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https://www.readbyqxmd.com/read/28436256/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#1
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28423145/brief-behavioral-therapy-for-pediatric-anxiety-and-depression-in-primary-care-a-randomized-clinical-trial
#2
V Robin Weersing, David A Brent, Michelle S Rozenman, Araceli Gonzalez, Megan Jeffreys, John F Dickerson, Frances L Lynch, Giovanna Porta, Satish Iyengar
Importance: Anxiety and depression affect 30% of youth but are markedly undertreated compared with other mental disorders, especially in Hispanic populations. Objective: To examine whether a pediatrics-based behavioral intervention targeting anxiety and depression improves clinical outcome compared with referral to outpatient community mental health care. Design, Setting, and Participants: This 2-center randomized clinical trial with masked outcome assessment conducted between brief behavioral therapy (BBT) and assisted referral to care (ARC) studied 185 youths (aged 8...
April 19, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28421871/exploring-predictors-of-work-competence-in-schizophrenia-the-role-of-theory-of-mind
#3
Margherita Bechi, Marco Spangaro, Alessandro Pigoni, Elena Ripamonti, Mariachiara Buonocore, Federica Cocchi, Laura Bianchi, Carmelo Guglielmino, Antonella Rita Mastromatteo, Roberto Cavallaro, Marta Bosia
In schizophrenia employment rate is dramatically low, also among patients receiving job support interventions. Recent studies showed a direct relationship between neurocognitive deficits and work functioning, as well as proving the benefits of combined neurocognitive and work interventions. Current evidence also supports a role of Theory of Mind (ToM), on work functioning. However, the effect of integrated rehabilitation programmes including a social cognitive training on job outcome is still less explored...
April 19, 2017: Neuropsychological Rehabilitation
https://www.readbyqxmd.com/read/28412900/reducing-behavioral-health-inpatient-readmissions-for-people-with-substance-use-disorders-do-follow-up-services-matter
#4
Sharon Reif, Andrea Acevedo, Deborah W Garnick, Catherine A Fullerton
OBJECTIVE: Individuals with substance use disorders are at high risk of hospital readmission. This study examined whether follow-up services received within 14 days of discharge from an inpatient hospital stay or residential detoxification reduced 90-day readmissions among Medicaid enrollees whose index admission included a substance use disorder diagnosis. METHODS: Claims data were analyzed for Medicaid enrollees ages 18-64 with a substance use disorder diagnosis coded in any position for an inpatient hospital stay or residential detoxification in 2008 (N=30,439)...
April 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28408145/cost-effectiveness-of-silver-dressings-for-paediatric-partial-thickness-burns-an-economic-evaluation-from-a-randomized-controlled-trial
#5
E Gee Kee, K Stockton, R M Kimble, L Cuttle, S M McPhail
BACKGROUND: Partial thickness burns of up to 10% total body surface area (TBSA) in children are common injuries primarily treated in the outpatient setting using expensive silver-containing dressings. However, economic evaluations in the paediatric burns population are lacking to assist healthcare providers when choosing which dressing to use. The aim of this study was to conduct a cost-effectiveness analysis of three silver dressings for partial thickness burns ≤10% TBSA in children aged 0-15 years using days to full wound re-epithelialization as the health outcome...
April 10, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28403462/medicaid-coverage-of-smoking-cessation-counseling-and-medication-is-underutilized-for-pregnant-women
#6
Taneisha S Scheuermann, Kimber P Richter, Lisette T Jacobson, Theresa I Shireman
Introduction: Policies to promote smoking cessation among Medicaid-insured pregnant women have the potential to assist a significant proportion of pregnant smokers. In 2010, Kansas Medicaid began covering smoking cessation counseling for pregnant smokers. Our aim was to evaluate the use of smoking cessation benefits provided to pregnant women as a result of the Kansas Medicaid policy change that provided reimbursement for physician-provided smoking cessation counseling. Methods: We examined Kansas Medicaid claims data to estimate rates of delivery of smoking cessation treatment to Medicaid-insured pregnant women in Kansas from fiscal year 2010 through 2013...
May 1, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28402864/meta-analysis-on-anticoagulation-and-prevention-of-thrombosis-and-mortality-among-patients-with-lung-cancer
#7
H E Fuentes, D M Oramas, L H Paz, A I Casanegra, A S Mansfield, A J Tafur
BACKGROUND: Venous thromboembolism (Wickham et al., 2012 [1]) is a leading cause of morbidity and mortality among patients with cancer; however, primary thromboprophylaxis is not routinely recommended. We performed a systematic review and meta-analysis of randomized control trials (RCTs) to measure the impact of primary VTE prevention and its effect on mortality among patients with lung cancer. METHODS: With assistance from a master librarian, we searched Ovid, Scopus, DARE, CINAHL, MEDLINE, EMBASE, EBM reviews-Cochrane database of systematic reviews, EBM reviews-ACP journal, and EBM Reviews-Databases for relevant studies following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines...
