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Home care medicine

Tracey-Lea Laba, Tom Lung, Stephen Jan, Anish Scaria, Tim Usherwood, Jo-Anne Brien, Natalie A Plant, Stephen Leeder
BACKGROUND AND OBJECTIVES: This study investigated the effect of management - including home medicines reviews and chronic disease management plans funded through the Medicare Benefits Schedule - on self-reported medication non-adherence. METHOD: An observational cohort study including 244 individuals with an exacerbation of chronic illness enrolled into the Care Navigation randomised controlled trial of integrated care. Non-adherence was measured using the Morisky-Greene-Levine self-reported adherence tool...
August 2018: Australian journal of general practice
Pengqing Deng, Jianlong Yu, Naitong Zhou, Ming Hu
OBJECTIVE: To investigate medicine accessibility and antibiotic use in households in western China using World Health Organization (WHO) methodology as well as to identify the influencing factor of care-seeking outside the home and primary determinant factors that influence the use of antibiotics in Chinese residents. METHODS: A cross-sectional household survey was conducted from March to July 2015, and 1200 households from six cities in Sichuan China were selected for a questionnaire survey using stratified multistage random cluster sampling...
2018: PloS One
Ryan Chang Tseng, Ching-Chuen Chen, Sheng-Min Hsu, Han-Sheng Chuang
Rapid diagnosis and screening of diseases have become increasingly important in predictive and preventive medicine as they improve patient treatment strategies and reduce cost as well as burden on our healthcare system. In this regard, wearable devices are emerging as effective and reliable point-of-care diagnostics that can allow users to monitor their health at home. These wrist-worn, head-mounted, smart-textile, or smart-patches devices can offer valuable information on the conditions of patients as a non-invasive form of monitoring...
August 13, 2018: Sensors
Liron Sinvani, Jessy Warner-Cohen, Andrew Strunk, Travis Halbert, Ruchika Harisingani, Colm Mulvany, Michael Qiu, Andrzej Kozikowski, Vidhi Patel, Tara Liberman, Maria Carney, Renee Pekmezaris, Gisele Wolf-Klein, Corey Karlin-Zysman
OBJECTIVES: To determine whether a multicomponent intervention improves care in hospitalized older adults with cognitive impairment. DESIGN: One-year retrospective chart review with propensity score matching on critical demographic and clinical variables was used to compare individauls with cognitive impairmenet on intervention and nonintervention units. SETTING: Large tertiary medical center. PARTICIPANTS: All hospitalized individuals age 65 and older with cognitive impairment admitted to medicine who required constant or enhanced observation for behavioral and psychological symptoms...
August 11, 2018: Journal of the American Geriatrics Society
Randall S Stafford
The recently released 2017 High Blood Pressure Guidelines depart from past guidelines in both their approach and recommendations. Developed by multiple health organizations, including the American College of Preventive Medicine, the guidelines continue to define normal blood pressure as <120/80 mmHg, but now define hypertension as ≥130/80 mmHg (previously ≥140/90 mmHg). This change categorizes 101 million Americans (46% of adults) as hypertensive (compared to 32% previously). The guidelines rely heavily on findings from the Systolic Blood Pressure Intervention Trial (SPRINT)...
August 6, 2018: American Journal of Preventive Medicine
Jenifer Jeba, Shrikant Atreya, Sulagna Chakraborty, Nikki Pease, Ann Thyle, Alka Ganesh, Gayatri Palat, Lulu Matthew, Sahaya Anbarasi, Raman Kumar, Mary Ann Muckaden, Alan Barnard, Mhoira Leng, Dan Munday, Scott A Murray
Purpose: This joint position statement, by the Indian Association of Palliative Care (IAPC) and Academy of Family Physicians of India (AFPI), proposes to address gaps in palliative care provision in the country by developing a community-based palliative care model that will empower primary care physicians to provide basic palliative care. Evidence: India ranks very poorly, 67th of 80 countries in the quality of death index. Two-thirds of patients who die need palliative care and many such patients spend the last hours of life in the Intensive care unit...
March 2018: Journal of Family Medicine and Primary Care
Madalina Macrea, Sabrina Campbell, Thomas Martin, Kris Ann Oursler
BACKGROUND: Overlap syndrome (OS) describes the association of obstructive sleep apnea (OSA) and chronic obstructive pulmonary disease (COPD) in a single individual. Subjects with OS have increased cardiovascular mortality which is presumed to be inflammation-mediated. As a clinical biomarker, an increased neutrophil count correlates with the severity of coronary artery stenosis. OBJECTIVES: As little is known about the role of neutrophils in the underlying inflammatory mechanisms in OS, we aimed to assess the percentage of peripheral neutrophils (PPN) in OS vs in COPD alone...
