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Outcome based care

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https://www.readbyqxmd.com/read/28340482/the-effect-of-interprofessional-team-based-learning-among-nursing-students-a-quasi-experimental-study
#1
Arkers Kwan Ching Wong, Frances Kam Yuet Wong, Lap Ki Chan, Namkiu Chan, Fraide A Ganotice, Jacqueline Ho
BACKGROUND: Although interprofessional education has received attention in recent years as a means of providing opportunities for health-care professionals to learn with, from and about other disciplines and enhance the quality of patient care, evidence of its effectiveness is limited. Interprofessional team-based learning was introduced to make it possible for students in different healthcare disciplines to interact with each other, and to prepare them to function effectively within a team in their future career...
March 9, 2017: Nurse Education Today
https://www.readbyqxmd.com/read/28340143/protecting-pain-patients-the-evaluation-of-a-chronic-pain-educational-intervention
#2
Simon Holliday, Chris Hayes, Adrian Dunlop, Simon Morgan, Amanda Tapley, Kim Henderson, Briony Larance, Parker Magin
Introduction. : Advocacy and commercially funded education successfully reduced barriers to the provision of long-term opioid analgesia. The subsequent escalation of opioid prescribing for chronic noncancer pain has seen increasing harms without improved pain outcomes. Methods. : This was a one-group pretest-posttest design study. A multidisciplinary team developed a chronic pain educational package for general practitioner trainees emphasizing limitations, risk-mitigation, and deprescribing of opioids with transition to active self-care...
March 13, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28340128/crossing-the-health-it-chasm-considerations-and-policy-recommendations-to-overcome-current-challenges-and-enable-value-based-care
#3
Julia Adler-Milstein, Peter J Embi, Blackford Middleton, Indra Neil Sarkar, Jeff Smith
While great progress has been made in digitizing the US health care system, today's health information technology (IT) infrastructure remains largely a collection of systems that are not designed to support a transition to value-based care. In addition, the pursuit of value-based care, in which we deliver better care with better outcomes at lower cost, places new demands on the health care system that our IT infrastructure needs to be able to support. Provider organizations pursuing new models of health care delivery and payment are finding that their electronic systems lack the capabilities needed to succeed...
March 15, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340009/designing-an-optimal-screening-program-for-unknown-atrial-fibrillation-a-cost-effectiveness-analysis
#4
Mattias Aronsson, Emma Svennberg, Mårten Rosenqvist, Johan Engdahl, Faris Al-Khalili, Leif Friberg, Viveka Frykman, Lars-Åke Levin
Aims: The primary objective of this study was to use computer simulations to suggest an optimal age for initiation of screening for unknown atrial fibrillation and to evaluate if repeated screening will add value. Methods and results: In the absence of relevant clinical studies, this analysis was based on a simulation model. More than two billion different designs of screening programs for unknown atrial fibrillation were simulated and analysed. Data from the published scientific literature and registries were used to construct the model and estimate lifelong effects and costs...
March 1, 2017: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28339996/fathers-perceptions-of-change-following-parenting-intervention-randomized-controlled-trial-of-triple-p-for-parents-of-children-with-asthma-or-eczema1
#5
Alina Morawska, Amy E Mitchell, Scott Burgess, Jennifer Fraser
 To test whether families' participation in an evidence-based parenting program can improve health-related outcomes reported by fathers of 2- to 10-year-old children with asthma and/or eczema.  A 2 (Triple P-Positive Parenting Program vs. care as usual) by 3 (baseline, postintervention, 6-month follow-up) design was used, with random group assignment. Of 107 families, 51.4% ( N  = 55) had a father participate alongside the child's mother, who was the primary intervention target. Fathers completed questionnaires assessing illness-related child behavior problems; self-efficacy with illness management and illness-related child behavior problems; and health-related quality of life...
