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https://www.readbyqxmd.com/read/28944775/gradual-initiation-of-dialysis-as-a-means-to-reduce-cost-while-providing-quality-health-care
#1
Mohamed E Elrggal, Rowan Zyada
No abstract text is available yet for this article.
September 25, 2017: Nature Reviews. Nephrology
https://www.readbyqxmd.com/read/28944752/a-randomised-controlled-study-of-the-effectiveness-of-breathing-retraining-exercises-taught-by-a-physiotherapist-either-by-instructional-dvd-or-in-face-to-face-sessions-in-the-management-of-asthma-in-adults
#2
Mike Thomas, Anne Bruton, Paul Little, Stephen Holgate, Amanda Lee, Lucy Yardley, Steve George, James Raftery, Jennifer Versnel, David Price, Ian Pavord, Ratko Djukanovic, Michael Moore, Sarah Kirby, Guiqing Yao, Shihua Zhu, Emily Arden-Close, Manimekalai Thiruvothiyur, Frances Webley, Mark Stafford-Watson, Elizabeth Dixon, Lynda Taylor
BACKGROUND: Asthma control is suboptimal, resulting in quality of life (QoL) impairment and costs. Breathing retraining exercises have evidence of effectiveness as adjuvant treatment, but are infrequently used. OBJECTIVES: To transfer the contents of a brief (three-session) physiotherapist-delivered breathing retraining programme to a digital versatile disc (DVD) and booklet format; to compare the effectiveness of the self-guided intervention with that of 'face-to-face' physiotherapy and usual care for QoL and other asthma-related outcomes; to perform a health economic assessment of both interventions; and to perform a process evaluation using quantitative and qualitative methods...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28944734/outcomes-based-contracting-experience-research-findings-from-u-s-and-european-stakeholders
#3
Tara Nazareth, John J Ko, Rahul Sasane, Christian Frois, Stephen Carpenter, Sebastian Demean, Ashok Vegesna, Eric Wu, Robert P Navarro
BACKGROUND: Outcomes-based contracts (OBCs), a type of risk-sharing arrangement (RSA), have emerged as a promising avenue for payers to engage with pharmaceutical manufacturers to share risk and improve patient access to medicines via evaluation of real-world outcomes. OBJECTIVE: To assess the level of recent OBC activity and stakeholder perceptions of these arrangements, as well as the outlook for future OBC activity from a payer and manufacturer perspective in the United States and EU-5 (France, Germany, Italy, Spain, and the United Kingdom)...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944732/patient-centered-drug-approval-the-role-of-patient-advocacy-in-the-drug-approval-process
#4
T Joseph Mattingly, Linda Simoni-Wastila
Recent approval of eteplirsen for Duchenne muscular dystrophy (DMD), a rare disease with few treatment alternatives, has reignited the debate over the U.S. drug approval process. The evolution of legal and regulatory restrictions to the marketing and sale of pharmaceuticals has spanned more than a century, and throughout this history, patient advocacy has played a significant role. Scientific evidence from clinical trials serves as the foundation for drug approval, but the patient voice has become increasingly influential...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944730/optimization-of-medication-use-at-accountable-care-organizations
#5
Chrisanne Wilks, Erik Krisle, Kimberly Westrich, Kristina Lunner, David Muhlestein, Robert Dubois
BACKGROUND: Optimized medication use involves the effective use of medications for better outcomes, improved patient experience, and lower costs. Few studies systematically gather data on the actions accountable care organizations (ACOs) have taken to optimize medication use. OBJECTIVES: To (a) assess how ACOs optimize medication use; (b) establish an association between efforts to optimize medication use and achievement on financial and quality metrics; (c) identify organizational factors that correlate with optimized medication use; and (d) identify barriers to optimized medication use...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944729/using-performance-based-risk-sharing-arrangements-to-address-uncertainty-in-indication-based-pricing
#6
Kai Yeung, Meng Li, Josh J Carlson
BACKGROUND: The rise in pharmaceutical expenditures in recent years has increased health care payer interest in ensuring good value for the money. Indication-based pricing (IBP) sets separate, indication-specific prices paid to the manufacturer according to the expected efficacy of a drug in each of its indications. IBP allows payers to consistently pay for value across indications. While promising, a limitation of IBP as originally conceived is that efficacy estimates are typically based on clinical trial data, which may differ from real-world effectiveness...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944728/performance-based-risk-sharing-arrangements-u-s-payer-experience
