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"Multiple Chronic Conditions"

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https://www.readbyqxmd.com/read/29033551/healthcare-provider-relational-quality-is-associated-with-better-self-management-and-less-treatment-burden-in-people-with-multiple-chronic-conditions
#1
David T Eton, Jennifer L Ridgeway, Mark Linzer, Deborah H Boehm, Elizabeth A Rogers, Kathleen J Yost, Lila J Finney Rutten, Jennifer L Sauver, Sara Poplau, Roger T Anderson
PURPOSE: Having multiple chronic conditions (MCCs) can lead to appreciable treatment and self-management burden. Healthcare provider relational quality (HPRQ) - the communicative and interpersonal skill of the provider - may mitigate treatment burden and promote self-management. The objectives of this study were to 1) identify the associations between HPRQ, treatment burden, and psychosocial outcomes in adults with MCCs, and 2) determine if certain indicators of HPRQ are more strongly associated than others with these outcomes...
2017: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29032898/estimating-influenza-vaccine-effectiveness-evolution-of-methods-to-better-understand-effects-of-confounding-in-older-adults
#2
REVIEW
Janet E McElhaney, Melissa K Andrew, Shelly A McNeil
Older adults are at high risk for serious complications of influenza illness and loss of vaccine-mediated protection. It is increasingly recognized that in addition to age, multiple chronic conditions and associated frailty contribute to the decline in vaccine effectiveness in this population. However, observational studies have been fraught with issues of confounding related to the degree of frailty and functional decline, measures of which are not included in standard administrative health care databases that are used to calculate vaccine effectiveness...
November 1, 2017: Vaccine
https://www.readbyqxmd.com/read/29029293/multiple-chronic-conditions-in-spousal-caregivers-of-older-adults-with-functional-disability-associations-with-caregiving-difficulties-and-gains
#3
Courtney A Polenick, Amanda N Leggett, Noah J Webster, Benjamin H Han, Steven H Zarit, John D Piette
Objectives: Multiple chronic conditions (MCCs) are common and have harmful consequences in later life. Along with managing their own health, many aging adults care for an impaired partner. Spousal caregiving may be more stressful when caregivers have MCCs, particularly those involving complex management. Yet, little is known about combinations of conditions that are most consequential for caregiving outcomes. Method: Using a U.S. sample of 359 spousal caregivers and care recipients from the 2011 National Aging Trends Study and National Study of Caregiving, we examined three categories of MCCs based on similarity of management strategies (concordant only, discordant only, and both concordant and discordant) and their associations with caregiving difficulties and gains...
September 18, 2017: Journals of Gerontology. Series B, Psychological Sciences and Social Sciences
https://www.readbyqxmd.com/read/28972834/how-we-care-for-an-older-patient-with-cancer
#4
Armin Shahrokni, Soo Jung Kim, George J Bosl, Beatriz Korc-Grodzicki
As the number of older patients with cancer is increasing, oncology disciplines are faced with the challenge of managing patients with multiple chronic conditions who have difficulty maintaining independence, who may have cognitive impairment, and who also may be more vulnerable to adverse outcomes. National and international societies have recommended that all older patients with cancer undergo geriatric assessment (GA) to detect unaddressed problems and introduce interventions to augment functional status to possibly improve patient survival...
February 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28970754/how-do-policy-and-institutional-settings-shape-opportunities-for-community-based-primary-health-care-a-comparison-of-ontario-qu%C3%A3-bec-and-new-zealand
#5
Tim Tenbensel, Fiona Miller, Mylaine Breton, Yves Couturier, Frances Morton-Chang, Toni Ashton, Nicolette Sheridan, Alexandra Peckham, A Paul Williams, Tim Kenealy, Walter Wodchis
Community-based primary health care describes a model of service provision that is oriented to the population health needs and wants of service users and communities, and has particular relevance to supporting the growing proportion of the population with multiple chronic conditions. Internationally, aspirations for community-based primary health care have stimulated local initiatives and influenced the design of policy solutions. However, the ways in which these ideas and influences find their way into policy and practice is strongly mediated by policy settings and institutional legacies of particular jurisdictions...