April 1, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28390774/surgeon-leadership-in-the-coding-billing-and-contractual-negotiations-for-fenestrated-endovascular-aortic-aneurysm-repair-increases-medical-center-contribution-margin-and-physician-reimbursement
#8
Francesco Aiello, Jonathan Durgin, Vijaya Daniel, Louis Messina, Danielle Doucet, Jessica Simons, James Jenkins, Andres Schanzer
BACKGROUND: Fenestrated endovascular aneurysm repair (FEVAR) allows endovascular treatment of thoracoabdominal and juxtarenal aneurysms previously outside the indications of use for standard devices. However, because of considerable device costs and increased procedure time, FEVAR is thought to result in financial losses for medical centers and physicians. We hypothesized that surgeon leadership in the coding, billing, and contractual negotiations for FEVAR procedures will increase medical center contribution margin (CM) and physician reimbursement...
April 5, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28358754/open-label-study-of-injectable-extended-release-naltrexone-xr-ntx-in-healthcare-professionals-with-opioid-dependence
#9
Paul H Earley, Jacqueline Zummo, Asli Memisoglu, Bernard L Silverman, David R Gastfriend
OBJECTIVES: Healthcare professionals (HCPs) with opioid dependence are at risk for relapse and death, particularly in the first year of recovery; however, maintenance treatment with opioid agonists is controversial in this safety-sensitive group. We evaluated long-term safety, tolerability, and treatment outcomes of injectable, intramuscular, extended-release naltrexone (XR-NTX) in opioid-dependent HCPs. METHODS: This single-arm, multisite, open-label study was conducted in opioid-dependent HCPs who had been detoxified from opioids for at least 2 weeks...
March 29, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28350730/pas-in-orthopedics-in-the-vha-s-community-based-outpatient-clinics
#10
Daniel O Reed, Roderick S Hooker
In the Veterans Health Administration (VHA) system, most orthopedic care takes place in the VA medical centers (VAMCs). Because most patients receiving orthopedic care were referred by adult medicine providers, more widely deploying physician assistants (PAs) in orthopedic medicine might help offset this workload. An orthopedic medicine demonstration project recruited, trained, and positioned PAs in community-based outpatient clinics (CBOCs) to improve access to care. The project involved surgeons at the Houston VAMC instructing five newly employed PAs in a wide range of orthopedic evaluation and management strategies before their assignment to a CBOC...
April 2017: JAAPA: Official Journal of the American Academy of Physician Assistants
https://www.readbyqxmd.com/read/28345436/characterizing-health-care-utilization-direct-costs-and-comorbidities-associated-with-interstitial-cystitis-a-retrospective-claims-analysis
#11
Amy Tung, Zsolt Hepp, Aasthaa Bansal, Emily Beth Devine
BACKGROUND: Interstitial cystitis (IC) is a debilitating condition that affects up to 5% of the U.S. POPULATION: This condition is characterized by bladder pain, urinary urgency and frequency, nocturia, and, in some patients, bladder lesions called Hunner's lesions (HL). IC patients who have HL experience a clinical course that is distinct from those without HL and, as a result, respond differently to existing treatments. Without effective and lasting therapeutic options, IC patients are expected to experience a reduced quality of life and be a significant economic burden...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28345371/ewma-document-negative-pressure-wound-therapy
#12
Jan Apelqvist, Christian Willy, Ann-Mari Fagerdahl, Marco Fraccalvieri, Malin Malmsjö, Alberto Piaggesi, Astrid Probst, Peter Vowden
1. Introduction Since its introduction in clinical practice in the early 1990's negative pressure wounds therapy (NPWT) has become widely used in the management of complex wounds in both inpatient and outpatient care.(1) NPWT has been described as a effective treatment for wounds of many different aetiologies(2,3) and suggested as a gold standard for treatment of wounds such as open abdominal wounds,(4-6) dehisced sternal wounds following cardiac surgery(7,8) and as a valuable agent in complex non-healing wounds...
March 1, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28290977/actinomyces-related-tubo-ovarian-abscess-in-a-poorly-controlled-type-ii-diabetic-with-a-copper-intrauterine-device
#13
Ashley L Sawtelle, Nicole P Chappell, Caela R Miller
BACKGROUND: The historic association of Actinomyces israelii infection with intrauterine devices (IUDs) has long been recognized. In recent years, the risk of developing pelvic inflammatory disease with a copper or levonorgestrel IUD has been less than 1% in women who are low risk for sexually transmitted infections. IUD-related pelvic infections secondary to actinomyces have largely vanished from contemporary practice. CASE: A 49-year-old using a copper IUD for contraception with poorly controlled type II diabetes mellitus was admitted for suspected tubo-ovarian abscess on the basis of abdominopelvic pain, leukocytosis, and computed tomography findings...