August 7, 2018: Advances in Clinical and Experimental Medicine: Official Organ Wroclaw Medical University
Nieltje Gedney, Kamyar Kalantar-Zadeh
An exponential interest in incremental transition to dialysis recently has emerged in lieu of outright three times/wk hemodialysis initiation as the standard of care. Incremental dialysis is consistent with precision medicine, given individualized dialysis dose adjustment based on patient's dynamic needs, leading to reduced patient suffering from longer or more frequent dialysis treatments and improved health-related quality of life. It includes twice-weekly or less frequent hemodialysis treatments with or without a low-protein diet on nondialysis days, or a shorter (<3 h) hemodialysis treatment three times per week or more frequent treatments, a useful approach for home hemodialysis initiation...
July 2018: Seminars in Nephrology
Len Usvyat, Lorien S Dalrymple, Franklin W Maddux
Consistent with the increase of precision medicine, the care of patients with end-stage kidney disease (ESKD) requiring maintenance dialysis therapy should evolve to become more personalized. Precise and personalized care is nuanced and informed by a number of factors including an individual's needs and preferences, disease progression, and response to and tolerance of treatments. Technology can support the delivery of more precise and personalized care through multiple mechanisms, including more accurate and real-time assessments of key care elements, enhanced treatment monitoring, and remote monitoring of home dialysis therapies...
July 2018: Seminars in Nephrology
Nadia Ali Rimi, Rebeca Sultana, Kazi Ishtiak-Ahmed, Najmul Haider, Eduardo Azziz-Baumgartner, Nazmun Nahar, Stephen P Luby
BACKGROUND: In Bangladesh, backyard poultry raisers lack awareness of avian influenza and infrequently follow government recommendations for its prevention. Identifying where poultry raisers seek care for their ill poultry might help the government better plan how to disseminate avian influenza prevention and control recommendations. METHODS: In order to identify where backyard poultry raisers seek care for their ill poultry, we conducted in-depth and informal interviews: 70 with backyard poultry raisers and six with local poultry healthcare providers in two villages, and five with government veterinary professionals at the sub-district and union levels in two districts during June-August 2009...
August 3, 2018: BMC Public Health
Douglas Myhre, Olga Szafran, Shirley Schipper, James Dickinson, Fred Janke
INTRODUCTION: In Canada, rural-based family medicine residency programs were established largely in response to a shortage of rural physicians and the perception that urban-based training programs were not meeting the needs of rural populations. Examinations of practice patterns of physicians trained in rural and urban programs are lacking. The purpose of this study was to compare the scope of practice of family medicine graduates who completed a rural versus an urban residency program, by practice location...
July 2018: Rural and Remote Health
Kevin P Brazill, Stephen Warnick, Christopher White
Family medicine physicians are often the first providers to encounter and identify mental illness in their patients. Having a solid understanding of three landmark studies-Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE), Sequenced Treatment Alternatives to Relieve Depression (STAR*D), and Systemic Treatment Enhancement Program for Bipolar Disorder (STEP-BD)-can significantly improve a family medicine physician's approach to mental illness and treatment choices, ultimately improving patient outcomes...
July 30, 2018: International Journal of Psychiatry in Medicine
Kathryn A Atchison, Jane A Weintraub, R Gary Rozier
BACKGROUND: The National Academies of Sciences, Engineering, and Medicine commissioned an environmental scan describing the status of health care integration of oral health and primary care services. METHODS: The authors conducted an environmental scan of US integration activities with publications from January 2000 through August 2017. They categorized services as preventive oral health services (POHS) provided by medical care providers, POHS provided by dental providers in nondental settings, preventive health services provided by dental providers, or care coordination using dedicated personnel and technology...
July 26, 2018: Journal of the American Dental Association
Joseph M Maciuba, Julie M Chen
Introduction: Nearly half of all pregnancies in the USA are unintended with a relatively higher proportion occurring in military populations, which can have a large impact on military readiness. Military and civilian internal medicine residency programs do not place an emphasis on contraception in the primary care setting. This intervention sought to elucidate the perceptions of contraception in an internal medicine primary care setting in a military residency and improve confidence in contraceptive counseling and prescribing...