#7
Joseph A Goble, Brian Ung, Sascha van Boemmel-Wegmann, Robert P Navarro, Andrew Parece
BACKGROUND: As a result of global concern about rising drug costs, many U.S. payers and European agencies such as the National Health Service have partnered with pharmaceutical companies in performance-based risk-sharing arrangements (PBRSAs) by which manufacturers share financial risk with health care purchasing entities and authorities. However, PBRSAs present many administrative and legal challenges that have minimized successful contract experiences in the United States. OBJECTIVE: To (a) identify drug and disease characteristics and contract components that contribute to successful PBRSA experiences and the primary barriers to PBRSA execution and (b) explore solutions to facilitate contract negotiation and execution...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944726/paying-for-cures-how-can-we-afford-it-managed-care-pharmacy-stakeholder-perceptions-of-policy-options-to-address-affordability-of-prescription-drugs
#8
Kai Yeung, Kangho Suh, Anirban Basu, Louis P Garrison, Aasthaa Bansal, Josh J Carlson
BACKGROUND: High-priced medications with curative potential, such as the newer hepatitis C therapies, have contributed to the recent growth in pharmaceutical expenditure. Despite the obvious benefits, health care decision makers are just beginning to grapple with questions of how to value and pay for curative therapies that may feature large upfront cost, followed by health benefits that are reaped over a patient's lifespan. Alternative policy options have been proposed to promote high value and financially sustainable use of these therapies...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28944453/personalised-digital-interventions-for-reducing-hazardous-and-harmful-alcohol-consumption-in-community-dwelling-populations
#9
REVIEW
Eileen Fs Kaner, Fiona R Beyer, Claire Garnett, David Crane, Jamie Brown, Colin Muirhead, James Redmore, Amy O'Donnell, James J Newham, Frank de Vocht, Matthew Hickman, Heather Brown, Gregory Maniatopoulos, Susan Michie
BACKGROUND: Excessive alcohol use contributes significantly to physical and psychological illness, injury and death, and a wide array of social harm in all age groups. A proven strategy for reducing excessive alcohol consumption levels is to offer a brief conversation-based intervention in primary care settings, but more recent technological innovations have enabled people to interact directly via computer, mobile device or smartphone with digital interventions designed to address problem alcohol consumption...
September 25, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28944398/characteristics-of-international-staff-victims-of-psychiatric-patient-assaults-review-of-published-findings-2013-2017
#10
REVIEW
Raymond B Flannery, Grace Wyshak, Georgina J Flannery
Psychiatric patient assaults on staff are a worldwide occupational hazard for health care staff that results in human suffering and dollar cost expense. International research through 2012 documented the frequency of these assaults and a continuing high risk for nursing personnel. This present paper reviewed the international published literature on staff victims of patient assaults during the next five year period of 2013-2017. The findings indicate that assaults on staff remain a serious worldwide issue as it has been since the 1990s, even with new policy initiatives in place meant to reduce such violence...
September 25, 2017: Psychiatric Quarterly
https://www.readbyqxmd.com/read/28944291/acceptability-of-chairside-screening-for-racial-ethnic-minority-older-adults-a-qualitative-study
#11
A P Greenblatt, I Estrada, E W Schrimshaw, S S Metcalf, C Kunzel, M E Northridge
An aging and more racially and ethnically diverse population, coupled with changes in the health care policy environment, is demanding that the dental profession both redirect and expand its focus. Challenges include providing comprehensive care for patients with complicated medical needs while improving access to care for underserved groups. The purpose of this study is to examine the acceptability of screening for hypertension and diabetes in the dental setting for African American, Puerto Rican, and Dominican older adults who attend senior centers in northern Manhattan, New York City...
