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https://www.readbyqxmd.com/read/28054430/the-complex-patient-a-concept-clarification
#1
REVIEW
Eli Manning, Marilou Gagnon
Over the last decade, the concept of the "complex patient" has not only been more widely used in multidisciplinary healthcare teams and across various healthcare disciplines, but it has also become more vacuous in meaning. The uptake of the concept of the "complex patient" spans across disciplines, such as medicine, nursing, and social work, with no consistent definition. We review the chronological evolution of this concept and its surrogate terms, namely "comorbidity," "multimorbidity," "polypathology," "dual diagnosis," and "multiple chronic conditions...
January 5, 2017: Nursing & Health Sciences
https://www.readbyqxmd.com/read/28046033/chronic-pain-how-challenging-are-ddis-in-the-analgesic-treatment-of-inpatients-with-multiple-chronic-conditions
#2
Klarissa Siebenhuener, Emmanuel Eschmann, Alexander Kienast, Dominik Schneider, Christoph E Minder, Reinhard Saller, Lukas Zimmerli, Jürg Blaser, Edouard Battegay, Barbara M Holzer
BACKGROUND: Chronic pain is common in multimorbid patients. However, little is known about the implications of chronic pain and analgesic treatment on multimorbid patients. This study aimed to assess chronic pain therapy with regard to the interaction potential in a sample of inpatients with multiple chronic conditions. METHODS AND FINDINGS: We conducted a retrospective study with all multimorbid inpatients aged ≥18 years admitted to the Department of Internal Medicine of University Hospital Zurich in 2011 (n = 1,039 patients)...
2017: PloS One
https://www.readbyqxmd.com/read/28045720/impact-of-obesity-and-other-chronic-conditions-on-lifestyle-exercise-during-the-year-after-completion-of-cardiac-rehabilitation
#3
Abdus Sattar, Richard Josephson, Shirley M Moore
PURPOSE: Patients who attend cardiac rehabilitation programs have a high prevalence of multiple chronic conditions (MCCs). The extent to which different constellations of MCC influence lifestyle exercise in the year after completion of an outpatient phase 2 cardiac rehabilitation program (CRP) is unknown. Our objective was to examine the effects of MCC on lifestyle exercise in the year after completion of a CRP. METHODS: The effects of different constellations of comorbidities on objectively measured lifestyle exercise were examined using data from a randomized controlled trial testing lifestyle behavior change interventions in patients with cardiac events (n = 379) who completed a phase 2 CRP...
December 29, 2016: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28043163/assessing-adherence-to-multiple-medications-and-in-daily-life%C3%A2-among-patients-with-multimorbidity
#4
Jennifer Inauen, Walter Bierbauer, Janina Lüscher, Claudia König, Robert Tobias, Andreas Ihle, Lukas Zimmerli, Barbara M Holzer, Edouard Battegay, Klarissa Siebenhüner, Matthias Kliegel, Urte Scholz
OBJECTIVE: Chronic conditions often require multiple medication intake. However, past research has focused on assessing overall adherence or adherence to a single index medication only. This study explored adherence measures for multiple medication intake, and in daily life, among patients with multiple chronic conditions (i.e. multimorbidity). DESIGN: Eighty-four patients with multimorbidity and multiple-medication regimens completed three monthly panel questionnaires...
January 2, 2017: Psychology & Health
https://www.readbyqxmd.com/read/28038504/-in-our-corner
#5
Justine S Sefcik, Darina Petrovsky, Megan Streur, Mark Toles, Melissa O'Connor, Connie M Ulrich, Sherry Marcantonio, Ken Coburn, Mary D Naylor, Helene Moriarty
The purpose of this study was to explore participants' experience in the Health Quality Partners (HQP) Care Coordination Program that contributed to their continued engagement. Older adults with multiple chronic conditions often have limited engagement in health care services and face fragmented health care delivery. This can lead to increased risk for disability, mortality, poor quality of life, and increased health care utilization. A qualitative descriptive design with two focus groups was conducted with a total of 20 older adults enrolled in HQP's Care Coordination Program...
December 1, 2016: Clinical Nursing Research
https://www.readbyqxmd.com/read/28035968/changes-in-depressive-symptoms-among-older-adults-with-multiple-chronic-conditions-role-of-positive-and-negative-social-support
#6
SangNam Ahn, Seonghoon Kim, Hongmei Zhang
Depression severely affects older adults in the United States. As part of the social environment, significant social support was suggested to ameliorate depression among older adults. We investigate how varying forms of social support moderate depressive symptomatology among older adults with multiple chronic conditions (MCC). Data were analyzed using a sample of 11,400 adults, aged 65 years or older, from the 2006-2012 Health and Retirement Study. The current study investigated the moderating effects of positive or negative social support from spouse, children, other family, and friends on the association between MCC and depression...
