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Clinical inertia

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https://www.readbyqxmd.com/read/28324932/an-ict-and-mobile-health-integrated-approach-to-optimize-patients-education-on-hypertension-and-its-management-by-physicians-the-patients-optimal-strategy-of-treatment-post-pilot-study
#1
Fabio Albini, Xiaoqiu Liu, Camilla Torlasco, Davide Soranna, Andrea Faini, Renata Ciminaghi, Ada Celsi, Matteo Benedetti, Antonella Zambon, Marco di Rienzo, Gianfranco Parati
INTRODUCTION: Uncontrolled hypertension is largely attributed to unsatisfactory doctor's engagement in its optimal management and to poor patients' compliance to therapeutic interventions. ICT and mobile Health solutions might improve these conditions, being widely available and providing highly effective communication strategies. OBJECTIVE: To evaluate whether ICT and mobile Health tools are able to improve hypertension control by improving doctors' engagement and by increasing patients' education and involvement, and their compliance to lifestyle modification and prescribed drug therapy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28298899/decision-making-in-multiple-sclerosis-the-role-of-aversion-to-ambiguity-for-therapeutic-inertia-among-neurologists-discutir-ms
#2
Gustavo Saposnik, Angel P Sempere, Daniel Prefasi, Daniel Selchen, Christian C Ruff, Jorge Maurino, Philippe N Tobler
OBJECTIVES: Limited information is available on physician-related factors influencing therapeutic inertia (TI) in multiple sclerosis (MS). Our aim was to evaluate whether physicians' risk preferences are associated with TI in MS care, by applying concepts from behavioral economics. DESIGN: In this cross-sectional study, participants answered questions regarding the management of 20 MS case scenarios, completed 3 surveys, and 4 experimental paradigms based on behavioral economics...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/28279950/insuonline-an-electronic-game-for-medical-education-on-insulin-therapy-a-randomized-controlled-trial-with-primary-care-physicians
#3
Leandro Arthur Diehl, Rodrigo Martins Souza, Pedro Alejandro Gordan, Roberto Zonato Esteves, Izabel Cristina Meister Coelho
BACKGROUND: Most patients with diabetes mellitus (DM) are followed by primary care physicians, who often lack knowledge or confidence to prescribe insulin properly. This contributes to clinical inertia and poor glycemic control. Effectiveness of traditional continuing medical education (CME) to solve that is limited, so new approaches are required. Electronic games are a good option, as they can be very effective and easily disseminated. OBJECTIVE: The objective of our study was to assess applicability, user acceptance, and educational effectiveness of InsuOnline, an electronic serious game for medical education on insulin therapy for DM, compared with a traditional CME activity...
March 9, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28271251/efficacy-and-safety-of-metformin-and-sitagliptin-based-triple-antihyperglycemic-therapy-strategy-a-multicenter-randomized-controlled-non-inferiority-clinical-trial
#4
Wen Xu, Yiming Mu, Jiajun Zhao, Dalong Zhu, Qiuhe Ji, Zhiguang Zhou, Bin Yao, Anhua Mao, Samuel S Engel, Bin Zhao, Yan Bi, Longyi Zeng, Xingwu Ran, Juming Lu, Linong Ji, Wenying Yang, Weiping Jia, Jianping Weng
Despite the current guideline's recommendation of a timely stepwise intensification therapy, the "clinical inertia", termed as the delayed treatment intensification, commonly exists in the real world, which may be partly due to the relatively little substantial evidence and no clear consensus regarding the efficacy and safety of triple oral agents in patients inadequately controlled with dual therapy. In this clinical trial performed in 237 centers in China, 5,535 type 2 diabetic patients inadequately controlled by previous therapies were treated with a stable metformin/sitagliptin dual therapy for 20 weeks...
February 7, 2017: Science China. Life Sciences
https://www.readbyqxmd.com/read/28265910/-adherence-problems-and-clinical-inertia-11-strategies-keeping-patients-with-diabetes-onboard
#5
REVIEW
Bernhard Kulzer
No abstract text is available yet for this article.
March 2017: MMW Fortschritte der Medizin
https://www.readbyqxmd.com/read/28246928/raloxifene-improves-bone-mechanical-properties-in-mice-previously-treated-with-zoledronate
#6
Cory N Meixner, Mohammad W Aref, Aryaman Gupta, Erin M B McNerny, Drew Brown, Joseph M Wallace, Matthew R Allen
Bisphosphonates represent the gold-standard pharmaceutical agent for reducing fracture risk. Long-term treatment with bisphosphonates can result in tissue brittleness which in rare clinical cases manifests as atypical femoral fracture. Although this has led to an increasing call for bisphosphonate cessation, few studies have investigated therapeutic options for follow-up treatment. The goal of this study was to test the hypothesis that treatment with raloxifene, a drug that has cell-independent effects on bone mechanical material properties, could reverse the compromised mechanical properties that occur following zoledronate treatment...
