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https://www.readbyqxmd.com/read/29793213/end-stage-renal-disease-models-in-the-americas-optimizing-resources-to-achieve-better-health-outcomes
#1
Ramiro E Gilardino, Eduardo González-Pier, Claudia Brabata
End-stage renal disease, the last and most severe stage of chronic kidney disease, represents a major and rising concern for countries in Latin America, driven in large part by aging populations and the near-epidemic rises in diabetes, obesity, and hypertension. This places a great clinical, economic, and social burden on the region's health systems. During the ISPOR 6th Latin America Conference held in Sao Paulo, Brazil, in September 2017, an educational forum debated on value-based decision making in the treatment of end-stage renal disease in Latin America...
May 21, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29792735/hip-fracture-in-the-setting-of-limited-life-expectancy-the-importance-of-considering-goals-of-care-and-prognosis
#2
C Bree Johnston, Amanda Holleran, Thuan Ong, Ursula McVeigh, Elizabeth Ames
IMPORTANCE: Many older patients with a limited life expectancy experience fragility fracture of the hip, and this event is associated with increased risk of premature mortality, functional decline, and institutionalization. The treating team, in collaboration with patients and their families, must determine whether a surgical or conservative approach is in the patient's best interest when a patient has limited life expectancy. OBSERVATION: Goals of care discussions appear to be rare in the setting of fragility fracture...
May 24, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29792460/the-complexity-diversity-and-science-of-primary-care-teams
#3
Kevin Fiscella, Susan H McDaniel
This article examines the past, present and future of primary care and teamwork. It begins with a definition and description of primary care-its uniqueness, diversity and complexity, including the historical role of teams within primary care. The article then reviews the emergence of innovative primary care teams, including those grounded in new processes such as the Patient-Centered Medical Home and interprofessional teams that include new types of health professionals, particularly psychologists and other integrated behavioral health clinicians...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792063/integrating-childhood-obesity-resources-into-the-patient-centered-medical-home-provider-perspectives-in-the-united-states
#4
Samareh G Hill, Thao-Ly T Phan, George A Datto, Jobayer Hossain, Lloyd N Werk, Diane Abatemarco
Pediatric primary care providers play a critical role in managing obesity yet often lack the resources and support systems to provide effective care to children with obesity. The objective of this study was to identify system-level barriers to managing obesity and resources desired to better managing obesity from the perspective of pediatric primary care providers. A 64-item survey was electronically administered to 159 primary care providers from 26 practices within a large pediatric primary care network. Bivariate analyses were performed to compare survey responses based on provider and practice characteristics...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29791243/amcp-partnership-forum-managing-care-in-the-wave-of-precision-medicine
#5
(no author information available yet)
Precision medicine, the customization of health care to an individual's genetic profile while accounting for biomarkers and lifestyle, has increasingly been adopted by health care stakeholders to guide the development of treatment options, improve treatment decision making, provide more patient-centered care, and better inform coverage and reimbursement decisions. Despite these benefits, key challenges prevent its broader use and adoption. On December 7-8, 2017, the Academy of Managed Care Pharmacy convened a group of stakeholders to discuss these challenges and provide recommendations to facilitate broader adoption and use of precision medicine across health care settings...
May 23, 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29790905/the-hard-road-to-patient-centered-care-3-or-6-months-of-adjuvant-chemotherapy-for-patients-with-stage-iii-colon-cancer
#6
P Trensz, L Calvel, J E Kurtz
No abstract text is available yet for this article.
May 22, 2018: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/29790864/implementing-comprehensive-primary-care-referral-tracking-in-a-patient-centered-medical-home
#7
Jenny Spahr, Jennifer Coddington, Nancy Edwards, Sara McComb
The Patient-Centered Medical Home care model emphasizes efficient, coordinated care distributed among interdisciplinary team members. One key function to care coordination is referral/test tracking. This study evaluated the referral practices in a nurse-managed Patient-Centered Medical Home primary care clinic. The major findings corroborate the need for a well-organized referral-tracking system that is centralized and contains safety nets to reduce the number of delayed or missed referrals.
July 2018: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29789318/impact-of-a-pharmacist-physician-collaborative-care-model-on-patient-outcomes-and-health-services-utilization
#8
Gary R Matzke, Leticia R Moczygemba, Karen J Williams, Michael J Czar, William T Lee
PURPOSE: The impact of a pharmacist-physician collaborative care model on patient outcomes and health services utilization is described. METHODS: Six hospitals from the Carilion Clinic health system in southwest Virginia, along with 22 patient-centered medical home (PCMH) practices affiliated with Carilion Clinic, participated in this project. Eligibility criteria included documented diagnosis of 2 or more of the 7 targeted chronic conditions (congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and depression), prescriptions for 4 or more medications, and having a primary care physician in the Carilion Clinic health system...
