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Ambulatory Care

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https://www.readbyqxmd.com/read/28547273/case-distribution-and-complications-of-mid-urethral-sling-surgery-in-a-canadian-city-before-and-after-the-health-canada-advisory-on-pelvic-floor-mesh
#1
Kevin Carlson, Richard Baverstock, Andrea Civitarese, R Trafford Crump
INTRODUCTION AND HYPOTHESIS: Increased incidences of complications related to the use of mid-urethral slings (MUS) for the treatment of stress urinary incontinence resulted in both the Food and Drug Administration (FDA) and Health Canada issuing advisories in 2008 and 2010 respectively. The purpose of this study was to assess the effect these advisories had on the number of surgeons performing MUS surgery and post-surgical complications in Calgary, Canada. METHODS: In this study, we conducted a retrospective analysis of administrative data between 2006 and 2011...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28545743/tdap-vaccination-among-healthcare-personnel-internet-panel-survey-2012-2014
#2
Anup Srivastav, Carla L Black, Peng-Jun Lu, Jun Zhang, Jennifer L Liang, Stacie M Greby
INTRODUCTION: Healthcare personnel (HCP) are at risk for pertussis infection exposure or transmitting the disease to patients in their work settings. The Advisory Committee on Immunization Practices recommends tetanus toxoid, reduced diphtheria toxoid, and acellular pertussis (Tdap) vaccination for HCP to minimize these risks. This study assessed Tdap vaccination coverage among U.S. HCP by sociodemographic and occupation-related characteristics. METHODS: The 2012, 2013, and 2014 Internet Panel Surveys were analyzed in 2015 to assess HCP Tdap vaccination...
May 23, 2017: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/28545412/how-do-population-general-practice-and-hospital-factors-influence-ambulatory-care-sensitive-admissions-a-cross-sectional-study
#3
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Reducing unplanned hospital admissions is a key priority within the UK and other healthcare systems, however it remains uncertain how this can be achieved. This paper explores the relationship between unplanned ambulatory care sensitive condition (ACSC) admission rates and population, general practice and hospital characteristics. Additionally, we investigated if these factors had a differential impact across 28 conditions. METHODS: We used the English Hospital Episode Statistics to calculate the number of unplanned ACSC hospital admissions for 28 conditions at 8,029 general practices during 2011/12...
May 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28545402/regional-variations-of-perceived-problems-in-ambulatory-care-from-the-perspective-of-general-practitioners-and-their-patients-an-exploratory-focus-group-study-in-urban-and-rural-regions-of-northern-germany
#4
H Hansen, N J Pohontsch, L Bole, I Schäfer, M Scherer
BACKGROUND: Patients from rural and urban regions should have equitable access to health care. In Germany, the physician-patient-ratio and the supply of medical services vary greatly between urban and rural areas. The aim of our study was to explore the regional variations of the perceived health care problems in ambulatory care from the perspective of affected professionals and laypersons i.e. general practitioners and their patients. METHODS: We conducted 27 focus groups with general practitioners (n = 65) and patients (n = 145) from urban areas, environs and rural areas in northern Germany...
May 25, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28544197/body-mass-index-and-healthcare-costs-a-systematic-literature-review-of-individual-participant-data-studies
#5
REVIEW
Seamus Kent, Francesco Fusco, Alastair Gray, Susan A Jebb, Benjamin J Cairns, Borislava Mihaylova
Excess weight is associated with increased total healthcare costs, but it is less well known how the associations between excess weight and costs vary across different types of healthcare service. We reviewed studies using individual participant data to estimate associations between body mass index and healthcare costs, and summarized how annual healthcare costs for overweight (body mass index 25 to <30 kg/m(2) ) and obese (≥30 kg/m(2) ) individuals compared with those for healthy weight individuals (18...
