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Patient centered medical home

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https://www.readbyqxmd.com/read/28812381/retrospective-review-of-sglt2-inhibitor-exposures-reported-to-13-poison-centers
#1
Scott E Schaeffer, Carol DesLauriers, Henry A Spiller, Alfred Aleguas, Salvador Baeza, Mark L Ryan
BACKGROUND: SGLT2 inhibitors are a new class of oral antidiabetics prescribed in the United States since 2013. They act by inhibiting reabsorption of glucose in the proximal convoluted tubule of the kidney, allowing excess glucose to be excreted. Little has been reported regarding effects of non-therapeutic exposure to this class of medication. METHODS: Retrospective records from 13 poison centers were examined for human exposures to SGLT2 inhibitors between 1st January 2013 and 31st December 2016...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28808852/patient-experience-with-the-patient-centered-medical-home-in-michigan-s-statewide-multi-payer-demonstration-a-cross-sectional-study
#2
Issidoros Sarinopoulos, Diane L Bechel-Marriott, Jean M Malouin, Shaohui Zhai, Jason C Forney, Clare L Tanner
BACKGROUND: The literature on patient-centered medical homes (PCMHs) and patient experience is somewhat mixed. Government and private payers are promoting multi-payer PCMH initiatives to align requirements and resources and to enhance practice transformation outcomes. To this end, the multipayer Michigan Primary Care Transformation (MiPCT) demonstration project was carried out. OBJECTIVE: To examine whether the PCMH is associated with a better patient experience, and whether a mature, multi-payer PCMH demonstration is associated with even further improvement in the patient experience...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28805267/practices-in-the-evaluation-of-potential-kidney-transplant-recipients-who-are-elderly-a-survey-of-us-transplant-centers
#3
Didier A Mandelbrot, Aaron Fleishman, James R Rodrigue, Silas P Norman, Milagros Samaniego
Limited data exists regarding the evaluation and selection of older candidates for transplantation. To help guide the development of program protocols and help define research questions in this area, we surveyed US transplant centers regarding their current practices in the evaluation of older kidney transplant candidates. We emailed a 28-question survey to the medical and surgical directors of 190 adult kidney transplant programs in the US. We received usable responses from 59 programs, a 31.1% response rate...
August 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28801413/effectiveness-of-rehabilitation-after-a-total-hip-arthroplasty-a-protocol-for-an-observational-study-for-the-comparison-of-usual-care-in-the-netherlands-versus-germany
#4
Gesine H Seeber, Annet Wijnen, Djordje Lazovic, Sjoerd K Bulstra, Günter Dietz, Christiaan P van Lingen, Martin Stevens
INTRODUCTION: Osteoarthritis is the most common joint disorder worldwide. Total hip arthroplasty (THA) is considered one of the most effective treatments for end-stage hip osteoarthritis. The number of THAs is expected to increase dramatically in the coming decades. Usual postoperative rehabilitation after primary THA differs between the German and the Dutch system. In the Netherlands, patients undergo fast-track surgery and are discharged into their home environment within a few days without receiving any aftercare...
August 11, 2017: BMJ Open
https://www.readbyqxmd.com/read/28801006/palliative-care-in-kazakhstan
#5
Gulnara Kunirova, Ainur Shakenova
In Kazakhstan, like most ex-Soviet Union countries palliative care began in the late 1990's with the opening of the Almaty Hospice in 1999. Since that time, several palliative care services have opened in urban centers but there is little coverage in rural areas. Palliative care has grown due to the collaborative work of Parliament leaders, Ministry of Health, local governments officials, Public Health Higher School, National Center for Health Development, academic medical institutions, oncology and palliative care experts, NGO's, Soros Foundation Kazakhstan, and international experts...
