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https://www.readbyqxmd.com/read/29920972/physical-activity-intervention-in-primary-care-and-rheumatology-for-the-management-of-knee-osteoarthritis-a-review
#1
Esther Waugh, Lauren King, Natasha Gakhal, Gillian Hawker, Fiona Webster, Daniel White
Physical activity (PA) is recommended by osteoarthritis (OA) international organizations as an essential component of first-line management of knee OA. Primary care physicians (PCP) and rheumatologists can play a key role in promoting PA but the extent that PA recommendation is occurring in primary and rheumatology care is unclear. This review provides an overview of current practice of PCP- and rheumatology-delivered PA intervention in the United States, Canada and Europe for the management of knee OA and explores barriers to implementing PA intervention in primary and rheumatology care...
June 19, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29917118/considering-systemic-barriers-to-treating-tobacco-use-in-clinical-settings-in-the-united-states
#2
Alana M Rojewski, Steffani R Bailey, Steven L Bernstein, Nina A Cooperman, Ellen R Gritz, Maher A Karam-Hage, Megan E Piper, Nancy A Rigotti, Graham W Warren
The Comorbidity Workgroup of the Tobacco Treatment Research Network, within the Society for Research on Nicotine and Tobacco, previously highlighted the need to provide tobacco treatment to patients diagnosed with comorbid physical and mental health conditions. Yet, systemic barriers in the United States healthcare system prevent many patients who present for medical treatment from getting the evidence-based tobacco treatment that they need. The identified barriers include insufficient training in the epidemiologic impact of tobacco use, related disorders, and pharmacological and behavioral treatment approaches; misunderstanding among clinicians about the effectiveness of tobacco treatment; lack of therapeutic support from clinical staff; insufficient use of health information technology to improve tobacco use identification and treatment; and limited time and reimbursement for clinicians to provide treatment...
June 15, 2018: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/29917002/available-oral-lipid-lowering-agents-could-bring-most-high-risk-patients-to-target-an-estimate-based-on-the-dyslipidemia-international-study-ii-italy
#3
Gaetano M De Ferrari, Gian P Perna, Antonino Nicosia, Luigina Guasti, Gavino Casu, Claudio Cuccia, Francesca Picco, Caterina Strazzella, Rossana Totaro, Stefania Cercone, Laura Canullo, Martin Horack, Dominik Lautsch, Anselm K Gitt, Matteo Di Biase
AIMS: The analysis evaluated the contemporary percentage of patients with established coronary heart disease (CHD) reaching the European guidelines recommended LDL-cholesterol (LDL-C) levels of less than 70 mg/dl and the threshold required for proprotein convertase subtlisin/kexin type 9 reimbursement in Italy (100 mg/dl). It also assessed how these percentages would change in case of diffuse use of ezetimibe. METHODS: The Dyslipidemia International Study II enrolled CHD patients aged at least 18 either on lipid-lowering therapy (LLT) for at least 3 months or not on LLT at the time of the lipid profile...
June 18, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29915932/cost-effectiveness-of-long-term-incobotulinumtoxin-a-treatment-in-the-management-of-post-stroke-spasticity-of-the-upper-limb-from-the-australian-payer-perspective
#4
Koji Makino, Dominic Tilden, Carmel Guarnieri, Mia Mudge, Ian J Baguley
BACKGROUND: In Australia, the reimbursement of botulinum neurotoxin-A (BoNT-A) on the Pharmaceutical Benefits Scheme for the treatment of moderate to severe spasticity of the upper limb following a stroke (PSS-UL) is restricted to four treatment cycles per upper limb per lifetime. This analysis examined the cost effectiveness of extending the treatment beyond four treatments among patients with an adequate response to previous treatment cycles. METHODS: A Markov state transition model was developed to perform a cost-utility analysis of extending the use of incobotulinumtoxin-A beyond the current restriction of four treatment cycles among patients who have shown a successful response in previous treatment cycles ('known responders')...