May 22, 2017: Obesity Reviews: An Official Journal of the International Association for the Study of Obesity
https://www.readbyqxmd.com/read/28544106/inappropriate-prescribing-in-chronic-kidney-disease-a-systematic-review-of-prevalence-associated-clinical-outcomes-and-impact-of-interventions
#6
REVIEW
Wubshet Hailu Tesfaye, Ronald L Castelino, Barbara C Wimmer, Syed Tabish R Zaidi
INTRODUCTION: Adjusting doses of renally cleared medications and/or avoidance of nephrotoxic medications are standard clinical practices in chronic kidney disease (CKD), albeit the prevalence of inappropriate prescribing (IP) in these patients remains high. Therefore, this work sought to systematically review the prevalence of IP and compare the relative effectiveness of available interventions in reducing IP in CKD. METHODS: Studies were identified searching PubMed/Medline, EMBASE, Cochrane Library, IPA, Web of Science, Ovid/Medline, CINAHL, and PsychINFO databases...
May 23, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28541965/increasing-health-portal-utilization-in-cardiac-ambulatory-patients-a-pilot-project
#7
Carmen L Shaw, Gayle L Casterline, Dennis Taylor, Maureen Fogle, Bradi Granger
Increasing health portal participation actively engages patients in their care and improves outcomes. The primary aim for this project was to increase patient health portal utilization. Nurses used a tablet-based demo to teach patients how to navigate the health portal. Assigning health videos to the portal was a tactic used to increase utilization. Each patient participant was surveyed about health portal utilization at initial nurse navigator appointment, day of procedure, and 30 days after discharge. Seventy-three percent (n = 14) of the 19 selected patients received the intervention; 36% (n = 4) of patients reported using a health portal feature; meaningful use metric preintervention increased from 12% to 16% after the intervention; 16% and 18% of patients viewed assigned videos in their health portal prior to procedure and after hospital discharge...
May 25, 2017: Computers, Informatics, Nursing: CIN
https://www.readbyqxmd.com/read/28541137/clinical-use-of-continuous-glucose-monitoring-in-adults-with-type-2-diabetes
#8
Anders L Carlson, Deborah M Mullen, Richard M Bergenstal
Hemoglobin A1c is an excellent population health measure for the risk of vascular complications in diabetes, while continuous glucose monitoring (CGM) is a tool to help personalize a diabetes treatment plan. The value of CGM in individuals with type 1 diabetes (T1D) has been well demonstrated when compared with utilizing self-monitoring of blood glucose (SMBG) to guide treatment decisions. CGM is a tool for patients and clinicians to visualize the important role that diet, exercise, stress management, and the appropriate selection of diabetes medications can have in managing type 2 diabetes (T2D)...
May 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28540039/successful-withdrawal-from-high-dose-benzodiazepine-in-a-young-patient-through-electronic-monitoring-of-polypharmacy-a-case-report-in-an-ambulatory-setting
#9
REVIEW
Hèctor R Loscertales, Valerie Wentzky, Kenneth Dürsteler, Johannes Strasser, Kurt E Hersberger, Isabelle Arnet
BACKGROUND: Dependence on high-dose benzodiazepines (BZDs) is well known and discontinuation attempts are generally unsuccessful. A well established protocol for high-dose BZD withdrawal management is lacking. We present the case of withdrawal from high-dose lorazepam (>20 mg daily) in an unemployed 35-year-old male outpatient through agonist substitution with long-acting clonazepam and electronic monitoring over 28 weeks. METHODS: All medicines were repacked into weekly 7 × 4 cavity multidose punch cards with an electronic monitoring system...
May 2017: Therapeutic Advances in Psychopharmacology
https://www.readbyqxmd.com/read/28537323/high-prevalence-of-malnutrition-among-elderly-veterans-in-home-based-primary-care
#10
A Z Win, C Ceresa, K Arnold, T A Allison
INTRODUCTION: Elderly Veterans enrolled in VA Home Based Primary Care (HBPC) programs suffer from many diseases including malnutrition. Nutrition screening tools exist in the VA system but they are inconsistently utilized across ambulatory care programs and are neither research validated nor comparable with non-VA populations. The Mini-Nutritional Assessment short-form (MNA-SF) has been validated in international studies in a variety of settings. The primary aim of this study was to find the prevalence of malnutrition among Veterans enrolled in HBPC programs...
