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Transition, quality, outcomes

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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
#1
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/28336768/care-of-girls-and-women-with-turner-syndrome-beyond-growth-and-hormones
#2
Caroline Culen, Diana-Allexandra Ertl, Katharina Schubert, Lisa Bartha-Doering, Gabriele Haeusler
Turner syndrome (TS), although considered a rare disease, is the most common sex chromosome abnormality in women, with an incident of 1 in 2,500 female births. TS is characterized by distinctive physical features such as short stature, ovarian dysgenesis, an increased risk for heart and renal defects as well as a specific cognitive and psychosocial phenotype. Given the complexity of the condition, patients face manifold difficulties which increase over the lifespan. Furthermore, failures during the transitional phase to adult care result in moderate health outcomes and decreased quality of life...
March 23, 2017: Endocrine Connections
https://www.readbyqxmd.com/read/28334566/improving-communication-with-primary-care-physicians-at-the-time-of-hospital-discharge
#3
Lauren A Destino, Amy Dixit, Julie L Pantaleoni, Matthew S Wood, Natalie M Pageler, Joe Kim, Terry S Platchek
BACKGROUND: Communication with primary care physicians (PCPs) at the time of a patient's hospital discharge is important to safely transition care to home. The goal of this quality improvement initiative was to increase discharge communication to PCPs at an academic children's hospital. METHODS: A multidisciplinary team at Lucile Packard Children's Hospital Stanford used Lean A3 problem solving methodology to address the problem of inadequate discharge communication with PCPs...
February 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28334559/design-and-hospitalwide-implementation-of-a-standardized-discharge-summary-in-an-electronic-health-record
#4
Shannon M Dean, Andrea Gilmore-Bykovskyi, Joel Buchanan, Brad Ehlenfeldt, Amy J H Kind
BACKGROUND: The hospital discharge summary is the primary method used to communicate a patient's plan of care to the next provider(s). Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to posthospital care, incomplete discharge summaries remain a common problem that may contribute to poor posthospital outcomes. Electronic health records (EHRs) are regularly used as a platform on which standardization of content and format can be implemented...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333708/cost-effectiveness-of-antihypertensive-medication-exploring-race-and-sex-differences-using-data-from-the-reasons-for-geographic-and-racial-differences-in-stroke-study
#5
Gabriel S Tajeu, Stephen Mennemeyer, Nir Menachemi, Robert Weech-Maldonado, Meredith Kilgore
BACKGROUND: Antihypertensive medication decreases risk of cardiovascular disease (CVD) events in adults with hypertension. Although black adults have higher prevalence of hypertension and worse CVD outcomes compared with whites, limited attention has been given to the cost-effectiveness of antihypertensive medication for blacks. OBJECTIVE: To compare the cost-effectiveness of antihypertensive medication treatment versus no-treatment in white and black adults. RESEARCH DESIGN: We constructed a State Transition Model to assess the costs and quality-adjusted life-years (QALYs) associated with either antihypertensive medication treatment or no-treatment using data from the REasons for Geographic and Racial Differences in Stroke (REGARDS) study and published literature...
March 22, 2017: Medical Care
https://www.readbyqxmd.com/read/28319978/patient-experience-the-new-heart-of-healthcare-leadership
#6
Jason A Wolf
In a healthcare world in which consumerism is no longer a question and value has claimed its place at center stage, leaders are called to think differently about how they operate and manage their organizations. Priorities are curving in new directions with shifts in policy, direction of dollars, and evolution of practice. At the center of this transition is an opportunity for healthcare leaders to recognize that patient experience is the new heart of healthcare leadership.To address quality, safety, service, cost, and population health outcomes, leaders must rethink how they understand and engage in experience efforts overall...
