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"Multiple Chronic Conditions"

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https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#1
Jonathan Afilalo
With the emergence of transcatheter aortic valve replacement (TAVR) as a therapeutic option to treat high-risk older adults suffering from aortic stenosis, the geriatric concept of frailty has assumed mainstream relevance for cardiovascular practitioners. We have eagerly adopted tools to objectify the definition of frailty and accordingly discern good and bad candidates among a pool of complex octogenarians with multiple chronic conditions - a daunting yet mission-critical task. Initial studies published during the first half of this decade revealed that frailty status was one of the top predictors of mid-term mortality and incident disability after TAVR1, leading to its integration in clinical care pathways and predictive risk models...
March 16, 2017: Circulation
https://www.readbyqxmd.com/read/28285088/impact-of-multiple-chronic-conditions-in-patients-hospitalized-with-stroke-and-transient-ischemic-attack
#2
Mohammed Yousufuddin, Adam C Bartley, Mouaz Alsawas, Heather L Sheely, Jessica Shultz, Paul Y Takahashi, Nathan P Young, M Hassan Murad
BACKGROUND: The prevalence and clinical impact of chronic conditions (CCs) have increasingly been recognized as an important public health concern. We evaluated the prevalence of coexisting CCs and their association with 30-day mortality and readmission in hospitalized patients with stroke and transient ischemic attack (TIA). METHODS: In a retrospective study of patients aged ≥18 years hospitalized for first-ever stroke and TIA, we assessed the prevalence of coexisting CCs and their predictive value for subsequent 30-day mortality and readmission...
March 8, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28284416/using-the-beers-criteria-to-identify-potentially-inappropriate-medication-use-by-older-adult-dental-patients
#3
Daniel D Skaar, Heidi O'Connor
BACKGROUND: An aging population indicates that increasing numbers of older adults will seek oral health care and have multiple chronic conditions treated with a number of medications. The authors examined the Medicare Current Beneficiary Survey administrative data set to characterize potentially inappropriate medication (PIM) use by older adults visiting the dentist and related adverse experiences that may affect oral health care. METHODS: The authors used the 2015 Beers criteria to identify PIMs for older adults...
March 8, 2017: Journal of the American Dental Association
https://www.readbyqxmd.com/read/28283685/expansion-or-compression-of-multimorbidity-10-year-development-of-life-years-spent-in-multimorbidity-based-on-health-insurance-claims-data-of-lower-saxony-germany
#4
Juliane Tetzlaff, Denise Muschik, Jelena Epping, Sveja Eberhard, Siegfried Geyer
OBJECTIVES: Our study examined how life years spent in multimorbidity changed over a period of 10 years (2005-2014) and whether morbidity expansion or compression has taken place. There is a little evidence on whether life years gained due to increasing life expectancy are spent in good health, or if they are accompanied by morbidity expansion. METHODS: The analyses are based on German administrative claims data. Multimorbidity was defined as a combination of at least six chronic conditions and polypharmacy...
March 10, 2017: International Journal of Public Health
https://www.readbyqxmd.com/read/28282022/barriers-to-health-care-for-adults-with-multiple-chronic-conditions-united-states-2012-2015
#5
Brian W Ward
Data from the National Health Interview Survey •In 2015, the percentage of adults aged 18-64 who delayed or did not obtain needed medical care due to cost in the past 12 months was highest among those diagnosed with 2 or more of 10 selected chronic conditions (16.9%), and it was lowest among those with none of the selected conditions (8.5%). •The percentage of adults who delayed needed medical care for a non-cost reason in the past 12 months increased as the number of conditions increased. •The percentage of adults who had seen or talked to a health professional in the past 12 months increased as the number of conditions increased...