June 27, 2017: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28930901/hip-fracture-in-the-frail-elderly-making-the-case-for-early-integration-of-palliative-care-and-timely-hospice-referral
#6
Mary Atkinson Smith, Kristi Acker, Lisa Torres
With the projected increase of an aging population in the upcoming decades, coupled with increasing elderly longevity, the incidence of hip fractures among this vulnerable population is expected to grow. Current evidence reveals high mortality rates within 6 months to 1 year among frail elderly patients who suffer hip fracture. In addition, the presence of multiple chronic conditions negatively impacts mortality rates in this vulnerable population. The purpose of this article is to discuss both the importance of integrating early palliative care and the appropriateness for hospice referral among frail elderly hip fracture patients...
September 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28924641/eliciting-personal-values-of-patients-with-multiple-chronic-conditions-why-and-how
#7
EDITORIAL
Michele Heisler
No abstract text is available yet for this article.
September 18, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28917949/linear-association-between-number-of-modifiable-risk-factors-and-multiple-chronic-conditions-results-from-the-behavioral-risk-factor-surveillance-system
#8
Mary L Adams, Joseph Grandpre, David L Katz, Douglas Shenson
Multiple (≥2) chronic conditions (MCCs) are responsible for a large fraction of healthcare costs. Our aim was to examine possible associations between MCCs and composite measures of behavioral risk factors (RFs). Data were publicly available 2013 Behavioral Risk Factor Surveillance System and included 483,865 non-institutionalized US adults ages ≥18years. Chronic conditions included asthma, arthritis, chronic obstructive pulmonary disease, cognitive impairment, heart disease, stroke, cancer, and kidney disease...
September 14, 2017: Preventive Medicine
https://www.readbyqxmd.com/read/28905359/guideline-recommended-medications-and-physical-function-in-older-adults-with-multiple-chronic-conditions
#9
Gail McAvay, Heather G Allore, Andrew B Cohen, Danijela Gnjidic, Terrence E Murphy, Mary E Tinetti
BACKGROUND/OBJECTIVES: The benefit or harm of a single medication recommended for one specific condition can be difficult to determine in individuals with multiple chronic conditions and polypharmacy. There is limited information on the associations between guideline-recommended medications and physical function in older adults with multiple chronic conditions. The objective of this study was to estimate the beneficial or harmful associations between guideline-recommended medications and decline in physical function in older adults with multiple chronic conditions...
September 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28899848/a-multi-level-mobile-enabled-intervention-to-promote-physical-activity-in-older-adults-in-the-primary-care-setting-icanfit-2-0-protocol-for-a-cluster-randomized-controlled-trial
#10
Y Alicia Hong, Samuel N Forjuoh, Marcia G Ory, Michael D Reis, Huiyan Sang
BACKGROUND: Most older adults do not adhere to the US Centers for Disease Control physical activity guidelines; their physical inactivity contributes to overweight and multiple chronic conditions. An urgent need exists for effective physical activity-promotion programs for the large number of older adults in the United States. OBJECTIVE: This study presents the development of the intervention and trial protocol of iCanFit 2.0, a multi-level, mobile-enabled, physical activity-promotion program developed for overweight older adults in primary care settings...
September 12, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28890950/creating-conditions-for-patients-values-to-emerge-in-clinical-conversations-perspectives-of-health-care-team-members
#11
Andrew B L Berry, Catherine Lim, Andrea L Hartzler, Tad Hirsch, Evette Ludman, Edward H Wagner, James D Ralston
Eliciting, understanding, and honoring patients' values- the things most important to them in daily life-is a cornerstone of patient-centered care. However, this rarely occurs explicitly as a routine part of clinical practice. This is particularly problematic for individuals with multiple chronic conditions (MCC) because they face difficult choices about how to balance competing demands for self-care in accordance with their values. In this study, we sought to inform the design of interventions to support conversations about patient values between patients with MCC and their health care providers...
