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https://www.readbyqxmd.com/read/28748733/sensory-symptoms-in-low-back-pain-how-do-they-matter
#1
Janne Gierthmühlen, Jessica Greinacher, Johanna Höper, Violetta Oberlojer, Michael Lankes, Frieder Traulsen, Philipp Hüllemann, Christoph Borzikowsky, Maren Reimer, Ralf Baron
OBJECTIVE: Successful treatment of chronic low back pain (LBP) is difficult in clinical practice and hard to measure in trials. One reason might be the use of insufficient outcome parameters. The aim was to investigate the importance of typical clinical characteristics of chronic LBP on QoL and functionality. METHODS: A total of 51 patients with chronic LBP (19 with, 32 without radiculopathy) were investigated with different questionnaires. RESULTS: Burdening symptoms differed in frequency, intensity and impairment of QoL and functionality between patients with and without radiculopathy and between the area of pain within the same patient, i...
July 27, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28746028/the-kaiser-permanente-northern-california-enhanced-recovery-after-surgery-program-design-development-and-implementation
#2
Vincent X Liu, Efren Rosas, Judith C Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Alexander Mustille, Vivian M Reyes, Shirley S Paulson, Michelle Caughey, Stephen Parodi
Complications are common after surgery, highlighting the need for innovations that reduce postsurgical morbidity and mortality. In this report, we describe the design, development, and implementation of an Enhanced Recovery After Surgery program in the Kaiser Permanente Northern California integrated health care delivery system. This program was implemented and disseminated in 2014, targeting patients who underwent elective colorectal resection and those who underwent emergent hip fracture repair across 20 Medical Centers...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746024/impact-of-longitudinal-electronic-health-record-training-for-residents-preparing-for-practice-in-patient-centered-medical-homes
#3
Jung G Kim, Hector P Rodriguez, Katherine At Estlin, Carl G Morris
INTRODUCTION: Competence in using an electronic health record (EHR) is considered a critical skill for physicians practicing in patient-centered medical homes (PCMHs), but few studies have examined the impact of EHR training for residents preparing to practice in PCMHs. This study explored the educational outcomes associated with comprehensive EHR training for family medicine residents. METHODS: The PCMH EHR training consisted of case-based routine clinic visits delivered to 3 resident cohorts (N = 18)...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28746023/the-patient-centered-medical-home-as-a-community-based-strategy
#4
Berkeley A Franz, John W Murphy
Increasing attention has been devoted to the important role that primary care will play in improving population health. One innovation, the patient-centered medical home (PCMH), aims to unite a variety of professionals with patients in the prevention and treatment of illness. Although patient perspectives are critical to this model, this article questions whether the PCMH in practice is truly community-based. That is, do physicians, planners, and other health care professionals take seriously the value of integrating local knowledge into medical care? The argument presented is that community-based philosophy contains a foundational principle that the perspectives of health care practitioners and community members must be integrated...
2017: Permanente Journal
https://www.readbyqxmd.com/read/28745974/role-of-total-ankle-arthroplasty-in-stiff-ankles
#5
James W Brodsky, Justin M Kane, Akira Taniguchi, Scott Coleman, Yahya Daoud
BACKGROUND: The decision tree for the operative treatment of end-stage ankle arthritis involves either ankle arthrodesis (AA) or total ankle arthroplasty (TAA). Although both have documented success providing diminished pain, improved patient-centered outcomes, and improved objective measures of function, arthroplasty is unique in its ability to preserve motion at the tibiotalar joint. Arthroplasty procedures are normally thought of as a motion-sparing surgery rather than a motion-producing procedure, which may limit its success in patients with stiff ankles...
July 1, 2017: Foot & Ankle International
https://www.readbyqxmd.com/read/28745943/integrating-caring-into-patient-centered-care-through-interprofessional-education-and-ethics-the-caring-project
#6
Jane S Mahoney, Cynthia Mulder, Susan Hardesty, Alok Madan
In an era of health care that is driven by biological and technical advances, there is a need to safeguard the caring component of care, the humanistic part of care. With this in mind, the authors constructed a Patient-Centered Caring model consisting of three overlapping constructs: delivering customer service, understanding the illness experience, and providing trauma-informed care. These practices operate within an interprofessional competency context. The authors describe an interprofessional educational project focused on understanding the illness experience and providing trauma-informed care to faculty, staff, and administrators in an inpatient psychiatric setting...
July 26, 2017: Bulletin of the Menninger Clinic
https://www.readbyqxmd.com/read/28745137/exploring-the-value-proposition-of-primary-care-for-safety-net-patients-who-utilize-emergency-departments-to-address-unmet-needs
#7
Kimberly R Enard, Deborah M Ganelin
BACKGROUND: An underlying assumption of strategies intended to promote appropriate primary care over emergency department (ED) use for ongoing health care needs is that patients will understand the "value proposition" of primary care: that they will receive specific benefits from primary care providers over and above what they receive from EDs. However, there is evidence that this value proposition may be unclear to safety-net patients. The goals of this study are to describe factors motivating ED use for low-acuity conditions; describe similarities and differences in usual source of care (USOC) experiences, by ED versus non-ED setting; and assess awareness and perceptions of the patient-centered medical home (PCMH) concept among safety-net patients...
