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https://www.readbyqxmd.com/read/29793213/end-stage-renal-disease-models-in-the-americas-optimizing-resources-to-achieve-better-health-outcomes
#1
Ramiro E Gilardino, Eduardo González-Pier, Claudia Brabata
End-stage renal disease, the last and most severe stage of chronic kidney disease, represents a major and rising concern for countries in Latin America, driven in large part by aging populations and the near-epidemic rises in diabetes, obesity, and hypertension. This places a great clinical, economic, and social burden on the region's health systems. During the ISPOR 6th Latin America Conference held in Sao Paulo, Brazil, in September 2017, an educational forum debated on value-based decision making in the treatment of end-stage renal disease in Latin America...
May 21, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29792736/overutilization-of-health-care-resources-for-breast-pain
#2
Anne C Kushwaha, Kyungmin Shin, Megan Kalambo, Ravinder Legha, Karen E Gerlach, Megha Madhukar Kapoor, Wei T Yang
OBJECTIVE: The objective of this study is to analyze the incidence of women with breast pain who present to an imaging center and assess the imaging findings, outcomes, and workup costs at breast imaging centers affiliated with one institution. MATERIALS AND METHODS: Demographic characteristics of and imaging findings for female patients presenting with breast pain at three community breast imaging centers between January 1, 2014, and December 31, 2014, were reviewed...
May 24, 2018: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/29792460/the-complexity-diversity-and-science-of-primary-care-teams
#3
Kevin Fiscella, Susan H McDaniel
This article examines the past, present and future of primary care and teamwork. It begins with a definition and description of primary care-its uniqueness, diversity and complexity, including the historical role of teams within primary care. The article then reviews the emergence of innovative primary care teams, including those grounded in new processes such as the Patient-Centered Medical Home and interprofessional teams that include new types of health professionals, particularly psychologists and other integrated behavioral health clinicians...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792191/cost-of-provision-of-opioid-substitution-therapy-provision-in-tijuana-mexico
#4
Jose Luis Burgos, Javier A Cepeda, James G Kahn, Maria Luisa Mittal, Emilio Meza, Raúl Rafael Palacios Lazos, Psyché Calderón Vargas, Peter Vickerman, Steffanie A Strathdee, Natasha K Martin
BACKGROUND: Mexico recently enacted drug policy reform to decriminalize possession of small amounts of illicit drugs and mandated that police refer identified substance users to drug treatment. However, the economic implications of drug treatment expansion are uncertain. We estimated the costs of opioid substitution therapy (OST) provision in Tijuana, Mexico, where opioid use and HIV are major public health concerns. METHODS: We adopted an economic health care provider perspective and applied an ingredients-based micro-costing approach to quantify the average monthly cost of OST (methadone maintenance) provision at two providers (one private and one public) in Tijuana, Mexico...
May 23, 2018: Harm Reduction Journal
https://www.readbyqxmd.com/read/29792074/lessons-learned-conducting-a-multi-center-trial-with-a-military-population-the-tinnitus-retraining-therapy-trial
#5
Roberta W Scherer, Leonora D Sensinger, Benigno Sierra-Irizarry, Craig Formby
Background The Tinnitus Retraining Therapy Trial (TRTT), a randomized, placebo-controlled, multi-center trial, evaluated the efficacy of tinnitus retraining therapy and its individual components, tinnitus-specific educational counseling and sound therapy versus the standard of care, in military practice to improve study participants' quality of life. The trial was conducted at six US military hospitals to take advantage of the greater prevalence of tinnitus in the military population. Methods During the trial, various challenges arose that were uniquely related to the military setting...
May 1, 2018: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/29791945/global-health-epilepsy
#6
Amza Ali
Epilepsy is a frequently misunderstood and highly stigmatized condition. Major treatment gaps exist across the world, most so in areas of financial constraint. Classification permits the best approaches to treatment and to ascertaining prognosis. The International League Against Epilepsy's new classification system emphasizes clinical aspects and utilizes all available resources to determine whether it is a focal or generalized epilepsy. The most important tools are a careful history, clinical examination, electroencephalography, and appropriate neuroimaging...
April 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29791944/the-global-burden-of-headache
#7
Deanna Saylor, Timothy J Steiner
At the turn of the century, most of the world's population lived in regions where the prevalence of headache was unknown and its impact poorly understood. Lifting The Burden (LTB), a nonprofit organization in official relations with the World Health Organization, established the Global Campaign against Headache, with the ultimate purpose of reducing the burden of headache worldwide. First, the scope and scale of this burden had to be known. LTB embarked upon a program of population-based studies in countries in all world regions in order to achieve its aim...
April 2018: Seminars in Neurology
https://www.readbyqxmd.com/read/29791832/rationale-opportunities-and-reality-of-biosimilar-medications
#8
Gary H Lyman, Robin Zon, R Donald Harvey, Richard L Schilsky
Biologic therapies for cancer and other disorders contribute to improved outcomes for many patients but also account for a large proportion of health care expenditures. Opportunities for cost containment may emerge as the patents on originator products expire and highly similar agents known as..
