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Patient-centered medical home

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https://www.readbyqxmd.com/read/29053491/safety-and-feasibility-of-early-physical-therapy-for-patients-on-extracorporeal-membrane-oxygenator-university-of-maryland-medical-center-experience
#1
Chris L Wells, Jenny Forrester, Joshua Vogel, Raymond Rector, Ali Tabatabai, Daniel Herr
OBJECTIVES: To examine the feasibility and safety of mobilizing patients while on extracorporeal membranous oxygenation support. DESIGN: Retrospective cohort study. SETTING: Medical and Surgical ICUs in a large tertiary care hospital in the United States. PATIENTS: Adults supported on extracorporeal membranous oxygenation from January 2014 to December 2015. MEASUREMENTS AND MAIN RESULTS: We reviewed the medical records from physical therapy, perfusion, and intensivists to obtain the number and type of physical therapy interventions and discharge status; extracorporeal membranous oxygenation type and description of support, cannulation sites; and risk management details of adverse effects, if any...
October 19, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29052345/views-of-diverse-primary-care-patients-on-the-roles-of-healthcare-providers-and-staff-and-the-influence-of-other-variables-in-their-weight-management
#2
C M Tucker, J L Williams, G M Wippold, L A Bilello, T A Morrissette, A J Good, N R Shah, N E Rowland
The prevalence of overweight/obesity is disproportionately higher among racial/ethnic minority and low-income patients. The purpose of this study was to survey racially diverse, low-income patients regarding their experiences with and desires regarding their providers' involvement in weight management. Adult patients (N = 529), including mostly African American (42.7%), White (44.6%) and low-income (55.5% with incomes <$30 000) patients from 7 Patient-Centered Medical Homes voluntarily completed a brief anonymous survey while waiting to see their providers...
October 20, 2017: Clinical Obesity
https://www.readbyqxmd.com/read/29044930/effect-of-incident-nocturnal-home-hemodialysis-versus-incident-continuous-ambulatory-peritoneal-dialysis-on-employment-rate-clinical-and-laboratory-outcomes-a-1-year-retrospective-observation-study
#3
John Wing Li, Joseph Ho Sing Wong, Wai Leung Chak, Ka Foon Chau
INTRODUCTION: While studies demonstrated favorable outcomes of nocturnal home hemodialysis (NHHD), direct comparison on employment rate, clinical and laboratory outcomes between the NHHD and continuous ambulatory peritoneal dialysis (CAPD) had not been previously performed. METHODS: A 1-year retrospective observation study was performed in 20 incidents alternate night NHHD and 81 incident CAPD patients of Chinese ethnicity, who were sex, diabetic status, and Charlson comorbidity index matched, but not age due to our center's age limit for NHHD enrollment...
October 18, 2017: Hemodialysis International
https://www.readbyqxmd.com/read/29044479/the-strategies-to-reduce-injuries-and-develop-confidence-in-elders-intervention-falls-risk-factor-assessment-and-management-patient-engagement-and-nurse-co-management
#4
David B Reuben, Priscilla Gazarian, Neil Alexander, Katy Araujo, Dorothy Baker, Jonathan F Bean, Chad Boult, Peter Charpentier, Pamela Duncan, Nancy Latham, Rosanne M Leipzig, Lisa M Quintiliani, Thomas Storer, Siobhan McMahon
In response to the epidemic of falls and serious falls-related injuries in older persons, in 2014, the Patient Centered Outcomes Research Institute (PCORI) and the National Institute on Aging funded a pragmatic trial, Strategies to Reduce Injuries and Develop confidence in Elders (STRIDE) to compare the effects of a multifactorial intervention with those of an enhanced usual care intervention. The STRIDE multifactorial intervention consists of five major components that registered nurses deliver in the role of falls care managers, co-managing fall risk in partnership with patients and their primary care providers (PCPs)...
October 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29043569/nutritional-support-and-parenteral-nutrition-in-cancer-patients-an-expert-consensus-report
#5
REVIEW
J A Virizuela, M Camblor-Álvarez, L M Luengo-Pérez, E Grande, J Álvarez-Hernández, M J Sendrós-Madroño, P Jiménez-Fonseca, M Cervera-Peris, M J Ocón-Bretón
BACKGROUND: Malnutrition is a frequent medical problem of cancer patients that negatively impacts their quality of life. METHODS: A multidisciplinary group of experts in Medical Oncology, Pharmacy, and Nutrition convened to discuss the management of the nutritional support in cancer patients. RESULTS: Of the 18 questions addressed, 9 focused on nutritional support, 5 were related to parenteral nutrition (PN) and 4 about home PN (HPN). The panel of experts recommends using nutritional screening routinely, at diagnosis and throughout the disease course, for detecting the risk of malnutrition and, if it is positive, to perform a complete nutritional assessment, to diagnose malnutrition...
