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https://www.readbyqxmd.com/read/29346699/teaching-chronic-pain-in-the-family-medicine-residency
#1
Kimberly Zoberi, Kelly M Everard
BACKGROUND AND OBJECTIVES: Chronic pain is a significant condition affecting many Americans. Primary care physicians play an important role in chronic pain management, but many residents and physicians feel poorly prepared to manage it. METHODS: Data were collected as part of the 2016 Council of Academic Family Medicine Educational Research Alliance (CERA) Program Director Survey, which was sent electronically to 484 program directors in the United States. The authors sought to determine whether residency directors' attitudes about treating chronic pain were associated with the amount of time devoted to teaching family medicine residents about chronic pain assessment, therapy (use of opioids, use adjuvant pain medications, use of other nonopioids, use of nonpharmacological treatments), and risk management (risk assessment, use of pain management contracts, informed consent when prescribing opioids, and urine drug monitoring)...
January 2018: Family Medicine
https://www.readbyqxmd.com/read/29345553/quality-and-variability-of-patient-directions-in-electronic-prescriptions-in-the-ambulatory-care-setting
#2
Yuze Yang, Stacy Ward-Charlerie, Ajit A Dhavle, Michael T Rupp, James Green
BACKGROUND: The prescriber's directions to the patient (Sig) are one of the most quality-sensitive components of a prescription order. Owing to their free-text format, the Sig data that are transmitted in electronic prescriptions (e-prescriptions) have the potential to produce interpretation challenges at receiving pharmacies that may threaten patient safety and also negatively affect medication labeling and patient counseling. Ensuring that all data transmitted in the e-prescription are complete and unambiguous is essential for minimizing disruptions in workflow at prescribers' offices and receiving pharmacies and optimizing the safety and effectiveness of patient care...
January 18, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29342478/design-and-implementation-of-a-visual-analytics-electronic-antibiogram-within-an-electronic-health-record-system-at-a-tertiary-pediatric-hospital
#3
Allan F Simpao, Luis M Ahumada, Beatriz Larru Martinez, Ana M Cardenas, Talene A Metjian, Kaede V Sullivan, Jorge A Gálvez, Bimal R Desai, Mohamed A Rehman, Jeffrey S Gerber
BACKGROUND:  Hospitals use antibiograms to guide optimal empiric antibiotic therapy, reduce inappropriate antibiotic usage, and identify areas requiring intervention by antimicrobial stewardship programs. Creating a hospital antibiogram is a time-consuming manual process that is typically performed annually. OBJECTIVE:  We aimed to apply visual analytics software to electronic health record (EHR) data to build an automated, electronic antibiogram ("e-antibiogram") that adheres to national guidelines and contains filters for patient characteristics, thereby providing access to detailed, clinically relevant, and up-to-date antibiotic susceptibility data...
January 2018: Applied Clinical Informatics
https://www.readbyqxmd.com/read/29340937/association-between-electronic-medical-record-implementation-of-default-opioid-prescription-quantities-and-prescribing-behavior-in-two-emergency-departments
#4
M Kit Delgado, Frances S Shofer, Mitesh S Patel, Scott Halpern, Christopher Edwards, Zachary F Meisel, Jeanmarie Perrone
No abstract text is available yet for this article.
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29340802/longitudinal-trajectories-of-antidepressant-use-in-pregnancy-and-the-postnatal-period
#5
Gretchen Bandoli, Grace M Kuo, Renu Sugathan, Christina D Chambers, Matthieu Rolland, Kristin Palmsten
Studies of antidepressant safety in pregnancy typically do not address complex patterns of use throughout pregnancy. We performed longitudinal trajectory modeling to describe patterns of antidepressant use in the first 32 weeks of pregnancy, and test whether these trajectories are associated with a reduction in birth weight or gestational age at delivery. Our study included 166 pregnant women with deliveries between 2011 and 2015 who were prescribed an antidepressant between 91 days prior to last menstrual period and 32 weeks of gestation...
