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https://www.readbyqxmd.com/read/28089437/systems-innovation-model-an-integrated-interdisciplinary-team-approach-pre-and-post-bariatric-surgery-at-a-veterans-affairs-va-medical-center
#1
Dan Eisenberg, Jessica A Lohnberg, Eric P Kubat, Cheryl C Bates, Lauren M Greenberg, Susan M Frayne
BACKGROUND: Provision of bariatric surgery in the Veterans Health Administration must account for obese veterans' co-morbidity burden and the geographically dispersed location of patients relative to Veterans Affairs (VA) bariatric centers. OBJECTIVES: To evaluate a collaborative, integrated, interdisciplinary bariatric team of surgeons, bariatricians, psychologists, dieticians, and physical therapists working in a hub-and-spokes care model, for pre- and post-bariatric surgery assessment and management...
November 15, 2016: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
https://www.readbyqxmd.com/read/28088259/integration-for-coexistence-implementation-of-intercultural-health-care-policy-in-ghana-from-the-perspective-of-service-users-and-providers
#2
Razak Mohammed Gyasi, Adjoa Afriyie Poku, Simon Boateng, Padmore Adusei Amoah, Alhassan Abdul Mumin, Jacob Obodai, Williams Agyemang-Duah
OBJECTIVE: In spite of the World Health Organization's recommendations over the past decades, Ghana features pluralistic rather than truly integrated medical system. Policies about the integration of complementary medicine into the national health care delivery system need to account for individual-level involvement and cultural acceptability of care rendered by health care providers. Studies in Ghana, however, have glossed over the standpoint of the persons of the illness episode about the intercultural health care policy framework...
January 2017: Journal of Integrative Medicine
https://www.readbyqxmd.com/read/28087566/application-of-whole-exome-sequencing-in-the-clinical-diagnosis-and-management-of-inherited-cardiovascular-diseases-in-adults
#3
Sara B Seidelmann, Emily Smith, Lakshman Subrahmanyan, Daniel Dykas, Maen D Abou Ziki, Bani Azari, Fady Hannah-Shmouni, Yuexin Jiang, Joseph G Akar, Mark Marieb, Daniel Jacoby, Allen E Bale, Richard P Lifton, Arya Mani
BACKGROUND: With the advent of high throughput sequencing, the identification of genetic causes of cardiovascular disease (CVD) has become an integral part of medical diagnosis and management and at the forefront of personalized medicine in this field. The use of whole exome sequencing for clinical diagnosis, risk stratification, and management of inherited CVD has not been previously evaluated. METHODS AND RESULTS: We analyzed the results of whole exome sequencing in first 200 adult patients with inherited CVD, who underwent genetic testing at the Yale Program for Cardiovascular Genetics...
February 2017: Circulation. Cardiovascular Genetics
https://www.readbyqxmd.com/read/28087267/research-in-the-integration-of-behavioral-health-for-adolescents-and-young-adults-in-primary-care-settings-a-systematic-review
#4
REVIEW
Laura P Richardson, Carolyn A McCarty, Ana Radovic, Ahna Ballonoff Suleiman
Despite the recognition that behavioral and medical health conditions are frequently intertwined, the existing health care system divides management for these issues into separate settings. This separation results in increased barriers to receipt of care and contributes to problems of underdetection, inappropriate diagnosis, and lack of treatment engagement. Adolescents and young adults with mental health conditions have some of the lowest rates of treatment for their conditions of all age groups. Integration of behavioral health into primary care settings has the potential to address these barriers and improve outcomes for adolescents and young adults...
January 10, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28087180/a-comparison-of-hfref-vs-hfpef-s-clinical-workload-and-cost-in-the-first-year-following-hospitalization-and-enrollment-in-a-disease-management-program
#5
T M Murphy, D F Waterhouse, S James, C Casey, E Fitzgerald, E O'Connell, C Watson, J Gallagher, M Ledwidge, K McDonald
BACKGROUND: Admission with heart failure (HF) is a milestone in the progression of the disease, often resulting in higher intensity medical care and ensuing readmissions. Whilst there is evidence supporting enrolling patients in a heart failure disease management program (HF-DMP), not all reported HF-DMPs have systematically enrolled patients with HF with preserved ejection fraction (HFpEF) and there is a scarcity of literature differentiating costs based on HF-phenotype. METHODS: 1292 consenting, consecutive patients admitted with a primary diagnosis of HF were enrolled in a hospital based HF-DMP and categorized as HFpEF (EF≥45%) or HFrEF (EF<45%)...