February 28, 2017: Calcified Tissue International
https://www.readbyqxmd.com/read/28226549/an-ict-and-mobile-health-integrated-approach-to-optimize-patients-education-on-hypertension-and-its-management-by-physicians-the-patients-optimal-strategy-of-treatment-post-pilot-study
#7
Fabio Albini, Xiaoqiu Liu, Camilla Torlasco, Davide Soranna, Andrea Faini, Renata Ciminaghi, Ada Celsi, Matteo Benedetti, Antonella Zambon, Marco di Rienzo, Gianfranco Parati, Fabio Albini, Xiaoqiu Liu, Camilla Torlasco, Davide Soranna, Andrea Faini, Renata Ciminaghi, Ada Celsi, Matteo Benedetti, Antonella Zambon, Marco di Rienzo, Gianfranco Parati, Renata Ciminaghi, Marco di Rienzo, Davide Soranna, Ada Celsi, Gianfranco Parati, Fabio Albini, Antonella Zambon, Xiaoqiu Liu, Andrea Faini, Camilla Torlasco, Matteo Benedetti
INTRODUCTION: Uncontrolled hypertension is largely attributed to unsatisfactory doctor's engagement in its optimal management and to poor patients' compliance to therapeutic interventions. ICT and mobile Health solutions might improve these conditions, being widely available and providing highly effective communication strategies. OBJECTIVE: To evaluate whether ICT and mobile Health tools are able to improve hypertension control by improving doctors' engagement and by increasing patients' education and involvement, and their compliance to lifestyle modification and prescribed drug therapy...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28222959/clinical-inertia-time-to-reappraise-the-terminology
#8
EDITORIAL
Kamlesh Khunti, Melanie J Davies
No abstract text is available yet for this article.
April 2017: Primary Care Diabetes
https://www.readbyqxmd.com/read/28183347/application-of-incident-command-structure-to-clinical-trial-management-in-the-academic-setting-principles-and-lessons-learned
#9
Penny S Reynolds, Mary J Michael, Bruce D Spiess
BACKGROUND: Clinical trial success depends on appropriate management, but practical guidance to trial organisation and planning is lacking. The Incident Command System (ICS) is the 'gold standard' management system developed for managing diverse operations in major incident and public health arenas. It enables effective and flexible management through integration of personnel, procedures, resources, and communications within a common hierarchical organisational structure. Conventional ICS organisation consists of five function modules: Command, Planning, Operations, Logistics, and Finance/Administration...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28155046/early-combination-therapy-with-oral-glucose-lowering-agents-in-type-2-diabetes
#10
Cristina Bianchi, Giuseppe Daniele, Angela Dardano, Roberto Miccoli, Stefano Del Prato
Despite the considerable burden of disease associated with type 2 diabetes mellitus (T2DM), most patients are not at, or are unable to achieve, recommended glycemic targets. This is partly because of the relentless progressive nature of the disease, but it may also be attributable to the current diabetes treatment paradigm. The recommended stepwise approach may lead to frequent early treatment failure with prolonged periods of elevated glucose as a consequence of clinical inertia and delays in achieving optimal glycemic control...
February 3, 2017: Drugs
https://www.readbyqxmd.com/read/28149842/inertia-based-microfluidic-capture-and-characterisation-of-circulating-tumour-cells-for-the-diagnosis-of-lung-cancer
#11
Dimple Y Chudasama, Daria V Freydina, Maxim B Freidin, Maria Leung, Angeles Montero Fernandez, Alexandra Rice, Andrew G Nicholson, Emmanouil Karteris, Vladimir Anikin, Eric Lim
BACKGROUND: Routine clinical application of circulating tumour cells (CTCs) for blood based diagnostics is yet to be established. Despite growing evidence of their clinical utility for diagnosis, prognosis and treatment monitoring, the efficacy of a robust platform and universally accepted diagnostic criteria remain uncertain. We evaluate the diagnostic performance of a microfluidic CTC isolation platform using cytomorphologic criteria in patients undergoing lung cancer surgery. METHODS: Blood was processed from 51 patients undergoing surgery for known or suspected lung cancer using the ClearBridge ClearCell FX system(TM) (ClearBridge Biomedics, Singapore)...
December 2016: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28113461/on-the-quantitative-potential-of-viscoelastic-response-visr-ultrasound-using-the-one-dimensional-mass-spring-damper-model
#12
Mallory R Selzo, Christopher J Moore, Md Murad Hossain, Mark Palmeri, Caterina M Gallippi
Viscoelastic Response (VisR) ultrasound is an acoustic radiation force (ARF)-based imaging method that fits induced displacements to a one-dimensional (1D) mass-spring-damper (MSD) model to estimate the ratio of viscous to elastic moduli, τ, in viscoelastic materials. Error in VisR τ estimation arises from inertia and acoustic displacement underestimation. These error sources are herein evaluated using finite element method (FEM) simulations, error correction methods are developed, and corrected VisR τ estimates are compared to true simulated τ values to assess VisR's relevance to quantifying viscoelasticity...
