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https://www.readbyqxmd.com/read/28738327/updated-concepts-on-treatment-outcomes-for-obstructive-sleep-apnea
#1
Victor Certal, Robson Capasso
Obstructive sleep apnea is a highly prevalent and poorly understood condition that not only leads to significant individual patient health damage, but carries a large societal cost secondary to excessive healthcare utilization, motor-vehicle accidents, and work absenteeism. While a significant fund of knowledge about its damaging effects on the cardiovascular system and neural pathways has been gathered over the past few decades, the translation to direct patient care still presents numerous challenges. With the exception of clear issues such as socially unacceptable snoring and breathing irregularities, the exact cause and effect relationship between airway narrowing, hypoxemia, and sleep fragmentation with subjective sleep-related complaints and neurocognitive symptoms is less clear...
2017: Advances in Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28737993/the-effect-of-formulary-restrictions-on-patient-and-payer-outcomes-a-systematic-literature-review
#2
Yujin Park, Syed Raza, Aneesh George, Rumjhum Agrawal, John Ko
BACKGROUND: Formulary restrictions are implemented to reduce pharmacy costs and ensure appropriate use of pharmaceutical products. As adoption of formulary restrictions increases with rising pharmacy costs, there is a need to better understand the potential effect of formulary restrictions on patient and payer outcomes. OBJECTIVE: To conduct a systematic literature review that assesses the effect of formulary restrictions on the following outcomes: medication adherence, clinical outcomes, treatment satisfaction, drug utilization, health care resource utilization, and economic outcomes...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737989/incremental-effect-of-the-addition-of-prescriber-restrictions-on-a-state-medicaid-s-pharmacy-only-patient-review-and-restriction-program
#3
Shellie L Keast, Timothy Pham, Ashley Teel, Nancy J Nesser
BACKGROUND: Patient review and restriction programs (PRRPs), used by state Medicaid programs to limit potential abuse and misuse of opioids and related controlled medications, often restrict members to a single pharmacy for controlled medications. While most states use a restricted pharmacy access model, not all states include restricted prescriber access. Oklahoma Medicaid (MOK) added a restricted prescriber access feature to its PRRP in July 2014. OBJECTIVE: To evaluate the incremental effect that the addition of a prescriber restriction to MOK's pharmacy-only PRRP had on the pharmacy and resource utilization of the enrolled members...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737986/real-world-adherence-and-persistence-to-oral-disease-modifying-therapies-in-multiple-sclerosis-patients-over-1-year
#4
Kristen M Johnson, Huanxue Zhou, Feng Lin, John J Ko, Vivian Herrera
BACKGROUND: Disease-modifying therapies (DMTs) are indicated to reduce relapse rates and slow disease progression for relapsing-remitting multiple sclerosis (MS) patients when taken as prescribed. Nonadherence or non-persistence in the real-world setting can lead to greater risk for negative clinical outcomes. Although previous research has demonstrated greater adherence and persistence to oral DMTs compared with injectable DMTs, comparisons among oral DMTs are lacking. OBJECTIVE: To compare adherence, persistence, and time to discontinuation among MS patients newly prescribed the oral DMTs fingolimod, dimethyl fumarate, or teriflunomide...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737985/evaluation-of-patient-migration-patterns-and-related-health-care-costs-within-a-national-medicare-advantage-prescription-drug-plan-after-implementation-of-an-oxycodone-hcl-extended-release-access-restriction
#5
Chi-Chang Chen, Ajita P De, Brian Sweet, Rolin L Wade
BACKGROUND: Health plans use formulary restrictions (e.g., prior authorization, step therapy, tier change, nonformulary status) in an effort to control cost and promote quality, safety, and appropriate prescription utilization. Some Medicare payers perceive that the inclusion of certain agents, such as branded oxycodone HCl extended-release tablets (OERs), on their formularies is associated with attracting high-cost members to the plan. OBJECTIVE: To evaluate disenrollment rates, patient migration, and subsequent health care costs among OER users who disenrolled from a national Medicare Advantage Prescription Drug plan (study-MAPD) in the plan year following OER nonformulary restriction...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737647/risk-factors-for-30-day-hospital-readmission-for-diverticular-hemorrhage
#6
Jonah N Rubin, Daniel Shoag, John N Gaetano, Dejan Micic, Neil Sengupta
INTRODUCTION: The 2010 Affordable Care Act introduced the Hospital Readmissions Reduction Program to reduce health care utilization. Diverticular disease and its complications remain a leading cause of hospitalization among gastrointestinal disease. We sought to determine risk factors for 30-day hospital readmissions after hospitalization for diverticular bleeding. MATERIALS AND METHODS: We utilized the 2013 National Readmission Database sponsored by the Agency for Healthcare Research and Quality focusing on hospitalizations with the primary or secondary discharge diagnosis of diverticular hemorrhage or diverticulitis with hemorrhage...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28737638/a-bone-health-intervention-for-chinese-immigrants-in-santa-clara-county
#7
Joanne Zou, Michelle DeCoux Hampton, Kate Shade, Leonard Kaku
BACKGROUND: Among Chinese immigrants, osteoporosis is undertreated, misdiagnosed, and a leading cause of fragility fractures. In orthopaedic surgery departments, prevention education and health behavior change programs are necessary to improve their bone health. PURPOSE: The purpose of this study was to examine the effectiveness of an osteoporosis prevention education program on participants' self-efficacy with regard to exercise and nutrition when provided by an orthopaedic surgery team during an annual Chinese Health Fair in Santa Clara County, CA...