October 17, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/29040344/dilemmas-for-guardians-of-advanced-dementia-patients-regarding-tube-feeding
#6
Efrat Gil, Maayan Agmon, Ayal Hirsch, Miriam Ziv, Anna Zisberg
Background: advanced dementia is an incurable illness, its last stage marked by inability to eat. Tube feeding was deemed a helpful solution at this stage, but in recent years its inefficiency has been proved, and it is no longer practiced in many countries around the world. In Israel, however, the procedure is still accepted. In the gastroenterology department at the Bnai Zion Medical Center, a serious interaction is ongoing with patients' legal guardians, where detailed information is given about the inefficiency of the tube procedure...
October 13, 2017: Age and Ageing
https://www.readbyqxmd.com/read/29039720/trends-in-the-contribution-of-emergency-departments-to-the-provision-of-health-care-in-the-usa
#7
David Marcozzi, Brendan Carr, Alisha Liferidge, Nicole Baehr, Brian Browne
Traditional approaches to assessing the health of populations focus on the use of primary care and the delivery of care through patient-centered homes, managed care resources, and accountable care organizations. The use of emergency departments (EDs) has largely not been given consideration in these models. Our study aimed to determine the contribution of EDs to the health care received by Americans between 1996 and 2010 and to compare it with the contribution of outpatient and inpatient services using National Ambulatory Medical Care Survey and National Hospital Discharge Survey databases...
January 1, 2017: International Journal of Health Services: Planning, Administration, Evaluation
https://www.readbyqxmd.com/read/29034825/a-tale-of-four-practices
#8
Michelle Miller-Day, Janelle Applequist, Keri Zabokrtsky, Alexandra Dalton, Katherine Kellom, Robert Gabbay, Peter F Cronholm
Purpose The Patient-Centered Medical Home (PCMH) has become a dominant model of primary care re-design. This transformation presents a challenge to many care delivery organizations. The purpose of this paper is to describe attributes shaping successful and unsuccessful practice transformation within four medical practice groups. Design/methodology/approach As part of a larger study of 25 practices transitioning into a PCMH, the current study focused on diabetes care and identified high- and low-improvement medical practices in terms of quantitative patient measures of glycosylated hemoglobin and qualitative assessments of practice performance...
September 18, 2017: Journal of Health Organization and Management
https://www.readbyqxmd.com/read/29032299/association-of-antiplatelet-therapy-with-patient-outcomes-after-out-of-hospital-cardiac-arrest
#9
Alexandro Gianforcaro, Michael Kurz, Francis X Guyette, Clifton W Callaway, Jon C Rittenberger, Jonathan Elmer
BACKGROUND: Cessation of blood flow during out-of-hospital cardiac arrest (OHCA) results in microvascular thrombosis, protracted hypoperfusion after return of spontaneous circulation and damage to vital organs. We tested the hypothesis that pre-arrest antiplatelet and anticoagulant medication use would be associated with less post-arrest organ dysfunction and better outcomes. METHODS: We included OHCA patients treated from January 2005 to October 2014 at a single academic medical center...
October 11, 2017: Resuscitation
https://www.readbyqxmd.com/read/29020202/rates-of-and-risk-factors-for-adverse-drug-events-in-outpatient-parenteral-antimicrobial-therapy
#10
Sara C Keller, Deborah Williams, Mitra Gavgani, David Hirsch, John Adamovich, Dawn Hohl, Ayse P Gurses, Sara E Cosgrove
Background: To better monitor patients on outpatient parenteral antimicrobial therapy (OPAT), we need an improved understanding of risk factors for and timing of OPAT-associated adverse drug events (ADEs). Methods: We undertook an analysis of a prospective cohort of patients discharged from two academic medical centers on OPAT. Patients underwent chart abstraction and a telephone survey. Multivariable analyses estimated adjusted incident rate ratios (aIRR) between clinical and demographic risk factors and clinician-determined clinically significant ADEs...