December 26, 2016: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28032827/designing-integrated-approaches-to-support-people-with-multimorbidity-key-messages-from-systematic-reviews-health-system-leaders-and-citizens
#7
Michael G Wilson, John N Lavis, Francois-Pierre Gauvin
BACKGROUND: Living with multiple chronic conditions (multimorbidity) - and facing complex, uncoordinated and fragmented care - is part of the daily life of a growing number of Canadians. METHODS: We undertook: a knowledge synthesis; a "gap analysis" of existing systematic reviews; an issue brief that synthesized the available evidence about the problem, three options for addressing it and implementation considerations; a stakeholder dialogue involving key health-system leaders; and a citizen panel...
November 2016: Healthcare Policy, Politiques de Santé
https://www.readbyqxmd.com/read/28029709/increasing-role-of-nurse-practitioners-in-house-call-programs
#8
Nengliang Aaron Yao, Karen Rose, Virginia LeBaron, Fabian Camacho, Peter Boling
OBJECTIVES: Residence-based primary care provides homebound frail patients with a care plan that is individually tailored to manage multiple chronic conditions and functional limitations using a variety of resources. We (1) examine the visit volume and Medicare payments for residence-based health care provided by nurse practitioners (NPs) in the Medicare fee-for-service environment; (2) compare NP's residential visits to those of internists and family physicians; and (3) compare the geographical service area of full-time house call NPs versus NPs who make nursing facility visits a major portion of their work...
December 28, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28027031/occupational-therapy-and-management-of-multiple-chronic-conditions-in-the-context-of-health-care-reform
#9
Natalie E Leland, Donald J Fogelberg, Ashley D Halle, Tracy M Mroz
One in four individuals living in the United States has multiple chronic conditions (MCCs), and the already high prevalence of MCCs continues to grow. This population has high rates of health care utilization yet poor outcomes, leading to elevated concerns about fragmented, low-quality care provided within the current health care system. Several national initiatives endeavor to improve care for the population with MCCs, and occupational therapy is uniquely positioned to contribute to these efforts for more efficient, effective, client-centered management of care...
January 2017: American Journal of Occupational Therapy: Official Publication of the American Occupational Therapy Association
https://www.readbyqxmd.com/read/28018871/integration-of-chronic-disease-prevention-and-management-services-into-primary-care-a-pragmatic-randomized-controlled-trial-pr1mac
#10
Martin Fortin, Maud-Christine Chouinard, Marie-France Dubois, Martin Bélanger, José Almirall, Tarek Bouhali, Maxime Sasseville
BACKGROUND: Chronic disease prevention and management programs are usually single-disease oriented. Our objective was to evaluate an intervention that targeted multiple chronic conditions and risk factors. METHODS: We conducted a pragmatic randomized controlled trial involving patients aged 18-75 years with at least 1 of the targeted chronic conditions or risk factors from 8 primary care practices in the Saguenay region of Quebec, Canada, to evaluate an intervention that included self-management support and patient-centred motivational approaches...
October 2016: CMAJ Open
https://www.readbyqxmd.com/read/28003173/increasing-consumer-engagement-by-tailoring-a-public-reporting-website-on-the-quality-of-diabetes-care-a-qualitative-study
#11
Maureen A Smith, Lauren Bednarz, Peter A Nordby, Jennifer Fink, Robert T Greenlee, Daniel Bolt, Elizabeth M Magnan
BACKGROUND: The majority of health care utilization decisions in the United States are made by persons with multiple chronic conditions. Existing public reports of health system quality do not distinguish care for these persons and are often not used by the consumers they aim to reach. OBJECTIVE: Our goal was to determine if tailoring quality reports to persons with diabetes mellitus and co-occurring chronic conditions would increase user engagement with a website that publicly reports the quality of diabetes care...
December 21, 2016: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/27979584/impact-of-chronic-conditions-on-emergency-department-visits-of-children-using-medicaid
#12
Jay G Berry, Jonathan Rodean, Matthew Hall, Elizabeth R Alpern, Paul L Aronson, Stephen B Freedman, David C Brousseau, Samir S Shah, Harold K Simon, Eyal Cohen, Jennifer R Marin, Rustin B Morse, Margaret O'Neill, Mark I Neuman
OBJECTIVE: To assess the impact of chronic conditions on children's emergency department (ED) use. STUDY DESIGN: Retrospective analysis of 1 850 027 ED visits in 2010 by 3 250 383 children ages 1-21 years continuously enrolled in Medicaid from 10 states included in the Truven Marketscan Medicaid Database. The main outcome was the annual ED visit rate not resulting in hospitalization per 1000 enrollees. We compared rates by enrollees' characteristics, including type and number of chronic conditions, and medical technology (eg, gastrostomy, tracheostomy), using Poisson regression...
December 13, 2016: Journal of Pediatrics
https://www.readbyqxmd.com/read/27970992/generic-drug-utilization-among-the-elderly-with-multiple-chronic-conditions-in-the-united-states
#13
Y Xu
No abstract text is available yet for this article.