July 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28737544/utilization-of-large-data-sets-in-maternal-health-in-finland-a-case-for-global-health-research
#8
Reeta Lamminpää, Mika Gissler, Katri Vehviläinen-Julkunen
In recent years, the use of large data sets, such as electronic health records, has increased. These large data sets are often referred to as "Big Data," which have various definitions. The purpose of this article was to summarize and review the utilization, strengths, and challenges of register data, which means a written record containing regular entries of items or details, and Big Data, especially in maternal nursing, using 4 examples of studies from the Finnish Medical Birth Register data and relate these to other international databases and data sets...
July 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28737101/intervention-to-prevent-falls-community-based-clinics
#9
Dorothy I Baker, Linda Leo-Summers, Terrence E Murphy, Barbara Katz, Beth A Capobianco
PURPOSE: The purpose of this study was to document results of State funded fall prevention clinics on rates of self-reported falls and fall-related use of health services. METHODS: Older adults participated in community-based fall prevention clinics providing individual assessments, interventions, and referrals to collaborating community providers. A pre-post design compares self-reported 6-month fall history and fall-related use of health care before and after clinic attendance...
July 1, 2017: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28736796/longitudinal-research-on-aging-drivers-longroad-study-design-and-methods
#10
Guohua Li, David W Eby, Robert Santos, Thelma J Mielenz, Lisa J Molnar, David Strogatz, Marian E Betz, Carolyn DiGuiseppi, Lindsay H Ryan, Vanya Jones, Samantha I Pitts, Linda L Hill, Charles J DiMaggio, David LeBlanc, Howard F Andrews
BACKGROUND: As an important indicator of mobility, driving confers a host of social and health benefits to older adults. Despite the importance of safe mobility as the population ages, longitudinal data are lacking about the natural history and determinants of driving safety in older adults. METHODS: The Longitudinal Research on Aging Drivers (LongROAD) project is a multisite prospective cohort study designed to generate empirical data for understanding the role of medical, behavioral, environmental and technological factors in driving safety during the process of aging...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28736588/the-regulation-of-the-practice-of-acupuncture-by-physicians-in-the-united-states
#11
Katerina Lin, Cynthia Tung
Introduction: The landscape of acupuncture regulation has greatly evolved since the National Institutes of Health Consensus Statement in 1997. In recent decades, acupuncture treatment has become increasingly integrated with conventional medical care. Healthcare practitioners often utilize acupuncture as an adjunctive therapy to help alleviate symptoms of many conditions, such as nausea and pain. The popularity of this complementary and alternative modality has elevated the importance and urgency for states to regulate its practice and safety...
June 1, 2017: Medical Acupuncture
https://www.readbyqxmd.com/read/28735781/the-future-of-fracture-risk-assessment-in-the-management-of-osteoporosis
#12
Sanford Baim
There have been many advances in the field of osteoporosis that add to a greater understanding of skeletal integrity and the adverse effects menopause and aging have on bone. The World Health Organization, the International Osteoporosis Foundation, and numerous additional governmental and privately sponsored organizations, societies, and their respective task forces have provided guidance for the use of appropriate fracture assessment methodologies and fracture risk assessment tools, and for the prevention and management of osteoporosis...
July 20, 2017: Journal of Clinical Densitometry
https://www.readbyqxmd.com/read/28735567/policy-research-challenges-in-comparing-care-models-for-dual-eligible-beneficiaries
#13
Janet H Van Cleave, Brian L Egleston, Sarah Brosch, Elizabeth Wirth, Molly Lawson, Eileen M Sullivan-Marx, Mary D Naylor
Providing affordable, high-quality care for the 10 million persons who are dual-eligible beneficiaries of Medicare and Medicaid is an ongoing health-care policy challenge in the United States. However, the workforce and the care provided to dual-eligible beneficiaries are understudied. The purpose of this article is to provide a narrative of the challenges and lessons learned from an exploratory study in the use of clinical and administrative data to compare the workforce of two care models that deliver home- and community-based services to dual-eligible beneficiaries...