August 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28800384/exploring-conditions-for-redistribution-of-anti-tnfs-to-reduce-spillage-a-study-on-the-quality-of-anti-tnf-home-storage
#6
Marin J de Jong, Marieke J Pierik, Andy Peters, Mark Roemers, Veronique Hilhorst, Astrid van Tubergen
BACKGROUND AND AIM: Biologicals are potent drugs for immune mediated inflammatory diseases (IMIDs). After discontinuation or switch of therapy, many patients have unused biological injectors left. We aimed to evaluate potential redistribution of unused injectors to prevent spillage of these costly drugs by assessing 1) the quality of transport and home storage through the proportion of injectors stored within the recommended temperature range (2°C-8°C) and 2) acceptance of redistribution by patients...
August 11, 2017: Journal of Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28790806/perceptions-of-patients-with-rheumatic-diseases-on-the-impact-on-daily-life-and-satisfaction-with-their-medications-rheu-life-a-survey-to-patients-treated-with-subcutaneous-biological-products
#7
Carlos M González, Loreto Carmona, Javier de Toro, Enrique Batlle-Gualda, Antonio I Torralba, María J Arteaga, Luis Cea-Calvo
OBJECTIVE: The aim of this study was to explore perceptions of patients with rheumatic diseases treated with subcutaneous (SC) biological drugs on the impact on daily life and satisfaction with current therapy, including preferred attributes. METHODS: A survey was developed ad hoc by four rheumatologists and three patients, including Likert questions on the impact of disease and treatment on daily life and preferred attributes of treatment. Rheumatologists from 50 participating centers were instructed to handout the survey to 20 consecutive patients with rheumatoid arthritis (RA), axial spondyloarthritis (ax-SpA), or psoriatic arthritis (PsA) receiving SC biological drugs...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/28782539/leveraging-the-medical-context-to-increase-upper-extremity-reconstruction-among-patients-with-tetraplegia-a-qualitative-analysis
#8
Chelsea A Harris, John-Michael Muller, Melissa J Shauver, Kevin C Chung
OBJECTIVES: (1) To characterize patients' medical experiences from initial injury until they become candidates for Upper Extremity Reconstruction (UER). (2) To identify points in this medical context that may be most amenable to interventions designed to increase UER utilization. DESIGN: A qualitative cross-sectional study using grounded theory methodology and constant comparative analysis of data collected through semi-structured individual interviews. SETTING: Community PARTICIPANTS: A sample of individuals with C4-C8 cervical spinal injuries (N=19) who sustained injuries at least one year prior to interview...
August 3, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28782407/evaluation-of-pegfilgrastim-use-at-an-academic-medical-center
#9
Kathy Tang, Alison Duffy, Steven Gilmore
Purpose Pegfilgrastim is indicated to reduce the risk of febrile neutropenia. As a cost-savings initiative, Pegfilgrastim Process Guidelines were developed and implemented at a large, academic teaching institution to improve appropriate use of pegfilgrastim and to decrease costs of outpatient infusion center administration by deferring doses to home self-administration for eligible patients. Methods A retrospective medical record review was conducted post-implementation of the Pegfilgrastim Process Guideline to evaluate the use of pegfilgrastim and to assess the safety and efficacy of transferring pegfilgrastim orders from outpatient infusion center to home administration for eligible patients...