December 23, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/28086867/process-evaluation-of-an-integrated-care-pathway-in-geriatric-rehabilitation-for-people-with-complex-health-problems
#6
Irma H J Everink, Jolanda C M van Haastregt, Jose M C Maessen, Jos M G A Schols, Gertrudis I J M Kempen
BACKGROUND: An integrated care pathway in geriatric rehabilitation was developed to improve coordination and continuity of care for community-living older adults in the Netherlands, who go through the process of hospital admission, admission to a geriatric rehabilitation facility and discharge back to the home situation. This pathway is a complex intervention and is focused on improving communication, triage and transfers of patients between the hospital, geriatric rehabilitation facility and primary care organisations...
January 13, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28086770/social-pediatrics-weaving-horizontal-and-vertical-threads-through-pediatric-residency
#7
Meta van den Heuvel, Maria Athina Tina Martimianakis, Rebecca Levy, Adelle Atkinson, Elizabeth Ford-Jones, Michelle Shouldice
BACKGROUND: Social pediatrics teaches pediatric residents how to understand disease within their patients' social, environmental and political contexts. It's an essential component of pediatric residency training; however there is very little literature that addresses how such a broad-ranging topic can be taught effectively. The aim of this study was to determine and characterize social pediatric education in our pediatric residency training in order to identify strengths and gaps. METHODS: A social pediatrics curriculum map was developed, attending to 3 different dimensions: (1) the intended curriculum as prescribed by the Objectives of Training for Pediatrics of the Royal College of Physicians and Surgeons of Canada (RCPSC), (2) the formal curriculum defined by rotation-specific learning objectives, and (3) the informal/hidden curriculum as reflected in resident and teacher experiences and perceptions...
January 13, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/28078529/rethinking-preconception-care-a-critical-women-s-health-perspective
#8
Erika L Thompson, Coralia Vázquez-Otero, Cheryl A Vamos, Stephanie L Marhefka, Nolan S Kline, Ellen M Daley
Objectives Preconception care aims to provide care to reproductive aged individuals in order to improve pregnancy and birth outcomes. Given that preconception care is a public health priority, it is important to evaluate the evolution of this health paradigm and the promotion of preconception messages that are obtained by the public. We identified online preconception health messages, which were critically assessed through a women's health perspective. Methods We searched for "preconception care" on three major search engines...
January 11, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28077345/tips-and-traps-lessons-from-codesigning-a-clinician-e-monitoring-tool-for-computerized-cognitive-behavioral-therapy
#9
Frederick Sundram, Susan J Hawken, Karolina Stasiak, Mathijs Fg Lucassen, Theresa Fleming, Matthew Shepherd, Andrea Greenwood, Raechel Osborne, Sally N Merry
BACKGROUND: Computerized cognitive behavioral therapy (cCBT) is an acceptable and promising treatment modality for adolescents with mild-to-moderate depression. Many cCBT programs are standalone packages with no way for clinicians to monitor progress or outcomes. We sought to develop an electronic monitoring (e-monitoring) tool in consultation with clinicians and adolescents to allow clinicians to monitor mood, risk, and treatment adherence of adolescents completing a cCBT program called SPARX (Smart, Positive, Active, Realistic, X-factor thoughts)...
January 11, 2017: JMIR Mental Health
https://www.readbyqxmd.com/read/28076671/a-randomized-trial-of-collaborative-care-for-perinatal-depression-in-socioeconomically-disadvantaged-women-the-impact-of-comorbid-posttraumatic-stress-disorder
#10
Nancy K Grote, Wayne J Katon, Joan E Russo, Mary Jane Lohr, Mary Curran, Erin Galvin, Kathy Carson
OBJECTIVE: The comorbidity of posttraumatic stress disorder (PTSD) with antenatal depression poses increased risks for postpartum depression and may delay or diminish response to evidence-based depression care. In a secondary analysis of an 18-month study of collaborative care for perinatal depression, the authors hypothesized that pregnant, depressed, socioeconomically disadvantaged women with comorbid PTSD would show more improvement in the MOMCare intervention providing Brief Interpersonal Psychotherapy and/or antidepressants, compared to intensive public health Maternity Support Services (MSS-Plus)...