March 2017: NCHS Data Brief
https://www.readbyqxmd.com/read/28264943/innovative-home-visit-models-associated-with-reductions-in-costs-hospitalizations-and-emergency-department-use
#6
Sarah Ruiz, Lynne Page Snyder, Christina Rotondo, Caitlin Cross-Barnet, Erin Murphy Colligan, Katherine Giuriceo
While studies of home-based care delivered by teams led by primary care providers have shown cost savings, little is known about outcomes when practice-extender teams-that is, teams led by registered nurses or lay health workers-provide home visits with similar components (for example, care coordination and education). We evaluated findings from five models funded by Health Care Innovation Awards of the Centers for Medicare and Medicaid Services. Each model used a mix of different components to strengthen connections to primary care among fee-for-service Medicare beneficiaries with multiple chronic conditions; these connections included practice-extender home visits...
March 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28205206/apples-and-oranges-four-definitions-of-multiple-chronic-conditions-and-their-relationship-to-30-day-hospital-readmission
#7
Melissa Dattalo, Eva DuGoff, Katie Ronk, Korey Kennelty, Andrea Gilmore-Bykovskyi, Amy J Kind
OBJECTIVES: To determine the extent of agreement between four commonly used definitions of multiple chronic conditions (MCCs) and compare each definition's ability to predict 30-day hospital readmissions. DESIGN: Retrospective cohort study. SETTING: National Medicare claims data. PARTICIPANTS: Random sample of Medicare beneficiaries discharged from the hospital from 2005 to 2009 (n = 710,609). MEASUREMENTS: Baseline chronic conditions were determined for each participant using four definitions of MCC...
February 15, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28196486/integrated-care-at-home-reduces-unnecessary-hospitalizations-of-community-dwelling-frail-older-adults-a-prospective-controlled-trial
#8
Laura Di Pollina, Idris Guessous, Véronique Petoud, Christophe Combescure, Bertrand Buchs, Philippe Schaller, Michel Kossovsky, Jean-Michel Gaspoz
BACKGROUND: Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. METHODS: A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers...
February 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28181895/-inter-practice-variation-in-polypharmacy-prevalence-amongst-older-patients-in-primary-care
#9
J Sinnige, J C Braspenning, F G Schellevis, K Hek, I Stirbu, G P Westert, J C Korevaar
PURPOSE: Complex medication management in older people with multiple chronic conditions can introduce practice variation in polypharmacy prevalence. This study aimed to determine the inter-practice variation in polypharmacy prevalence and examine how this variation was influenced by patient and practice characteristics. METHODS: This cohort study included 45,731 patients aged 55 years and older with at least one prescribed medication from 126 general practices that participated in NIVEL Primary Care Database in the Netherlands...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28179450/prevalence-incidence-and-associated-comorbidities-of-treated-hypothyroidism-an-update-from-a-european-population
#10
Carlo B Giorda, Paolo Carnà, Francesco Romeo, Giuseppe Costa, Barbara Tartaglino, Roberto Gnavi
OBJECTIVE: Estimates of the prevalence of hypothyroidism in unselected populations date from the late 1990s. We present an update on the prevalence and incidence of overt hypothyroidism in Piedmont, northwest Italy and examine the association between hypothyroidism and multiple chronic comorbidities. DESIGN AND METHODS: Data were obtained from drug prescription and hospital discharge databases. Individuals who had received at least two levothyroxine prescriptions in 2012 were defined as having hypothyroidism; those who had undergone thyroidectomy or I(131) irradiation in the previous 5 years were defined as having iatrogenic hypothyroidism and those who had either obtained exemption from treatment co-payment or had been discharged from hospital with a chronic comorbidity (diabetes and connective tissue diseases) were identified as having one of these conditions...