May 22, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29789045/getting-paid-for-clinical-services
#9
Caren McHenry Martin
Increasingly, pharmacists are providing advanced, patient-centered clinical services. However, pharmacists are not currently included in key sections of the Social Security Act, which determines eligibility to bill and be reimbursed by Medicare. Many state and private health plans also cite the omission from Medicare as the rationale for excluding reimbursement of pharmacists for clinical services. This has prompted forward-thinking pharmacists to seek opportunities for reimbursement in other ways, allowing them to provide value to the health care system, while carving out unique niches for pharmacists to care for patients...
May 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29788309/rethinking-the-outpatient-medication-list-increasing-patient-activation-and-education-while-architecting-for-centralization-and-improved-medication-reconciliation
#10
Frank Pandolfe, Adam Wright, Warner V Slack, Charles Safran
Objective: Identify barriers impacting the time consuming and error fraught process of medication reconciliation. Design and implement an electronic medication management system where patient and trusted healthcare proxies can participate in establishing and maintaining an inclusive and up-to-date list of medications. Methods: A patient-facing electronic medication manager was deployed within an existing research project focused on elder care management funded by the AHRQ, InfoSAGE, allowing patients and patients' proxies the ability to build and maintain an accurate and up-to-date medication list...
May 17, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29787549/long-term-patient-centered-outcomes-of-lower-extremity-vascular-trauma
#11
Zane B Perkins, Barbaros Yet, Simon Glasgow, William Marsh, Nigel R M Tai, Todd E Rasmussen
OBJECTIVE: To describe the long-term outcomes of military lower extremity vascular injuries, and the decision-making of surgeons treating these injuries. BACKGROUND: Lower extremity vascular trauma is an important cause of preventable death and severe disability, and decisions on amputation or limb salvage can be difficult. Additionally, the complexity of the condition is not amenable to controlled study, and there is limited data to guide clinical decision-making and establish sensible treatment expectations during rehabilitation...
May 4, 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29785681/diabetes-symptoms-predictors-of-health-related-quality-of-life-in-adolescents-and-young-adults-with-type-1-or-type-2-diabetes
#12
James W Varni, Alan M Delamater, Korey K Hood, Jennifer K Raymond, Kimberly A Driscoll, Jenise C Wong, Saleh Adi, Joyce P Yi-Frazier, Ellen K Grishman, Melissa A Faith, Sarah D Corathers, Jessica C Kichler, Jennifer L Miller, Elena M Doskey, Vincent P Aguirre, Robert W Heffer, Don P Wilson
OBJECTIVES: The objective was to investigate the patient-reported diabetes symptoms predictors of generic health-related quality of life (HRQOL) in adolescents and young adults (AYA) with type 1 or type 2 diabetes. METHODS: The 15-item PedsQL™ 3.2 Diabetes Module Diabetes Symptoms Summary Score and PedsQL™ 4.0 Generic Core Scales were completed in a 10-site national field test study by 513 AYA ages 13-25 years with type 1 (n = 424) or type 2 (n = 89) diabetes...
May 21, 2018: Quality of Life Research
https://www.readbyqxmd.com/read/29784628/why-physics-in-medicine
#13
Ehsan Samei, Thomas M Grist
Despite its crucial role in the development of new medical imaging technologies, in clinical practice, physics has primarily been involved in the technical evaluation of technologies. However, this narrow role is no longer adequate. New trajectories in medicine call for a stronger role for physics in the clinic. The movement toward evidence-based, quantitative, and value-based medicine requires physicists to play a more integral role in delivering innovative precision care through the intentional clinical application of physical sciences...
May 18, 2018: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/29782601/patient-centered-medical-home-status-and-preparedness-to-assess-resident-milestones-a-cera-study
#14
Thad Wilkins, Wonsuk Yoo, Ralph A Gillies, Julie Dahl-Smith, Jacqueline Dubose, Joseph Hobbs, Selina Smith, Dean A Seehusen
Purpose: The patient-centered medical home (PCMH) model has been proposed as the ideal model for delivering primary care and is focused on improving patient safety and quality, reducing costs, and enhancing patient satisfaction. The mandated Accreditation Council for Graduate Medical Education educational milestones for evaluation of resident competency represent the skills graduates will utilize after graduation. Many of these skills are reflected in the PCMH model. We sought to determine if residency programs whose main family medicine (FM) practice sites have achieved PCMH recognition are therefore more prepared to evaluate milestones...
May 2018: PRiMER: peer-review reports in medical education research
https://www.readbyqxmd.com/read/29782404/evaluating-patient-centered-outcomes-in-clinical-trials-of-procedural-sedation-part-2-safety-sedation-consortium-on-endpoints-and-procedures-for-treatment-education-and-research-recommendations
#15
Denham S Ward, Mark R Williams, John W Berkenbosch, Maala Bhatt, Douglas Carlson, Phillip Chappell, Randall M Clark, Isabelle Constant, Aaron Conway, Joseph Cravero, Albert Dahan, Franklin Dexter, Raymond Dionne, Robert H Dworkin, Tong J Gan, David Gozal, Steven Green, Michael G Irwin, Suzanne Karan, Michael Kochman, Jerrold Lerman, Jenifer R Lightdale, Ronald S Litman, Keira P Mason, James Miner, Robert E O'Connor, Pratik Pandharipande, Richard R Riker, Mark G Roback, Daniel I Sessler, Anne Sexton, Joseph R Tobin, Dennis C Turk, Rebecca S Twersky, Richard D Urman, Mark Weiss, Hannah Wunsch, Anna Zhao-Wong
The Sedation Consortium on Endpoints and Procedures for Treatment, Education, and Research, established by the Analgesic, Anesthetic, and Addiction Clinical Trial Translations, Innovations, Opportunities, and Networks, a public-private partnership with the US Food and Drug Administration, convened a second meeting of sedation experts from a variety of clinical specialties and research backgrounds to develop recommendations for procedural sedation research. The previous meeting addressed efficacy and patient- and/or family-centered outcomes...