July 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28743661/chronic-pain-patient-physician-engagement-and-family-communication-associated-with-drug-using-hiv-patients-discussing-advanced-care-planning-with-their-physicians
#8
Eric D Hansen, Mary M Mitchell, Tom Smith, Nancy Hutton, Jeanne Keruly, Amy R Knowlton
CONTEXT: In the era of effective antiretroviral therapy, persons living with HIV/AIDS (PLWHA) are living longer, transforming HIV into a serious chronic illness, warranting patient-provider discussion about advanced care planning (ACP). Evidence is needed to inform physicians on how to approach ACP for these patients. Chronic pain is common in PLWHA, particularly in those who have substance use disorders; although it is known this population is at risk for poorer patient-physician engagement, the effects on ACP are unknown...
July 22, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28743204/the-use-of-clinical-databases-in-disease-outcomes-research-is-the-ethics-of-irb-review-keeping-up
#9
Eugene Bereza
There is a perceived tension in research ethics between protecting the interests of participants and promoting good research as a societal good. The challenge of balancing the potential benefits of large clinical databases for disease outcomes research while protecting patients' privacy and confidentiality is an example of this dynamic. What is new about this tension in the context of "data warehousing" is the conflation of many differing interpretations of relevant ethics terminology, the proliferation of different kinds of databases, as well as the growth of research on a global level without the requisite harmonization of regulatory frameworks...
July 1, 2017: Multiple Sclerosis: Clinical and Laboratory Research
https://www.readbyqxmd.com/read/28741970/efficacy-and-safety-of-once-weekly-semaglutide-for-the-treatment-of-type-2-diabetes
#10
Xueying Tan, Xiaojing Cao, Minzhi Zhou, Ping Zou, Jingbo Hu
Type 2 diabetes is a chronic metabolic disease characterized by persistent hyperglycemia resulting from progressive deficient of insulin in patients with a background of insulin resistance. Current treatment algorithms recommended by American Diabetes Association/The European Association for the Study of Diabetes promote a patient-centered approach that takes into account a comprehensive consideration of pharmacological properties of drugs, including glucose-lowering action, effects on body weight, correction on multiple pathophysiologic defects, tolerability, and long-term safety...
July 25, 2017: Expert Opinion on Investigational Drugs
https://www.readbyqxmd.com/read/28739405/the-burden-of-cystoscopic-bladder-cancer-surveillance-anxiety-discomfort-and-patient-preferences-for-decision-making
#11
Kevin Koo, Lisa Zubkoff, Brenda E Sirovich, Philip P Goodney, Douglas J Robertson, John D Seigne, Florian R Schroeck
Objective To examine discomfort, anxiety, and preferences for decision-making in patients undergoing surveillance cystoscopy for non-muscle-invasive bladder cancer (NMIBC). Methods Veterans with a prior diagnosis of NMIBC completed validated survey instruments assessing procedural discomfort, worry, and satisfaction, and were invited to participate in semi-structured focus groups about their experience and desire to be involved in surveillance decision-making. Focus group transcripts were analyzed qualitatively, using (1) systematic iterative coding, (2) triangulation involving multiple perspectives from urologists and an implementation scientist, and (3) searching and accounting for disconfirming evidence...
July 21, 2017: Urology
https://www.readbyqxmd.com/read/28739385/the-promise-of-patient-centered-text-messages-for-encouraging-hiv-testing-in-an-underserved-population
#12
Monisha Arya, Anna Huang, Disha Kumar, Vagish Hemmige, Richard L Street, Thomas P Giordano
No abstract text is available yet for this article.
July 11, 2017: Journal of the Association of Nurses in AIDS Care: JANAC
https://www.readbyqxmd.com/read/28738986/pilot-testing-fall-tips-tailoring-interventions-for-patient-safety-a-patient-centered-fall-prevention-toolkit
#13
Patricia C Dykes, Megan Duckworth, Stephanie Cunningham, Sasha Dubois, Melissa Driscoll, Zinnia Feliciano, Michael Ferrazzi, Farah E Fevrin, Stephanie Lyons, Mary Ellen Lindros, Allison Monahan, Matthew M Paley, Saby Jean-Pierre, Maureen Scanlan
BACKGROUND: Patient falls during an acute hospitalization cause injury, reduced mobility, and increased costs. The laminated paper Fall TIPS Toolkit (Fall TIPS) provides clinical decision support at the bedside by linking each patient's fall risk assessment with evidence-based interventions. Strategies were needed to integrate this evidence into clinical practice. METHODS: The Institute for Healthcare Improvement's Framework for Spread is the conceptual model for pilot implementation of Fall TIPS at Brigham and Women's Hospital (BWH; Boston) and Montefiore Medical Center (MMC; Bronx, New York)...