April 2017: Frontiers of Health Services Management
https://www.readbyqxmd.com/read/28318863/it-is-a-brave-new-world-alternative-payment-models-and-value-creation-in-total-joint-arthroplasty-creating-value-for-tjr-quality-and-cost-effectiveness-programs
#7
Kevin K Chen, Jonathan H Harty, Joseph A Bosco
BACKGROUND: The increasing cost of our country's healthcare is not sustainable. To address this crisis, the federal government is transiting healthcare reimbursement from the traditional volume-based system to a value-based system. As such, increasing healthcare value has become an essential point of discussion for all healthcare stakeholders. METHODS: The purpose of this study is to discuss the importance of healthcare value as a means to achieve this goal of value-based medicine and 3 methods to create value in total joint arthroplasty...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28314228/untreated-perinatal-paternal-depression-effects-on-offspring
#8
REVIEW
Salvatore Gentile, Maria Luigia Fusco
Transition to parenthood represents an important life event which increases vulnerability to psychological disorders. Aim of this article is to analyze all studies which investigated the effects of untreated perinatal paternal depression in offspring. We searched pertinent, peer-reviewed articles published in English (January 1980 to April 2016) on MEDLINE, PsycINFO, and Science.gov. Twenty-three studies met the inclusion criteria. Most of the reviewed studies suffer from methodological limitations, including the small sample, the lack of a structured psychiatric diagnosis, and inclusion bias...
March 2, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28288664/injured-bodies-damaged-lives-experiences-and-narratives-of-kenyan-women-with-obstetric-fistula-and-female-genital-mutilation-cutting
#9
Lillian Mwanri, Glory Joy Gatwiri
BACKGROUND: It is well acknowledged that Female Genital Mutilation/Cutting (FGM/C/C) leads to medical, psychological and sociocultural sequels. Over 200 million cases of FGM/C exist globally, and in Kenya alone, a total of 12,418,000 (28%) of women have undergone FGM/C, making the practice not only a significant national, but also a global health catastrophe. FGM/C is rooted in patriarchal and traditional cultures as a communal experience signifying a transition from girlhood to womanhood...
March 14, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28277861/state-transition-model-vorapaxar-added-to-standard-antiplatelet-therapy-to-prevent-thrombosis-post-myocardial-infarction-or-peripheral-artery-disease
#10
Mark Du, Monica Chase, Mustafa Oguz, Glenn Davies
OBJECTIVE: To evaluate long-term health benefits and risks of adding vorapaxar (VOR) to the standard care antiplatelet therapy (SC) of aspirin and/or clopidogrel, among a population with a recent myocardial infarction (MI) and/or peripheral artery disease (PAD). RESEARCH DESIGN AND METHODS: In a state-transition model, patients transition between health states (event-free, recurrent MI, stroke, death), while at risk of experiencing non-transition-related revascularization and non-fatal bleeding events...
March 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28277709/unique-contributions-of-dynamic-versus-global-measures-of-parent-child-interaction-quality-in-predicting-school-adjustment
#11
Sarah Bardack, Janette E Herbers, Jelena Obradović
This study investigates the unique contribution of microsocial and global measures of parent-child positive coregulation (PCR) in predicting children's behavioral and social adjustment in school. Using a community sample of 102 children, ages 4-6, and their parents, we conducted nested path analytic models to identify the unique effects of 2 measures of PCR on school outcomes. Microsocial PCR independently predicted fewer externalizing and inattention/impulsive behaviors in school. Global PCR did not uniquely relate to children's behavioral and social adjustment outcomes...