October 2017: JDR Clinical and Translational Research
https://www.readbyqxmd.com/read/28943267/the-effect-of-physical-activity-on-mortality-and-cardiovascular-disease-in-130%C3%A2-000-people-from-17-high-income-middle-income-and-low-income-countries-the-pure-study
#12
Scott A Lear, Weihong Hu, Sumathy Rangarajan, Danijela Gasevic, Darryl Leong, Romaina Iqbal, Amparo Casanova, Sumathi Swaminathan, R M Anjana, Rajesh Kumar, Annika Rosengren, Li Wei, Wang Yang, Wang Chuangshi, Liu Huaxing, Sanjeev Nair, Rafael Diaz, Hany Swidon, Rajeev Gupta, Noushin Mohammadifard, Patricio Lopez-Jaramillo, Aytekin Oguz, Katarzyna Zatonska, Pamela Seron, Alvaro Avezum, Paul Poirier, Koon Teo, Salim Yusuf
BACKGROUND: Physical activity has a protective effect against cardiovascular disease (CVD) in high-income countries, where physical activity is mainly recreational, but it is not known if this is also observed in lower-income countries, where physical activity is mainly non-recreational. We examined whether different amounts and types of physical activity are associated with lower mortality and CVD in countries at different economic levels. METHODS: In this prospective cohort study, we recruited participants from 17 countries (Canada, Sweden, United Arab Emirates, Argentina, Brazil, Chile, Poland, Turkey, Malaysia, South Africa, China, Colombia, Iran, Bangladesh, India, Pakistan, and Zimbabwe)...
September 21, 2017: Lancet
https://www.readbyqxmd.com/read/28943063/outpatient-laparoscopic-appendectomy-can-be-successfully-performed-for-uncomplicated-appendicitis-a-southwestern-surgical-congress-multicenter-trial
#13
Richard Frazee, Clay Cothren Burlew, Justin Regner, Robert McIntyre, Erik Peltz, Chris Cribari, Julie Dunn, Larry Butler, Paul Reckard, Sharmila Dissanaike, Karen Karimi, Charles Behnfield, Nic Melo, Daniel Margulies
BACKGROUND: Many laparoscopic procedures are now performed on an outpatient basis. We hypothesize laparoscopic appendectomy can be safely performed as an outpatient procedure. METHODS: Seven institutions adopted a previously described outpatient laparoscopic appendectomy protocol for uncomplicated appendicitis. Patients were dismissed unless there was a clinical indication for admission. Patient demographics, success with outpatient management, time of dismissal, morbidity, and readmissions were analyzed...
September 19, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28942692/the-role-of-tele-medicine-in-patients-with-respiratory-diseases
#14
Nicolino Ambrosino, Claudio Fracchia
Tele-medicine is a clinical application connecting a patient with specialized care consultants by means of electronic platforms, potentially able to improve patients' self-management and allow for the care of patients with limited access to health services. This article summarizes the use of tele-medicine as a tool in managing patients suffering from some pathological respiratory conditions. Areas covered: We searched papers published between 1990 and 2017 dealing with tele-medicine and respiratory diseases, COPD, asthma, interstitial lung disease, chronic respiratory failure, neuromuscular diseases, critical illness, home mechanical ventilation, and also legal and economic issues...
September 25, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/28942485/crowdsourcing-and-automated-retinal-image-analysis-for-diabetic-retinopathy
#15
REVIEW
Lucy I Mudie, Xueyang Wang, David S Friedman, Christopher J Brady
PURPOSE OF REVIEW: As the number of people with diabetic retinopathy (DR) in the USA is expected to increase threefold by 2050, the need to reduce health care costs associated with screening for this treatable disease is ever present. Crowdsourcing and automated retinal image analysis (ARIA) are two areas where new technology has been applied to reduce costs in screening for DR. This paper reviews the current literature surrounding these new technologies. RECENT FINDINGS: Crowdsourcing has high sensitivity for normal vs abnormal images; however, when multiple categories for severity of DR are added, specificity is reduced...
