.readbyqxmd.com/read/28642017/patterns-of-care-and-temporal-trends-in-ischemic-stroke-management-a-brazilian-perspective
#8
Monique Bueno Alves, Gisele Sampaio Silva, Renata Carolina Acri Miranda, Rodrigo Meireles Massaud, Andreia Maria Heins Vaccari, Miguel Cendoroglo-Neto, Solange Diccini
BACKGROUND AND PURPOSE: Demonstration of an improvement process of quality indicators in stroke care is essential to obtain certification as a primary stroke center (PSC). Our aim was to evaluate factors that influence temporal trends in quality indicators of ischemic stroke (IS) in a Brazilian hospital. METHODS: We evaluated patients discharged with IS from a tertiary hospital from January 2009 to December 2013. Ten predefined performance measures selected by the Get With the Guidelines-Stroke program were assessed...
June 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28641703/a-randomised-controlled-trial-to-assess-the-cost-effectiveness-of-intensive-versus-no-scheduled-follow-up-in-patients-who-have-undergone-resection-for-colorectal-cancer-with-curative-intent
#9
David Mant, Alastair Gray, Siân Pugh, Helen Campbell, Stephen George, Alice Fuller, Bethany Shinkins, Andrea Corkhill, Jane Mellor, Elizabeth Dixon, Louisa Little, Rafael Perera-Salazar, John Primrose
BACKGROUND: Intensive follow-up after surgery for colorectal cancer is common practice but lacks a firm evidence base. OBJECTIVE: To assess whether or not augmenting symptomatic follow-up in primary care with two intensive methods of follow-up [monitoring of blood carcinoembryonic antigen (CEA) levels and scheduled imaging] is effective and cost-effective in detecting the recurrence of colorectal cancer treatable surgically with curative intent. DESIGN: Randomised controlled open-label trial...
May 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28641599/association-between-level-of-exposure-to-death-and-dying-and-professional-quality-of-life-among-palliative-care-workers
#10
Tali Samson, Pesach Shvartzman
BACKGROUND: Exposure to the death and dying of others is an anxiety-provoking condition that can contribute to psychological stress. However, the results of empirical studies that evaluated work-related outcomes among physicians and nurses with repeated exposure to dying patients are not consistent. OBJECTIVE: Our aim was to evaluate whether a high level of exposure to death and dying (LED) can increase the risk for poor professional quality of life (ProQoL) in most healthcare workers, but it can also improve ProQoL in a subset of healthcare workers with specific characteristics...
June 23, 2017: Palliative & Supportive Care
https://www.readbyqxmd.com/read/28640822/effective-treatment-options-for-musculoskeletal-pain-in-primary-care-a-systematic-overview-of-current-evidence
#11
Opeyemi O Babatunde, Joanne L Jordan, Danielle A Van der Windt, Jonathan C Hill, Nadine E Foster, Joanne Protheroe
BACKGROUND & AIMS: Musculoskeletal pain, the most common cause of disability globally, is most frequently managed in primary care. People with musculoskeletal pain in different body regions share similar characteristics, prognosis, and may respond to similar treatments. This overview aims to summarise current best evidence on currently available treatment options for the five most common musculoskeletal pain presentations (back, neck, shoulder, knee and multi-site pain) in primary care...
2017: PloS One
https://www.readbyqxmd.com/read/28640330/-incorporation-of-information-and-communication-technologies-and-quality-of-primary-healthcare-in-brazil
#12
Alaneir de Fátima Dos Santos, Délcio Fonseca, Lucas Lobato Araujo, Cristiane da Silva Diniz Procópio, Érica Araújo Silva Lopes, Angela Maria de Lourdes Dayrell de Lima, Clarice Magalhães Rodrigues Dos Reis, Daisy Maria Xavier de Abreu, Alzira Oliveira Jorge, Antonio Thomaz Matta-Machado
Information and Communication Technologies (ICTs) are means to handle information, streamline communication, and contribute to patient care. This article describes the incorporation of Information and Communication Technologies in primary care and its association with quality, based on the Brazilian National Program for the Improvement of Access and Quality in Primary Care (PMAQ in portuguese). This was a cross-sectional study with 17,053 teams. An Index of Incorporation of ICTs was created, which included: information infrastructure, systems, and utilization...
June 5, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28640136/cost-effectiveness-of-neck-specific-exercise-with-or-without-a-behavioral-approach-versus-physical-activity-prescription-in-the-treatment-of-chronic-whiplash-associated-disorders-analyses-of-a-randomized-clinical-trial
#13
Maria Landén Ludvigsson, Anneli Peolsson, Gunnel Peterson, Åsa Dedering, Gun Johansson, Lars Bernfort
BACKGROUND: Fifty percent of people injured by whiplash still report neck pain after 1 year and costs associated with whiplash associated disorders (WAD) are mostly attributed to health service and sick-leave costs in chronic conditions. With increasing health care expenditures the economic impact of interventions needs to be considered. OBJECTIVE: To analyze the cost-effectiveness of physiotherapist-led neck-specific exercise without (NSE) or with a behavioral approach (NSEB), or prescription of physical activity (PPA) in chronic WAD, grade 2 to 3...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28639974/an-evaluation-of-cardioprevent-a-technology-enabled-health-behavior-change-program-for-the-global-reduction-of-cardiovascular-risk
#14
Stephanie A Prince, Robert D Reid, Andrew L Pipe, Lisa A McDonnell
PURPOSE OF REVIEW: Cardiovascular diseases (CVDs) are the leading cause of mortality globally. Primary CVD prevention programs have the potential to improve risk factor profiles and, ultimately, the risk of developing CVD. The present study presents an evaluation of CardioPrevent, a global cardiovascular risk reduction program. RECENT FINDINGS: Of the 478 participants enrolled in the CardioPrevent program, 308 and 236 had complete 6-month and 12-month data, respectively at the time of evaluation...
