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"Multiple Chronic Conditions"

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https://www.readbyqxmd.com/read/28549592/economic-outcomes-of-pharmacist-physician-medication-therapy-management-for-polypharmacy-elderly-a-prospective-randomized-controlled-trial
#1
Hsiang-Wen Lin, Chih-Hsueh Lin, Chin-Kai Chang, Che-Yi Chou, I-Wen Yu, Cheng-Chieh Lin, Tsai-Chung Li, Chia-Ing Li, Yow-Wen Hsieh
BACKGROUND/PURPOSE: With an increasing geriatric population, the need for effective management of chronic conditions and medication use in the elderly is growing. Medication use in the elderly presents significant challenges due to changes in pharmacodynamic and pharmacokinetic profiles. We aimed to examine the impact of a collaborative physician-pharmacist medication therapy management (MTM) program for polypharmacy elderly patients. METHODS: Elderly patients with multiple chronic conditions on polypharmacy were enrolled in this prospective, randomized, and controlled study over 16 months of implementation...
May 23, 2017: Journal of the Formosan Medical Association, Taiwan Yi Zhi
https://www.readbyqxmd.com/read/28535380/development-of-an-international-comorbidity-education-framework
#2
C Lawson, S Pati, J Green, G Messina, A Strömberg, N Nante, D Golinelli, A Verzuri, S White, T Jaarsma, P Walsh, P Lonsdale, U T Kadam
CONTEXT: The increasing number of people living with multiple chronic conditions in addition to an index condition has become an international healthcare priority. Health education curricula have been developed alongside single condition frameworks in health service policy and practice and need redesigning to incorporate optimal management of multiple conditions. AIM: Our aims were to evaluate current teaching and learning about comorbidity care amongst the global population of healthcare students from different disciplines and to develop an International Comorbidity Education Framework (ICEF) for incorporating comorbidity concepts into health education...
May 17, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28516325/capsule-commentary-on-bennett-et-al-engaging-stakeholders-to-inform-clinical-practice-guidelines-that-address-multiple-chronic-conditions
#3
Miquel À Mas
No abstract text is available yet for this article.
May 17, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28498650/medicare-beneficiaries-high-out-of-pocket-costs-cost-burdens-by-income-and-health-status
#4
Cathy Schoen, Karen Davis, Amber Willink
ISSUE: Fifty-six million people--17 percent of the U.S. population--rely on Medicare. Yet, its benefits exclude dental, vision, hearing, and long-term services, and it contains no ceiling on out-of-pocket costs for covered services, exposing beneficiaries to high costs. GOAL: To inform discussion of possible changes to Medicare, this issue brief looks at beneficiaries’ out-of-pocket costs by income and health status. METHODS: Spending estimates based on the Medicare Current Beneficiary Survey. FINDINGS AND CONCLUSION: More than one-fourth of all Medicare beneficiaries--15 million people--spend 20 percent or more of their incomes on premiums plus medical care, including cost-sharing and uncovered services...
May 2017: Issue Brief of the Commonwealth Fund
https://www.readbyqxmd.com/read/28493626/why-do-people-choose-emergency-and-urgent-care-services-a-rapid-review-utilizing-a-systematic-literature-search-and-narrative-synthesis
#5
Joanne E Coster, Janette K Turner, Daniel Bradbury, Anna Cantrell
OBJECTIVES: Rising demand for emergency and urgent care services are well documented, as are the consequences, for example, ED crowding, increased costs, pressure on services and waiting times. Multiple factors have been suggested to explain why demand is increasing, including an aging population, rising number of people with multiple chronic conditions and behavioural changes relating to how people choose to access health services. The aim of this systematic mapping review is to bring together published research from urgent and emergency care settings to identify drivers that underpin patient decisions to access urgent and emergency care...
May 11, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28477302/association-between-multiple-chronic-conditions-and-urolithiasis
#6
Michael E Rezaee, Charlotte E Ward, Martha Pollock, Sugandh D Shetty
PURPOSE: Given the risk factors for stone disease, it is possible that multiple chronic condition (MCC) patients are at increased risk of developing new, recurrent, or worsening urolithiasis. The purpose of our investigation was to evaluate the relationship between MCCs and urolithiasis. METHODS: Retrospective cohort using outpatient claims data for all adult members (≥18 years) of the Beaumont Employee Health Plan who received outpatient care between 2008 and 2013...