June 18, 2018: PharmacoEconomics Open
https://www.readbyqxmd.com/read/29915640/standardized-review-and-approval-process-for-high-cost-medication-use-promotes-value-based-care-in-a-large-academic-medical-system
#5
REVIEW
Raghu Durvasula, Janet Kelly, Anneliese Schleyer, Bradley D Anawalt, Shabir Somani, Timothy H Dellit
Background: As healthcare costs rise and reimbursements decrease, healthcare organization leadership and clinical providers must collaborate to provide high-value healthcare. Medications are a key driver of the increasing cost of healthcare, largely as a result of the proliferation of expensive specialty drugs, including biologic agents. Such medications contribute significantly to the inpatient diagnosis-related group payment system, often with minimal or unproved benefit over less-expensive therapies...
April 2018: American Health & Drug Benefits
https://www.readbyqxmd.com/read/29915451/disruptive-hearing-technologies-and-mild-sensorineural-hearing-loss-i-accessibility-and-affordability-issues
#6
REVIEW
Anna Marie Jilla, Carole E Johnson, Jeffrey L Danhauer
Limited accessibility to and affordability of hearing health care (HHC) and hearing aids (HAs) are two reasons why people do not seek treatment for their hearing losses. This article is the first in a series of two and discusses affordability issues (i.e., billing models, cost-effectiveness, insurance coverage, and reimbursement) related to and provides a historical context for the Over-the-Counter Hearing Aid Act of 2017. This piece of legislation supports development of a new class of over-the-counter HAs that represents a disruptive technology that may transform the HHC industry by reducing costs specific to the device...
May 2018: Seminars in Hearing
https://www.readbyqxmd.com/read/29914611/patterns-of-point-of-care-test-use-among-obstetricians-and-gynaecologists-in-the-us
#7
Anne M Rompalo, Neko Castleberry, Lea Widdice, Jay Schulkin, Charlotte A Gaydos
Background: Point-of-care tests (POCTs) for reproductive health conditions have existed for decades. Newer POCTs for syphilis, HIV and trichomonas are currently available and easy to use. We surveyed practicing obstetricians and gynaecologists to determine current POCT use and perceived obstacles to use. Methods: Between June and August 2016, 1000 members of the American College of Obstetricians and Gynecologists were randomly selected and invited to complete a Qualtrics (222 West river Park Drive, Provo, Utah 84604, USA) survey; 600 of these were members of the Collaborative Ambulatory Research Network...
June 19, 2018: Sexual Health
https://www.readbyqxmd.com/read/29914029/hospitalization-after-oral-antibiotic-initiation-in-finnish-community-dwellers-with-and-without-alzheimer-s-disease-retrospective-register-based-cohort-study
#8
Heli Järvinen, Heidi Taipale, Marjaana Koponen, Antti Tanskanen, Jari Tiihonen, Anna-Maija Tolppanen, Sirpa Hartikainen
BACKGROUND: Persons with Alzheimer's disease (AD) are frequently hospitalized from infection-related causes. There are no previous studies investigating hospitalization associated with antibiotic initiation in persons with AD. OBJECTIVE: To investigate the frequency and risk of hospitalization associated with oral antibiotic initiation among community dwellers with and without AD. METHODS: We performed a retrospective register-based study utilizing register-based Medication Use and Alzheimer's disease (MEDALZ) cohort...
June 8, 2018: Journal of Alzheimer's Disease: JAD
https://www.readbyqxmd.com/read/29912735/effectiveness-of-a-model-bundle-payment-initiative-for-femur-fracture-patients
#9
Ariana Lott, Rebekah Belayneh, Jack Haglin, Sanjit Konda, Kenneth A Egol
OBJECTIVES: Analyze the effectiveness of a BPCI (Bundle Payments for Care Improvement) initiative for patients who would be included in a future potential Surgical Hip and Femur Fracture Treatment (SHFFT) bundle. DESIGN: Retrospective cohort SETTING:: Single Academic Institution PATIENTS/PARTICIPANTS:: Patients discharged with operative fixation of a hip or femur fracture (DRG codes 480-482) between 1/2015-10/2016 were included. A BPCI initiative based upon an established program for BPCI Total Joint Arthroplasty (TJA) was initiated for patients with hip and femur fractures in January 2016...