November 2016: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/27965843/the-aging-community-and-health-research-unit-community-partnership-program-for-older-adults-with-type-2-diabetes-and-multiple-chronic-conditions-a-feasibility-study
#14
Maureen Markle-Reid, Jenny Ploeg, Kathryn Fisher, Holly Reimer, Sharon Kaasalainen, Amiram Gafni, Andrea Gruneir, Ross Kirkconnell, Sam Marzouk, Noori Akhtar-Danesh, Lehana Thabane, Carlos Rojas-Fernandez, Ross Upshur
BACKGROUND: Few studies have examined the effectiveness of community-based self-management interventions in older adults with type 2 diabetes mellitus (T2DM) and multiple chronic conditions (MCC). The objectives of this study were to examine the feasibility of implementation in practice (primary) and the feasibility of study methods and potential effectiveness (secondary) of the Aging, Community and Health-Community Partnership Program, a new 6-month interprofessional, nurse-led program to promote diabetes self-management in older adults (>65 years) with T2DM and MCC...
2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27959480/how-high-need-patients-experience-health-care-in-the-united-states-findings-from-the-2016-commonwealth-fund-survey-of-high-need-patients
#15
Jamie Ryan, Melinda K Abrams, Michelle M Doty, Tanya Shah, Eric C Schneider
Issue: Health care costs are highly concentrated among people with multiple chronic conditions, behavioral health problems, and those with physical limitations or disabilities. With a better understanding of these patients’ challenges, health care systems and providers can address patients’ complex social, behavioral, and medical needs more effectively and efficiently. Goal: To investigate how the challenges faced by this population affect their experiences with the health care system and examine potential opportunities for improvement...
2016: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/27927729/offsetting-the-effects-of-medical-expenses-on-older-adults-household-food-budgets-an-analysis-of-the-standard-medical-expense-deduction
#16
Grace Bagwell Adams, Jung Sun Lee, Vibha Bhargava, David A Super
The Supplemental Nutrition Assistance Program (SNAP) provides critical nutrition assistance to over 40 million Americans each month. Low-income older adults (60 and older) and disabled participants experience additional budgetary constraints because of high out-of-pocket medical expenses. In recent years, some states have adopted a "Standard Medical Expense Deduction" (SMED) for senior and disabled beneficiaries, making it easier to report medical expenses in the SNAP application process. We conduct a descriptive national analysis that shows increases in benefit levels and reporting of medical expenses for states that have implemented SMED...
December 7, 2016: Gerontologist
https://www.readbyqxmd.com/read/27909039/algorithm-for-predicting-death-among-older-adults-in-the-home-care-setting-study-protocol-for-the-risk-evaluation-for-support-predictions-for-elder-life-in-the-community-tool-respect
#17
Amy T Hsu, Douglas G Manuel, Monica Taljaard, Mathieu Chalifoux, Carol Bennett, Andrew P Costa, Susan Bronskill, Daniel Kobewka, Peter Tanuseputro
INTRODUCTION: Older adults living in the community often have multiple, chronic conditions and functional impairments. A challenge for healthcare providers working in the community is the lack of a predictive tool that can be applied to the broad spectrum of mortality risks observed and may be used to inform care planning. OBJECTIVE: To predict survival time for older adults in the home care setting. The final mortality risk algorithm will be implemented as a web-based calculator that can be used by older adults needing care and by their caregivers...
December 1, 2016: BMJ Open
https://www.readbyqxmd.com/read/27906647/county-level-variation-in-per-capita-spending-for-multiple-chronic-conditions-among-fee-for-service-medicare-beneficiaries-united-states-2014
#18
Kevin A Matthews, James Holt, Anne H Gaglioti, Kim A Lochner, Carla Shoff, Lisa C McGuire, Kurt J Greenlund
No abstract text is available yet for this article.
December 1, 2016: Preventing Chronic Disease
https://www.readbyqxmd.com/read/27906645/age-differences-in-visits-to-office-based-physicians-by-adults-with-hypertension-united-states-2013
#19
Jill J Ashman, Pinyao Rui, Susan M Schappert
Data from the National Ambulatory Medical Care Survey •The percentage of all adult visits to office-based physicians made by adults with hypertension increased with age, from 9% for those aged 18-44 to 58% for those aged 75 and over. •Hypertensive medications were provided, prescribed, or continued at 62% of visits made by adults with hypertension. •Eighty-two percent of visits by adults with hypertension were made by those with multiple chronic conditions, and the number of chronic conditions increased with age...
November 2016: NCHS Data Brief
https://www.readbyqxmd.com/read/27880632/burden-of-multiple-chronic-conditions-in-delaware-2011-2014
#20
Sangeeta Gupta
The objective of this study was to use data from the Behavioral Risk Factor Surveillance System (BRFSS) to examine the prevalence of multiple chronic conditions (MCC) by select sociodemographic groups and determine the prevalence of most common MCC dyads and triads among Delaware adults. Combined data for 2011 through 2014 from BRFSS (n = 18,052) were analyzed to determine prevalence of MCC. Delaware adults were categorized as having 0, 1, 2, or 3 or more of the following diagnosed chronic conditions: angina, arthritis, asthma, cancer, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, high blood pressure, high cholesterol, myocardial infarction (heart attack), obesity, or stroke...
November 23, 2016: Preventing Chronic Disease
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