May 5, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28471724/economic-burden-of-chronic-conditions-among-survivors-of-cancer-in-the-united-states
#7
Gery P Guy, K Robin Yabroff, Donatus U Ekwueme, Sun Hee Rim, Rui Li, Lisa C Richardson
Purpose The prevalence of cancer survivorship and chronic health conditions is increasing. Limited information exists on the economic burden of chronic conditions among survivors of cancer. This study examines the prevalence and economic effect of chronic conditions among survivors of cancer. Methods Using the 2008 to 2013 Medical Expenditure Panel Survey, we present nationally representative estimates of the prevalence of chronic conditions (heart disease, high blood pressure, stroke, emphysema, high cholesterol, diabetes, arthritis, and asthma) and multiple chronic conditions (MCCs) and the incremental annual health care use, medical expenditures, and lost productivity for survivors of cancer attributed to individual chronic conditions and MCCs...
May 4, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28461356/medical-group-structural-integration-may-not-ensure-that-care-is-integrated-from-the-patient-s-perspective
#8
Michaela J Kerrissey, Jonathan R Clark, Mark W Friedberg, Wei Jiang, Ashley K Fryer, Molly Frean, Stephen M Shortell, Patricia P Ramsay, Lawrence P Casalino, Sara J Singer
Structural integration is increasing among medical groups, but whether these changes yield care that is more integrated remains unclear. We explored the relationships between structural integration characteristics of 144 medical groups and perceptions of integrated care among their patients. Patients' perceptions were measured by a validated national survey of 3,067 Medicare beneficiaries with multiple chronic conditions across six domains that reflect knowledge and support of, and communication with, the patient...
May 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28449592/-i-had-to-change-so-much-in-my-life-to-live-with-my-new-limitations-multimorbid-patients-descriptions-of-their-most-bothersome-chronic-conditions
#9
Cindie A Slightam, Kirsten Brandt, Emily C Jenchura, Eleanor T Lewis, Steven M Asch, Donna M Zulman
Objective To characterize diseases that are described as most bothersome by individuals with multiple chronic conditions and to identify themes that characterize their experiences with their most bothersome condition. Methods In a survey of patients at an academic center and a Veterans Affairs hospital, we asked individuals with multiple chronic conditions to identify their most bothersome chronic condition and describe why it is challenging. Standard content analysis methods were used to code responses and identify themes reflecting characteristics of most bothersome conditions...
January 1, 2017: Chronic Illness
https://www.readbyqxmd.com/read/28443096/the-microbiota-and-epigenetic-regulation-of-t-helper-17-regulatory-t-cells-in-search-of-a-balanced-immune-system
#10
REVIEW
Annie Luo, Steven T Leach, Romain Barres, Luke B Hesson, Michael C Grimm, David Simar
Immune cells not only affect tissue homeostasis at the site of inflammation but also exert systemic effects contributing to multiple chronic conditions. Recent evidence clearly supports an altered T helper 17/regulatory T cell (Th17/Treg) balance leading to the development and progression of inflammatory diseases that not only affect the gastrointestinal tract but also have whole-body manifestations, including insulin resistance. Epigenetic mechanisms are amenable to both environmental and circulating factors and contribute to determining the T cell landscape...
2017: Frontiers in Immunology
https://www.readbyqxmd.com/read/28399316/predicting-health-promotion-and-quality-of-life-with-symptom-clusters-and-social-supports-among-older-adults-with-multiple-sclerosis
#11
Wenhui Zhang, Heather Becker, Alexa K Stuifbergen, Adama Brown
Symptoms common among individuals with multiple sclerosis (MS) may influence health promotion and quality of life, especially among older adults, who often experience multiple chronic conditions. To identify and examine symptom clusters' effect on health promotion and quality of life, data from 215 adults with MS older than 60 (average years with diagnosis = 29) were analyzed. Correlations among symptoms ranged from 0.33 to 0.81. Factor analysis identified two symptom clusters: (a) physical/psychological/cognitive symptoms and (b) pain symptoms...
April 11, 2017: Journal of Gerontological Nursing
https://www.readbyqxmd.com/read/28388911/the-impact-of-multi-morbidity-on-disability-among-older-adults-in-south-africa-do-hypertension-and-socio-demographic-characteristics-matter
#12
Philippa Waterhouse, Nele van der Wielen, Pamela Chirwa Banda, Andrew Amos Channon
BACKGROUND: Alongside the global population ageing phenomenon, there has been a rise in the number of individuals who suffer from multiple chronic conditions. Taking the case of South Africa, this study aims, first, to investigate the association between multi-morbidity and disability among older adults; and second, to examine whether hypertension (both diagnosed and undiagnosed) mediates this relationship. Lastly, we consider whether the impact of the multi-morbidity on disability varies by socio-demographic characteristics...
April 8, 2017: International Journal for Equity in Health
https://www.readbyqxmd.com/read/28381395/a-mobile-app-for-chronic-disease-self-management-protocol-for-a-randomized-controlled-trial
#13
Raymond L Ownby, Amarilis Acevedo, Drenna Waldrop-Valverde, Joshua Caballero, Michael Simonson, Rosemary Davenport, Kofi Kondwani, Robin J Jacobs
BACKGROUND: Health literacy is a critically important skill that helps people become active participants in their health care. Multiple studies in the United States and across the world have documented the association of health literacy with multiple health outcomes. In particular, the elderly and many members of minority groups have been shown to have low levels of health literacy; the same groups are disproportionately affected by chronic illnesses. These twin burdens affect the people most in need of the skills and knowledge required for coping with chronic illnesses...