June 2017: DIS (Des Interact Syst Conf)
https://www.readbyqxmd.com/read/28880839/differences-between-younger-and-older-us-adults-with-multiple-chronic-conditions
#12
Mary L Adams
INTRODUCTION: Adults with multiple (≥2) chronic conditions (MCCs) account for a large portion of US health care costs. Despite the increase in MCC rates with age, most people with MCCs are working age. The study objective was to compare adults with MCCs who were younger than 65 years with those aged 65 years or older on selected measures to better understand the differences between groups and inform interventions that could lower health care costs. METHODS: Data from respondents to the 2015 Behavioral Risk Factor Surveillance System data (N = 201,711) were used to compare adults aged 65 or older with MCCs with those younger than 65 with MCCs in unadjusted and adjusted analyses on chronic conditions, quality of life measures, disability status, access to health care, and modifiable risk factors...
September 7, 2017: Preventing Chronic Disease
https://www.readbyqxmd.com/read/28872035/prevalence-and-severity-of-peripheral-arterial-disease-among-patient-with-heel-pressure-ulcer-a-retrospective-study-of-42-patients
#13
Guillaume Tisserand, Nora Zenati, Christophe Seinturier, Sophie Blaise, Gilles Pernod
Heel pressure ulcer is a major complication in elderly hospitalized patients. The association with peripheral arterial disease (PAD) which is also a frequent disease in this population is poorly known. The aim of this study was to assess the prevalence of PAD and critical limb ischemia (CLI) in patients with heel pressure ulcer. Patients referred to the vascular medicine department for heel pressure ulcer from October 2014 to June 2015 were included in the study. The assessment of peripheral arterial disease was made with the results of ankle brachial index and/or doppler ultra sound of lower limb arteries...
September 1, 2017: Gériatrie et Psychologie Neuropsychiatrie du Vieillissement
https://www.readbyqxmd.com/read/28871027/case-management-in-primary-care-among-frequent-users-of-healthcare-services-with-chronic-conditions-protocol-of-a-realist-synthesis
#14
Catherine Hudon, Maud-Christine Chouinard, Kris Aubrey-Bassler, Nazeem Muhajarine, Fred Burge, Pierre Pluye, Paula L Bush, Vivian R Ramsden, France Legare, Line Guenette, Paul Morin, Mireille Lambert, Antoine Groulx, Martine Couture, Cameron Campbell, Margaret Baker, Lynn Edwards, Véronique Sabourin, Claude Spence, Gilles Gauthier, Mike Warren, Julie Godbout, Breanna Davis, Norma Rabbitskin
INTRODUCTION: A common reason for frequent use of healthcare services is the complex healthcare needs of individuals suffering from multiple chronic conditions, especially in combination with mental health comorbidities and/or social vulnerability. Frequent users (FUs) of healthcare services are more at risk for disability, loss of quality of life and mortality. Case management (CM) is a promising intervention to improve care integration for FU and to reduce healthcare costs. This review aims to develop a middle-range theory explaining how CM in primary care improves outcomes among FU with chronic conditions, for what types of FU and in what circumstances...
September 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28863719/the-effects-of-multiple-chronic-conditions-on-adult-patient-readmissions-and-hospital-finances-a-management-case-study
#15
Michael Mihailoff, Shreyasi Deb, James A Lee, Joanne Lynn
Medicare and other payers have launched initiatives to reduce hospital utilization, especially targeting readmissions within 30 days of discharge. Hospital managers have traditionally contended that hospitals would prosper better by ignoring the penalties for high readmission rates and keeping the beds more full. We aimed to test the financial effects of admissions and readmissions by persons with and without specified chronic conditions in one regional hospital. This is a management case study with a descriptive brief report...
