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Home care medicine

Yu V Voskanyan
The article deals with the analysis of retrospective and prospective studies dedicated to examining patient safety regarding epidemiology, frequency and severity of adverse events associated with rendering medical care. Electronic retrieval was carried out over the period from 1990 to 2017 using the following databases: MEDLINE, Cochrane Collaboration, EMBASE, SCOPUS, ISI Web of Science. The carried out meta-analysis made it possible to determine that cases of doing harm (adverse events) while rendering medical care are registered in 10...
2018: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
Paige I Partain, Jacob White, Paul Hammerness
PURPOSE OF REVIEW: To provide an up-to-date clinical review of U.S. Food and Drug Administration (FDA)-approved stimulant medications for attention-deficit/hyperactivity disorder (ADHD), including a framework for individualized treatment by primary care pediatric providers. RECENT FINDINGS: Stimulant medications are first-line agents for pediatric ADHD. Since 2012, 11 novel stimulant medications have been approved by the FDA for the treatment of ADHD. Because of an expanded formulary of available methylphenidate-based and amphetamine-based stimulants, primary care providers may be unfamiliar with some novel medications outside a select formulary...
December 6, 2018: Current Opinion in Pediatrics
Joseph Carson, Stephanie Gottheil, Sherri Lawson, Tim Rice
BACKGROUND: Long-term care (LTC) homes expressed concern that patients had experienced medication incidents after hospital discharge as a result of poor coordination of care. OBJECTIVE: The London Transfer Project aimed to reduce LTC medication incidents by 50% within 48 hours of discharge from general medicine units at the London Health Sciences Centre. DESIGN: This quality improvement study involved 2 hospitals and 5 LTC homes in London, Ontario, Canada...
December 4, 2018: Journal of the American Medical Directors Association
James A G Crispo, Dylan P Thibault, Allison W Willis
BACKGROUND: Adverse drug events (ADEs) are common; however, there are limited data on the impact of ADEs on post-discharge outcomes. OBJECTIVES: To identify ADEs responsible for readmission within 6 months of hospital discharge in the United States. Secondary objectives were to examine whether demographic, clinical, and hospital characteristics were associated with ADE readmission. METHODS: We identified all adults hospitalized between January and June using the 2014 Nationwide Readmission Database...
December 10, 2018: Annals of Pharmacotherapy
Kenneth A Dodge
Acting alone, psychologists rarely achieve population impact on important mental health and well-being outcomes for families and young children. The traditional Institute of Medicine model of moving from efficacy trials to effectiveness trials to scaling up has not succeeded, partly due to degradation of program quality and impact during scale-up and partly due to a failure to consider system-context issues at the outset. Analysis of barriers to population impact leads to the proposal of a new comprehensive system of care that includes both top-down coordination among community agencies providing services and bottom-up outreach to every family to connect them with services...
December 2018: American Psychologist
Gijsbert Wieringa
The 20th century digital revolution has already seen the introduction of faster, more diverse, easier to use technologies with extended capacity and capability that has enhanced productivity in Laboratory Medicine and allowed more effective use of human resource. With increasing demands for better health and best care the challenge to future healthcare systems is to deploy technology, facilities and human resources more effectively. For the 21st century the digital age heralds opportunities for information-led technology providers to become healthcare providers when algorithm driven care can support patients' needs at the point of care close to or in their homes...
December 4, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
Kenneth Lam, Howard B Abrams, John Matelski, Karen Okrainec
BACKGROUND: Follow-up with a primary care provider within 1-2 weeks of discharge from hospital has been associated with reduced readmissions. We sought to determine appointment attendance with primary care providers postdischarge and identify factors associated with attendance. METHODS: We conducted a retrospective cohort study involving general medicine patients who had been discharged from hospital between Sept. 1, 2014, and Dec. 30, 2015, from 2 Ontario academic hospitals, and who had been supported by a transitional care specialist and advised to see a primary care provider within 1 week...
October 2018: CMAJ Open
Barbara Riegel, Liming Huang, Mark E Mikkelsen, Ann Kutney-Lee, Alexandra L Hanlon, Christopher M Murtaugh, Kathryn H Bowles
BACKGROUND/OBJECTIVES: New or worsened disabilities in functional, cognitive, or mental health following an intensive care unit (ICU) stay are referred to as post-intensive care syndrome (PICS). PICS has not been described in older adults receiving home care. Our aim was to examine the relationship between length of ICU stay and PICS among older adults receiving home care. We expected that patients in the ICU for 3 days or longer would demonstrate significantly more disability in all three domains on follow-up than those not in the ICU...