July 20, 2017: Current Opinion in Cardiology
https://www.readbyqxmd.com/read/28639389/implementing-two-nurse-practitioner-models-of-service-at-an-australian-male-prison-a-quality-assurance-study
#15
Ides Wong, Eryn Wright, Damian Santomauro, Raquel How, Christopher Leary, Meredith Harris
AIMS AND OBJECTIVES: To examine the quality and safety of nurse practitioner services of two newly implemented nurse practitioner models of care at a correctional facility. BACKGROUND: Nurse practitioners could help to meet the physical and mental health needs of Australia's growing prison population; however, the nurse practitioner role has not previously been evaluated in this context. DESIGN: A quality assurance study conducted in an Australian prison where a primary health nurse practitioner and a mental health nurse practitioner were incorporated into an existing primary healthcare service...
June 21, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28639262/interprofessional-collaboration-to-improve-professional-practice-and-healthcare-outcomes
#16
REVIEW
Scott Reeves, Ferruccio Pelone, Reema Harrison, Joanne Goldman, Merrick Zwarenstein
BACKGROUND: Poor interprofessional collaboration (IPC) can adversely affect the delivery of health services and patient care. Interventions that address IPC problems have the potential to improve professional practice and healthcare outcomes. OBJECTIVES: To assess the impact of practice-based interventions designed to improve interprofessional collaboration (IPC) amongst health and social care professionals, compared to usual care or to an alternative intervention, on at least one of the following primary outcomes: patient health outcomes, clinical process or efficiency outcomes or secondary outcomes (collaborative behaviour)...
June 22, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28638569/quality-improvement-for-hiv-screening-in-a-primary-care-resident-clinic
#17
Tracey Doering, Sagal Mohamed, Laura Hollar, Zachary Pugh
Primary care physicians are responsible for the initiation of the preventive health screening tests and examinations for their patients. Resident physicians may be uncomfortable obtaining a sexual history from their patient. A performance improvement project was carried out in the resident clinic to see if we could improve HIV screening of our patients. With a cohesive effort between the faculty preceptors and residents, we were able to improve screening rates for HIV and improve some aspects, but not all, of sexual history taking for our population of patients...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28637654/implementation-of-instrument-based-vision-screening-for-preschool-age-children-in-primary-care
#18
Jonathan R Modest, Katherine M Majzoub, Bruce Moore, Vijeta Bhambhani, Sarah R McLaughlin, Louis Vernacchio
BACKGROUND: Vision screening is an essential element of well-child care for young children. Recently, several professional groups have recommended the use of instrument-based screening; however, studies demonstrating the effectiveness of this technique in pediatric primary care settings are lacking. METHODS: We designed a cluster randomized quality improvement project to test the implementation of instrument-based vision screening for 3- to 5-year-old children within a pediatric primary care network...
June 21, 2017: Pediatrics
https://www.readbyqxmd.com/read/28637554/the-g60-trauma-center-a-future-consideration
#19
Marko Bukur, Joshua Simon, Joseph Catino, Margaret Crawford, Ivan Puente, Fahim Habib
With a considerably increasing elderly population, we sought to determine whether the volume of elderly trauma patients treated impacted outcomes at two different Level I trauma centers. This is a retrospective review of all elderly patients (>60 years) at two state-verified Level I trauma centers over the past five years. The elderly trauma center (ETC) saw a greater proportion (52%) of elderly patients than the reference trauma center (30%, TC). Demographic and clinical characteristics were abstracted and stratified into ETC and TC groups for comparison...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28636834/implementation-of-medical-homes-in-federally-qualified-health-centers
#20
Justin W Timbie, Claude M Setodji, Amii Kress, Tara A Lavelle, Mark W Friedberg, Peter J Mendel, Emily K Chen, Beverly A Weidmer, Christine Buttorff, Rosalie Malsberger, Mallika Kommareddi, Afshin Rastegar, Aaron Kofner, Lisa Hiatt, Ammarah Mahmud, Katherine Giuriceo, Katherine L Kahn
Background From 2011 through 2014, the Federally Qualified Health Center Advanced Primary Care Practice Demonstration provided care management fees and technical assistance to a nationwide sample of 503 federally qualified health centers to help them achieve the highest (level 3) medical-home recognition by the National Committee for Quality Assurance, a designation that requires the implementation of processes to improve access, continuity, and coordination. Methods We examined the achievement of medical-home recognition and used Medicare claims and beneficiary surveys to measure utilization of services, quality of care, patients' experiences, and Medicare expenditures in demonstration sites versus comparison sites...
June 21, 2017: New England Journal of Medicine
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