March 2, 2017: Journal of Pediatric Psychology
https://www.readbyqxmd.com/read/28339771/implementing-patient-reported-outcome-surveys-as-part-of-routine-care-lessons-from-an-academic-radiation-oncology-department
#6
Lisa S Rotenstein, Ankit Agarwal, Kelly O'Neil, Andrea Kelly, Maureen Keaty, Colleen Whitehouse, Barbara Kalinowski, Peter F Orio, Neil Wagle, Neil E Martin
Patient reported outcomes (PROs) are reports of health conditions that come directly from patients. Use of PROs has been associated with improved patient outcomes, enhanced quality of life, and reduced end-of-life spending. Yet there are still outstanding questions regarding the process of implementing PRO collection in routine practice. In this article, we describe the experience of selecting and implementing PROs in a multisite, multidisease academic medical center-based radiation oncology practice and demonstrate that such large-scale rollout is feasible...
March 2, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28339592/active-collaboration-with-clients-an-underemphasized-but-vital-part-of-evidence-based-practice
#7
James Drisko
Evidence-based practice (EBP) is a widely recognized concept in contemporary social work practice. However, recent studies have shown that social workers do not understand EBP correctly. Standardized administrative approaches to implementing EBP have led to confusion about its core practice decision-making process. This collaborative process is the heart of EBP in direct social work practice. This article explores the EBP process and addresses a vital but often underemphasized step of EBP: active collaboration with the client in decision making...
January 28, 2017: Social Work
https://www.readbyqxmd.com/read/28339460/evaluating-implementation-of-a-fire-prevention-injury-prevention-briefing-in-children-s-centres-cluster-randomised-controlled-trial
#8
Toity Deave, Adrian Hawkins, Arun Kumar, Mike Hayes, Nicola Cooper, Michael Watson, Joanne Ablewhite, Carol Coupland, Alex Sutton, Gosia Majsak-Newman, Lisa McDaid, Trudy Goodenough, Kate Beckett, Elaine McColl, Richard Reading, Denise Kendrick
BACKGROUND: Many developed countries have high mortality rates for fire-related deaths in children aged 0-14 years with steep social gradients. Evidence-based interventions to promote fire safety practices exist, but the impact of implementing a range of these interventions in children's services has not been assessed. We developed an Injury Prevention Briefing (IPB), which brought together evidence about effective fire safety interventions and good practice in delivering interventions; plus training and facilitation to support its use and evaluated its implementation...
2017: PloS One
https://www.readbyqxmd.com/read/28339434/platelet-rich-plasma-in-musculoskeletal-pathology-a-necessary-rescue-or-a-lost-cause
#9
Annu Navani, Gang Li, Joshua Chrystal
BACKGROUND: Platelet rich plasma (PRP) has been used for decades to facilitate surgical tissue repair; therefore, the current trend of percutaneously injecting PRP to theoretically enhance tissue regeneration and repair is a logical progression. Applications include treatment of osteoarthritis, tendinopathy, chondropathy, acute and chronic soft tissue injuries, muscle or ligament tear, as well as enhancement of healing after bone or tissue reconstruction. However, there is limited evidence to support the use of PRP in the abovementioned conditions...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28338946/instrumental-variable-methods-for-continuous-outcomes-that-accommodate-nonignorable-missing-baseline-values
#10
Ashkan Ertefaie, James H Flory, Sean Hennessy, Dylan S Small
Instrumental variable (IV) methods provide unbiased treatment effect estimation in the presence of unmeasured confounders under certain assumptions. To provide valid estimates of treatment effect, treatment effect confounders that are associated with the IV (IV-confounders) must be included in the analysis, and not including observations with missing values may lead to bias. Missing covariate data are particularly problematic when the probability that a value is missing is related to the value itself, which is known as nonignorable missingness...