January 1, 2017: Inquiry: a Journal of Medical Care Organization, Provision and Financing
https://www.readbyqxmd.com/read/28844522/patient-priorities-and-the-doorknob-phenomenon-in-primary-care-can-technology-improve-disclosure-of-patient-stressors
#16
Marsha N Wittink, Patrick Walsh, Sule Yilmaz, Michael Mendoza, Richard L Street, Benjamin P Chapman, Paul Duberstein
OBJECTIVE: Patients with multiple chronic conditions face many stressors (e.g. financial, safety, transportation stressors) that are rarely prioritized for discussion with the primary care provider (PCP). In this pilot randomized controlled trial we examined the effects of a novel technology-based intervention called Customized Care on stressor disclosure. METHODS: The main outcomes were stressor disclosure, patient confidence and activation, as assessed by self-report and observational methods (transcribed and coded audio-recordings of the office visit)...
August 8, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28836711/delirium-tremens-and-alcohol-withdrawal-nationally-in-the-veterans-health-administration
#17
David Thomas Moore, Brian Scott Fuehrlein, Robert Alan Rosenheck
BACKGROUND AND OBJECTIVES: Alcohol withdrawal-especially delirium tremens (DT)-is a potentially life-threatening condition. While short-term treatment regimens and factors that predispose to more severe symptomatology have been extensively studied, little attention has been paid to the clinical epidemiology and long-term care of the chronic medical, addictive, psychiatric, and psychosocial problems faced by these patients. METHODS: National Veterans Health Administration data from fiscal year 2012 were examined to identify veterans diagnosed with DT; with withdrawal but not DT (WNDT); and with Alcohol Use Disorder (AUD) but neither DT nor WNDT...
October 2017: American Journal on Addictions
https://www.readbyqxmd.com/read/28817334/community-health-worker-support-for-disadvantaged-patients-with-multiple-chronic-diseases-a-randomized-clinical-trial
#18
RANDOMIZED CONTROLLED TRIAL
Shreya Kangovi, Nandita Mitra, David Grande, Hairong Huo, Robyn A Smith, Judith A Long
OBJECTIVES: To determine whether a community health worker (CHW) intervention improved outcomes in a low-income population with multiple chronic conditions. METHODS: We conducted a single-blind, randomized clinical trial in Philadelphia, Pennsylvania (2013-2014). Participants (n = 302) were high-poverty neighborhood residents, uninsured or publicly insured, and diagnosed with 2 or more chronic diseases (diabetes, obesity, tobacco dependence, hypertension). All patients set a disease-management goal...
October 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28812452/national-trends-in-hospital-emergency-department-visits-among-those-with-and-without-multiple-chronic-conditions-2007-2012
#19
M Paige Powell, Xinhua Yu, Oluaseyi Isehunwa, Cyril F Chang
Emergency department (ED) visits and the number of adults with multiple chronic conditions (MCC) have been increasing over the last decade, but little is known about the trends in ED use for patients with MCC. This study examined national trends in ED use for those with MCC compared with one chronic condition and no chronic conditions and used data from the 2007-2012 National Emergency Department Sample, limited to patients 45 years old or older. ED visits for encounters with one chronic condition and MCC increased at significantly greater rates than for those with no chronic conditions both overall and for all subgroups examined...
August 16, 2017: Hospital Topics
https://www.readbyqxmd.com/read/28806917/study-protocol-pragmatic-randomized-control-trial-of-an-internet-based-intervention-my-tools-4-care-for-family-carers
#20
Wendy Duggleby, Jenny Ploeg, Carrie McAiney, Kathryn Fisher, Jenny Swindle, Tracey Chambers, Sunita Ghosh, Shelley Peacock, Maureen Markle-Reid, Jean Triscott, Allison Williams, Dorothy Forbes, Lori Pollard
BACKGROUND: Family carers of older persons with Alzheimer's' disease and related dementia (ADRD) and multiple chronic conditions (MCC) experience significant, complex, and distressing transitions such as changes to their environment, roles and relationships, physical health, and mental health. An online intervention (My Tools 4 Care) was developed for family carers of persons with ADRD and MCC living at home, with the aim of supporting these carers through transitions and increasing their self-efficacy, hope, and health related quality of life (HRQoL)...
August 14, 2017: BMC Geriatrics
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