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https://www.readbyqxmd.com/read/28230459/estimated-cost-effectiveness-cost-benefit-and-risk-reduction-associated-with-an-endocrinologist-pharmacist-diabetes-intense-medical-management-tune-up-clinic
#1
Jan D Hirsch, Mark Bounthavong, Anisa Arjmand, David R Ha, Christine L Cadiz, Andrew Zimmerman, Heather Ourth, Anthony P Morreale, Steven V Edelman, Candis M Morello
BACKGROUND: In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230458/progression-to-type-2-diabetes-and-its-effect-on-health-care-costs-in-low-income-and-insured-patients-with-prediabetes-a-retrospective-study-using-medicaid-claims-data
#2
Jun Wu, Eileen Ward, Tiffaney Threatt, Z Kevin Lu
BACKGROUND: Prediabetes is a high-risk factor for progression to diabetes. Without lifestyle changes, such as weight loss and moderate physical activity, 15%-30% of people with prediabetes are projected to develop type 2 diabetes within 5 years. Progression to diabetes increases the financial burden significantly for patients and health care systems. Populations with low socioeconomic status are associated with a higher risk of diabetes. However, knowledge is limited about the effect of transition to diabetes on future costs incurred in low-income populations...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230457/comparative-effectiveness-of-rapid-acting-insulins-in-adults-with-diabetes
#3
Patrick N Racsa, Yunus Meah, Jeffrey J Ellis, Kimberly R Saverno
BACKGROUND: Although there are a variety of insulin products and new delivery modalities available, the absence of direct clinical and economic comparisons can make treatment planning and formulary decision making difficult. Direct comparisons between insulin aspart and insulin lispro from a large heterogeneous population are not available. OBJECTIVE: To assess differences in clinical outcomes, medication adherence, utilization, and total health care costs between aspart and lispro and vial versus pen modalities for administering these short-acting insulin analogs...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230456/off-label-prescribing-for-children-with-migraines-in-u-s-ambulatory-care-settings
#4
L Leanne Lai, Leroy Koh, Jane Ai-Chen Ho, Alexander Ting, Augustine Obi
BACKGROUND: Migraines, Which Affect About 10% Of School-Age Children In The United States, Can Significantly Impair Quality Of Life. Despite Potential Disability, Many Children Do Not Receive Treatment Or Prophylaxis, Since Medications Specifically Approved For Children Are Significantly Less Than For Adults. There Is Also Controversy Surrounding The Apparent Widespread Practice Of Prescribing Off-Label Medications For Children With Migraines. However, Little Research Has Been Done To Identify Physician-Prescribing Patterns Of Migraine Medication For Children...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230455/outcomes-of-pharmacy-led-hepatitis-c-direct-acting-antiviral-utilization-management-at-a-veterans-affairs-medical-center
#5
Sendra Yang, Rachel B Britt, Mohamed G Hashem, Jamie N Brown
BACKGROUND: The Veterans Affairs Health (VA) Administration has reported hepatitis C virus (HCV) infection rates among veterans to be twice that of the general U.S population. New HCV direct-acting antiviral (DAA) treatment options offer superior sustained virologic response (SVR) rates, improved side-effect profiles, and shortened treatment courses; yet, these new HCV DAAs are expensive, and utilization management strategies are needed to optimize use and improve clinical outcomes. A VA medical center uses pharmacist-led HCV DAA utilization management strategies that includes clinical guidance, optimizing operational flow, budget tracking and forecasting, and patient outcomes tracking...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230454/adherence-persistence-and-health-care-costs-for-patients-receiving-dipeptidyl-peptidase-4-inhibitors
#6
Karen L Rascati, Karen Worley, Yunus Meah, Damian Everhart
BACKGROUND: The dipeptidyl peptidase-4 (DPP-4) inhibitors are among the newer, yet more established, classes of diabetes medications. OBJECTIVE: To compare adherence, persistence, and health care costs among patients taking DPP-4 inhibitors. METHODS: Claims were extracted from Humana Medicare Advantage Prescription Drug (MAPD) or commercial plans for patients aged > 18 years with ≥ 1 prescription filled for a DPP-4 inhibitor between July 1, 2011, and March 31, 2013...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230452/prescription-drug-utilization-and-reimbursement-increased-following-state-medicaid-expansion-in-2014
