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Comanagement

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https://www.readbyqxmd.com/read/29760030/nurse-practitioner-physician-comanagement-a-theoretical-model-to-alleviate-primary-care-strain
#1
Allison A Norful, Krystyna de Jacq, Richard Carlino, Lusine Poghosyan
PURPOSE: Various models of care delivery have been investigated to meet the increasing demands in primary care. One proposed model is comanagement of patients by more than 1 primary care clinician. Comanagement has been investigated in acute care with surgical teams and in outpatient settings with primary care physicians and specialists. Because nurse practitioners are increasingly managing patient care as independent clinicians, our study objective was to propose a model of nurse practitioner-physician comanagement...
May 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29759124/the-seronegative-spondyloarthropathies
#2
REVIEW
Ayyappa S Duba, Stephanie D Mathew
The seronegative spondyloarthropathies are a group of five diseases characterized by inflammatory oligoarticular arthritis, enthesitis, and axial involvement. They have an increased incidence of the HLA-B27 gene. They are commonly associated with extra-articular features including involvement of the skin, eyes, and gastrointestinal tract. Early recognition and referral are key to limit disability, and comanagement with primary care and rheumatology offers the best outcomes.
June 2018: Primary Care
https://www.readbyqxmd.com/read/29748427/promoting-high-value-care-during-hospitalist-and-intensivist-comanagement-in-the-care-of-the-deteriorating-child-with-bronchiolitis
#3
Justin Lockwood, Justin Robison, Todd Carpenter, Jennifer Reese
No abstract text is available yet for this article.
May 10, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29675629/-geriatric-trauma-center-dgu%C3%A2-evaluation-of-clinical-and-economic-parameters-a-pilot-study-in-a-german-university-hospital
#4
M Knobe, B Böttcher, M Coburn, T Friess, L C Bollheimer, H J Heppner, C J Werner, J-P Bach, M Wollgarten, S Poßelt, C Bliemel, B Bücking
BACKGROUND: Previous studies on orthogeriatric models of care suggest that there is substantial variability in how geriatric care is integrated in the patient management and the necessary intensity of geriatric involvement is questionable. OBJECTIVE: The aim of the current prospective cohort study was the clinical and economic evaluation of fragility fracture treatment pathways before and after the implementation of a geriatric trauma center in conformity with the guidelines of the German Trauma Society (DGU)...
April 19, 2018: Der Unfallchirurg
https://www.readbyqxmd.com/read/29669046/nephrology-comanagement-and-the-quality-of-antibiotic-prescribing-in-primary-care-for-patients-with-chronic-kidney-disease-a-retrospective-cross-sectional-study
#5
Justin X G Zhu, Danielle M Nash, Eric McArthur, Alexandra Farag, Amit X Garg, Arsh K Jain
Background: In primary care, patients with chronic kidney disease (CKD) are frequently prescribed excessive doses of antibiotics relative to their kidney function. We examined whether nephrology comanagement is associated with improved prescribing in primary care. Methods: In a retrospective propensity score-matched cross-sectional study, we studied the appropriateness of antibiotic prescriptions by primary care physicians to Ontarians ≥66 years of age with CKD Stages 4 and 5 (estimated glomerular filtration rate <30 mL/min/1...
April 12, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29649395/top-10-tips-palliative-care-clinicians-should-know-when-caring-for-patients-with-endometrial-cancer
#6
Brittany A Davidson, Haley A Moss, Jaclyn Arquiette, Arif H Kamal
Endometrial cancer incidence has been increasing over the last two decades, likely due to the obesity epidemic. The majority of these cancers are confined to the uterus at diagnosis and can be cured with surgery. Overall, five-year disease-specific survival is about 80%, but some patients have locally advanced or metastatic disease that is not amenable to control with radiation and/or chemotherapy. Disease-related symptoms are most common in this subset of patients with endometrial cancer, although women with early-stage disease may also experience side effects related to surgical menopause or adjuvant treatment...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29623157/collaborative-comanagement-between-neurohospitalists-and-internal-medicine-hospitalists-decreases-provider-costs-and-enhances-satisfaction-with-neurology-care-at-an-academic-medical-center
#7
James G Greene
Background and Purpose: The majority of academic medical centers are moving to a neurohospitalist model of care for hospital neurology coverage. Potential benefits over a more traditional academic model of patient care include greater expertise in acute neurologic disease, increased efficiency, and improved availability to patients, providers, and learners. Despite these perceived advantages, switching to a neurohospitalist model can come at substantial financial cost, so finding ways to maximize the positive impact of a limited number of neurohospitalists is very important to the future health of academic neurology departments...