January 1, 2017: Policy, Politics & Nursing Practice
https://www.readbyqxmd.com/read/28735551/quality-of-pharmacist-managed-anticoagulation-therapy-in-long-term-ambulatory-settings-a-systematic-review
#14
Beenish S Manzoor, Wei-Han Cheng, James C Lee, Ellen M Uppuluri, Edith A Nutescu
OBJECTIVE: To perform a systematic review to evaluate the quality of warfarin anticoagulation control in outpatient pharmacist-managed anticoagulation services (PMAS) compared with routine medical care (RMC). DATA SOURCES: MEDLINE, SCOPUS, EMBASE, IPA, CINAHL, and Cochrane CENTRAL, from inception to May 2017. Search terms employed: ("pharmacist-managed" OR "pharmacist-provided" OR "pharmacist-led" OR "pharmacist-directed") AND ("anticoagulation services" OR "anticoagulation clinic" OR "anticoagulation management" OR "anticoagulant care") AND ("quality of care" OR "outcomes" OR "bleeding" OR "thromboembolism" OR "mortality" OR "hospitalization" OR "length of stay" OR "emergency department visit" OR "cost" OR "patient satisfaction")...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28734748/effects-of-arginine-based-immunonutrition-on-inpatient-total-costs-and-hospitalization-outcomes-for-patients-undergoing-colorectal-surgery
#15
Souvik Banerjee, Louis P Garrison, Aurelie Danel, Juan B Ochoa Gautier, David R Flum
OBJECTIVE: The aim of this study was to assess the effects of an arginine-based immunonutrition intervention for patients undergoing elective colorectal surgery on postsurgical utilization and cost outcomes. METHODS: This analysis was based on data from two Washington State databases: Surgical Care and Outcomes Assessment Program (SCOAP) linked to the Comprehensive Hospital Abstract Reporting System (CHARS). The sample (N=722) comprises adult patients who underwent elective colorectal surgery with anastomosis in a Washington State hospital that participated in the Strong for Surgery (S4S) initiative between January 1, 2012, and December 31, 2013...
June 24, 2017: Nutrition
https://www.readbyqxmd.com/read/28733718/antimicrobial-resistance-in-the-next-30%C3%A2-years-humankind-bugs-and-drugs-a-visionary-approach
#16
REVIEW
Matteo Bassetti, Garyphallia Poulakou, Etienne Ruppe, Emilio Bouza, Sebastian J Van Hal, Adrian Brink
PURPOSE: To describe the current standards of care and major recent advances with regard to antimicrobial resistance (AMR) and to give a prospective overview for the next 30 years in this field. METHODS: Review of medical literature and expert opinion were used in the development of this review. RESULTS: There is undoubtedly a large clinical and public health burden associated with AMR in ICU, but it is challenging to quantify the associated excess morbidity and mortality...
July 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28733434/added-value-of-patient-reported-outcome-measures-in-stroke-clinical-practice
#17
Irene L Katzan, Nicolas R Thompson, Brittany Lapin, Ken Uchino
BACKGROUND: There is uncertainty regarding the clinical utility of the data obtained from patient-reported outcome measures (PROMs) for patient care. We evaluated the incremental information obtained by PROMs compared to the clinician-reported modified Rankin Scale (mRS). METHODS AND RESULTS: This was an observational study of 3283 ischemic stroke patients seen in a cerebrovascular clinic from September 14, 2012 to June 16, 2015 who completed the routinely collected PROMs: Stroke Impact Scale-16 (SIS-16), EQ-5D, Patient Health Questionnaire-9, PROMIS Physical Function, and PROMIS fatigue...
July 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28733182/the-association-of-depressive-symptoms-with-rates-of-acute-exacerbations-in-patients-with-copd-results-from-a-3-year-longitudinal-follow-up-of-the-eclipse-cohort
#18
Abebaw Mengistu Yohannes, Hana Mülerová, Kim Lavoie, Jorgen Vestbo, Steve I Rennard, Emile Wouters, Nicola A Hanania
BACKGROUND: Depression increases disability and health care utilization in older patients with chronic obstructive pulmonary disease (COPD). OBJECTIVES: To determine contribution of depressive symptoms to the incidence of moderate-severe and severe acute exacerbations of COPD (AECOPD) over 3 years. DESIGN: We analyzed data collected from a prospective cohort of patients with COPD (Evaluation of COPD Longitudinally to Identify Predictive Surrogate Endpoints; ECLIPSE)...
July 18, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28733155/implementation-of-a-health-information-exchange-into-community-pharmacy-workflow
#19
Kenneth C Hohmeier, Christina A Spivey, Samantha Boldin, Tara B Moore, Marie Chisholm-Burns
OBJECTIVES: To explore the feasibility and report preliminary outcomes of the integration of a health information exchange (HIE) into community pharmacy workflow clinical service delivery. SETTING: Independent pharmacy in eastern Tennessee. PRACTICE DESCRIPTION: The pharmacy offers medication reconciliation services via HIE access, as well as other clinical pharmacy services. The average number of prescriptions filled weekly is 1900, and staffing included 3...
July 18, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28732718/longitudinal-latent-cognitive-profiles-and-psychosocial-well-being-in-early-adolescence
#20
Afshin Zilanawala, Amanda Sacker, Yvonne Kelly
PURPOSE: Engaging in exploratory risky behaviors and experiencing poor mental health during early adolescence are important markers for poor health during adulthood. Prior research suggests protective effects from cognition, but less is known about the associations between early childhood cognition and early adolescent psychosocial well-being, as identified by self-esteem, mental health, and exploratory risky behaviors. This article investigates the extent that early adolescent psychosocial well-being at the age of 11 years is associated with patterns of cognitive skills measured across the first decade of a child's life...
July 18, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
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