#7
Nirosha Mahendraratnam, Stacie B Dusetzina, Joel F Farley
BACKGROUND: The Affordable Care Act (ACA) expanded health care and medication insurance coverage through Medicaid expansion in select states. Expansion has the potential to increase the availability of health services to patients, including prescription medications. However, limited studies have examined how expansion affected prescription drug utilization and reimbursement. OBJECTIVE: To compare prescription drug utilization (number of prescriptions filled) and reimbursement trends between states that did and did not expand Medicaid coverage in 2014, while accounting for known effects of expansion on Medicaid enrollment...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230451/positive-medication-changes-resulting-from-comprehensive-and-noncomprehensive-medication-reviews-in-a-medicare-part-d-population
#8
Allison Buhl, Jill Augustine, Ann M Taylor, Rose Martin, Terri L Warholak
BACKGROUND: Health care organizations face the challenge of reducing costs while improving health outcomes. Currently, more than 39 million seniors are enrolled in a Medicare Part D prescription benefit plan, many of whom also qualify for medication therapy management (MTM) services. MTM programs provide valuable services designed to prevent or resolve medication-related problems (MRPs). Two core components of all MTM programs include comprehensive medication reviews (CMRs) with followup interventions and focused non-CMR interventions...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230448/opioid-use-for-pain-management-after-implementation-of-a-medicaid-short-acting-opioid-quantity-limit
#9
Catherine S Riggs, Sarah J Billups, Samantha Flores, Rachana J Patel, Rachel M F Heilmann, Jessica L Milchak
BACKGROUND: The United States is currently experiencing an opioid abuse epidemic. Many policies and programs have been implemented at local, state, and national levels in an attempt to decrease prescription opioid addiction and overdose. On August 1, 2014, Colorado Medicaid implemented a policy change that limited the quantity of short-acting opioids (SAOs) that could be filled through the Medicaid benefit to no more than 4 tablets per day, or 120 tablets in 30 days. OBJECTIVE: To compare mean total daily dose (TDD) of opioids purchased by Kaiser Permanente Colorado (KPCO) Medicaid patients before and after implementation of the Medicaid SAO quantity limit...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230447/effect-of-medicaid-policy-changes-on-medication-adherence-differences-by-baseline-adherence
#10
Krutika Amin, Joel F Farley, Matthew L Maciejewski, Marisa E Domino
BACKGROUND: In 2001, the North Carolina (NC) Medicaid program reduced the number of days prescription supply that enrollees could fill from 100 days to 34 days and increased copayments for brand-name medications. Previous work has shown that a change in these policies led to a decrease in medication adherence from 2.9 to 8.0 percentage points in specific populations with chronic conditions. Studies have also shown that days supply limits and copayment increases have heterogeneous effects based on enrollees' baseline characteristics, including baseline adherence...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28228515/intrafamily-and-intragenomic-conflicts-in-human-warfare
#11
Alberto J C Micheletti, Graeme D Ruxton, Andy Gardner
Recent years have seen an explosion of multidisciplinary interest in ancient human warfare. Theory has emphasized a key role for kin-selected cooperation, modulated by sex-specific demography, in explaining intergroup violence. However, conflicts of interest remain a relatively underexplored factor in the evolutionary-ecological study of warfare, with little consideration given to which parties influence the decision to go to war and how their motivations may differ. We develop a mathematical model to investigate the interplay between sex-specific demography and human warfare, showing that: the ecology of warfare drives the evolution of sex-biased dispersal; sex-biased dispersal modulates intrafamily and intragenomic conflicts in relation to warfare; intragenomic conflict drives parent-of-origin-specific patterns of gene expression-i...