July 19, 2018: Military Medicine
Kam Lun Hon, Yan Min Bao, Kate C Chan, Kin Wai Chau, Rong-Shan Chen, Kun Tat Gary Cheok, Wa Keung Chiu, Li Deng, Chun-Hui He, Kin Mui Ieong, Jeng Sum C Kung, Ping Lam, Shu Yan David Lam, Qun Ui Lee, So Lun Lee, Ting Fan Leung, Theresa N H Leung, Lei Shi, Ka Ka Siu, Wei-Ping Tan, Maggie Haitian Wang, Tak Wai Wong, Bao-Jing Wu, Ada Y F Yip, Yue-Jie Zheng, Daniel K Ng
BACKGROUND: Asthma is a significant chronic health problem worldwide. Management aims at disease control by reducing functional impairment and exacerbations and improving quality of life (QoL). We report a multi-center study to survey asthma control and QoL in four cities in the Pearl River Delta. METHODS: The conjoint survey involved ten Hong Kong pediatric hospitals/units, two Shenzhen hospitals, two Macau hospitals, and two Guangzhou hospitals on asthma control (using Asthma Control Test) and QoL (Pediatric Allergic Disease Quality of Life Questionnaire, PADQLQ)...
July 25, 2018: World Journal of Pediatrics: WJP
Yuka Kamijo, Shino Fujimoto, Yoshitaka Ishibashi
BACKGROUND: Advances in dialysis medicine have enabled end-stage renal disease (ESRD) patients to live longer. ESRD patients and their family members experience the illness in everyday life, and patients are required to manage their own disease to live longer. Psychological flexibility benefits a person and leads to healthier outcomes. Constructing an independent-minded attitude toward their lives with ESRD is preferably needed. SUMMARY: Holistic care is needed to see patients with ESRD and their families because they are faced with life-long illness...
2018: Contributions to Nephrology
Katherine A Auger, Samir S Shah, Heather L Tubbs-Cooley, Heidi J Sucharew, Jennifer M Gold, Susan Wade-Murphy, Angela M Statile, Kathleen D Bell, Jane C Khoury, Colleen Mangeot, Jeffrey M Simmons
Importance: Families often struggle after discharge of a child from the hospital. Postdischarge challenges can lead to increased use of urgent health care services. Objective: To determine whether a single nurse-led telephone call after pediatric discharge decreased the 30-day reutilization rate for urgent care services and enhanced overall transition success. Design, Setting, and Participants: This Hospital-to-Home Outcomes (H2O) randomized clinical trial included 966 children and adolescents younger than 18 years (hereinafter referred to as children) admitted to general medicine services at a free-standing tertiary care children's hospital from May 11 through October 31, 2016...
July 23, 2018: JAMA Pediatrics
David A Nace, Subashan K Perera, Joseph T Hanlon, Stacey Saracco, Gulsum Anderson, Steven J Schweon, Michele Klein-Fedyshin, Charles B Wessel, Mary Mulligan, Paul J Drinka, Christopher J Crnich
OBJECTIVES: To identify a set of signs and symptoms most likely to indicate uncomplicated cystitis in noncatheterized nursing home residents ≥65 years of age using consensus-based methods informed by a literature review. DESIGN: Literature review and modified Delphi survey with strict inclusion criteria. SETTING AND PARTICIPANTS: Expert panel of 20 physicians certified in geriatric medicine and/or medical direction, actively practicing in post-acute and long-term care settings...
July 20, 2018: Journal of the American Medical Directors Association
Megan E Young, Lindsay B Demers, Victoria Parker, Hollis Day, Serena Chao
Internal medicine residency programs consider effectively discharging patients from the hospital an important training milestone. However, it is rare for residents to have the opportunity to follow discharged patients into the community and see discharge plans in action. This curriculum provided residents with the opportunity to evaluate patients in their homes after they were discharged from the hospital to assess the alignment of the discharge plan with patients' real-life circumstances. Thirty-nine internal medicine residents participated in a structured exercise during a posthospital discharge home visit to older patients they cared for during the hospital admission...
July 18, 2018: Gerontology & Geriatrics Education
Liping Tong, Tim Arnold, Jie Yang, Xinyong Tian, Cole Erdmann, Tina Esposito
BACKGROUND: As an effort to reduce hospital readmissions, early follow-up visits were recommended by the Society of Hospital Medicine. However, published literature on the effect of follow-up visits is limited with mixed conclusions. Our goal here is to fully explore the relationship between follow-up visits and the all-cause non-elective 30-day readmission rate (RR) after adjusting for confounders. METHODS AND RESULTS: To conduct this retrospective observational study, we extracted data for 55,378 adult inpatients from Advocate Health Care, a large, multi-hospital system serving a diverse population in a major metropolitan area...
2018: PloS One
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