August 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29019810/management-of-patients-who-receive-an-organ-transplant-abroad-and-return-home-for-follow-up-care-recommendations-from-the-declaration-of-istanbul-custodian-group
#11
Beatriz Domínguez-Gil, Gabriel Danovitch, Dominique E Martin, Marta López-Fraga, Kristof Van Assche, Michele L Morris, Jacob Lavee, Gilad Erlich, Riadh Fadhil, Mirela Busic, Glynn Rankin, Mona Al-Rukhaimi, Philip O Connell, Jacqueline Chin, Triona Norman, Pablo Massari, Refaat Kamel, Francis L Delmonico
Eradicating transplant tourism depends upon complex solutions that include efforts to progress towards self-sufficiency in transplantation. Meanwhile, professionals and authorities are faced with medical, legal, and ethical problems raised by patients who return home after receiving an organ transplant abroad, particularly when the organ has been obtained through illegitimate means. In 2016, the Declaration of Istanbul Custodian Group convened an international, multidisciplinary workshop in Madrid, Spain, to address these challenges and provide recommendations for the management of these patients, which are presented in this paper...
October 11, 2017: Transplantation
https://www.readbyqxmd.com/read/29017994/utilizing-consumer-health-informatics-to-support-management-of-hypertension-by-clinical-pharmacists-in-primary-care-study-protocol
#12
Lorraine R Buis, Dana N Roberson, Reema Kadri, Nicole G Rockey, Melissa A Plegue, Hae Mi Choe, Caroline R Richardson
BACKGROUND: Hypertension (HTN) is a major public health concern in the United States given its wide prevalence, high cost, and poor rates of control. Multiple strategies to counter this growing epidemic have been studied, and home blood pressure (BP) monitoring, mobile health (mHealth) interventions, and referrals to clinical pharmacists for BP management have all shown potential to be effective intervention strategies. OBJECTIVE: The purpose of this study is to establish feasibility and acceptability of BPTrack, a clinical pharmacist-led mHealth intervention that aims to improve BP control by supporting home BP monitoring and medication adherence among patients with uncontrolled HTN...
October 10, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/29017595/a-series-of-n-of-1-trials-to-assess-the-therapeutic-interchangeability-of-two-enalapril-formulations-in-the-treatment-of-hypertension-in-addis-ababa-ethiopia-study-protocol-for-a-randomized-controlled-trial
#13
Chalachew Alemayehu, Geoffrey Mitchell, Abraham Aseffa, Alexandra Clavarino, James McGree, Jane Nikles
BACKGROUND: Hypertension is one of the leading causes of morbidity and mortality in Ethiopia. Treatment usually involves lifelong medication use. Enalapril is a common drug for the treatment of hypertension in Ethiopia. However, the drug is expensive and, therefore, there is limited capacity for people to afford the treatment. Locally produced Enalapril is a cost-effective solution to treat the disease. However, as local medicines regulation does not include bioequivalence tests on locally produced drugs, physicians and patients need assurance about the effectiveness and safety of local generics...
October 10, 2017: Trials
https://www.readbyqxmd.com/read/28992666/-an-increase-in-cases-of-bladder-tamponade-due-to-cystitis-among-elderly-women-and-clinical-background-factors
#14
Kazunari Tsuchihashi, Yuki Makino, Masahiro Emura, Kazutaka Kida, Yosuke Shimizu, Sojun Kanamaru, Ryo Iguchi, Tetsuya Noguchi, Miharu Sasaki, Noriyuki Ito
Bladder tamponade is thought to be caused mainly by bladder cancer or radiation cystitis. However, in women, it may often be caused by cystitis in clinical settings. This has not been noted in previous reports of bladder tamponade in Japan. Thus, we retrospectively analyzed the clinical features of 83 male and 41 female patients with bladder tamponade. Seventy-four patients were treated at Nishi-Kobe Medical Center between April 2005 and March 2015, and 50 were treated at Shizuoka City Shizuoka Hospital between November 2008 and March 2015...
September 2017: Hinyokika Kiyo. Acta Urologica Japonica
https://www.readbyqxmd.com/read/28992154/the-patient-centered-medical-home-a-reality-for-hiv-care-in-nigeria
#15
Aima A Ahonkhai, Ifeyinwa Onwuatuelo, Susan Regan, Abdulkabir Adegoke, Elena Losina, Bolanle Banigbe, Juliet Adeola, Timothy G Ferris, Prosper Okonkwo, Kenneth A Freedberg
Objective: HIV care delivery in resource-limited settings (RLS) may serve as a paradigm for chronic disease care, but comprehensive measurement frameworks are lacking. Our objective was to adapt the patient-centered medical home (PCMH) framework for use in RLS, and evaluate the performance of HIV treatment programs within this framework. Design and setting: Cross-sectional survey administered within the AIDS Prevention Initiative in Nigeria (APIN) network. Participants: Medical directors at APIN clinics...
