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Electronic personal health records

Magnolia Cardona, Ebony T Lewis, Robin M Turner, Hatem Alkhouri, Stephen Asha, John Mackenzie, Margaret Perkins, Sam Suri, Anna Holdgate, Luis Winoto, Chan-Wei Chang, Blanca Gallego-Luxan, Sally McCarthy, Mette R Kristensen, Michael O'Sullivan, Helene Skjøt-Arkil, Anette A Ekmann, Hanne H Nygaard, Jonas J Jensen, Rune O Jensen, Jonas L Pedersen, Dorothy Breen, John A Petersen, Birgitte N Jensen, Christian Backer Mogensen, Ken Hillman, Mikkel Brabrand
BACKGROUND: Prognostic uncertainty inhibits clinicians from initiating timely end-of-life discussions and advance care planning. This study evaluates the efficacy of the CriSTAL (Criteria for Screening and Triaging to Appropriate aLternative care) checklist in emergency departments. METHODS: Prospective cohort study of patients aged ≥65 years with any diagnosis admitted via emergency departments in ten hospitals in Australia, Denmark and Ireland. Electronic and paper clinical records will be used to extract risk factors such as nursing home residency, physiological deterioration warranting a rapid response call, personal history of active chronic disease, history of hospitalisations or intensive care unit admission in the past year, evidence of proteinuria or ECG abnormalities, and evidence of frailty to be concurrently measured with Fried Score and Clinical Frailty Scale...
March 6, 2018: Archives of Gerontology and Geriatrics
Sajidah Al-Hawamdih, Muayyad M Ahmad
The purpose of this study was to examine nursing informatics competency and the quality of information processing among nurses in Jordan. The study was conducted in a large hospital with 380 registered nurses. The hospital introduced the electronic health record in 2010. The measures used in this study were personal and job characteristics, self-efficacy, Self-Assessment Nursing Informatics Competencies, and Health Information System Monitoring Questionnaire. The convenience sample consisted of 99 nurses who used the electronic health record for at least 3 months...
March 2018: Computers, Informatics, Nursing: CIN
Brigg Reilley, Dana L Haberling, Marissa Person, Jessica Leston, Jonathan Iralu, Rick Haverkate, Azfar-E-Alam Siddiqi
OBJECTIVES: The objectives of this study were to use Indian Health Service (IHS) data from electronic health records to analyze human immunodeficiency virus (HIV) diagnoses among American Indian/Alaska Natives (AI/ANs) and to identify current rates and trends that can support data-driven policy implementation and resource allocation for this population. METHODS: We analyzed provider visit data from IHS to capture all AI/AN patients who met a definition of a new HIV diagnosis from 2005 through 2014 by using International Classification of Diseases, Ninth Revision, Clinical Modification codes...
January 1, 2018: Public Health Reports
Yochai Schonmann, Oz Bleich, Andre Matalon, Hanny Yeshua
Aims The aim of this study was to evaluate the performance of the US Preventive Services Task Force (USPSTF) cholesterol recommendations in a contemporary non-US cohort. Methods and results This is a historical cohort analysis of electronic records from Israel's largest health provider. All patients in the Tel Aviv district eligible for primary cardiovascular prevention were followed between January 2005 and December 2015. Risk was estimated by the pooled cohort equations. Statin eligibility was determined by USPSTF and American College of Cardiology and American Heart Association (ACC/AHA) recommendations...
January 1, 2018: European Journal of Preventive Cardiology
Rodrigo Carmona, Benjamin Lê Cook, Enrique Baca-García, Ligia Chavez, Kiara Alvarez, Miren Iza, Margarita Alegría
Analyses of healthcare expenditures and adequacy are needed to identify cost-effective policies and practices that improve mental healthcare quality. Data are from 2010 to 2012 electronic health records from three hospital psychiatry departments in Madrid (n = 29,944 person-years) and three in Boston (n = 14,109 person-years). Two-part multivariate generalized linear regression and logistic regression models were estimated to identify site differences in mental healthcare expenditures and quality of care...
March 7, 2018: Journal of Behavioral Health Services & Research
Antonio Rodriguez-Poncelas, Joan Barrot-de la-Puente, Gabriel Coll de Tuero, Carles López-Arpí, Bogdan Vlacho, Flora Lopéz-Simarro, Xavier Mundet Tudurí, Josep Franch-Nadal
AIM: The aim of this study was to assess glycaemic control and prescribing practices of antihyperglycaemic treatment in patients with diabetes mellitus type 2 aged 75 years or older. METHODS: We analysed data from health electronic records from 4,581 persons attended at primary healthcare centres of the Institut Català de la Salut (ICS), in the Girona Sud area of Catalonia, Spain, during 2013 and 2016. Variables such as age, gender, body mass index (BMI), diabetes duration, age at diabetes diagnosis, glycated haemoglobin (HbA1c), creatinine, glomerular filtrate rate and the albumin/creatinine ratio in urine were collected...