April 2018: Neurohospitalist
https://www.readbyqxmd.com/read/29547599/disease-comanagement-a-case-study-of-hiv-aids-and-cancer-care-in-sub-saharan-africa
#8
Biemba Maliti, Patience Mbozi
Cancer care is increasingly complicated worldwide by its management with concurrent acute and chronic illness states. In low- and middle-income countries, including those in sub-Saharan Africa, this results in lower overall survival rates and a higher burden of cancer deaths. A case study is presented to highlight the challenges patients with cancer in Zambia-many of whom are also positive for HIV or AIDS-face in relationship to access to care and comanagement of disease states.
April 1, 2018: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/29496972/models-of-care-delivery-for-children-with-medical-complexity
#9
Elisabeth Pordes, John Gordon, Lee M Sanders, Eyal Cohen
Children with medical complexity (CMC) are a subset of children and youth with special health care needs with high resource use and health care costs. Novel care delivery models in which care coordination and other services to CMC are provided are a focus of national and local health care and policy initiatives. Current models of care for CMC can be grouped into 3 main categories: (1) primary care-centered models, (2) consultative- or comanagement-centered models, and (3) episode-based models. Each model has unique advantages and disadvantages...
March 2018: Pediatrics
https://www.readbyqxmd.com/read/29496970/families-of-children-with-medical-complexity-a-view-from-the-front-lines
#10
Carolyn Allshouse, Meg Comeau, Rylin Rodgers, Nora Wells
This article, written by a group of experienced parents of children with medical complexity (CMC), provides an overview of the demands of managing care from their unique perspective. The article articulates why attention to understanding the challenges that families of CMC face with a fragmented health care system, inadequate health insurance coverage, deficits in the delivery of medical care, and problems accessing other critical services (as well as lack of support for children and adolescents in developing and exercising self-management skills) are vital to efforts to improve the current system and positively impact the life course of vulnerable populations...
March 2018: Pediatrics
https://www.readbyqxmd.com/read/29483201/guidelines-for-adolescent-depression-in-primary-care-glad-pc-part-ii-treatment-and-ongoing-management
#11
Amy H Cheung, Rachel A Zuckerbrot, Peter S Jensen, Danielle Laraque, Ruth E K Stein
OBJECTIVES: To update clinical practice guidelines to assist primary care (PC) in the screening and assessment of depression. In this second part of the updated guidelines, we address treatment and ongoing management of adolescent depression in the PC setting. METHODS: By using a combination of evidence- and consensus-based methodologies, the guidelines were updated in 2 phases as informed by (1) current scientific evidence (published and unpublished) and (2) revision and iteration among the steering committee, including youth and families with lived experience...
February 26, 2018: Pediatrics
https://www.readbyqxmd.com/read/29463971/physician-perceptions-of-patient-health-a-comparative-analysis-between-urologist-and-hospitalist-perceptions-of-need-for-inpatient-hospitalist-comanagement-following-radical-cystectomy
#12
Jessica H Hannick, William Adams, Jasmin Sandhu, Stephanie Kliethermes, Daniel J Mazur, Joshua J Meeks, Sabine Sobek, Christopher L Coogan, Aliyah Sadaf, Marcus L Quek, Elizabeth Schulwolf
Background/Aims: The morbidity of radical cystectomy remains high. A multidisciplinary approach utilizing hospitalist comanagement may improve outcomes. It is unclear what factors should be considered to determine which patients might benefit from this approach. We sought to determine if there are differences between the perceived need for co-management between urologists and hospitalists. Preoperative variables were analyzed to determine which factors might be associated with need for comanagement...
November 2017: Current Urology
https://www.readbyqxmd.com/read/29377198/updates-on-obesity-pharmacotherapy
#13
REVIEW
Amanda Velazquez, Caroline M Apovian
Obesity is a chronic, relapsing disease that necessitates a multidisciplinary approach to management. Behavioral changes are the foundation to management, but adjunctive therapy is often warranted, including pharmacologic therapies and/or bariatric surgery. Until recently, treatment options included only short-term therapy (≤12 weeks), and paths beyond that schedule were challenging, as knowledge of the biology of obesity was lacking. With increased recognition of obesity as a chronic, complex medical disease, newer agents have been approved as long-term therapy, and the cornerstone of treatment is chronic behavior and lifestyle change...
January 2018: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/29332302/preoperative-cognitive-impairment-as-a-predictor-of-postoperative-outcomes-in-a-collaborative-care-model
#14
Kahli Zietlow, Shelley R McDonald, Richard Sloane, Jeffrey Browndyke, Sandhya Lagoo-Deenadayalan, Mitchell T Heflin
OBJECTIVES: To compare postoperative outcomes of individuals with and without cognitive impairment enrolled in the Perioperative Optimization of Senior Health (POSH) program at Duke University, a comanagement model involving surgery, anesthesia, and geriatrics. DESIGN: Retrospective analysis of individuals enrolled in a quality improvement program. SETTING: Tertiary academic center. PARTICIPANTS: Older adults undergoing surgery and referred to POSH (N = 157)...