March 16, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28338849/a-preventative-lifestyle-intervention-for-older-adults-lifestyle-matters-a-randomised-controlled-trial
#11
Gail Mountain, Gill Windle, Daniel Hind, Stephen Walters, Anju Keertharuth, Robin Chatters, Kirsty Sprange, Claire Craig, Sarah Cook, Ellen Lee, Tim Chater, R Woods, Louise Newbould, Lauren Powell, Katy Shortland, Jennifer Roberts
Objectives: to test whether an occupation-based lifestyle intervention can sustain and improve the mental well-being of adults aged 65 years or over compared to usual care, using an individually randomised controlled trial. Participants: 288 independently living adults aged 65 years or over, with normal cognition, were recruited from two UK sites between December 2011 and November 2015. Interventions: lifestyle Matters is a National Institute for Health and Care Excellence recommended multi-component preventive intervention designed to improve the mental well-being of community living older people at risk of decline...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28338585/a-16-year-journey-in-the-study-of-rheumatoid-hand-disease
#12
Kevin C Chung, Sandra V Kotsis
Evidence-based medicine is a relatively new concept in hand surgery. A lack of high-level evidence often leads to uncertainty in the effectiveness of various procedures and regional variation in their use. Rheumatoid hand surgery has been plagued by a lack of quality data that has caused controversy between rheumatologists and hand surgeons. Research over the past 16 years has strived to provide data that can be used to provide evidence-based care for rheumatoid arthritis (RA) patients. The Silicone Arthroplasty in Rheumatoid Arthritis (SARA) Study is a prospective, long-term cohort study of RA patients with severe metacarpophalangeal joint deformity who have elected to undergo or to not undergo metacarpophalangeal joint arthroplasty...
March 3, 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28338215/delirium-during-postacute-nursing-home-admission-and-risk-for-adverse-outcomes
#13
Cyrus M Kosar, Kali S Thomas, Sharon K Inouye, Vincent Mor
OBJECTIVES: To identify the rate of delirium present during admission to postacute care (PAC) in the nursing home setting and to determine whether patients with delirium had higher risk for adverse outcomes. DESIGN: Retrospective cohort study. SETTING: US Medicare- and Medicaid-certified nursing homes, 2011 to 2014. PARTICIPANTS: Individuals admitted to all US nursing homes for PAC, aged ≥65 years, and without prior history of nursing home residence (n = 5,588,702)...
March 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28338214/light-therapies-for-acne-abridged-cochrane-systematic-review-including-grade-assessments
#14
REVIEW
J Barbaric, R Abbott, P Posadzki, M Car, L H Gunn, A M Layton, A Majeed, J Car
We undertook a Cochrane review of randomized controlled trials (RCTs) evaluating the effects of light-based interventions for acne vulgaris. We searched the Cochrane Skin Specialised Register, CENTRAL, MEDLINE, Embase, LILACS, ISI Web of Science, and grey literature sources (September 2015). We used the Grading of Recommendations Assessment, Development and Evaluation Working Group approach to assess the quality of evidence (QE). We included 71 RCTs (4211 participants, median sample size 31). Results from a single study (n = 266, low QE) showed little or no difference in effectiveness on participants' assessment of improvement between 20% aminolevulinic acid (ALA) photodynamic therapy (PDT), activated by blue light, versus vehicle plus blue light, whereas another study (n = 180) of a comparison of ALA-PDT (red light) concentrations showed 20% ALA-PDT was no more effective than 15%, but better than 10% and 5% ALA-PDT...
March 24, 2017: British Journal of Dermatology
https://www.readbyqxmd.com/read/28337821/mindfulness-based-stress-reduction-added-to-care-as-usual-for-lung-cancer-patients-and-or-their-partners-a-multi-centre-randomized-controlled-trial
#15
M P J Schellekens, D G M van den Hurk, J B Prins, A R T Donders, J Molema, R Dekhuijzen, M A van der Drift, A E M Speckens
BACKGROUND: Lung cancer patients report among the highest distress rates of all cancer patients. Partners report similar distress rates. The present study examined the effectiveness of additional Mindfulness-Based Stress Reduction (CAU + MBSR) versus solely care as usual (CAU) to reduce psychological distress in lung cancer patients and/or their partners. METHODS: We performed a multicentre, parallel-group, randomized controlled trial. MBSR is an 8-week group-based intervention, including mindfulness practice and teachings on stress...