May 24, 2018: New England Journal of Medicine
https://www.readbyqxmd.com/read/29791730/integration-of-parenting-and-nutrition-interventions-in-a-community-health-program-in-pakistan-an-implementation-evaluation
#9
Aisha K Yousafzai, Muneera A Rasheed, Saima Siyal
Policy and program implementers require evidence on whether integrated psychosocial stimulation and nutrition interventions can be effectively delivered at-scale, how, and at what cost? To address some of these issues, a comprehensive evaluation of implementation was designed for a trial in Pakistan that integrated psychosocial stimulation and nutrition interventions in a community health service. The first objective was to describe, analyze, and assess the quality and accuracy of the implementation of the interventions...
May 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29791657/estimated-costs-of-hospitalization-due-to-coronary-artery-disease-attributable-to-familial-hypercholesterolemia-in-the-brazilian-public-health-system
#10
Luciana R Bahia, Roger S Rosa, Raul D Santos, Denizar V Araujo
OBJECTIVE: Cardiovascular diseases are the leading cause of death in Brazil, imposing substantial economic burden on the health care system. Familial hypercholesterolemia (FH) is known to greatly increase the risk of premature coronary artery disease (CAD). This study aimed to estimate the economic impact of hospitalizations due to CAD attributable to FH in the Brazilian Unified Health Care System (SUS). SUBJECTS AND METHODS: Retrospective, cross-sectional study of data obtained from the Hospital Information System of the SUS (SIHSUS)...
May 17, 2018: Archives of Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29791648/time-use-by-family-caregivers-of-elderly-with-dementia-an-integrative-review
#11
Elcyana Bezerra Carvalho, Anita Liberalesso Neri
OBJECTIVE: To describe the development of measures used between 1993 and 2016 to evaluate time use by family caregivers of elderly with dementia and to find out the patterns of time use identified in the literature. METHOD: An integrative review of articles was performed, indexed by the following terms: time use management, family caregiver and elderly. RESULTS: A total of 17 articles were found, of which seven were methodological. Among these seven articles, five were psychometric...
2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29791646/repercussions-of-hospitalization-due-to-fall-of-the-elderly-health-care-and-prevention
#12
Adriana Remião Luzardo, Newton Ferreira de Paula Júnior, Marcelo Medeiros, Paula Carolina Bejo Wolkers, Silvia Maria Azevedo Dos Santos
OBJECTIVE: To know the repercussions of the fall reported by the elderly and their caregiver during hospitalization in a public hospital in Florianópolis city from October to December 2014. METHOD: Exploratory research with a qualitative approach, conducted by depth interviews with 16 participants, the eight elderly were hospitalized for falls and eight elderly caregivers. Data analysis were performed through the Thematic Content Analysis. RESULTS: It was evidenced the thematic axis: Faller Elderly supported by four thematic categories: Changes caused by Falls, I am a faller, I take care of me and Prevention of the Fall...
2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29791557/new-and-repurposed-drugs-to-treat-multidrug-and-extensively-drug-resistant-tuberculosis
#13
Denise Rossato Silva, Margareth Dalcolmo, Simon Tiberi, Marcos Abdo Arbex, Marcela Munoz-Torrico, Raquel Duarte, Lia D'Ambrosio, Dina Visca, Adrian Rendon, Mina Gaga, Alimuddin Zumla, Giovanni Battista Migliori
Multidrug-resistant and extensively drug-resistant tuberculosis (MDR-TB and XDR-TB, respectively) continue to represent a challenge for clinicians and public health authorities. Unfortunately, although there have been encouraging reports of higher success rates, the overall rate of favorable outcomes of M/XDR-TB treatment is only 54%, or much lower when the spectrum of drug resistance is beyond that of XDR-TB. Treating M/XDR-TB continues to be a difficult task, because of the high incidence of adverse events, the long duration of treatment, the high cost of the regimens used, and the drain on health care resources...
April 2018: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29790786/the-impact-of-disruption-of-the-care-delivery-system-by-commercial-laboratory-testing-in-a-children-s-health-care-system
#14
Beverly B Rogers, James L Adams, Alexis B Carter, Francine Uwindatwa, Cynthia B Brawley, Charles G Cochran, Leah N Bryan, Elizabeth P Weinzierl, Sampath Prahalad
CONTEXT: - Disruption of outpatient laboratory services by routing the samples to commercial reference laboratories may seem like a cost-saving measure by the payers, but results in hidden costs in quality and resources to support this paradigm. OBJECTIVE: - To identify differences when outpatient tests are performed at a Children's Hospital lab compared to a commercial reference lab, and the financial costs to support the reference laboratory testing. DESIGN: - Outpatient testing was sent to 3 different laboratories, specified by the payer...