September 23, 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28941632/professional-practice-evaluation-of-emergency-department-prescriptions-for-community-acquired-infections-in-lebanon
#16
Iqbal Fahs, Zeina Shrayteh, Rima Abdulkhalek, Pascale Salameh, Souheil Hallit, Diana Malaeb
BACKGROUND: Selecting appropriate antibiotic regimens is extremely an important role in improving patient outcomes, minimizing antimicrobial resistance, and reducing costs. This study was conducted to evaluate current practices of prescribing empiric antibiotics at the time of admission to the emergency department (ED) and to assess their appropriateness in Lebanon. METHODS: This is a retrospective observational study conducted at three different Lebanese hospitals between June and December 2016...
September 20, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28941608/economic-evaluation-of-left-ventricular-assist-devices-for-patients-with-end-stage-heart-failure-who-are-ineligible-for-cardiac-transplantation
#17
Derek S Chew, Braden Manns, Robert J H Miller, Nakul Sharma, Derek V Exner
BACKGROUND: Continuous flow (CF) left ventricular assist devices (LVADs) improve survival in end-stage heart failure patients who are ineligible for cardiac transplantation. Their use in this population (referred to as destination therapy) is increasing in many countries, yet they are not routinely funded for this indication in Canada. We assessed the cost-effectiveness of destination therapy CF-LVADs from the perspective of the Canadian health care payer. METHODS: A Markov model was used to project the outcomes and costs of 2 treatment pathways, CF-LVAD implantation and medical management alone, in an end-stage heart failure patient cohort ineligible for transplantation...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28941604/current-risk-of-contrast-induced-acute-kidney-injury-after-coronary-angiography-and-intervention-a-reappraisal-of-the-literature
#18
Lorenzo Azzalini, Luciano Candilio, Peter A McCullough, Antonio Colombo
Contrast-induced acute kidney injury (CI-AKI) is the acute impairment of renal function further to the intravascular administration of iodinated contrast media, and occurs most frequently after coronary angiography, percutaneous coronary intervention, and contrast-enhanced computed tomography. CI-AKI has been associated with the development of acute renal failure, worsening of chronic kidney disease, requirement for dialysis, prolonged hospital stay, and higher mortality rates and health care costs. Recently, a number of studies suggested that contrast media exposure might not be the causative agent in the occurrence of acute kidney injury, particularly in stable patients who receive small to moderate amounts of contrast media...
October 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28941506/correction-of-nasal-fractures
#19
REVIEW
G Nina Lu, Clinton D Humphrey, J David Kriet
Nasal fractures are the most frequently fractured facial bone from blunt facial trauma resulting in a significant number of patients seeking treatment. Proper evaluation and treatment in the acute setting can minimize secondary surgeries, lower overall health care costs, and increase patient satisfaction. Nasal fracture management, however, varies widely between surgeons. The open treatment of isolated nasal fractures is a particularly controversial subject. This review seeks to describe the existing literature in isolated nasal fracture management...
November 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/28941065/an-economic-model-of-professional-doula-support-in-labor-in-british-columbia-canada
#20
Gillian E Hanley, Lily Lee
INTRODUCTION: Spending on care in childbirth represents a sizable portion of health care budgets. This has engendered a growing interest in potential clinical tools that could be used to improve patient experience and population health at a lower cost. A possible such tool is continuous support in labor from a trained doula, as doula care can decrease the likelihood of cesarean birth, epidural analgesia, and assisted vaginal birth. In addition, there is some emerging evidence suggesting that involving doulas in prenatal care can reduce rates of preterm birth...
September 20, 2017: Journal of Midwifery & Women's Health
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