January 1, 2017: Journal of Oncology Pharmacy Practice
https://www.readbyqxmd.com/read/28782004/second-flexner-century-the-democratization-of-medical-knowledge-repurposing-a-general-pathology-course-into-multigrade-level-gateway-courses
#10
Ronald S Weinstein, Amy L Waer, John B Weinstein, Margaret M Briehl, Michael J Holcomb, Kristine A Erps, Angelette L Holtrust, Julie M Tomkins, Gail P Barker, Elizabeth A Krupinski
Starting in 1910, the "Flexner Revolution" in medical education catalyzed the transformation of the US medical education enterprise from a proprietary medical school dominated system into a university-based medical school system. In the 21st century, what we refer to as the "Second Flexner Century" shifts focus from the education of medical students to the education of the general population in the "4 health literacies." Compared with the remarkable success of the first Flexner Revolution, retrofitting medical science education into the US general population today, starting with K-12 students, is a more daunting task...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28781135/five-year-epidemiology-of-liquefied-petroleum-gas-related-burns
#11
Ronghua Jin, Pan Wu, Jon Kee Ho, Xingang Wang, Chunmao Han
BACKGROUND: The incidence of liquefied petroleum gas (LPG)-related burns has increased over recent years, and it has become a serious public health issue in developing countries such as India and Turkey. This paper aims to investigate the epidemiological characteristics of LPG-related burns to provide assistance and suggestions for planning prevention strategies. METHODS: A 5-year retrospective study was conducted in patients with LPG-related burns admitted to the Department of Burns & Wound Care Center, Second Affiliated Hospital of Zhejiang University, College of Medicine, between 1st January 2011 and 31st December 2015...
August 3, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28780910/drug-related-problems-in-community-dwelling-primary-care-patients-screened-positive-for-dementia
#12
D Wucherer, J R Thyrian, T Eichler, J Hertel, I Kilimann, S Richter, B Michalowsky, I Zwingmann, A Dreier-Wolfgramm, C A Ritter, S Teipel, W Hoffmann
BACKGROUND: Older people have a higher risk of drug-related problems (DRPs). However, little is known about the prevalence of DRPs in community-dwelling people who screened positive for dementia. Our study aimed to determine (1) the prevalence and types of DRPs and (2) the socio-demographic and clinical variables associated with DRPs in people screened positive for dementia in primary care. METHODS: The Dementia: life- and person-centered help in Mecklenburg-Western Pomerania (DelpHi-MV) study is a general practitioner (GP)-based cluster-randomized controlled intervention study to implement and evaluate an innovative concept of collaborative dementia care management in the primary care setting in Germany...
August 7, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28780547/paediatric-asthma-control-under-a-community-management-model-in-china-a-protocol-for-a-prospective-multicentre-cohort-study
#13
Juan Xu, Yong Yin, Hao Zhang, Wen Wei Zhong, Lei Zhang, Jing Zhang, Shu Hua Yuan, Fen Zhang, Li Xia Zhao
INTRODUCTION: Childhood asthma is globally one of the most common respiratory disorders and accounts for more school absences and more hospitalizations than any other chronic illness. The worldwide economic burden of this disease exceeds those of HIV/AIDS and tuberculosis combined. Proper intervention and effective management is of paramount importance for the control and prognosis of paediatric asthma. Unfortunately, the rate of uncontrolled and partially controlled paediatric asthma in China is >90%...
August 4, 2017: BMJ Open
https://www.readbyqxmd.com/read/28772095/advance-directives-among-nursing-home-residents-with-mild-moderate-and-advanced-dementia
#14
Jennifer Tjia, Marisa Dharmawardene, Jane L Givens
OBJECTIVE: To describe prevalence and content of AD documentation among NH residents by dementia stage. BACKGROUND: The prevalence of advance directives (ADs) among nursing home (NH) residents with mild, moderate, and advanced dementia remains unclear. METHODS: Population-based, cross-sectional study of all licensed NHs in five U.S. states. Subjects included all long-stay (>90 day) NH residents with dementia, aged ≥65 years, and a Cognitive Performance Scale (CPS) score ≥1 from the 2007 to 2008 Minimum Data Set 2...
August 3, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28761451/the-impact-of-educational-intervention-on-self-care-behaviors-in-overweight-hypertensive-women-a-randomized-control-trial
#15
Seyedeh Shahrbanoo Daniali, Ahmad Ali Eslami, Mohammad Reza Maracy, Javad Shahabi, Firoozeh Mostafavi-Darani
BACKGROUND: The improper control of self-care in hypertension imposes a lot of financial burden on the health-care system. On the other hand, the importance of participatory care and high effectiveness of self-management programs have been confirmed. This study was aimed to examine the effect of an educational intervention on self-efficacy, self-care behaviors and blood pressure (BP) of hypertensive obese or overweight women in the primary health-care setting in Isfahan, Iran. METHODS: This randomized controlled trial was an educational intervention program...