2017: Journal of Nutrition, Health & Aging
https://www.readbyqxmd.com/read/28536766/pediatric-radiology-malpractice-claims-characteristics-and-comparison-to-adult-radiology-claims
#11
REVIEW
Micheál A Breen, Kathy Dwyer, Winnie Yu-Moe, George A Taylor
Medical malpractice is the primary method by which people who believe they have suffered an injury in the course of medical care seek compensation in the United States and Canada. An increasing body of research demonstrates that failure to correctly diagnose is the most common allegation made in malpractice claims against radiologists. Since the 1994 survey by the Society of Chairmen of Radiology in Children's Hospitals (SCORCH), no other published studies have specifically examined the frequency or clinical context of malpractice claims against pediatric radiologists or arising from pediatric imaging interpretation...
June 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28536657/depression-treatment-among-adults-with-multiple-sclerosis-and-depression-in-ambulatory-care-settings-in-the-united-states
#12
Sandipan Bhattacharjee, Lisa Goldstone, Queeny Ip, Terri Warholak
Background. There is little information regarding depression treatment patterns among adults with MS and depression in ambulatory settings at national level in the United States (US). Objectives. The objectives of this study were to identify patterns and predictors of depression treatment in ambulatory settings in US among adults with MS and depression. Methods. A cross-sectional study was conducted by pooling multiple years (2005-2011) of National Ambulatory Medical Care Survey and the outpatient department of the National Hospital Ambulatory Medical Care Survey data...
2017: Multiple Sclerosis International
https://www.readbyqxmd.com/read/28536211/pathological-fracture-of-the-femoral-neck-following-septic-coxitis-and-chronic-osteomyelitis-a-potential-complication-of-lemierre-s-syndrome
#13
Dominik Maximilian Vogt, Ludger Tüshaus, Martin Kaiser, Martin Russlies
We portray the case of a 16-year-old girl who was initially admitted to the paediatric emergency department with non-specific symptoms of a severe cold and was first treated symptomatically on an ambulatory basis. Within 6 days she developed the full clinical picture of Lemierre's syndrome with the extraordinary manifestation of involvement of her right hip. Despite an interdisciplinary coordinated treatment as well as surgical therapy, a full-blown sepsis evolved within a short time period and resulted in almost 2 months of intensive care...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28535109/intranasal-steroid-use-for-otitis-media-with-effusion-ongoing-opportunities-for-quality-improvement
#14
David E Wang, Derek J Lam, Angela M Bellmunt, Richard M Rosenfeld, Allison K Ikeda, Jennifer J Shin
Objectives Our objectives were (1) to assess patterns of intranasal steroid administration when otitis media with effusion (OME) has been diagnosed in children, (2) to investigate whether usage varies according to visit setting, and (3) to determine if practice gaps are such that quality improvement could be tracked. Study Design Cross-sectional analysis of an administrative database. Subjects and Methods National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005 to 2012; univariate, multivariate, and stratified analyses of intranasal steroid usage were performed...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28531549/impact-of-community-based-nurse-led-clinics-on-patient-outcomes-patient-satisfaction-patient-access-and-cost-effectiveness-a-systematic-review
#15
REVIEW
Sue Randall, Tonia Crawford, Jane Currie, Jo River, Vasiliki Betihavas
BACKGROUND: The role and scope of nursing practice has evolved in response to the dynamic needs of individuals, communities, and healthcare services. Health services are now focused on maintaining people in their communities, and keeping them out of hospital where possible. Community based nurse-led clinics are ideally placed to work towards this goal. The initial impetus for these services was to increase patient access to care, to provide a cost-effective and high quality streamlined service...