May 28, 2018: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/29912700/pediatric-complicated-pneumonia-caused-by-streptococcus-pneumoniae-serotype-3-in-13-valent-pneumococcal-conjugate-vaccinees-portugal-2010-2015
#10
Catarina Silva-Costa, Maria João Brito, Marcos D Pinho, Ana Friães, Sandra I Aguiar, M Ramirez, Jose Melo-Cristino
Despite use of 7-valent pneumococcal conjugate vaccine, incidence of pleural effusion and empyema (pediatric complicated pneumococcal pneumonia [PCPP]) is reportedly increasing globally. We cultured and performed PCR on 152 pleural fluid samples recovered from pediatric patients in Portugal during 2010-2015 to identify and serotype Streptococcus pneumoniae. We identified only 17 cases by culture, but molecular methods identified S. pneumoniae in 68% (92/135) of culture-negative samples. The most frequent serotypes were 3, 1, and 19A, together accounting for 62% (68/109) of cases...
July 2018: Emerging Infectious Diseases
https://www.readbyqxmd.com/read/29911931/profile-of-roche-s-ariosa-harmony-prenatal-test
#11
Elisa Bevilacqua, Serena Resta, Andrew Carlin, Xin Kang, Teresa Cos Sanchez, Jérôme de Marchin, Jacques C Jani
Roche's Ariosa HarmonyTM Prenatal Test, a noninvasive cfDNA (cell-free DNA) method for major trisomies has been available since January-2013 at the authors unit and tests were sent to California. From July-2017 onwards, prenatal cfDNA has been reimbursed in Belgium for all pregnancies, however since then samples are sent to a local technology transfer center. Little data are available on patient's profile and choices towards cfDNA and on the performance of local technology transfer centers. Areas covered: The profiles and choices of women regarding this test were evaluated...
June 18, 2018: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/29911521/integrated-perinatal-mental-health-care-a-national-model-of-perinatal-primary-care-in-vulnerable-populations
#12
Kimberly C Lomonaco-Haycraft, Jennifer Hyer, Britney Tibbits, Jennifer Grote, Kelly Stainback-Tracy, Claire Ulrickson, Alison Lieberman, Lies van Bekkum, M Camille Hoffman
IntroductionPerinatal mood and anxiety disorders (PMADs) are the most common complication of pregnancy and have been found to have long-term implications for both mother and child. In vulnerable patient populations such as those served at Denver Health, a federally qualified health center the prevalence of PMADs is nearly double the nationally reported rate of 15-20%. Nearly 17% of women will be diagnosed with major depression at some point in their lives and those numbers are twice as high in women who live in poverty...
June 18, 2018: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29911187/impact-of-the-cms-no-pay-policy-on-hospital-acquired-fall-prevention-related-practice-patterns
#13
Elizabeth A Fehlberg, Robert J Lucero, Michael T Weaver, Anna M McDaniel, A Michelle Chandler, Phyllis A Richey, Lorraine C Mion, Ronald I Shorr
Background and Objectives: In October 2008, the Centers for Medicare & Medicaid Services (CMS) stopped reimbursing hospitals for costs related to patient falls. This study aimed to examine whether the CMS no-pay policy influenced four fall prevention practices: bed alarms, sitters, room changes, and physical restraints. Research Design and Methods: Using electronic medical record data collected from four hospitals between 2005 and 2010, this secondary observational analysis examined the associations between the CMS no-pay policy and nursing interventions and medical orders related to fall prevention...
November 2017: Innovation in Aging
https://www.readbyqxmd.com/read/29911104/cell-and-gene-therapies-european-view-on-challenges-in-translation-and-how-to-address-them
#14
Cécile F Rousseau, Romaldas Mačiulaitis, Dariusz Śladowski, Gopalan Narayanan
Advanced therapy medicinal products (ATMPs), i.e ., cell and gene therapy products, is a rapidly evolving field of therapeutic development. A significant proportion of the products are being developed by academia or small/medium-sized enterprises (SMEs). The many challenges in translation posed by this class of products include aspects covering: manufacturing, non-clinical development plan as relevant to clinical trial, marketing authorization, and reimbursement. In this context, the term translation refers to the relevance of non-clinical data in relation to how it impacts on appropriate and efficient clinical development...