February 22, 2017: Proceedings. Biological Sciences
https://www.readbyqxmd.com/read/28226595/response-conflict-processes-classification-in-7-and-9-year-old-children-using-eeg-brain-connectivity-measures
#12
T Almabruk, K Iyer, S Girdler, M M Khan, T Tan, T Almabruk, K Iyer, S Girdler, M M Khan, T Tan, S Girdler, M M Khan, T Tan, T Almabruk
Investigating cognitive development of children poses interesting challenges pertaining to emergence of children's' ability to think and understand. Psychological tasks that involve conflict, like the Flanker task, are widely used to understand development of response conflict processes. In this study, EEG signals were used to examine the coherence and imaginary part of coherency within the delta, theta, alpha and beta bands across different conditions of the Flanker task. Longitudinal data were collected from a group of typically developing children at ages of seven and nine...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226332/responsible-safe-and-effective-prescription-of-opioids-for-chronic-non-cancer-pain-american-society-of-interventional-pain-physicians-asipp-guidelines
#13
Laxmaiah Manchikanti, Adam M Kaye, Nebojsa Nick Knezevic, Heath McAnally, Konstantin Slavin, Andrea M Trescot, Susan Blank, Vidyasagar Pampati, Salahadin Abdi, Jay S Grider, Alan D Kaye, Kavita N Manchikanti, Harold Cordner, Christopher G Gharibo, Michael E Harned, Sheri L Albers, Sairam Atluri, Steve M Aydin, Sanjay Bakshi, Robert L Barkin, Ramsin M Benyamin, Mark V Boswell, Ricardo M Buenaventura, Aaron K Calodney, David L Cedeno, Sukdeb Datta, Timothy R Deer, Bert Fellows, Vincent Galan, Vahid Grami, Hans Hansen, Standiford Helm Ii, Rafael Justiz, Dhanalakshmi Koyyalagunta, Yogesh Malla, Annu Navani, Kent H Nouri, Ramarao Pasupuleti, Nalini Sehgal, Sanford M Silverman, Thomas T Simopoulos, Vijay Singh, Daneshvari R Solanki, Peter S Staats, Ricardo Vallejo, Bradley W Wargo, Arthur Watanabe, Joshua A Hirsch
BACKGROUND: Opioid use, abuse, and adverse consequences, including death, have escalated at an alarming rate since the 1990s. In an attempt to control opioid abuse, numerous regulations and guidelines for responsible opioid prescribing have been developed by various organizations. However, the US opioid epidemic is continuing and drug dose deaths tripled during 1999 to 2015. Recent data show a continuing increase in deaths due to natural and semisynthetic opioids, a decline in methadone deaths, and an explosive increase in the rates of deaths involving other opioids, specifically heroin and illicit synthetic fentanyl...
February 2017: Pain Physician
https://www.readbyqxmd.com/read/28225000/carcinogenesis-and-therapeutics-the-microbiota-perspective
#14
REVIEW
Matthew C B Tsilimigras, Anthony Fodor, Christian Jobin
Cancer arises from the acquisition of multiple genetic and epigenetic changes in host cells over the span of many years, promoting oncogenic traits and carcinogenesis. Most cancers develop following random somatic alterations of key oncogenic genes, which are favoured by a number of risk factors, including lifestyle, diet and inflammation. Importantly, the environment where tumours evolve provides a unique source of signalling cues that affects cancer cell growth, survival, movement and metastasis. Recently, there has been increased interest in how the microbiota, the collection of microorganisms inhabiting the host body surface and cavities, shapes a micro-environment for host cells that can either promote or prevent cancer formation...
February 22, 2017: Nature Microbiology
https://www.readbyqxmd.com/read/28224271/the-perfect-womb-promoting-equality-of-fetal-opportunity
#15
Evie Kendal
This paper aims to address how artificial gestation might affect equality of opportunity for the unborn and any resultant generation of "ectogenetic" babies. It will first explore the current legal obstacles preventing the development of ectogenesis, before looking at the benefits of allowing this technology to control fetal growth and development. This will open up a discussion of the treatment/enhancement divide regarding the use of reproductive technologies, a topic featured in various bioethical debates on the subject...