November 2016: Journal of Clinical Psychiatry
https://www.readbyqxmd.com/read/28075698/older-adults-and-management-of-medical-devices-in-the-home-five-requirements-for-appropriate-use
#11
Sara C Keller, Ayse P Gurses, Nicole Werner, Dawn Hohl, Ashley Hughes, Bruce Leff, Alicia I Arbaje
Medical devices, or instruments or tools to manage disease, are increasingly used in the home, yet there have been limited evaluations of how older adults and caregivers safely use these devices. This study concerns a qualitative evaluation of (1) barriers and facilitators of appropriate use, and (2) outcomes of inappropriate use, among older adults at the transition from hospital to home with skilled home health care (SHHC). Guided by a human factors engineering work system model, the authors (1) conducted direct observations with contextual inquiry of the start-of-care or resumption-of-care SHHC provider visit, and (2) semi-structured interviews with 24 older adults and their informal caregivers, and 39 SHHC providers and administrators...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28074569/screening-brief-intervention-and-referral-to-treatment-implications-of-samhsa-s-sbirt-initiative-for-substance-abuse-policy-and-practice
#12
Thomas F Babor, Frances Del Boca, Jeremy W Bray
AIMS: This paper describes the major findings and public health implications of a cross-site evaluation of a national Screening, Brief Intervention and Referral to Treatment (SBIRT) demonstration program funded by the US Substance Abuse and Mental Health Services Administration (SAMHSA). METHODS: Eleven multi-site programs in two cohorts of SAMHSA grant recipients were each funded for 5 years to promote the adoption and sustained implementation of SBIRT. The SBIRT cross-site evaluation used a multi-method evaluation design to provide comprehensive information on the processes, outcomes and costs of SBIRT as implemented in a variety of medical and community settings...
February 2017: Addiction
https://www.readbyqxmd.com/read/28070939/oncologists-perspectives-on-post-cancer-treatment-communication-and-care-coordination-with-primary-care-physicians
#13
C N Klabunde, D Haggstrom, K L Kahn, S W Gray, B Kim, B Liu, J Eisenstein, N L Keating
Post-treatment cancer care is often fragmented and of suboptimal quality. We explored factors that may affect cancer survivors' post-treatment care coordination, including oncologists' use of electronic technologies such as e-mail and integrated electronic health records (EHRs) to communicate with primary care physicians (PCPs). We used data from a survey (357 respondents; participation rate 52.9%) conducted in 2012-2013 among medical oncologists caring for patients in a large US study of cancer care delivery and outcomes...
January 10, 2017: European Journal of Cancer Care
https://www.readbyqxmd.com/read/28069855/prevalence-and-spending-associated-with-patients-who-have-a-behavioral-health-disorder-and-other-conditions
#14
Ken Thorpe, Sanjula Jain, Peter Joski
: People with multiple medical conditions are a growing and increasingly costly segment of the U.S. POPULATION: Despite the co-occurrence of physical and behavioral health comorbidities, the US health care system tends to treat these conditions separately rather than holistically. To identify opportunities for population health improvement, we examined the treated prevalence of and health care spending on behavioral health disorders, by the number of coexisting physical disorders, among noninstitutionalized adults...