2018: Frontiers in Medicine
https://www.readbyqxmd.com/read/29909874/state-medicaid-reimbursement-for-medications-for-chronic-hepatitis-c-infection-from-2012-through-2015
#15
Christine Y Lu, Fang Zhang, Nicole Golonski, Caitlin Lupton, Paul Jeffrey, Anita K Wagner
BACKGROUND: New direct-acting antivirals (DAAs) can cure chronic hepatitis C virus (HCV) infection. High DAA prices combined with a large number of patients needing treatment may pose substantial economic burden on health systems. OBJECTIVES: To examine Medicaid reimbursement for medications for HCV infection before and after the availability of new DAAs overall and by state and to also assess the impact of Medicaid expansion on reimbursement for DAAs. METHODS: We calculated Medicaid reimbursements for medications for HCV infection between 2012 and 2015 in all 50 states and the District of Columbia...
June 2018: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/29909370/changes-in-the-rate-of-publicly-financed-knee-arthroscopies-an-analysis-of-data-from-the-norwegian-patient-registry-from-2012-to-2016
#16
Robin Holtedahl, Jens Ivar Brox, Arne Kristian Aune, Daniel Nguyen, May Arna Risberg, Ole Tjomsland
OBJECTIVE: To examine rates of publicly financed knee arthroscopic surgery in Norway between 2012 and 2016. DESIGN: Analysis of anonymised data from the National Patient Registry. INTERVENTIONS: Beginning in 2012, South-Eastern Norway Regional Health Authority implemented administrative measures to bring down rates of knee arthroscopy. Similar measures were not introduced in the other three Regional Health Authorities. MAIN OUTCOME MEASURES: We analysed annual national rates of publicly financed knee arthroscopies in 2012 and 2016...
June 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29908931/cost-of-surgical-treatment-for-distal-radius-fractures-and-the-implications-of-episode-based-bundled-payments
#17
Helen E Huetteman, Lin Zhong, Kevin C Chung
PURPOSE: To examine the cost of care of surgical treatment for a distal radius fracture (DRF) and develop episodes that may be used to develop future bundled payment programs. METHODS: Using 2009 to 2015 claims data from the Truven MarketScan Databases, we examined the cost of care for surgical treatment of DRFs among adult patients in the United States. We excluded patients with concurrent fractures, patients who required complex care, and patients in assisted living facilities...
June 13, 2018: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29908198/in-hospital-delays-result-in-worse-patient-outcomes-and-higher-cost-after-cardiac-surgery
#18
Diane R M Somlo, Nelson P Repenning, Abeel A Mangi
BACKGROUND: Contemporary reimbursement systems allow hospitals to maintain profitability by offering procedural services. However, increasing procedural volume can be met with structural inefficiencies that in turn cause delays, worse patient outcomes, and increased cost. METHODS: A multidisciplinary team assessed operations and outcomes at the Heart and Vascular Center at Yale New Haven Hospital, a tertiary academic medical center. Data were analyzed retrospectively to assess delays in transferring patients between care environments, patient outcomes, and cost...
June 13, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29906211/the-state-of-oncology-practice-in-america-2018-results-of-the-asco-practice-census-survey
#19
M Kelsey Kirkwood, Amy Hanley, Suanna S Bruinooge, Elizabeth Garrett-Mayer, Laura A Levit, Caroline Schenkel, Jerome E Seid, Blase N Polite, Richard L Schilsky
PURPOSE: To describe the US hematology and medical oncology practice landscape and to report findings of the sixth annual ASCO Oncology Practice Census survey. PARTICIPANTS AND METHODS: ASCO used Medicare Physician Compare data to characterize oncology practices in the United States. Practice size, number of care sites, and geographic distribution were determined. Trends in the number and size of practices from 2013 to 2017 were examined. All US oncology practices were targeted for the survey; survey responses were linked to the practices identified from Physician Compare to augment results and assess generalizability...
June 15, 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29905971/impact-of-insurance-type-on-eligibility-for-advanced-heart-failure-therapies-and-survival
#20
Sarah Streeter Hutcheson, Victoria Phillips, Rachel Patzer, Andrew Smith, J David Vega, Alanna A Morris
BACKGROUND: Medicaid insurance in Georgia provides limited reimbursement for heart transplant (HT) and left ventricular assist devices (LVAD). We examined whether insurance type affects eligibility for and survival after receipt of HT or LVAD. METHODS AND RESULTS: We retrospectively identified patients evaluated for HT/LVAD from 2012 to 2016. We used multivariable logistic and Cox proportional hazards regression to examine the association of insurance type on treatment eligibility and one year survival...
June 15, 2018: Clinical Transplantation
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