October 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28990992/comparing-patient-centered-medical-home-implementation-in-urban-and-rural-vha-clinics-results-from-the-patient-aligned-care-team-initiative
#16
Victoria Johnson, Edwin Wong, Michelle Lampman, Idamay Curtis, John Fortney, Peter Kaboli, Stephan Fihn, Karin Nelson
Rural Veterans Health Administration (VHA) primary care clinics are smaller, have fewer staff, and serve more rural patients compared with urban VHA primary care clinics. This may lead to different challenges to implementation of the Patient-Centered Medical Home (PCMH) model, the Patient Aligned Care Team, in the VHAs' large integrated health system. In this cross-sectional observational study of 905 VHA primary clinics in the United States and Puerto Rico, we found overall PCMH implementation was greater in rural compared to urban primary care clinics...
October 4, 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/28990831/the-patient-centered-medical-home-model-healthcare-services-utilization-and-cost-for-non-elderly-adults-with-mental-illness
#17
Jennifer J Bowdoin, Rosa Rodriguez-Monguio, Elaine Puleo, David Keller, Joan Roche
BACKGROUND: The patient-centered medical home (PCMH) model is designed to improve health outcomes while containing the cost of care. However, the evidence is inconclusive. AIMS: The aim of this study was to examine the associations between receipt of care consistent with the PCMH and healthcare services utilization and expenditures for non-elderly adults with mental illness in the USA. METHOD: A surveillance study was conducted using self-reported data for 6908 non-elderly adults with mental illness participating in the 2007-2012 Medical Expenditure Panel Survey...
October 9, 2017: Journal of Mental Health
https://www.readbyqxmd.com/read/28987265/performance-and-sleepiness-in-nurses-working-12-h-day-shifts-or-night-shifts-in-a-community-hospital
#18
Marian Wilson, Regan Permito, Ashley English, Sandra Albritton, Carlana Coogle, Hans P A Van Dongen
Hospitals are around-the-clock operations and nurses are required to care for patients night and day. The nursing shortage and desire for a more balanced work-to-home life has popularized 12-h shifts for nurses. The present study investigated sleep/wake cycles and fatigue levels in 22 nurses working 12-h shifts, comparing day versus night shifts. Nurses (11day shift and 11 night shift) were recruited from a suburban acute-care medical center. Participants wore a wrist activity monitor and kept a diary to track their sleep/wake cycles for 2 weeks...
October 5, 2017: Accident; Analysis and Prevention
https://www.readbyqxmd.com/read/28981185/infective-endocarditis-in-the-setting-of-renal-transplantation-case-report-and-review-of-the-literature
#19
Inbar Nardi Agmon, Elad Goldberg, Eytan Cohen, Ilan Krause
The potent immunosuppressive drugs used by transplant recipients places them at risk of infections. Data on infective endocarditis (IE) in the setting of renal transplantation (RT) are sparse. We describe a 36-year-old woman referred to a tertiary medical center for evaluation of elevated creatinine levels 1 month after a second RT. Work-up revealed the presence of all four of Duke's criteria: fever, persistent bacteremia, new-onset tricuspid regurgitation, and masses suspected to be vegetation attached to the tricuspid annulus...
October 5, 2017: Transplant Infectious Disease: An Official Journal of the Transplantation Society
https://www.readbyqxmd.com/read/28979980/association-of-public-health-initiatives-with-outcomes-for-out-of-hospital-cardiac-arrest-at-home-and-in-public-locations
#20
Christopher B Fordyce, Carolina M Hansen, Kristian Kragholm, Matthew E Dupre, James G Jollis, Mayme L Roettig, Lance B Becker, Steen M Hansen, Tomoya T Hinohara, Claire C Corbett, Lisa Monk, R Darrell Nelson, David A Pearson, Clark Tyson, Sean van Diepen, Monique L Anderson, Bryan McNally, Christopher B Granger
Importance: Little is known about the influence of comprehensive public health initiatives according to out-of-hospital cardiac arrest (OHCA) location, particularly at home, where resuscitation efforts and outcomes have historically been poor. Objective: To describe temporal trends in bystander cardiopulmonary resuscitation (CPR) and first-responder defibrillation for OHCAs stratified by home vs public location and their association with survival and neurological outcomes...
October 4, 2017: JAMA Cardiology
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