August 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28738685/assessing-the-effect-of-the-vha-pcmh-model-on-utilization-patterns-among-veterans-with-ptsd
#14
Ian Randall, Charles Maynard, Gary Chan, Beth Devine, Chris Johnson
OBJECTIVES: The Veterans Health Administration (VHA) implemented a patient-centered medical home (PCMH)-based Patient Aligned Care Teams (PACT) model in 2010. We examined its effects on the utilization of health services among US veterans with posttraumatic stress disorder (PTSD). STUDY DESIGN: We analyzed VHA clinical and administrative data to conduct an interrupted time series study. Encounter-level data were obtained for the period of April 1, 2005, through March 31, 2014...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28738403/developing-consensus-based-priority-outcome-domains-for-trials-in-kidney-transplantation-a-multinational-delphi-survey-with-patients-caregivers-and-health-professionals
#15
Bénédicte Sautenet, Allison Tong, Karine E Manera, Jeremy R Chapman, Anthony N Warrens, David Rosenbloom, Germaine Wong, John Gill, Klemens Budde, Lionel Rostaing, Lorna Marson, Michelle A Josephson, Peter P Reese, Timothy L Pruett, Camilla S Hanson, Donal O'Donoghue, Helen Tam-Tham, Jean-Michel Halimi, Jenny I Shen, John Kanellis, John D Scandling, Kirsten Howard, Martin Howell, Nick Cross, Nicole Evangelidis, Philip Masson, Rainer Oberbauer, Samuel Fung, Shilpa Jesudason, Simon Knight, Sreedhar Mandayam, Stephen P McDonald, Steve Chadban, Tasleem Rajan, Jonathan C Craig
BACKGROUND: Inconsistencies in outcome reporting and frequent omission of patient-centered outcomes can diminish the value of trials in treatment decision making. We identified critically important outcome domains in kidney transplantation based on the shared priorities of patients/caregivers and health professionals. METHODS: In a 3-round Delphi survey, patients/caregivers and health professionals rated the importance of outcome domains for trials in kidney transplantation on a 9-point Likert scale and provided comments...
August 2017: Transplantation
https://www.readbyqxmd.com/read/28737983/advancing-patient-care-through-specialty-pharmacy-services-in-an-academic-health-system
#16
Autumn Bagwell, Tara Kelley, Alicia Carver, Jennifer B Lee, Brandon Newman
BACKGROUND: With the rapid growth of specialty pharmacies, including those within academic health systems, pharmacists have the opportunity to improve patient care through the management of specialty medications. Specialty pharmacists within academic health systems are uniquely positioned to overcome restrictions to medication access, financial constraints, and provider burdens that often lead to obstacles for patients to start and maintain necessary treatments. The Vanderbilt Specialty Pharmacy (VSP) model at Vanderbilt University Medical Center (VUMC) provides an example of a patient-centered, collaborative care prototype that places pharmacists directly into specialty clinics to assist with comprehensive management of patients on specialty medications...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737538/patient-centered-culturally-sensitive-maternity-care-begins-at-home
#17
Elisabeth D Howard
No abstract text is available yet for this article.
July 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28736251/patient-centered-approaches-to-creating-understandable-health-information
#18
REVIEW
Anobel Y Odisho, John L Gore
As care delivery shifts to further include patients in shared decision-making, patient-centered health information can balance the information asymmetry between patients and providers. Patient health literacy, numeracy, and graph literacy must match that of health information materials to create understandable health information that empowers patients to participate in shared decision-making. We consider an iterative approach focused on three key steps: assessment of the specific information needs of the selected patient community, assessment of that community's ability to receive and understand health information, and evaluation of the materials developed to assess effectiveness...
July 20, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/28735783/myocardial-viability-state-of-the-art-is-it-still-relevant-and-how-to-best-assess-it-with-imaging
#19
REVIEW
Hena Patel, Wojciech Mazur, Kim Allan Williams, Dinesh K Kalra
Despite major advances, ischemic cardiomyopathy (ICM) remains a significant cause of death and disability worldwide, with coronary artery disease (CAD) the leading cause of left ventricular (LV) systolic dysfunction. Coronary revascularization may improve LV function, heart failure symptoms and cardiovascular outcomes in high-risk patients with myocardial viability. Multiple imaging modalities have been utilized to detect viable myocardium and predict functional recovery following revascularization. Dobutamine stress echocardiography (DSE), nuclear imaging and cardiac MRI (CMR) are frequently used to assess viability...
July 10, 2017: Trends in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28734782/the-adapt-online-education-program-a-tool-for-practicing-pharmacists-delivering-patient-centered-care
#20
Leticia R Moczygemba, Andrea L Pierce, Aziza Dang, Philip Emberley, Michael J Czar, Gary R Matzke
OBJECTIVES: The ADapting pharmacists' skills and Approaches to maximize Patient's drug Therapy effectiveness (ADAPT) e-learning program was developed by a consortium of Canadian pharmacy educators and researchers to prepare practicing pharmacists for patient-centered care. We selected this education program to provide training for pharmacists as the workforce transformation component of a Center for Medicare and Medicaid Innovation project. In this report we share our experiences with this educational program...
July 19, 2017: Journal of the American Pharmacists Association: JAPhA
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