March 2017: Military Medicine
https://www.readbyqxmd.com/read/28253887/effectiveness-of-robot-assisted-gait-training-in-children-with-cerebral-palsy-a-bicenter-pragmatic-randomized-cross-over-trial-pelogait
#14
C Ammann-Reiffer, C H G Bastiaenen, A D Meyer-Heim, H J A van Hedel
BACKGROUND: Walking ability is a priority for many children with cerebral palsy (CP) and their parents when considering domains of importance regarding treatment interventions. Partial body-weight supported treadmill training has become an established therapeutic treatment approach to address this demand. Further, new robotic rehabilitation technologies have increasingly been implemented in the clinical setting to allow for longer training sessions with increased step repetitions while maintaining a consistent movement pattern...
March 2, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28243440/adopting-and-sustaining-a-virtual-fracture-clinic-model-in-the-district-hospital-setting-a-quality-improvement-approach
#15
Kartik Logishetty
Virtual Fracture Clinics (VFCs) are an alternative to the conventional fracture clinics, to manage certain musculoskeletal injuries. This has recently been reported as a safe, cost-effective and efficient care model. As demonstrated at vanguard sites in the United Kingdom, VFCs can enhance patient care by standardising treatment and reducing outpatient appointments. This project demonstrates how a Quality Improvement approach was applied to introduce VFCs in the District General Hospital setting. We demonstrate how undertaking Process Mapping, Driver Diagrams, and Stakeholder Analysis can assist implementation...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28237048/heterogeneity-in-pathways-to-abstinence-among-women-in-treatment-for-alcohol-use-disorder
#16
Cathryn Glanton Holzhauer, Elizabeth E Epstein, Amy M Cohn, Barbara S McCrady, Fiona S Graff, Sharon Cook
BACKGROUND: Although many providers recommend alcohol abstinence as an initial step in the treatment of alcohol use disorders (AUD), there is a scarcity of research on specific behavioral strategies to achieve this step. The current study examined efficacy of a unique abstinence planning intervention for alcohol in a cognitive behavioral therapy (CBT) outpatient protocol. DESIGN: 128 women enrolled in a randomized controlled trial of CBT for AUD at a university-based clinic comprised the sample...
April 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/28236956/financial-incentives-for-improving-adherence-to-maintenance-treatment-in-patients-with-psychotic-disorders-money-for-medication-a-multicentre-open-label-randomised-controlled-trial
#17
Ernst L Noordraven, André I Wierdsma, Peter Blanken, Anthony F T Bloemendaal, Anton B P Staring, Cornelis L Mulder
BACKGROUND: Provision of financial incentives is a promising intervention for improving adherence in patients taking antipsychotic medication. We aimed to assess the effectiveness of this intervention for improving adherence to antipsychotic depot medication in patients with psychotic disorders, irrespective of their previous compliance. METHODS: We did this multicentre, open-label, randomised controlled trial at three mental health-care institutions in secondary psychiatric care services in the Netherlands...
March 2017: Lancet Psychiatry
https://www.readbyqxmd.com/read/28230456/off-label-prescribing-for-children-with-migraines-in-u-s-ambulatory-care-settings
#18
L Leanne Lai, Leroy Koh, Jane Ai-Chen Ho, Alexander Ting, Augustine Obi
BACKGROUND: Migraines, Which Affect About 10% Of School-Age Children In The United States, Can Significantly Impair Quality Of Life. Despite Potential Disability, Many Children Do Not Receive Treatment Or Prophylaxis, Since Medications Specifically Approved For Children Are Significantly Less Than For Adults. There Is Also Controversy Surrounding The Apparent Widespread Practice Of Prescribing Off-Label Medications For Children With Migraines. However, Little Research Has Been Done To Identify Physician-Prescribing Patterns Of Migraine Medication For Children...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28211251/burden-of-rheumatoid-arthritis-from-a-societal-perspective-a-prevalence-based-study-on-cost-of-illness-for-patients-with-rheumatoid-arthritis-in-china
#19
Hao Hu, Luan Luan, Keqin Yang, Shu-Chuen Li
AIM: To provide a comprehensive estimation of the economic burden of rheumatoid arthritis (RA) in China, especially for patients from less developed areas, and to explore the cost transferability between regions to assist healthcare decision-making. METHODS: The study was conducted in south and north China from May 2013 to December 2013. The burden of RA was investigated by interviewing participants with a questionnaire battery containing socio-demographic, cost of illness (COI) and medical treatments...
February 17, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28210617/inpatient-treatment-for-the-middle-aged-and-elderly-in-central-china
#20
Yan Jiang, Yu Wang, Yang Li, Yuming Zhang, Yinjun Zhao, Xiaojun Wang, Chi Ma, Shuangge Ma
BACKGROUND: Compared to outpatient treatment and self-treatment, inpatient treatment corresponds to more severe illness and poses more serious health and financial burden to patients. The goal of this study is to provide an updated and comprehensive description of the prevalence, characteristics, and cost of inpatient treatment for the middle-aged and elderly in Central China, which is highly populated, less-developed, and agriculture-dominating. METHODS: A survey was conducted in August 2013 in the Henan province...
2017: Frontiers in Public Health
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