March 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29319389/top-10-tips-palliative-care-clinicians-should-know-when-caring-for-patients-with-ovarian-cancer
#15
Brittany A Davidson, Haley A Moss, Arif H Kamal
The vast majority of women diagnosed with ovarian cancer present with advanced-stage disease with a five-year survival rate less than 50%. Studies have shown that in the past, gynecologic oncologists were not routinely collaborating with palliative care physicians resulting in goals of care planning often not occurring until the last 30 days before death. In recent years, professional societies have been increasingly more vocal about the importance of incorporating palliative care early in a patient's disease course...
February 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29280174/scientific-evidence-on-the-links-between-periodontal-diseases-and-diabetes-consensus-report-and-guidelines-of-the-joint-workshop-on-periodontal-diseases-and-diabetes-by-the-international-diabetes-federation-and-the-european-federation-of-periodontology
#16
Mariano Sanz, Antonio Ceriello, Martin Buysschaert, Iain Chapple, Ryan T Demmer, Filippo Graziani, David Herrera, Søren Jepsen, Luca Lione, Phoebus Madianos, Manu Mathur, Eduard Montanya, Lior Shapira, Maurizio Tonetti, Daniel Vegh
BACKGROUND: Diabetes and periodontitis are chronic non-communicable diseases independently associated with mortality and have a bidirectional relationship. AIMS: To update the evidence for their epidemiological and mechanistic associations and re-examine the impact of effective periodontal therapy upon metabolic control (glycated haemoglobin, HbA1C). EPIDEMIOLOGY: There is strong evidence that people with periodontitis have elevated risk for dysglycaemia and insulin resistance...
February 2018: Journal of Clinical Periodontology
https://www.readbyqxmd.com/read/29189528/incidence-and-diagnostic-evaluation-of-postoperative-fever-in-pediatric-patients-with-neuromuscular-disorders
#17
Mohamed A A Yousef, Darius Dranginis, Scott Rosenfeld
BACKGROUND: Children with neuromuscular disorders have a significant chance of developing scoliosis and/or hip dislocation during childhood and adolescence and often undergo surgical reconstruction. Because of their high rate of medical comorbidities, these patients are at higher risk of postoperative complications and are therefore often comanaged, along with orthopaedics, by pediatric medicine and critical care teams. Fever during the postoperative stay is a frequent occurrence and often prompts extensive diagnostic workup which increases the cost and burden on the health system but have unclear effects on the care of the patient...
February 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29181874/using-a-statewide-survey-methodology-to-prioritize-pediatric-cardiology-core-content
#18
MULTICENTER STUDY
Ashley E Neal, Elizabeth Lehto, Karen Hughes Miller, Craig Ziegler, Erin Davis
OBJECTIVE: Although pediatrician-reported relevance of Canadian cardiology-specific objectives has been studied, similar data are not available for the 2016 American Board of Pediatrics (ABP) cardiology-specific objectives. This study asked Kentucky trainees, pediatricians, and pediatric cardiologists to identify "most important" content within these objectives. DESIGN, METHODS, OUTCOME MEASURES: This cross-sectional study used an original, online survey instrument based on the 2016 ABP cardiology-specific objectives...
January 2018: Congenital Heart Disease
https://www.readbyqxmd.com/read/29167886/payment-reform-to-enhance-collaboration-of-primary-care-and-cardiology-a-review
#19
Steven A Farmer, Paul N Casale, Linda D Gillam, John S Rumsfeld, Shari Erickson, Neil M Kirschner, Kevin de Regnier, Bruce R Williams, R Shawn Martin, Mark B McClellan
Importance: The US health care system faces an unsustainable trajectory of high costs and inconsistent outcomes. The fee-for-service payment model has contributed to inefficiency, and new payment methods are a promising approach to improving value. Health reforms are needed to increase patient access, reduce costs, and improve health care quality, and the landmark Medicare Access and CHIP Reauthorization Act presents a roadmap for reform. The product of a collaboration between primary care and cardiology clinicians, this review describes a conceptual approach to delivery and payment reforms that aim to better support primary care-cardiology comanagement of chronic cardiovascular disease (CVD)...
November 22, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/29132667/complementary-and-alternative-medicine-for-treatment-of-food-allergy
#20
REVIEW
Xiu-Min Li
The prevalence of food allergy is increasing. Food allergy can be life threatening and there is no approved treatment available. Allergen avoidance and rescue medication remain the sole management tools. Complementary and alternative medicine (CAM) use is common in the United States. However, research into safety and efficacy for food allergy is limited. Continued scientific research into food allergy herbal formula 2 (FAHF-2), refined methods of formulation, purified compounds, and other modalities are needed...
February 2018: Immunology and Allergy Clinics of North America
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