March 8, 2016: IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control
https://www.readbyqxmd.com/read/28109138/adaptations-in-the-microarchitecture-and-load-distribution-of-maternal-cortical-and-trabecular-bone-in-response-to-multiple-reproductive-cycles-in-rats
#13
Chantal Mj de Bakker, Allison R Altman-Singles, Yihan Li, Wei-Ju Tseng, Connie Li, X Sherry Liu
Pregnancy, lactation, and weaning result in dramatic changes in maternal calcium metabolism. In particular, the increased calcium demand during lactation causes a substantial degree of maternal bone loss. This reproductive bone loss has been suggested to be largely reversible, as multiple clinical studies have found that parity and lactation history have no adverse effect on postmenopausal fracture risk. However, the precise effects of pregnancy, lactation, and post-weaning recovery on maternal bone structure are not well understood...
January 21, 2017: Journal of Bone and Mineral Research: the Official Journal of the American Society for Bone and Mineral Research
https://www.readbyqxmd.com/read/28105580/pixel-based-dxa-derived-structural-properties-strongly-correlate-with-pqct-measures-at-the-one-third-distal-femur-site
#14
Alexander M Baker, David W Wagner, B Jenny Kiratli, Gary S Beaupre
While bone mineral density has been traditionally used to quantify fracture risk for individuals with spinal cord injuries, recent studies are including engineering measurements such as section modulus and cross sectional moment of inertia. These are almost exclusively calculated by peripheral QCT scanners which, unlike DXA scanners, are rarely found in clinical settings. Using fifty-four fresh frozen femora, we developed and validated a pixel-by-pixel method to calculate engineering properties at the distal femur using a Hologic QDR-1000 W DXA scanner and compared them against similar parameters measured using a Stratec XCT-3000 peripheral QCT scanner...
January 19, 2017: Annals of Biomedical Engineering
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#15
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28095039/update-on-a-quality-initiative-to-overcome-clinical-inertia-in-the-postoperative-care-of-inpatients-with-diabetes-mellitus
#16
Curtiss B Cook, Heidi A Apsey, Elizabeth B Habermann, Amy E Glasgow, Janna C Castro, Richard T Schlinkert
No abstract text is available yet for this article.
January 17, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/28087182/multimorbidity-and-acute-heart-failure-in-internal-medicine
#17
F Martínez, L Martínez-Ibañez, G Pichler, A Ruiz, J Redon
AIMS: To analyse the characteristics of hospitalized patients for AHF, with special attention to the clustering of morbidities. METHODS AND RESULTS: Clinical records of patients, admitted in Internal Medicine due to AHF, during three years, were reviewed. The characteristics of patients-episodes were registered and key indicators of performance. Multiple correspondence analysis (MCA) was used to assess the distribution of morbidities. LR models were used to study clinical variables related with death or readmission...
January 5, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28069041/understanding-how-primary-care-practitioners-perceive-an-online-intervention-for-the-management-of-hypertension
#18
Katherine Bradbury, Katherine Morton, Rebecca Band, Carl May, Richard McManus, Paul Little, Lucy Yardley
BACKGROUND: In order to achieve successful implementation an intervention needs to be acceptable and feasible to its users and must overcome barriers to behaviour change. The Person-Based Approach can help intervention developers to improve their interventions to ensure more successful implementation. This study provides an example of using the Person-Based Approach to refine a digital intervention for hypertension (HOME BP). METHODS: Our Person-Based Approach involved conducting qualitative focus groups with practice staff to explore their perceptions of HOME BP and to identify any potential barriers to implementation of the HOME BP procedures...
January 9, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28064252/philosophical-provocation-the-lifeblood-of-clinical-ethics
#19
Laurence B McCullough
The daily work of the clinical ethics teacher and clinical ethics consultant falls into the routine of classifying clinical cases by ethical type and proposing ethically justified alternatives for the professionally responsible management of a specific type of case. Settling too far into this routine creates the risk of philosophical inertia, which is not good either for the clinical ethicist or for the field of clinical ethics. The antidote to this philosophical inertia and resultant blinkered vision of clinical ethics is sustained, willing exposure to philosophical provocation...
February 2017: Journal of Medicine and Philosophy
https://www.readbyqxmd.com/read/28053550/real-world-medication-persistence-and-outcomes-associated-with-basal-insulin-and-glucagon-like-peptide-1-receptor-agonist-free-dose-combination-therapy-in-patients-with-type-2-diabetes-in-the-us
#20
Jay Lin, Melissa Lingohr-Smith, Tao Fan
BACKGROUND: Free-dose combination treatment with basal insulin and short-acting glucagon-like peptide-1 receptor agonists (GLP-1 RAs) reduces hyperglycemia via complementary targeting of fasting and postprandial blood glucose levels, however, in the real world, due to injection burden and clinical inertia, the full efficacy may not be able to translate into clinical and economic benefits. OBJECTIVE: The aim of the study was to evaluate treatment persistence and associated outcomes in patients with type 2 diabetes (T2D) treated with a GLP-1 RA in free-dose combination with basal insulin...
2017: ClinicoEconomics and Outcomes Research: CEOR
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