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Patient centered medical home

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https://www.readbyqxmd.com/read/29352620/family-caregivers-facilitation-of-daily-adult-prescription-medication-use
#1
Debra L Roter, Siva Narayanan, Katherine Smith, Ray Bullman, Paula Rausch, Jennifer L Wolff, G Caleb Alexander
OBJECTIVE: To describe ways family members assist adult patients with prescription medications at home, during medical visits and at the pharmacy. METHODS: Online survey of 400 adults (caregivers) who help another adult (care recipient) with prescription medication use. Regression modeled the contribution of caregiver communication during recipients' medical visits, evaluation of physicians' medication communication and discussions with the dispensing pharmacist on caregivers' assistance with home medication management...
December 27, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29339347/hospital-owned-apps-in-taiwan-nationwide-survey
#2
Hao-Yen Liu, Wui-Chiang Lee, Ying-Chou Sun, Jun-Jeng Fen, Tzeng-Ji Chen, Li-Fang Chou, Shinn-Jang Hwang
BACKGROUND: Over the last decade, the use of mobile phone apps in the health care industry has grown rapidly. Owing to the high penetration rate of Internet use in Taiwan, hospitals are eager to provide their own apps to improve the accessibility of medical care for patients. OBJECTIVE: The aims of this study were to provide an overview of the currently available hospital-owned apps in Taiwan and to conduct a cross-hospital comparison of app features. METHODS: In May 2017, the availability of apps from all 414 hospitals in Taiwan was surveyed from the hospital home pages and the Google Play app store...
January 16, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29339012/patient-rated-access-to-needed-care-patient-centered-medical-home-principles-intertwined
#3
Julian Brunner, Emmeline Chuang, Donna L Washington, Danielle E Rose, Catherine Chanfreau-Coffinier, Jill E Darling, Ismelda A Canelo, Elizabeth M Yano
BACKGROUND: Primary care teams can facilitate access to care by helping patients to determine whether and when care is needed, and coordinating care across multiple clinicians and settings. Appointment availability metrics may or may not capture these contributions, but patients' own ratings of their access to care provide an important alternative view of access that may be more closely related to these key functions of care teams. PROCEDURES: We used a 2015 telephone survey of 1,395 women veterans to examine associations between key care team functions and patient-rated access to needed care...
January 12, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29339011/facilitators-and-barriers-to-healthy-pregnancy-spacing-among-medicaid-beneficiaries-findings-from-the-national-strong-start-initiative
#4
Caitlin Cross-Barnet, Brigette Courtot, Ian Hill, Sarah Benatar, Morgan Cheeks, Jenny Markell
BACKGROUND: Closely spaced, unintended pregnancies are common among Medicaid beneficiaries and create avoidable risks for women and infants, including preterm birth. The Strong Start for Mothers and Newborns Initiative, a program of the Center for Medicare and Medicaid Innovation, intended to prevent preterm birth through psychosocially based enhanced prenatal care in maternity care homes, group prenatal care, and birth centers. Comprehensive care offers the opportunity for education and family planning to promote healthy pregnancy spacing...
January 12, 2018: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/29330243/task-delegation-and-burnout-trade-offs-among-primary-care-providers-and-nurses-in-veterans-affairs-patient-aligned-care-teams-va-pacts
#5
Samuel T Edwards, Christian D Helfrich, David Grembowski, Elizabeth Hulen, Walter L Clinton, Gordon B Wood, Linda Kim, Danielle E Rose, Greg Stewart
PURPOSE: Appropriate delegation of clinical tasks from primary care providers (PCPs) to other team members may reduce employee burnout in primary care. However, (1) the extent to which delegation occurs within multidisciplinary teams, (2) factors associated with greater delegation, and (3) whether delegation is associated with burnout are all unknown. METHODS: We performed a national cross-sectional survey of Veterans Affairs (VA) PCP-nurse dyads in Department of VA primary care clinics, 4 years into the VA's patient-centered medical home initiative...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330238/changing-patterns-of-mental-health-care-use-the-role-of-integrated-mental-health-services-in-veteran-affairs-primary-care
#6
Lucinda B Leung, Jean Yoon, Lisa V Rubenstein, Edward P Post, Maureen E Metzger, Kenneth B Wells, Catherine A Sugar, José J Escarce
OBJECTIVE: Aiming to foster timely, high-quality mental health care for Veterans, VA's Primary Care-Mental Health Integration (PC-MHI) embeds mental health specialists in primary care and promotes care management for depression. PC-MHI and patient-centered medical home providers work together to provide the bulk of mental health care for primary care patients with low-to-moderate-complexity mental health conditions. This study examines whether increasing primary care clinic engagement in PC-MHI services is associated with changes in patient health care utilization and costs...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329163/the-importance-of-parental-connectedness-and-relationships-with-healthcare-professionals-in-end-of-life-care-in-the-picu
#7
Jeannette L Falkenburg, Dick Tibboel, Ruard R Ganzevoort, Saskia J Gischler, Monique van Dijk
OBJECTIVES: Support from healthcare professionals in a PICU is highly valuable for parents of dying children. The way they care for the patients and their families affects the parents' initial mourning process. This study explores what interaction with hospital staff is meaningful to parents in existential distress when their child is dying in the PICU. DESIGN: Qualitative interview study. SETTING: Level 3 PICU in the Erasmus University Medical Center-Sophia Children's Hospital, Rotterdam, and the Netherlands...