February 21, 2017: Journal of Bioethical Inquiry
https://www.readbyqxmd.com/read/28222794/potential-benefits-of-an-integrated-military-civilian-trauma-system-experiences-from-two-major-regional-conflicts
#16
Jeffry L Kashuk, Kobi Peleg, Elon Glassberg, Adi Givon, Irina Radomislensky, Yoram Kluger
BACKGROUND: Although differences of opinion and controversies may arise, lessons learned from military conflicts often translate into improvements in triage, resuscitation strategies, and surgical technique. Our fully integrated national trauma system, providing care for both military and civilian casualties, necessitates close cooperation between all aspects of both sectors. We theorized that lessons learned from two regional conflicts over 8 years, with resultant improved triage, reduced hospital length of stay, and sustained low mortality would aid performance improvement and provide evidence of overall trauma system maturation...
February 21, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28215066/how-to-modulate-gut-microbiota-diet-pre-probiotics-or-antibiotics
#17
Francesca R Ponziani, Cecilia Binda, Antonio Gasbarrini
The gut microbiota is involved in the maintenance of humans' health and its alterations have been associated to several intestinal and extra intestinal disorders. For this reason, there is increasing interest on gut microbiota modulation as both a preventive strategy or as a therapeutic option in different gastrointestinal, hepatic and systemic diseases. Many studies have tried to find out the impact of diet, prebiotic, probiotic and antibiotics on gut microbiota composition and function, obtaining very heterogeneous and sometimes conflicting results, especially as regards the effect on clinical outcomes...
February 17, 2017: Minerva Gastroenterologica e Dietologica
https://www.readbyqxmd.com/read/28215011/implementation-of-the-first-adaptive-management-plan-for-a-european-migratory-waterbird-population-the-case-of-the-svalbard-pink-footed-goose-anser-brachyrhynchus
#18
Jesper Madsen, James Henty Williams, Fred A Johnson, Ingunn M Tombre, Sergey Dereliev, Eckhart Kuijken
An International Species Management Plan for the Svalbard population of the pink-footed goose was adopted under the Agreement on the Conservation of African-Eurasian Migratory Waterbirds in 2012, the first case of adaptive management of a migratory waterbird population in Europe. An international working group (including statutory agencies, NGO representatives and experts) agreed on objectives and actions to maintain the population in favourable conservation status, while accounting for biodiversity, economic and recreational interests...
March 2017: Ambio
https://www.readbyqxmd.com/read/28215010/key-actions-towards-the-sustainable-management-of-european-geese
#19
David A Stroud, Jesper Madsen, Anthony D Fox
Increasing abundance of geese in North America and Europe constitutes a major conservation success, but has caused increasing conflicts with economic, health and safety interests, as well as ecosystem impacts. Potential conflict resolution through a single, 'one size fits all' policy is hindered by differences in species' ecology, behaviour, abundance and population status, and in contrasting political and socio-economic environments across the flyways. Effective goose management requires coordinated application of a suite of tools from the local level to strategic flyway management actions...
March 2017: Ambio
https://www.readbyqxmd.com/read/28214111/remediation-of-contaminated-lands-in-the-niger-delta-nigeria-prospects-and-challenges
#20
REVIEW
Nenibarini Zabbey, Kabari Sam, Adaugo Trinitas Onyebuchi
Contamination of the total environment (air, soil, water and biota) by crude oil has become a paramount interest in the Niger Delta region of Nigeria. Studies have revealed variable impacts of oil toxicity on the environment and exposed populations. The revelation gained much international attention in 2011 with the release of Environmental Assessment of Ogoniland report by the United Nations Environment Programme (UNEP). This has up scaled local and international pressures for urgent clean-up and restoration of degraded bio-resource rich environments of the Niger Delta, starting from Ogoniland...
February 14, 2017: Science of the Total Environment
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