March 23, 2017: Psycho-oncology
https://www.readbyqxmd.com/read/28337766/integration-of-family-planning-services-into-hiv-care-and-treatment-services-a-systematic-review
#16
Sabina A Haberlen, Manjulaa Narasimhan, Laura K Beres, Caitlin E Kennedy
Evidence on the feasibility, effectiveness, and cost-effectiveness of integrating family planning (FP) and HIV services has grown significantly since the 2004 Glion Call to Action. This systematic review adds to the knowledge base by characterizing the range of models used to integrate FP into HIV care and treatment, and synthesizing the evidence on integration outcomes among women living with HIV. Fourteen studies met our inclusion criteria, eight of which were published after the last systematic review on the topic in 2013...
March 24, 2017: Studies in Family Planning
https://www.readbyqxmd.com/read/28337719/an-early-health-economic-analysis-of-the-potential-cost-effectiveness-of-an-adherence-intervention-to-improve-outcomes-for-patients-with-cystic-fibrosis
#17
Paul Tappenden, Susannah Sadler, Martin Wildman
BACKGROUND: Cystic fibrosis (CF) negatively impacts upon health-related quality of life and survival. Adherence to nebulised treatments is low; improving adherence is hypothesised to reduce rates of exacerbation requiring intravenous antibiotics and lung function decline. OBJECTIVE: A state transition model was developed to assess the cost effectiveness of an intervention aimed at increasing patient adherence to nebulised and inhaled antibiotics compared with current CF care, in advance of the forthcoming CFHealthHub randomised controlled trial (RCT)...
March 23, 2017: PharmacoEconomics
https://www.readbyqxmd.com/read/28337432/the-current-and-future-role-of-heart-rate-variability-for-assessing-and-training-compassion
#18
James N Kirby, James R Doty, Nicola Petrocchi, Paul Gilbert
The evolution of mammalian caregiving involving hormones, such as oxytocin, vasopressin, and the myelinated vagal nerve as part of the ventral parasympathetic system, enables humans to connect, co-regulate each other's emotions and create prosociality. Compassion-based interventions draw upon a number of specific exercises and strategies to stimulate these physiological processes and create conditions of "interpersonal safeness," thereby helping people engage with, alleviate, and prevent suffering. Hence, compassion-based approaches are connected with our evolved caring motivation and attachment and our general affiliative systems that help regulate distress...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28336508/using-web-based-search-data-to-study-the-public-s-reactions-to-societal-events-the-case-of-the-sandy-hook-shooting
#19
Nir Menachemi, Saurabh Rahurkar, Mandar Rahurkar
BACKGROUND: Internet search is the most common activity on the World Wide Web and generates a vast amount of user-reported data regarding their information-seeking preferences and behavior. Although this data has been successfully used to examine outbreaks, health care utilization, and outcomes related to quality of care, its value in informing public health policy remains unclear. OBJECTIVE: The aim of this study was to evaluate the role of Internet search query data in health policy development...
March 23, 2017: JMIR Public Health and Surveillance
https://www.readbyqxmd.com/read/28336345/dancing-for-parkinson-s-a-randomized-trial-of-irish-set-dancing-compared-to-usual-care
#20
Joanne Shanahan, Meg E Morris, Orfhlaith Ni Bhriain, Daniele Volpe, Tim Lynch, Amanda M Clifford
OBJECTIVE: This pilot trial examined the feasibility of a randomised controlled study design and explored the benefits of the set dancing intervention compared to usual care. DESIGN: Randomised controlled design, with participants randomised to Irish set dance classes or a usual care control group. SETTING: Community based PARTICIPANTS: Individuals with idiopathic PD INTERVENTIONS: The dance group attended a 1.5 hour dancing class each week for 10 weeks and undertook a home dance programme for 20 minutes three times per week...
March 21, 2017: Archives of Physical Medicine and Rehabilitation
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