May 2017: European Journal of Endocrinology
https://www.readbyqxmd.com/read/28166816/the-achru-cpp-versus-usual-care-for-older-adults-with-type-2-diabetes-and-multiple-chronic-conditions-and-their-family-caregivers-study-protocol-for-a-randomized-controlled-trial
#11
Maureen Markle-Reid, Jenny Ploeg, Kimberly D Fraser, Kathryn Ann Fisher, Noori Akhtar-Danesh, Amy Bartholomew, Amiram Gafni, Andrea Gruneir, Sandra P Hirst, Sharon Kaasalainen, Caralyn Kelly Stradiotto, John Miklavcic, Carlos Rojas-Fernandez, Cheryl A Sadowski, Lehana Thabane, Jean A C Triscott, Ross Upshur
BACKGROUND: Many community-based self-management programs have been developed for older adults with type-2 diabetes mellitus (T2DM), bolstered by evidence from randomized controlled trials (RCTs) that T2DM can be prevented and managed through lifestyle modifications. However, the evidence for their effectiveness is contradictory and weakened by reliance on single-group designs and/or small samples. Additionally, older adults with multiple chronic conditions (MCC) are often excluded because of recruiting and retention challenges...
February 6, 2017: Trials
https://www.readbyqxmd.com/read/28165698/don-t-forget-the-needs-of-older-persons-community-health-needs-assessments
#12
Joanna Tenet, Indu Spugnardi
In a recent review of hospital community health needs assessments and implementation strategies, which are now required of tax-exempt hospitals by the Affordable Care Act, the Catholic Health Association found childhood obesity' and mental health services2 were some of the most commonly identified needs that hospitals planned to address. However, CHA found little or no mention of the needs of the elderly and their family caregivers. This was surprising, given the rapid aging of the U.S. population, a population that is living longer with multiple chronic conditions...
July 2016: Health Progress
https://www.readbyqxmd.com/read/28156491/integrating-a-palliative-care-longitudinal-track-into-a-family-medicine-residency-program
#13
(no author information available yet)
156 Background: Palliative care and Palliative care skills are being instituted in many hospitals and clinics as they have been shown to improve health care outcomes and decrease costs. While health care organizations are adopting these coordinated care programs, finding competent physicians to work effectively in these programs is difficult. METHODS: PIH Health Hospital Whittier Family Medicine Residency Program developed a longitdudinal Palliative Care and Chronic Disease track to generate a transformed workforce of future family physicians that can deliver innovative, empathetic and effective care for seriously ill patients who are at risk due to health disparities, advanced multiple chronic conditions, or frailty...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152767/understanding-the-comorbidome-and-its-effect-on-survival-in-colorectal-cancer
#14
Ernest Shen, Janet S Lee, Corrine E Munoz-Plaza, Carly Parry, Michael K Gould
210 Background: Effectively managing comorbidities is an essential component of high-quality cancer care. Evidence suggests colorectal cancer (CRC) patients with multiple comorbid conditions are less likely to complete standard treatments and can have lower rates of survival. In order to provide personalized care, it is critical to understand how comorbid conditions cluster within CRC patients. METHODS: We identified Kaiser Permanente Southern California CRC patients diagnosed with first malignancy between 01/01/2008 - 12/31/2013...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151775/continuity-of-care-in-older-adults-with-multiple-chronic-conditions-how-well-do-administrative-measures-correspond-with-patient-experiences
#15
Eva H DuGoff
Continuity of care (COC) is a fundamental component of primary care and particularly important to older adults who are managing multiple chronic conditions. Administrative measures of continuity are often used to evaluate care coordination interventions, but it is not known whether administrative continuity are correlated with patient reports of continuity among older adults with multiple chronic conditions (MCCs). The objective of this study is to assess the concordance of administrative continuity indices and patient reports of continuity among older adults with MCCs...