March 7, 2018: International Journal of Clinical Practice
Sabrina Roy, Fred H Hochberg, Pamela S Jones
This article aims to document the growth in extracellular vesicle (EV) research. Here, we report the growth in EV-related studies, patents, and grants as well as emerging companies with major intent on exosomes. Four different databases were utilized for electronic searches of published literature: two general databases - Scopus/Elsevier and Web of Science (WoS), as well as two specialized US government databases - the USA Patent and Trademark Office and National Institutes of Health (NIH) of the Department of Health and Human Services...
2018: Journal of Extracellular Vesicles
Scott Powers, Junyang Qian, Kenneth Jung, Alejandro Schuler, Nigam H Shah, Trevor Hastie, Robert Tibshirani
When devising a course of treatment for a patient, doctors often have little quantitative evidence on which to base their decisions, beyond their medical education and published clinical trials. Stanford Health Care alone has millions of electronic medical records that are only just recently being leveraged to inform better treatment recommendations. These data present a unique challenge because they are high dimensional and observational. Our goal is to make personalized treatment recommendations based on the outcomes for past patients similar to a new patient...
March 6, 2018: Statistics in Medicine
Johannes M I H Gho, Amand F Schmidt, Laura Pasea, Stefan Koudstaal, Mar Pujades-Rodriguez, Spiros Denaxas, Anoop D Shah, Riyaz S Patel, Chris P Gale, Arno W Hoes, John G Cleland, Harry Hemingway, Folkert W Asselbergs
OBJECTIVES: To investigate the incidence and determinants of heart failure (HF) following a myocardial infarction (MI) in a contemporary cohort of patients with MI using routinely collected primary and hospital care electronic health records (EHRs). METHODS: Data were used from the CALIBER programme, linking EHRs in England from primary care, hospital admissions, an MI registry and mortality data. Subjects were eligible if they were 18 years or older, did not have a history of HF and survived a first MI...
March 3, 2018: BMJ Open
Karin Lisspers, Christer Janson, Kjell Larsson, Gunnar Johansson, Gunilla Telg, Marcus Thuresson, Björn Ställberg
BACKGROUND: Asthma is often associated with other diseases. To identify and manage comorbidities is important, as these conditions may increase the disease burden. OBJECTIVE: To describe the prevalence of comorbidities, disease burden and mortality across age groups in a large Swedish primary care real-life asthma population. METHODS: Observational cohort study of asthma patients, all ages, identified from electronic medical records by ICD-10-CM code, data from 36 primary care centers...
March 2018: Respiratory Medicine
Steven Barnes, Julie Prescott
BACKGROUND: Extant evidence suggests that the proportion of adolescents suffering from anxiety disorders (ADs) has increased by up to 70% since the mid-1980s, with experience of anxiety at this stage associated with significant negative short- and long-term life outcomes. The existing therapeutic interventions (eg, cognitive behavioral therapy, CBT; attention bias modification, ABM) have proven to have clinically measurable benefits in reducing anxiety, but their efficacy is often compromised by social and practical barriers...
February 28, 2018: JMIR Serious Games
Kevin Selby, Gillian Bartlett-Esquilant, Jacques Cornuz
With their longitudinal patient relationships, primary care physicians and their care teams are uniquely situated to promote preventive medicine, including cancer screening. A confluence of forces is driving the demand for the personalization of cancer screening recommendations. Recommendations are increasingly based on individual patient preferences, medical history, genetic and environmental risk factors, and level of interaction with the healthcare system. Current examples include choices between colonoscopy, fecal testing, and emerging tests for colorectal cancer (CRC) screening; the use of genetic information and availability of home self-testing in cervical cancer screening; the integration of multiple risk factors and patient preferences to decide the intensity and length of breast cancer screening; and the issues of smoking cessation and competing priorities when deciding whether or not to pursue lung cancer screening...
2018: Public Health Reviews
Yulia Orlova, Paul Rizzoli, Elizabeth Loder
Importance: In 2006, the US Food and Drug Administration (FDA) issued an advisory warning on the risk of serotonin syndrome with concomitant use of triptans and selective serotonin reuptake inhibitor (SSRI) or selective norepinephrine reuptake inhibitor (SNRI) antidepressants, but the true risk of serotonin syndrome in these patients remains unknown. Objective: To assess the risk of serotonin syndrome with concomitant use of triptans and SSRI or SNRI antidepressants...