March 9, 2017: Journal of Family Psychology: JFP
https://www.readbyqxmd.com/read/28277408/hospital-standards-to-promote-optimal-surgical-care-of-the-older-adult-a-report-from-the-coalition-for-quality-in-geriatric-surgery
#12
Julia R Berian, Ronnie A Rosenthal, Tracey L Baker, JoAnn Coleman, Emily Finlayson, Mark R Katlic, Sandhya A Lagoo-Deenadayalan, Victoria L Tang, Thomas N Robinson, Clifford Y Ko, Marcia M Russell
OBJECTIVE: The aim of this study was to establish high-quality, valid standards to improve surgical care of the older adult. BACKGROUND: The aging population increases demand for high-quality surgical care. Building upon prior guidelines, quality indicators, and pilot projects, the Coalition for Quality in Geriatric Surgery (CQGS) includes 58 diverse stakeholder organizations committed to improving geriatric surgery. METHODS: Using a modified RAND-UCLA Appropriateness Methodology, 44 of 58 CQGS Stakeholders twice rated validity (primary outcome) and feasibility for 308 standards, ranging from goals and decision-making, pre-operative assessment and optimization, perioperative and postoperative care, to transitions of care beyond the acute care hospital...
March 8, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28277260/transitioning-a-bachelor-of-science-in-nursing-program-to-blended-learning-successes-challenges-outcomes
#13
Laurie Posey, Christine Pintz
To help address the challenges of providing undergraduate nursing education in an accelerated time frame, the Teaching and Transforming through Technology (T3) project was funded to transition a second-degree ABSN program to a blended learning format. The project has explored the use of blended learning to: enable flexible solutions to support teaching goals and address course challenges; provide students with new types of independent learning activities outside of the traditional classroom; increase opportunities for active learning in the classroom; and improve students' digital literacy and lifelong learning skills...
October 18, 2016: Nurse Education in Practice
https://www.readbyqxmd.com/read/28274941/supporting-insulin-initiation-in-type-2-diabetes-in-primary-care-results-of-the-stepping-up-pragmatic-cluster-randomised-controlled-clinical-trial
#14
John Furler, David O'Neal, Jane Speight, Jo-Anne Manski-Nankervis, Alexandra Gorelik, Elizabeth Holmes-Truscott, Louise Ginnivan, Doris Young, James Best, Elizabeth Patterson, Danny Liew, Leonie Segal, Carl May, Irene Blackberry
Objective To compare the effectiveness of a novel model of care ("Stepping Up") with usual primary care in normalising insulin initiation for type 2 diabetes, leading to improved glycated haemoglobin (HbA1c) levels.Design Cluster randomised controlled trial.Setting Primary care practices in Victoria, Australia, with a practice nurse and at least one consenting eligible patient (HbA1c ≥7.5% with maximal oral treatment).Participants 266 patients with type 2 diabetes and 74 practices (mean cluster size 4 (range 1-8) patients), followed up for 12 months...
March 8, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28273410/cost-effectiveness-analysis-of-ledipasvir-sofosbuvir-in-patients-with-chronic-hepatitis-c-treatment-of-patients-with-absence-or-mild-fibrosis-compared-to-patients-with-advanced-fibrosis
#15
M Buti, R Domínguez-Hernández, I Oyagüez, M A Casado, R Esteban
OBJECTIVE: To evaluate the cost-effectiveness of Ledipasvir/Sofosbuvir (LDV/SOF) in treatment-naïve patients with chronic hepatitis C (CHC) genotype 1 (GT1) in the absence or mild fibrosis (F0-F1) versus advanced fibrosis (F2-F4), from the perspective of the Spanish Health System. METHODS: A Markov model was developed to simulate disease progression, estimating costs and outcomes [life years gained, (LYG), and quality adjusted life years, (QALY)] derived from starting with LDV/SOF in patients with F0-F1 compared with F2-F4...
March 8, 2017: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/28271250/cost-effectiveness-of-vedolizumab-compared-with-infliximab-adalimumab-and-golimumab-in-patients-with-ulcerative-colitis-in-the-united-kingdom
#16
Michele R Wilson, Annika Bergman, Helene Chevrou-Severac, Ross Selby, Michael Smyth, Matthew C Kerrigan
OBJECTIVE: To examine the clinical and economic impact of vedolizumab compared with infliximab, adalimumab, and golimumab in the treatment of moderately to severely active ulcerative colitis (UC) in the United Kingdom (UK). METHODS: A decision analytic model in Microsoft Excel was used to compare vedolizumab with other biologic treatments (infliximab, adalimumab, and golimumab) for the treatment of biologic-naïve patients with UC in the UK. Efficacy data were obtained from a network meta-analysis using placebo as the common comparator...