November 30, 2018: Journal of the American Geriatrics Society
Mia Yang, Jantira Thomas, Rachel Zimmer, Maryjo Cleveland, Jennifer L Hayashi, Jessica L Colburn
Home-based primary care (HBPC) is experiencing a reemergence to meet the needs of homebound older adults. This brief review based on existing literature and expert opinion discusses 10 key facts about HBPC that every geriatrician should know: (1) the team-based nature of HBPC is key to its success; (2) preparations and after-hour access for house calls are required; (3) home safety for the clinician and patient must be considered; (4) being homebound is an independent mortality risk factor with a high symptom burden; (5) home care medicine presents unique benefits and challenges; (6) a systems-based approach to care is essential; (7) HBPC is a sustainable model within value-based care proven by the Department of Veterans Affairs and the Independence at Home Medicare Demonstration Project; (8) HBPC has an educational mission; (9) national organizations for HBPC include American Academy of Home Care Medicine and Home Centered Care Institute; and (10) practicing HBPC is a privilege...
November 28, 2018: Journal of the American Geriatrics Society
J Chenbhanich, A Wu, T Phupitakphol, A Atsawarungruangkit, T Treadwell
BACKGROUND: Life expectancy of individuals with Down syndrome (DS) has improved significantly over the past decades. However, there are sparse data documenting the co-morbidities and hospitalisation of adult patients with DS in the literature. The aim of this study was to characterise the co-morbidities and pattern of hospitalisation in adult patients with DS during a 10-year period at the community hospital as well as to compare hospitalisation parameters with the general adult population during the same years...
November 28, 2018: Journal of Intellectual Disability Research: JIDR
Samy A Alsirafy, Ahmad M Hammad, Noha Y Ibrahim, Dina E Farag, Omar Zaki
BACKGROUND: Little is known about the place of death of patients with cancer in Eastern Mediterranean countries including Egypt, where palliative care is underdeveloped. Identifying the preferred place of death (PPoD) is important for the development of appropriate palliative care models in these countries. OBJECTIVES: To know the PPoD of Egyptian patients with incurable cancer and their family caregivers (FCGs) and to determine the factors that may impact their preferences...
November 26, 2018: American Journal of Hospice & Palliative Care
René Amalberti, Charles Vincent, Wendy Nicklin, Jeffrey Braithwaite
Health systems are under more pressure than ever before, and the challenges are multiplying and accelerating. Economic forces, new technology, genomics, AI in medicine, increasing demands for care-all are playing a part, or are predicted to increasingly do so. Above all, ageing populations in many parts of the world are exacerbating the disease burden on the system and intensifying the requirements to provide effective care equitably to citizens. In this first of two companion articles on behalf of the Innovation and Systems Change Working Group of the International Society for Quality in Health Care (ISQua), in consultation with representatives from over 40 countries, we assess this situation and discuss the implications for safety and quality...
November 22, 2018: International Journal for Quality in Health Care
Andrea Jakubowski, Alexander Pappas, Lee Isaacsohn, Felipe Castillo, Mariya Masyukova, Richard Silvera, Louisa Holaday, Evan Rausch, Sameen Farooq, Keith T Veltri, Chinazo O Cunningham, Marcus A Bachhuber
BACKGROUND: Overdose education and naloxone distribution (OEND) to people at risk of witnessing or experiencing an opioid overdose has traditionally been provided through harm reduction agencies. Expanding OEND to inpatient general medical settings may reach at-risk individuals who do not access harm reduction services and have not been trained. An OEND program targeting inpatients was developed, piloted, and evaluated on 2 general medicine floors at Montefiore Medical Center, a large urban academic medical center in Bronx, New York...