February 26, 2018: JAMA Neurology
Zoe Edwards, Alison Blenkinsopp, Lucy Ziegler, Michael I Bennett
Pain experienced by many patients with advanced cancer is often not well controlled and community pharmacists are potentially well placed to provide support. The study objective was to explore the views and experiences of patients with advanced cancer about community pharmacies, their services and attitudes towards having a community pharmacist pain medicines consultation. Purposive sampling of GP clinical information systems was used to recruit patients with advanced cancer, living in the community and receiving opioid analgesics in one area of England, UK between January 2015 and July 2016...
February 26, 2018: Health & Social Care in the Community
Marc Casajuana, Maria Giner-Soriano, Albert Roso-Llorach, Cristina Vedia, Concepció Violan, Rosa Morros
Atrial fibrillation (AF) is the most common chronic arrhythmia, with increasing healthcare and economic burden and a prevalence which increases with progressive ageing. This study aims to describe overall annual costs per patient for management of non-valvular AF in a primary healthcare (PHC) setting and compare these costs between the groups of patients treated with vitamin K antagonists, antiplatelets or non-treated through a population-based study conducted with electronic health records. We analysed annual costs per person of 19,787 patients in 2012; PHC visits, hospital admissions, AF-related events requiring hospital admission, referrals to secondary specialists, sick leave, diagnostic tests and laboratory tests at PHC level, including INR determinations performed in PHC, and drug therapy...
February 20, 2018: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
Sagar Dugani, Jeffrey M Ames, JoAnn E Manson, Samia Mora
PURPOSE OF REVIEW: The role of aspirin in secondary cardiovascular prevention is well understood; however, the role in primary prevention is less clear, and requires careful balancing of potential benefits with risks. Here, we summarize the evidence base on the benefits and risks of aspirin therapy, discuss clinical practice guidelines and decision support tools to assist in initiating aspirin therapy, and highlight ongoing trials that may clarify the role of aspirin in cardiovascular disease prevention...
February 21, 2018: Current Atherosclerosis Reports
Evan A DeZeeuw, Ashley M Coleman, Milap C Nahata
OBJECTIVES: The majority of studies on medication therapy management (MTM) have focused on the conduct of in-person comprehensive medication reviews (CMRs). Although face-to-face MTM services may be the most well-known mode of delivery, there are other ways CMRs can be implemented as part of an MTM service. Specifically, telephonic CMR is an alternative method of offering MTM services that many patients may welcome. The purpose of this commentary was to highlight current findings regarding the impact of telephonic CMRs as a component of MTM services on health outcomes...
February 1, 2018: American Journal of Managed Care
Megan B Cole, Brad Wright, Ira B Wilson, Omar Galárraga, Amal N Trivedi
BACKGROUND: To monitor progress towards eliminating health disparities, community health centers have reported on hypertension control, diabetes control, and birthweight by race and ethnicity since 2008. OBJECTIVE: To evaluate racial/ethnic time trends in quality outcomes in health centers and to assess both within- and between-center disparities in outcomes. DESIGN AND SAMPLE: Using 2009-2014 data from all US health centers (n = 1047 centers, serving 19...
February 16, 2018: Journal of General Internal Medicine
Michael B Rothberg, Bo Hu, Laura Lipold, Sarah Schramm, Xian Wen Jin, Andrea Sikon, Glen B Taksler
IMPORTANCE: Cervical cancer screening guidelines are in evolution. Current guidelines do not differentiate recommendations based on individual patient risk. OBJECTIVE: To derive and validate a tool for predicting individualized probability of cervical intraepithelial neoplasia grade 2 or higher (CIN2+) at a single time point, based on demographic factors and medical history. DESIGN: The study design consisted of an observational cohort with hierarchical generalized linear regression modeling...
February 15, 2018: Cancer Causes & Control: CCC
Steve R Barnes, Zimy Wansaula, Kristen Herrick, Eyal Oren, Kacey Ernst, Sonja J Olsen, Mariana G Casal
BACKGROUND: From October 2010 through February 2016, Arizona conducted surveillance for severe acute respiratory infections (SARI) among adults hospitalized in the Arizona-Mexico border region. There are few accurate mortality estimates in SARI patients, particularly in adults ≥ 65 years old. The purpose of this study was to generate mortality estimates among SARI patients that include deaths occurring shortly after hospital discharge and identify risk factors for mortality. METHODS: Patients admitted to two sentinel hospitals between 2010 and 2014 who met the SARI case definition were enrolled...
February 12, 2018: BMC Infectious Diseases
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