March 8, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28265718/cost-effectiveness-analysis-of-once-yearly-injection-of-zoledronic-acid-for-the-treatment-of-osteoporosis-in-japan
#17
K Moriwaki, M Mouri, H Hagino
Model-based economic evaluation was performed to assess the cost-effectiveness of zoledronic acid. Although zoledronic acid was dominated by alendronate, the incremental quality-adjusted life year (QALY) was quite small in extent. Considering the advantage of once-yearly injection of zoledronic acid in persistence, zoledronic acid might be a cost-effective treatment option compared to once-weekly oral alendronate. INTRODUCTION: The purpose of this study was to estimate the cost-effectiveness of once-yearly injection of zoledronic acid for the treatment of osteoporosis in Japan...
March 6, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28262216/effects-of-prebiotics-and-synbiotics-on-functional-constipation
#18
REVIEW
Ting Yu, Yong-Ping Zheng, Jia-Cheng Tan, Wen-Jie Xiong, Yun Wang, Lin Lin
The objective was to determine the effects of prebiotics and synbiotics on adults with functional constipation (FC). Medline, Embase and the Cochrane Library were searched for literature published up to February 2015. We selected randomized controlled trials (RCTs) that reported administration of prebiotics or synbiotics to adults with FC. The end points included stool frequency, stool consistency and other symptoms related to constipation. Mean differences (MD) or standard mean differences (SMD) were used for continuous outcomes and risk ratios for discontinuous outcomes using a random-effects model...
March 2017: American Journal of the Medical Sciences
https://www.readbyqxmd.com/read/28259853/effectiveness-of-a-cough-management-algorithm-at-the-transitional-phase-from-acute-to-chronic-cough-in-australian-children-aged-15%C3%A2-years-protocol-for-a-randomised-controlled-trial
#19
Kerry-Ann F O'Grady, Keith Grimwood, Maree Toombs, Theo P Sloots, Michael Otim, David Whiley, Jennie Anderson, Sheree Rablin, Paul J Torzillo, Helen Buntain, Anne Connor, Don Adsett, Oon Meng Kar, Anne B Chang
INTRODUCTION: Acute respiratory infections (ARIs) are leading causes of hospitalisation in Australian children and, if recurrent, are associated with increased risk of chronic pulmonary disorders later in life. Chronic (>4 weeks) cough in children following ARI is associated with decreased quality-of-life scores and increased health and societal economic costs. We will determine whether a validated evidence-based cough algorithm, initiated when chronic cough is first diagnosed after presentation with ARI, improves clinical outcomes in children compared with usual care...
March 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/28257591/treatment-of-patients-waitlisted-for-liver-transplant-with-an-all-oral-daas-is-a-cost-effective-treatment-strategy-in-the-united-states
#20
Aijaz Ahmed, Stevan A Gonzalez, George Cholankeril, Ryan B Perumpail, Justin McGinnis, Sammy Saab, Rachel Beckerman, Zobair M Younossi
BACKGROUND AND OBJECTIVE: All-oral direct acting antivirals (DAAs) have been shown to have high safety and efficacy in treating patients with Hepatitis C (HCV) awaiting liver transplant (LT). However, there is limited empirical evidence comparing the health and economic outcomes associated with treating patients pre- vs. post-LT. The objective of this study was to analyze the cost-effectiveness of pre- vs. post-LT treatment with an all-oral DAA regimen among HCV patients with HCC (hepatocellular carcinoma) or DCC (decompensated cirrhosis)...
March 3, 2017: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
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