January 16, 2018: Archives of Women's Mental Health
https://www.readbyqxmd.com/read/29338288/transcranial-magnetic-stimulation-tms-safety-a-practical-guide-for-psychiatrists
#6
Rohan Taylor, Veronica Galvez, Colleen Loo
OBJECTIVES: Repetitive transcranial magnetic stimulation (rTMS) is increasingly being utilised as a treatment option for depression, and with this comes a need for a practical review of safety issues intended for clinicians. This article provides an overview of the current literature regarding safety issues with rTMS for depression, and provides recommendations for clinical practice. CONCLUSIONS: Overall, rTMS is a well-tolerated treatment with common side effects (such as headache or local pain at the site of stimulation) being mild...
January 1, 2018: Australasian Psychiatry: Bulletin of Royal Australian and New Zealand College of Psychiatrists
https://www.readbyqxmd.com/read/29336013/systematic-review-of-atopic-dermatitis-disease-definition-in-studies-using-routinely-collected-health-data
#7
REVIEW
M P Dizon, A M Yu, R K Singh, J Wan, Mary-Margaret Chren, Carsten Flohr, J Silverberg, D J Margolis, S M Langan, K Abuabara
BACKGROUND: Routinely collected electronic health data (RCD) obtained for administrative and clinical purposes are increasingly used to study atopic dermatitis (AD). Methods for identifying AD patients in RCD differ, and it is unknown how this might affect study results. OBJECTIVES: We sought to evaluate how AD patients have been identified in studies using RCD, to determine whether these methods were validated, and to estimate how the method for identifying AD patients affected variability in prevalence estimates...
January 16, 2018: British Journal of Dermatology
https://www.readbyqxmd.com/read/29333271/childhood-asthma-prevalence-cross-sectional-record-linkage-study-comparing-parent-reported-wheeze-with-general-practitioner-recorded-asthma-diagnoses-from-primary-care-electronic-health-records-in-wales
#8
Lucy J Griffiths, Ronan A Lyons, Amrita Bandyopadhyay, Karen S Tingay, Suzanne Walton, Mario Cortina-Borja, Ashley Akbari, Helen Bedford, Carol Dezateux
Introduction: Electronic health records (EHRs) are increasingly used to estimate the prevalence of childhood asthma. The relation of these estimates to those obtained from parent-reported wheezing suggestive of asthma is unclear. We hypothesised that parent-reported wheezing would be more prevalent than general practitioner (GP)-recorded asthma diagnoses in preschool-aged children. Methods: 1529 of 1840 (83%) Millennium Cohort Study children registered with GPs in the Welsh Secure Anonymised Information Linkage databank were linked...
2018: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/29330652/dietary-management-in-the-immediate-preoperative-period-of-bariatric-surgery-a-national-overview-bariatric-preoperative-diets
#9
Mariana Steffen Holderbaum, Caroline Buss
BACKGROUND: Although widely applied, there is no consensus about the characteristics of the diets prescribed in the immediate preoperative period of bariatric surgery (BS). The objective of this study was to perform a survey on preoperative dietary management in BS centers. METHODS: This was a cross-sectional study with BS Brazilian centers. Only BS centers with certificate of excellence by Surgical Review Corporation were included. An electronic questionnaire was applied to assess details about the dietary management in the immediate preoperative period of BS...