May 23, 2018: Archives of Pathology & Laboratory Medicine
https://www.readbyqxmd.com/read/29790202/incidence-and-cost-of-medication-harm-in-older-adults-following-hospital-discharge-a-multicentre-prospective-study-in-the-uk
#15
Nikesh Parekh, Khalid Ali, Jennifer M Stevenson, J Graham Davies, Rebekah Schiff, Tischa Van der Cammen, Jatinder Harchowal, James Raftery, Chakravarthi Rajkumar
AIMS: Polypharmacy is increasingly common in older adults, placing them at risk of medication-related harm (MRH). Patients are particularly vulnerable to problems with their medications in the period following hospital discharge due to medication changes, and poor information transfer between hospital and primary care. The aim of this study was to investigate the incidence, severity, preventability and cost of medication-related harm (MRH) in older adults in England post-discharge. METHODS: An observational multicentre prospective cohort study recruited 1280 older adults (median age 82 years) from five teaching hospitals in Southern England, UK...
May 22, 2018: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29790166/physical-therapy-as-the-first-point-of-care-to-treat-low-back-pain-an-instrumental-variables-approach-to-estimate-impact-on-opioid-prescription-health-care-utilization-and-costs
#16
Bianca K Frogner, Kenneth Harwood, C Holly A Andrilla, Malaika Schwartz, Jesse M Pines
OBJECTIVE: To compare differences in opioid prescription, health care utilization, and costs among patients with low back pain (LBP) who saw a physical therapist (PT) at the first point of care, at any time during the episode or not at all. DATA SOURCES: Commercial health insurance claims data, 2009-2013. STUDY DESIGN: Retrospective analyses using two-stage residual inclusion instrumental variable models to estimate rates for opioid prescriptions, imaging services, emergency department visits, hospitalization, and health care costs...
May 23, 2018: Health Services Research
https://www.readbyqxmd.com/read/29790073/effect-of-low-back-pain-risk-stratification-strategy-on-patient-outcomes-and-care-processes-the-match-randomized-trial-in-primary-care
#17
Dan Cherkin, Benjamin Balderson, Rob Wellman, Clarissa Hsu, Karen J Sherman, Sarah C Evers, Rene Hawkes, Andrea Cook, Martin D Levine, Diane Piekara, Pam Rock, Katherine Talbert Estlin, Georgie Brewer, Mark Jensen, Anne-Marie LaPorte, John Yeoman, Gail Sowden, Jonathan C Hill, Nadine E Foster
BACKGROUND: The STarT Back strategy for categorizing and treating patients with low back pain (LBP) improved patients' function while reducing costs in England. OBJECTIVE: This trial evaluated the effect of implementing an adaptation of this approach in a US setting. DESIGN: The Matching Appropriate Treatments to Consumer Healthcare needs (MATCH) trial was a pragmatic cluster randomized trial with a pre-intervention baseline period. Six primary care clinics were pair randomized, three to training in the STarT Back strategy and three to serve as controls...
May 22, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29790040/building-behavioral-health-homes-clinician-and-staff-perspectives-on-creating-integrated-care-teams
#18
Tracy Anastas, Elizabeth Needham Waddell, Sonya Howk, Mark Remiker, Gretchen Horton-Dunbar, L J Fagnan
Adults with serious mental illness and substance use disorders have elevated risk of mortality and higher healthcare costs compared to the general population. As these disparities have been linked to poor management of co-occurring chronic conditions in primary care, the behavioral health setting may be a preferred setting for routine medical screening and treatment. This qualitative study describes early stages of integrating care teams in emerging medical homes based in mental health and addiction treatment settings...
May 22, 2018: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29790020/can-we-accurately-predict-cost-effectiveness-without-access-to-overall-survival-data-the-case-study-of-nivolumab-in-combination-with-ipilimumab-for-the-treatment-of-patients-with-advanced-melanoma-in-england
#19
D Lee, A Amadi, J Sabater, J Ellis, H Johnson, S Kotapati, S McNamara, A Walker, M Cooper, K Patterson, N Roskell, Y Meng
BACKGROUND: Nivolumab with ipilimumab (the Regimen) is the first immuno-oncology combination treatment to demonstrate long-term clinical benefit for advanced melanoma patients. We evaluated the cost effectiveness of the Regimen in this population, with and without the availability of overall survival (OS) data. METHODS: A partitioned survival model and a Markov state-transition model were developed to estimate the lifetime costs and benefits of the Regimen versus ipilimumab...
May 22, 2018: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29789890/surveillance-magnetic-resonance-imaging-for-isolated-optic-pathway-gliomas-is-gadolinium-necessary
#20
Ezekiel Maloney, A Luana Stanescu, Francisco A Perez, Ramesh S Iyer, Randolph K Otto, Sarah Leary, Lotte Steuten, Amanda I Phipps, Dennis W W Shaw
BACKGROUND: Pediatric optic pathway gliomas are typically indolent but have a variable clinical course. Treatment is dictated by symptoms and changes on contrast-enhanced MRI examinations. Gadolinium retention in children has motivated parsimonious use of gadolinium-based contrast agents. OBJECTIVES: To determine surveillance MR factors that motivate changes in tumor-directed therapies and extrapolate cost-efficacy of a non-contrast follow-up protocol. MATERIALS AND METHODS: Using an imaging database search we identified children with isolated optic pathway gliomas and ≥3 follow-up contrast-enhanced MRIs...
May 22, 2018: Pediatric Radiology
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