April 5, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28371441/comorbidity-physical-and-mental-health-among-cancer-patients-and-survivors-an-australian-population-based-study
#14
Huah Shin Ng, David Roder, Bogda Koczwara, Agnes Vitry
AIM: To assess the prevalence of comorbidities and measures of physical and mental health among the cancer patients and survivors compared with the general population. METHODS: Data collected by the Australian Bureau of Statistics from 2011-2012 National Health Survey were utilized for this cross-sectional study. Comparisons were made between adults aged 25 years and over with history of cancer (n = 2170) and those respondents who did not report having had a cancer (n = 11 592) using logistic regression models...
March 29, 2017: Asia-Pacific Journal of Clinical Oncology
https://www.readbyqxmd.com/read/28365140/deregulation-of-crtcs-in-aging-and-age-related-disease-risk
#15
REVIEW
Caroline C Escoubas, Carlos G Silva-García, William B Mair
Advances in public health in the past century have seen a sharp increase in human life expectancy. With these changes have come an increased prevalence of age-related pathologies and health burdens in the elderly. Patient age is the biggest risk factor for multiple chronic conditions that often occur simultaneously within a single individual. An alternative to disease-centric therapeutic approaches is that of 'geroscience', which aims to define molecular mechanisms that link age to overall disease risk. One such mechanism is deregulation of CREB-regulated transcriptional coactivators (CRTCs)...
March 29, 2017: Trends in Genetics: TIG
https://www.readbyqxmd.com/read/28349856/older-adult-spouses-with-multiple-chronic-conditions-challenges-rewards-and-coping-strategies
#16
Shelley Peacock, Bharati Sethi, Allison Williams, Wendy Duggleby, Melanie Bayly, Jenny Swindle, Jenny Ploeg, Maureen Markle-Reid
There is a paucity of research exploring how spouses to older adults with multiple chronic conditions make meaning of their caregiving experience. For this study, we asked: What is the experience of spousal caregivers to persons with multiple chronic conditions? We applied Thorne's interpretive description approach, interviewing 18 spouses who provided a rich description of their caregiving experience; interviews were transcribed verbatim and thematically analysed. Themes were categorized according to challenges encountered, rewards gleaned, and sustaining strategies employed by participants in caregiving to their spouse with multiple chronic conditions...
June 2017: Canadian Journal on Aging, la Revue Canadienne du Vieillissement
https://www.readbyqxmd.com/read/28349409/engaging-stakeholders-to-inform-clinical-practice-guidelines-that-address-multiple-chronic-conditions
#17
Wendy L Bennett, Craig W Robbins, Elizabeth A Bayliss, Renee Wilson, Heather Tabano, Richard A Mularski, Wiley V Chan, Milo Puhan, Tsung Yu, Bruce Leff, Tianjing Li, Kay Dickersin, Carol Glover, Katie Maslow, Karen Armacost, Suzanne Mintz, Cynthia M Boyd
BACKGROUND: Having more than one chronic condition is common and is associated with greater health care utilization, higher medication burden and complexity of treatment. However, clinical practice guidelines (CPGs) do not routinely address the balance between harms and benefits of treatments for people with multiple chronic conditions (MCCs). OBJECTIVE: To partner with the Kaiser Permanente Integrated Cardiovascular Health (ICVH) program to engage multiple stakeholders in a mixed-methods approach in order to: 1) identify two high-priority clinical questions related to MCCs, and 2) understand patients' and family caregivers' perceptions of meaningful outcomes to inform benefit/harm assessments for these two high-priority questions...
March 27, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28342694/nursing-led-home-visits-post-hospitalization-for-children-with-medical-complexity
#18
Sarah Wells, Margaret O'Neill, Jayne Rogers, Kevin Blaine, Amy Hoffman, Sarah McBride, Meghan M Tschudy, Igor Shumskiy, Sangeeta Mauskar, Jay G Berry
PURPOSE: Hospital discharge for children with medical complexity (CMC) can be challenging for families. Home visits could potentially benefit CMC and their families after leaving the hospital. We assessed the utility of post-discharge home visits to identify and address health problems for recently hospitalized CMC. DESIGN AND METHODS: A prospective study of 36 CMC admitted to a children's hospital from 4/15/2015 to 4/14/2016 identified with a possible high risk of hospital readmission and offered a post-discharge home visit within 72h of discharge...
March 23, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28302750/the-clinical-frailty-scale-upgrade-your-eyeball-test
#19
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
#20
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
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