January 12, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29330245/impact-of-pharmacist-previsit-input-to-providers-on-chronic-opioid-prescribing-safety
#10
Nicholas Cox, Casey R Tak, Susan E Cochella, Eric Leishman, Karen Gunning
INTRODUCTION: Primary care providers (PCPs) account for half of opioid prescriptions, often feel chronic pain patients are challenging to manage, and there is wide variability in practice patterns. The purpose of this pilot study was to evaluate the impact of a previsit pharmacist review of high-risk patients treated with opioids for chronic pain on compliance to guideline recommendations at a family medicine residency clinic. METHODS: All adult patients with an appointment for chronic pain who were prescribed >50 morphine milligram equivalents (MMEs)/day had charts reviewed by a pharmacist before each appointment; recommendations were sent electronically to the provider before the appointment...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330236/antidepressants-and-incident-hypertension-in-primary-care-patients
#11
Matthew Breeden, Jay Brieler, Joanne Salas, Jeffrey F Scherrer
OBJECTIVE: Many ADMs can alter blood pressure (BP), but the research on the effect of antidepressant medication (ADMs) on incident hypertension is mixed. We investigated whether the use of ADMs was associated with the subsequent development of hypertension. METHODS: A retrospective cohort study was conducted using electronic medical record data from 6224 patients with primary care visits from 2008 to 2015. Prescription orders were used to identify ADM use, and hypertension was defined by medical record diagnosis...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330165/survival-in-relation-to-multimorbidity-patterns-in-older-adults-in-primary-care-in-barcelona-spain-2010-2014-a-longitudinal-study-based-on-electronic-health-records
#12
Carolina Ibarra-Castillo, Marina Guisado-Clavero, Concepció Violan-Fors, Mariona Pons-Vigués, Tomàs López-Jiménez, Albert Roso-Llorach
BACKGROUND: Several studies have analysed the characteristics of multimorbidity patterns but none have evaluated the relationship with survival. The purpose of this study was to compare survival across older adults with different chronic multimorbidity patterns (CMPs). METHODS: Prospective longitudinal observational study using electronic health records for 190 108 people aged ≥65 years in Barcelona, Spain (2009-2014). CMPs were identified by cluster analysis...
January 12, 2018: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/29330009/the-almanach-project-preliminary-results-and-potentiality-from-afghanistan
#13
A Bernasconi, F Crabbé, R Rossi, I Qani, A Vanobberghen, M Raab, S Du Mortier
INTRODUCTION: ALMANACH (ALgorithms for the MANagement of Acute CHildhood illnesses) is an electronic version of IMCI (Integrated Management of Childhood Illness) running on tablets. ALMANACH enhances its concept, it integrates well into health staff's daily consultation work and facilitates diagnosis and treatment. ALMANACH informs when to refer a child or to perform a rapid diagnostic test (RDT), recommends the right treatment dosage and synchronizes collected data real time with a Health Management Information System (DHIS2) for epidemiological evaluation and decision making...
December 28, 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29325160/implementing-electronic-health-record-default-settings-to-reduce-opioid-overprescribing-a-pilot-study
#14
Kara Zivin, Jessica O White, Sandra Chao, Anna L Christensen, Luke Horner, Dana M Petersen, Morgan R Hobbs, Grace Capreol, Kevin A Halbritter, Christopher M Jones
Objective: To pilot test the effectiveness, feasibility, and acceptability of instituting a 15-pill quantity default in the electronic health record for new Schedule II opioid prescriptions. Design: A mixed-methods pilot study in two health systems, including pre-post analysis of prescribed opioid quantity and focus groups or interviews with prescribers and health system administrators. Methods: We implemented a 15-pill electronic health record default for new Schedule II opioids and assessed opioid quantity before and after implementation using electronic health record data on 6,390 opioid prescriptions from 448 prescribers...
January 9, 2018: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29321043/what-is-in-your-wallet-a-cluster-randomized-trial-of-the-effects-of-showing-comparative-patient-out-of-pocket-costs-on-primary-care-prescribing-for-uncomplicated-hypertension
#15
Robyn Tamblyn, Nancy Winslade, Christina J Qian, Teresa Moraga, Allen Huang
BACKGROUND: Drug expenditures are responsible for an increasing proportion of health costs, accounting for $1.1 trillion in annual expenditure worldwide. As hundreds of billions of dollars are being spent each year on overtreatment with prescribed medications that are either unnecessary or are in excess of lowest cost-effective therapy, programs are needed that optimize fiscally appropriate use. We evaluated whether providing physicians with information on the patient out-of-pocket payment consequences of prescribing decisions that were in excess of lowest cost-effective therapy would alter prescribing decisions using the treatment of uncomplicated hypertension as an exemplar...