May 11, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28531241/effect-of-statin-treatment-vs-usual-care-on-primary-cardiovascular-prevention-among-older-adults-the-allhat-llt-randomized-clinical-trial
#16
Benjamin H Han, David Sutin, Jeff D Williamson, Barry R Davis, Linda B Piller, Hannah Pervin, Sara L Pressel, Caroline S Blaum
Importance: While statin therapy for primary cardiovascular prevention has been associated with reductions in cardiovascular morbidity, the effect on all-cause mortality has been variable. There is little evidence to guide the use of statins for primary prevention in adults 75 years and older. Objectives: To examine statin treatment among adults aged 65 to 74 years and 75 years and older when used for primary prevention in the Lipid-Lowering Trial (LLT) component of the Antihypertensive and Lipid-Lowering Treatment to Prevent Heart Attack Trial (ALLHAT-LLT)...
May 22, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28530524/is-real-world-evidence-used-in-p-t-monographs-and-therapeutic-class-reviews
#17
Jason T Hurwitz, Mary Brown, Jennifer S Graff, Loretta Peters, Daniel C Malone
BACKGROUND: Payers are faced with making coverage and reimbursement decisions based on the best available evidence. Often these decisions apply to patient populations, provider networks, and care settings not typically studied in clinical trials. Treatment effectiveness evidence is increasingly available from electronic health records, registries, and administrative claims. However, little is known about when and what types of real-world evidence (RWE) studies inform pharmacy and therapeutic (P&T) committee decisions...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530490/role-of-continuous-glucose-monitoring-in-clinical-trials-recommendations-on-reporting
#18
Oliver Schnell, Katharine Barnard, Richard Bergenstal, Emanuele Bosi, Satish Garg, Bruno Guerci, Thomas Haak, Irl B Hirsch, Linong Ji, Shashank R Joshi, Maarten Kamp, Lori Laffel, Mathieu Chantal, William H Polonsky, Frank Snoek, Philip Home
Thanks to significant improvements in the precision, accuracy, and usability of continuous glucose monitoring (CGM), its relevance in both ambulatory diabetes care and clinical research is increasing. In this study, we address the latter perspective and derive provisional reporting recommendations. CGM systems have been available since around the year 2000 and used primarily in people with type 1 diabetes. In contrast to self-measured glucose, CGM can provide continuous real-time measurement of glucose levels, alerts for hypoglycemia and hyperglycemia, and a detailed assessment of glycemic variability...
May 22, 2017: Diabetes Technology & Therapeutics
https://www.readbyqxmd.com/read/28528356/operating-room-fires-in-periocular-surgery
#19
Michael A Connor, Anne M Menke, Ivan Vrcek, John W Shore
AIM: A survey of ophthalmic plastic and reconstructive surgeons as well as seven-year data regarding claims made to the Ophthalmic Mutual Insurance Company (OMIC) is used to discuss operating room fires in periocular surgery. METHODS: A retrospective review of all closed claim operating room fires submitted to OMIC was performed. A survey soliciting personal experiences with operating room fires was distributed to all American Society of Oculoplastic and Reconstructive Surgeons...
May 20, 2017: International Ophthalmology
https://www.readbyqxmd.com/read/28528337/association-between-chronic-kidney-disease-and-risk-of-cataract-a-nationwide-retrospective-cohort-study
#20
Yin-Tzu Liu, Tzu-Yao Hung, Yi-Kung Lee, Ming-Yuan Huang, Chen-Yang Hsu, Yung-Cheng Su
BACKGROUND: Previous studies have established a relationship between chronic kidney disease (CKD) and cataract, but the relationship between the severity of renal impairment and risk of cataract is uncertain. This study investigates the relationship between the severity of renal disease and cataract in a nationwide sample from Taiwan. METHODS: The cohort from 1-million National Health Insurance beneficiaries from Taiwan was retrospectively analyzed. All adult beneficiaries were followed from January 1, 2005 until December 31, 2013, to identify patients who underwent cataract surgeries...
May 20, 2017: American Journal of Nephrology
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