January 11, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29324427/lemons-in-the-arizona-sunshine-the-effects-of-furocoumarins-leading-to-phytophotodermatitis-and-burn-like-injuries
#8
Marc R Matthews, Joel C VanderVelde, Daniel M Caruso, Kevin N Foster
INTRODUCTION: Phytophototoxic dermatitis is a strong phototoxic reaction to ultraviolet A (UV-A) radiation exposure after cutaneous contact with citrus fruit containing furocoumarins, leading to skin injury. At the Arizona Burn Center (Phoenix, AZ), the majority of these injuries are managed in the outpatient setting. CASE REPORT: The authors present a pediatric admission for burn-like injuries following prolonged cutaneous exposure to lemons while playing in the Arizona sunshine...
December 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/29317399/effect-of-a-single-dose-of-i-v-ondansetron-on-qtc-interval-in-emergency-department-patients
#9
Kai Li, Kathy Vo, Byron K Lee, Newton Addo, Zlatan Coralic
PURPOSE: Results of a study to determine whether i.v. administration of a single dose of 4 mg of ondansetron was associated with QT interval prolongation in emergency department (ED) patients are reported. METHODS: In a prospective observational study conducted at an urban academic medical center ED, a convenience sample of adult ED patients treated with ondansetron 4 mg i.v. were enrolled. A 12-lead electrocardiogram (ECG) was obtained immediately before and 5 minutes after ondansetron administration...
January 9, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29314304/role-of-telehealth-in-renal-replacement-therapy-education
#10
Anna Malkina, Delphine S Tuot
The prevalence of end-stage renal disease is rising in the United States, which bears high financial and public health burden. The most common modality of renal replacement therapy (RRT) in the United States is in-center hemodialysis. Many patients report lack of comprehensive and timely education about their treatment options, which may preclude them from participating in home-based dialysis therapies and kidney transplantation evaluation. While RRT education has traditionally been provided in-person, the rise of telehealth has afforded new opportunities to improve upon the status quo...
January 3, 2018: Seminars in Dialysis
https://www.readbyqxmd.com/read/29311170/integrating-community-health-workers-into-medical-homes
#11
Elizabeth A Rogers, Sarah Turcotte Manser, Joan Cleary, Anne M Joseph, Eileen M Harwood, Kathleen T Call
PURPOSE: Though evidence supports the value of community health workers (CHWs) in chronic disease self-management support, and authorities have called for expanding their roles within patient-centered medical homes (PCMHs), few PCMHs in Minnesota have incorporated these health workers into their care teams. We undertook a qualitative study to (1) identify facilitators and barriers to utilizing a CHW model among PCMHs in Minnesota, and (2) define roles played by this workforce within the PCMH team...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29310585/factors-contributing-to-measles-transmission-during-an-outbreak-in-kamwenge-district-western-uganda-april-to-august-2015
#12
Fred Nsubuga, Lilian Bulage, Immaculate Ampeire, Joseph K B Matovu, Simon Kasasa, Patricia Tanifum, Alex Ario Riolexus, Bao-Ping Zhu
BACKGROUND: In April 2015, Kamwenge District, western Uganda reported a measles outbreak. We investigated the outbreak to identify potential exposures that facilitated measles transmission, assess vaccine effectiveness (VE) and vaccination coverage (VC), and recommend prevention and control measures. METHODS: For this investigation, a probable case was defined as onset of fever and generalized maculopapular rash, plus ≥1 of the following symptoms: Coryza, conjunctivitis, or cough...
January 8, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29307979/psychosocial-status-and-economic-dependence-for-healthcare-and-nonhealthcare-among-elderly-population-in-rural-coastal-karnataka
#13
Priyanka Dsouza Rent, Sudeep Kumar, Mackwin Kenwood Dmello, Jagannath Purushotham
Introduction: The elderly who will constitute 10% of the Indian population by 2021 face problems such as deteriorating healthcare status, loneliness, and economic constraints among others. All these factors together may affect the psychosocial status of the elderly and their health-seeking behavior. With this background, the current study tried to evaluate the psychosocial status, economic dependence for health and nonhealth expenses and awareness regarding geriatric welfare services (GWS) among elderly patients...
October 2017: Journal of Mid-life Health
https://www.readbyqxmd.com/read/29304742/key-attributes-of-patient-centered-medical-homes-associated-with-patient-activation-of-diabetes-patients
#14
Lori A Bilello, Allyson Hall, Jeffrey Harman, Christopher Scuderi, Nipa Shah, Jon C Mills, Shenae Samuels
BACKGROUND: Approximately 24 million Americans are living with diabetes. Patient activation among individuals with diabetes is critical to successful diabetes management. The Patient Centered Medical Home (PCMH) model holds promise for increasing patient activation in managing their health. However, what is not well understood is the extent to which individual components of the PCMH model, such as the quality of physician-patient interactions and organizational features of care, contribute to patient activation...