January 10, 2018: Implementation Science: IS
https://www.readbyqxmd.com/read/29320945/the-influence-of-exercise-dosing-on-outcomes-in-patients-with-knee-disorders-a-systematic-review
#16
Jodi L Young, Daniel I Rhon, Joshua A Cleland, Suzanne J Snodgrass
Study Design Systematic review. Background Therapeutic exercise is commonly used to treat individuals with knee disorders, but dosing parameters for optimal outcomes are unclear. Large variations exist in exercise prescription, and research related to specific dosing variables for knee osteoarthritis, patellar tendinopathy and patellofemoral pain syndrome is sparse. Objectives To identify specific doses of exercise related to improved outcomes of pain and function in individuals with common knee disorders, categorized by effect size...
January 10, 2018: Journal of Orthopaedic and Sports Physical Therapy
https://www.readbyqxmd.com/read/29320931/physician-decision-making-in-anticoagulating-atrial-fibrillation-a-prospective-survey-of-a-physician-notification-system-for-atrial-fibrillation-detected-on-cardiac-implantable-electronic-devices-of-patients-at-increased-risk-of-stroke
#17
Justin M Cloutier, Clarence Khoo, Brett Hiebert, Anthony Wassef, Colette M Seifer
OBJECTIVES: The objectives of this study were to evaluate the effectiveness of a physician notification system for atrial fibrillation (AF) detected on cardiac devices, and to assess predictors of anticoagulation in patients with device-detected AF. METHODS: In 2013, a physician notification system for AF detected on a patient's CIED [including pacemakers, implantable cardioverter defibrillators (ICD) or cardiac resynchronization therapy (CRT) devices] was implemented, with a recommendation to consider oral anticoagulation in high-risk patients...
January 1, 2018: Therapeutic Advances in Cardiovascular Disease
https://www.readbyqxmd.com/read/29320600/providing-physicians-with-feedback-on-medication-adherence-for-people-with-chronic-diseases-taking-long-term-medication
#18
REVIEW
Vincent Zaugg, Virginie Korb-Savoldelli, Pierre Durieux, Brigitte Sabatier
BACKGROUND: Poor medication adherence decreases treatment efficacy and worsens clinical outcomes, but average rates of adherence to long-term pharmacological treatments for chronic illnesses are only about 50%. Interventions for improving medication adherence largely focus on patients rather than on physicians; however, the strategies shown to be effective are complex and difficult to implement in clinical practice. There is a need for new care models addressing the problem of medication adherence, integrating this problem into the patient care process...
January 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29318460/nebulization-of-antimicrobial-agents-in-mechanically-ventilated-adults-in-2017-an-international-cross-sectional-survey
#19
Joana Alves, Emine Alp, Despoina Koulenti, Zhongheng Zhang, Stephan Ehrmann, Stijn Blot, Matteo Bassetti, Andrew Conway-Morris, Rosa Reina, Enrique Teran, Candela Sole-Lleonart, Maria Ruiz-Rodríguez, Jordi Rello
2017 ESCMID practice guidelines reported safety concerns and weak evidence of benefit supporting use of aerosolized antibiotics in mechanically ventilated patients. Our primary goal was to assess current patterns of aerosolized antibiotic prescription in mechanically ventilated patients. A sequential global survey was performed prior to the release of the ESCMID guidelines, from the 1st of February to the 30th of April 2017, using an electronic platform. Responses were analyzed comparing geographical regions...
January 9, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29318381/-evaluation-of-the-medical-treatment-situation-of-the-visually-impaired-significant-differences-between-young-and-old
#20
M Oeverhaus, H Hirche, J Esser, A Eckstein, B Schaperdoth-Gerlings
BACKGROUND AND OBJECTIVE: Patients with irreversible visual impairment need individual visual rehabilitation to regain or improve reading ability and mobility. To analyze the prescription of low vision aids (LVA) and their relation to age, we performed a retrospective chart analysis of our specialized low vision outpatient clinic. METHODS: Patient charts of all patients who attended our low vision outpatient clinic from 2014-2016 were analyzed with respect to the diagnosis, visual acuity, magnification needs, age and prescribed or used LVA...
January 9, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
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