November 26, 2018: Substance Abuse
Mari Sato, Hitoshi Oshitani, Raita Tamaki, Nobuko Oyamada, Kineko Sato, Alkaff Raihana Nadra, Jhoys Landicho, Portia P Alday, Socorro Lupisan, Veronica L Tallo
OBJECTIVES: Pneumonia remains a primary cause of death for under-five children. It is possible to reduce the mortality impact from childhood pneumonia if caregivers recognise the danger signs of pneumonia and obtain appropriate healthcare. Among caregivers, research on fathers' healthcare-seeking behaviours and perceptions are limited, whereas research on mothers is available. This study aims to reveal fathers' roles and perspectives with respect to the selection of care and treatment for children with pneumonia in a remote island of the Philippines...
November 21, 2018: BMJ Open
Christine Pailler, Thierry Chapot, Souad Softa, Nicolas Gandrille, Deborah Ruiz, Sylvaine Mathieu, Suzette Delaloge
In 2013, the European Medicines Agency authorized a new pharmaceutical formulation of the trastuzumab for breast cancer treatment. The latter allows a sub-cutaneous injection that reduces significantly the injection time and permits an administration at home. This study aims to assess the experience of patients treated by trastuzumab subcutaneously at home in 2016, and the experience of the nurses who performed these injections. In 2017, a retrospective survey by phone calls could gather the impressions from 84 patients on their treatment...
November 19, 2018: Bulletin du Cancer
Kristine K Miller, Susan H Lin, Marsha Neville
Based on a review of the evidence, members of the American Congress of Rehabilitation Medicine Stroke Group's Movement Interventions Task Force offer these five recommendations to help improve transitions of care for patients and their caregivers: (1) improving communication processes, (2) utilizing transition specialists, (3) implementing a patient-centered discharge checklist, (4) utilizing standardized outcome measures, and (5) establishing partnerships with community wellness programs. Due to changes in healthcare policy, there are incentives to improve transitions during stroke rehabilitation...
November 19, 2018: Archives of Physical Medicine and Rehabilitation
Sarah H Vepraskas, Peter O'Day, Liyun Zhang, Pippa Simpson, Sandra Gage
OBJECTIVES: To identify caregiver preferences for discharge education components, content, and techniques. METHODS: Before discharge education, a 9-question structured interview was performed with caregivers of children from 2 populations admitted to the hospital medicine service: patients with asthma (age 2-17 years) or children who were not dependent on technology (age <2 years). McNemar's tests were used to evaluate for significant differences between response options...
November 21, 2018: Hospital Pediatrics
Sarah A Sobotka, Dipika S Gaur, Denise M Goodman, Rishi K Agrawal, Jay G Berry, Robert J Graham
OBJECTIVE: Children with invasive home mechanical ventilation (HMV) are a growing population with complex health service needs. Single institution studies provide insight into successful program structures and outcomes. Our study objectives were to assess health service structures, providers, and programs caring for this population throughout the U.S., and to understand barriers to high-quality care. DESIGN: Using purposeful sampling with capture-recapture and snowball sampling methods, we identified key informants for care of the U...
November 20, 2018: Pediatric Pulmonology
Heeyoun Kim Cho
Dementia is a clinical syndrome that is progressive and degenerative, affecting memory, behavior, emotion, and personality. Persons with dementia often experience deterioration of cognitive ability, as well as various behavioral and psychological disturbances, which significantly contribute to reduced quality of life and emotional well-being. The demand for long-term care continues to rise rapidly and it is therefore critical to develop effective strategies and evidence-based interventions to improve the quality of life for persons with dementia...
2018: Frontiers in Medicine
Divya Taneja, Anil Khurana, Anil Vichitra, Sarabjit Sarkar, Arun Kumar Gupta, Renu Mittal, Ramesh Bawaskar, Amulya Ratan Sahoo, Umakanta Prusty, Shweta Singh, Meera Sharma, Richa Pant, Udaiveer Singh, Alok Kumar Upadhyay, Shruti Sehegal, Satyashree Patnaik, Tapan Nath, Raj K Manchanda
BACKGROUND:  During primary teething, children suffer from running nose, mild fever, diarrhoea and other mild irritations and inflammations. A public health programme, 'Homoeopathy for the Healthy Child', was undertaken on a pilot basis focusing on promotion of healthy teething by provision of home-based care through six pre-identified homeopathic medicines for complaints commonly observed during primary teething. This article assesses the feasibility of this programme and reports the impact of this initiative on teething profile in children and episodes of diarrhoea and upper respiratory tract infection (URTI)...
November 20, 2018: Homeopathy: the Journal of the Faculty of Homeopathy
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