February 1, 2017: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/28146334/dementia-and-co-occurring-chronic-conditions-a-systematic-literature-review-to-identify-what-is-known-and-where-are-the-gaps-in-the-evidence
#16
REVIEW
Mark B Snowden, Lesley E Steinman, Lucinda L Bryant, Monique M Cherrier, Kurt J Greenlund, Katherine H Leith, Cari Levy, Rebecca G Logsdon, Catherine Copeland, Mia Vogel, Lynda A Anderson, David C Atkins, Janice F Bell, Annette L Fitzpatrick
OBJECTIVE: The challenges posed by people living with multiple chronic conditions are unique for people with dementia and other significant cognitive impairment. There have been recent calls to action to review the existing literature on co-occurring chronic conditions and dementia in order to better understand the effect of cognitive impairment on disease management, mobility, and mortality. METHODS: This systematic literature review searched PubMed databases through 2011 (updated in 2016) using key constructs of older adults, moderate-to-severe cognitive impairment (both diagnosed and undiagnosed dementia), and chronic conditions...
February 1, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28143412/managing-multiple-chronic-conditions-in-the-community-a-canadian-qualitative-study-of-the-experiences-of-older-adults-family-caregivers-and-healthcare-providers
#17
Jenny Ploeg, Nancy Matthew-Maich, Kimberly Fraser, Sinéad Dufour, Carrie McAiney, Sharon Kaasalainen, Maureen Markle-Reid, Ross Upshur, Laura Cleghorn, Anna Emili
BACKGROUND: The prevalence of multiple chronic conditions (MCC) among older persons is increasing worldwide and is associated with poor health status and high rates of healthcare utilization and costs. Current health and social services are not addressing the complex needs of this group or their family caregivers. A better understanding of the experience of MCC from multiple perspectives is needed to improve the approach to care for this vulnerable group. However, the experience of MCC has not been explored with a broad sample of community-living older adults, family caregivers and healthcare providers...
January 31, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28122925/interprofessional-primary-care-team-meetings-a-qualitative-approach-comparing-observations-with-personal-opinions
#18
Jerôme Jean Jacques van Dongen, Marloes Amantia van Bokhoven, Ramon Daniëls, Stephanie Anna Lenzen, Trudy van der Weijden, Anna Beurskens
BACKGROUND: The number of people with multiple chronic conditions requiring primary care services increases. Professionals from different disciplines collaborate and coordinate care to deal with the complex health care needs. There is lack of information on current practices regarding interprofessional team (IPT) meetings. OBJECTIVES: This study aimed to improve our understanding of the process of interprofessional collaboration in primary care team meetings in the Netherlands by observing the current practice and exploring personal opinions...
February 2017: Family Practice
https://www.readbyqxmd.com/read/28121534/a-strategy-for-identifying-and-disseminating-best-practice-innovations-in-the-care-of-patients-with-multiple-chronic-conditions-or-end-of-life-care-needs
#19
Daphna Gans, David A Ganz, Wendy Senelick, Heather E Mccreath, Jessica Jew, Dan Osterweil, Romilla A Batra, Zaldy Tan, Lee A Jennings, David B Reuben
Patients with multiple chronic conditions and those with end-of-life care needs experience high health care costs and needs for skilled coordination and well-trained staff. Focusing on these populations presents an opportunity to improve the patient experience toward the goal of more patient-centered care and reduced costs. Although innovative programs that provide better care to these patient populations have been developed, these innovations are often localized and not actively disseminated to other settings...
July 2016: Managed Care
https://www.readbyqxmd.com/read/28117243/patient-perceptions-of-integrated-care-and-their-relationship-to-utilization-of-emergency-inpatient-and-outpatient-services
#20
Ashley-Kay Fryer, Mark W Friedberg, Ryan W Thompson, Sara J Singer
BACKGROUND: Patients with multiple chronic conditions have garnered particular attention from policymakers and health service researchers because these patients utilize more services and contribute disproportionally to rising health care expenses. The growing prevalence of patients with multiple chronic conditions has increased the importance of achieving better health care integration for this patient population. Patients may be well positioned to assess integration of their care, but the relationship between patients' perceptions of care integration and use of health services has not been studied...
January 21, 2017: Healthcare
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