January 5, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29300339/a-retrospective-review-of-resuscitation-planning-at-a-children-s-hospital
#15
Jean Kelly, Jo Ritchie, Leigh Donovan, Carol Graham, Anthony Herbert
Resuscitation plans (RP) are an important clinical indicator relating to care at the end of life in paediatrics. A retrospective review of the medical records of children who had been referred to the Royal Children's Hospital, Brisbane, Australia who died in the calendar year 2011 was performed. Of 62 records available, 40 patients (65%) had a life limiting condition and 43 medical records (69%) contained a documented RP. This study demonstrated that both the underlying condition (life-limiting or life-threatening) and the setting of care (Pediatric Intensive Care Unit or home) influenced the development of resuscitation plans...
January 4, 2018: Children
https://www.readbyqxmd.com/read/29299753/factors-associated-with-the-outcome-of-very-elderly-patients-with-large-hemispheric-infarction-treated-with-medical-management-only
#16
Sudhir Datar, Christopher McLouth, Patrick Reynolds
BACKGROUND: Large ischemic stroke in the very elderly population is presumed to invariably carry a poor prognosis and clinicians may refrain from continuing intensive care. Many elderly patients are not surgical candidates, and there is a paucity of data outlining the real-world outcomes of continued medical management. Our objective is to identify the factors associated with the outcome of very elderly patients with large hemispheric infarction (LHI) treated with medical management alone...
January 3, 2018: Neurocritical Care
https://www.readbyqxmd.com/read/29296050/the-hospice-information-system-and-its-association-with-the-congruence-between-the-preferred-and-actual-place-of-death
#17
Huang-Ren Lin, Jen-Hung Wang, Jyh-Gang Hsieh, Ying-Wei Wang, Sheng-Lun Kao
Objective: A Hospice Information System (HIS) developed in eastern Taiwan in 2012 aimed to improve the quality of hospice care through an integrated system that provided telemetry-based vital sign records, online 24/7 consultations, online video interviews, and online health educations. The purpose of this study was to explore the congruence between the preferred and actual place of death (POD) among patients who received HIS services. Materials and Methods: A retrospective study was performed from January 2012 to August 2016...
October 2017: Ci Ji Yi Xue za Zhi, Tzu-chi Medical Journal
https://www.readbyqxmd.com/read/29286434/mri-guided-focused-ultrasound-thalamotomy-for-patients-with-medically-refractory-essential-tremor
#18
Ying Meng, Yuexi Huang, Benjamin Solomon, Kullervo Hynynen, Nadia Scantlebury, Michael L Schwartz, Nir Lipsman
Essential tremor (ET) is the most common type of tremor in adults. While ET does not result in decreased life expectancy, the disabilities associated with ET can have a significant impact on quality of life, mood, functional activities, and socialization. Patients suffering from ET not sufficiently treated with first line medications may be eligible for alternative strategies such as deep brain stimulation, radiofrequency ablation, and MRI guided focused ultrasound (MRgFUS). High-intensity MRgFUS is an emerging modality to treat ET, its attraction for patients being that it is noninvasive and associated with short recovery time, as patients are home the day after treatment...
December 13, 2017: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/29283617/treating-ptsd-in-primary-care-one-small-step-is-one-giant-leap
#19
Andrew S Pomerantz
Comments on an article by J. A. Cigrang et al. (see record 2017-56601-006). At first glance, the article by Cigrang et al. is another in a long line of randomized clinical trials of psychotherapy for a common condition. Under closer scrutiny, however, it is a groundbreaking study that challenges many commonly held beliefs about effective interventions for posttraumatic stress disorder (PTSD). Cigrang et al. have begun to change the status quo with this study within the DoD. The same protocol is now in the early stages of implementation as a pilot in the VA's Patient Aligned Care Team (VA equivalent of the Patient Centered Medical Home)...
December 2017: Families, Systems & Health: the Journal of Collaborative Family Healthcare
https://www.readbyqxmd.com/read/29280778/perceptions-of-integration-of-the-clinical-pharmacist-into-the-pcmh-model-by-the-pcmh-team
#20
M Shawn McFarland, Kristen Lamb, Jonathan Hughes, Ashley Thomas, Justin Gatwood, Jacob Hathaway
INTRODUCTION: The patient-centered medical home (PCMH) model is a multidisciplinary, team-based approach to healthcare that focuses on actively involving the patient in clinical decision making. The Veterans Health Administration (VA), while desiring to be a national leader in the delivery of primary care services, used the principles of the PCMH model to design the patient-aligned care team (PACT). The purpose of this study, was to explore the perception of the PACT members after integration of a clinical pharmacist to the PACT...
December 22, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
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