January 1, 2017: Health Affairs
https://www.readbyqxmd.com/read/28068138/payment-reform-in-the-patient-centered-medical-home-enabling-and-sustaining-integrated-behavioral-health-care
#15
Benjamin F Miller, Kaile M Ross, Melinda M Davis, Stephen P Melek, Roger Kathol, Patrick Gordon
The patient-centered medical home (PCMH) is a promising framework for the redesign of primary care and more recently specialty care. As defined by the Agency for Healthcare Research and Quality, the PCMH framework has 5 attributes: comprehensive care, patient-centered care, coordinated care, accessible services, and quality and safety. Evidence increasingly demonstrates that for the PCMH to best achieve the Triple Aim (improved outcomes, decreased cost, and enhanced patient experience), treatment for behavioral health (including mental health, substance use, and life stressors) must be integrated as a central tenet...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28068137/meeting-evolving-workforce-needs-preparing-psychologists-for-leadership-in-the-patient-centered-medical-home
#16
Abbie O Beacham, Kristi S Van Sickle, Parinda Khatri, Mana K Ali, Daniel Reimer, Eugene W Farber, Nadine J Kaslow
Behavioral health integration in the patient-centered medical home (PCMH) offers opportunities for psychologists to play leadership roles. Widespread practice transition to PCMH models of care are expected to substantially impact the psychology workforce. Conservative estimates suggest that approximately 90% of the 93,000 clinically trained psychologists would be required to meet projected need in these settings. This has implications for how health service psychologists are trained. In addition to relevant clinical competencies, they must be versed in system/program development, administration, evaluation, quality improvement, and interprofessional collaboration...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28068134/psychologists-in-patient-centered-medical-homes-pcmhs-roles-evidence-opportunities-and-challenges
#17
Anne E Kazak, Justin M Nash, Kimberly Hiroto, Nadine J Kaslow
The patient-centered medical home (PCMH) is an increasingly common model of health care delivery with many exciting opportunities for psychologists. The PCMH reflects a philosophy and model of care that is highly consistent with psychological science and practice. It strives to provide patient-centered, comprehensive, team-based, coordinated, accessible, and quality and safety-oriented health care delivery to individuals and families. Moreoever, in keeping with changes in the health care system more broadly, the PCMH model prioritizes the integration of behavioral and physical health care, and this emphasis lays the foundation for active and full engagement of psychologists in this context...
January 2017: American Psychologist
https://www.readbyqxmd.com/read/28067594/nicotine-withdrawal-relapse-of-mental-illness-or-medication-side-effect-implementing-a-monitoring-tool-for-people-with-mental-illness-into-quitline-counseling
#18
Catherine J Segan, Amanda L Baker, Alyna Turner, Jill M Williams
BACKGROUND: Smokers with mental illness and their health care providers are often concerned that smoking cessation will worsen mental health. Smokers with mental illness tend to be more nicotine dependent and experience more severe symptoms of nicotine withdrawal, some of which are difficult to distinguish from psychiatric symptoms. In addition, smoking cessation can increase the blood levels and hence side-effects of some psychotropic medications. Improved monitoring of nicotine withdrawal and medication side-effects may help distinguish temporary withdrawal symptoms from psychiatric symptoms and facilitate targeted treatment to help smokers with mental illness manage the acute phase of nicotine withdrawal...
January 9, 2017: Journal of Dual Diagnosis
https://www.readbyqxmd.com/read/28066820/hiv-care-providers-attitudes-regarding-mobile-phone-applications-and-web-based-dashboards-to-support-patient-self-management-and-care-coordination-results-from-a-qualitative-feasibility-study
#19
Dallas Swendeman, Shu Farmer, Deborah Mindry, Sung-Jae Lee, Melissa Medich
In-depth qualitative interviews were conducted with healthcare providers (HCPs) from five HIV medical care coordination teams in a large Los Angeles County HIV clinic, including physicians, nurses, and psychosocial services providers. HCPs reported on the potential utility, acceptability, and barriers for patient self-monitoring and notifications via mobile phones, and web-based dashboards for HCPs. Potential benefits included: 1) enhancing patient engagement, motivation, adherence, and self-management; and 2) improving provider-patient relationships and HCP care coordination...
October 2016: Journal of HIV and AIDS
https://www.readbyqxmd.com/read/28065700/integrating-supportive-care-principles-into-dialysis-decision-making-a-primer-for-palliative-medicine-providers
#20
Alvin H Moss
Despite advances in pre-dialysis care and dialysis technology, patients with advanced chronic kidney disease and end-stage renal disease continue to experience multiple comorbidities, a high symptom burden, a shortened life expectancy and substantial physical, emotional, and spiritual suffering. Patients with acute kidney injury and end-stage renal disease, especially if they are older, often undergo prolonged hospitalizations, greater use of intensive medical treatment, and limited survival. Unfortunately, most nephrologists are not trained to conduct shared decision-making conversations to elicit patients' values, preferences, and goals for treatment and address their patients' multifactorial suffering...
January 5, 2017: Journal of Pain and Symptom Management
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