January 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/28759685/association-between-extending-carefirst-s-medical-home-program-to-medicare-patients-and-quality-of-care-utilization-and-spending
#16
G Greg Peterson, Kristin Lowe Geonnotti, Lauren Hula, Timothy Day, Laura Blue, Keith Kranker, Boyd Gilman, Kate Stewart, Sheila Hoag, Lorenzo Moreno
Importance: CareFirst, the largest commercial insurer in the mid-Atlantic Region of the United States, runs a medical home program focusing on financial incentives for primary care practices and care coordination for high-risk patients. From 2013 to 2015, CareFirst extended the program to Medicare fee-for-service (FFS) beneficiaries in participating practices. If the model extension improved quality while reducing spending, the Centers for Medicare and Medicaid Services could expand the program to Medicare beneficiaries broadly...
July 31, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28758564/do-medical-residents-perform-patient-centered-medical-home-tasks-a-mixed-methods-study
#17
Lauren Block, Nancy LaVine, Jennifer Verbsky, Ankita Sagar, Miriam A Smith, Susan Lane, Joseph Conigliaro, Saima A Chaudhry
BACKGROUND: Increasingly, residents are being trained in Patient-centered Medical Home (PCMH) settings. A set of PCMH entrustable professional activities (EPAs) for residents has been defined but not evaluated in practice. OBJECTIVE: To understand whether residents trained at PCMH sites reported higher likelihood of engaging in PCMH tasks than those training in non-PCMH sites. DESIGN: Survey and nominal group data from post-graduate trainees at three residency programs...
2017: Medical Education Online
https://www.readbyqxmd.com/read/28755097/provider-experiences-with-chronic-care-management-ccm-services-and-fees-a-qualitative-research-study
#18
Ann S O'Malley, Rumin Sarwar, Rosalind Keith, Patrick Balke, Sai Ma, Nancy McCall
BACKGROUND: Support for ongoing care management and coordination between office visits for patients with multiple chronic conditions has been inadequate. In January 2015, Medicare introduced the Chronic Care Management (CCM) payment policy, which reimburses providers for CCM activities for Medicare beneficiaries occurring outside of office visits. OBJECTIVE: To explore the experiences, facilitators, and challenges of practices providing CCM services, and their implications going forward...
July 28, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28754579/rapid-discharge-to-home-after-total-knee-arthroplasty-is-safe-in-eligible-medicare-patients
#19
Gregory G Klingenstein, Scott D Schoifet, Rajesh K Jain, Jeremy J Reid, Manny D Porat, Mojisola K Otegbeye
BACKGROUND: This study was aimed at assessing the risk of readmission for Medicare patients discharged home within a day of total knee arthroplasty (TKA) compared to those discharged on day 2 or beyond in a community medical center. METHODS: A hospital inpatient database was queried for all unilateral, primary TKAs performed on patients 65 years or older from January 1, 2013, to December 31, 2015. A total of 2287 patients met the study criteria, of which 1502 were discharged within a day (short stay), and 785 were discharged on day 2 or beyond (traditional stay)...
June 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28746024/impact-of-longitudinal-electronic-health-record-training-for-residents-preparing-for-practice-in-patient-centered-medical-homes
#20
Jung G Kim, Hector P Rodriguez, Katherine At Estlin, Carl G Morris
INTRODUCTION: Competence in using an electronic health record (EHR) is considered a critical skill for physicians practicing in patient-centered medical homes (PCMHs), but few studies have examined the impact of EHR training for residents preparing to practice in PCMHs. This study explored the educational outcomes associated with comprehensive EHR training for family medicine residents. METHODS: The PCMH EHR training consisted of case-based routine clinic visits delivered to 3 resident cohorts (N = 18)...
2017: Permanente Journal
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