May 17, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29781980/disclosure-coaching-an-ask-tell-ask-model-to-support-clinicians-in-disclosure-conversations
#16
Jo Shapiro, Lynne Robins, Pamela Galowitz, Thomas H Gallagher, Sigall Bell
Error disclosure is a high-stakes, emotionally charged interaction for patients and families as well as clinicians. A failed disclosure can result in emotional distress, reduced patient and family trust, litigation, and lost opportunities to learn from and prevent subsequent errors. However, many clinicians have little expertise in handling these challenging interactions and can inadvertently make a bad situation worse. Even those clinicians who have had formal disclosure training may have trouble remembering what they were taught when faced with the need to actually discuss an error with patients...
May 16, 2018: Journal of Patient Safety
https://www.readbyqxmd.com/read/29781722/survey-of-north-american-multidisciplinary-cleft-palate-and-craniofacial-team-clinic-administration
#17
Kristin D Pfeifauf, Kamlesh B Patel, Alison Snyder-Warwick, Gary B Skolnick, Sibyl Scheve, Sybill D Naidoo
OBJECTIVE: This study aims to provide an understanding of the ways cleft palate (CP) and craniofacial teams address billing, administration, communication of clinical recommendations, appointment scheduling, and diagnosis-specific protocols. DESIGN: An online clinic administration survey was developed using data from an open-ended telephone questionnaire. The online survey was distributed by e-mail to the American Cleft Palate-Craniofacial Association (ACPA) nurse coordinator electronic mailing list, used regularly by the ACPA and its members to communicate with teams...
January 1, 2018: Cleft Palate-craniofacial Journal
https://www.readbyqxmd.com/read/29779198/redeveloping-substance-abuse-treatment-for-military-personnel
#18
REVIEW
Christian Schrader, Antoinette Lenton, Peter Gertonson, Alexander Rahimi
PURPOSE OF REVIEW: We review the prevailing evidence surrounding treatment of substance use disorder (SUD), with specific focus on alcohol, tobacco, and prescription opiates, and how it informs guidelines for treating active duty military. We survey the evidence regarding preventive screening, treatment, and relapse prevention in substance misuse as it pertains to patient-centered care of the service member. RECENT FINDINGS: Holistic, patient-centered care with an emphasis on identifying maladaptive use or dependence prior to progression to chronic disease is now recognized as the evidenced approach to treating substance use disorders...
May 19, 2018: Current Psychiatry Reports
https://www.readbyqxmd.com/read/29779180/the-impact-of-an-adolescent-depressive-disorders-clinical-pathway-on-healthcare-utilization
#19
Brooke Lifland, Davene R Wright, Rita Mangione-Smith, Arti D Desai
Clinical pathways are known to improve the value of health care in medical and surgical settings but have been rarely studied in the psychiatric setting. This study examined the association between level of adherence to an adolescent depressive disorders inpatient clinical pathway and length of stay (LOS), cost, and readmissions. Patients in the high adherence category had significantly longer LOS and higher costs compared to the low adherence category. There was no difference in the odds of 30-day emergency department return visits or readmissions...
May 19, 2018: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/29778506/quality-of-life-symptoms-and-care-needs-in-patients-with-persistent-or-recurrent-platinum-resistant-ovarian-cancer-an-nrg-oncology-gynecologic-oncology-group-study
#20
Vivian E von Gruenigen, Helen Q Huang, David Cella, MichaelA Zevon, Jason A LaChance, Joan L Walker, Ritu Salani, Susan C Modesitt, Robert T Morris, William H Bradley, Matthew P Boente, Lari Wenzel
OBJECTIVES: The goals of treating recurrent platinum-resistant ovarian cancer are palliative, aimed at reducing symptoms and improving progression free survival. A prospective trial was conducted to determine the prevalence and severity of symptoms, and associated care needs. METHODS: Eligible women included those with persistent or recurrent platinum-resistant ovarian cancer with an estimated life expectancy of at least 6 months. The Needs at the End-of-Life Screening Tool (NEST), FACIT-Fatigue (FACIT-F), NCCN-FACT Ovarian Symptom Index [NFOSI-18]; Disease Related Symptoms (DRS), Treatment Side Effects (TSE), and Function/Well Being (F/WB) were collected at study entry, 3 and 6 months...
May 17, 2018: Gynecologic Oncology
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