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https://www.readbyqxmd.com/read/28448781/assessment-of-clinical-pharmacy-interventions-to-reduce-outpatient-use-of-high-risk-medications-in-the-elderly
#1
Sarah C Weddle, A Shaun Rowe, Julie W Jeter, Rachel C Renwick, Shaunta' M Chamberlin, Andrea S Franks
BACKGROUND: Use of high-risk medications in the elderly (HRME) and drug-disease (Rx-DIS) interactions in the elderly, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) Measures, are significantly associated with mortality, hospital admission, and need for emergency care. No published studies to date evaluate interventions to reduce the use of HEDIS-defined HRME, although many studies have postulated a beneficial effect of such interventions. OBJECTIVE: To evaluate the effect of pharmacist interventions on use of HRME and Rx-DIS interactions in the outpatient elderly population...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28435484/outcomes-by-mode-of-transport-of-st-elevation-mi-patients-in-the-united-arab-emirates
#2
Edward L Callachan, Alawi A Alsheikh-Ali, Satish Chandrasekhar Nair, Stevan Bruijns, Lee A Wallis
INTRODUCTION: The purpose of this multicenter study was to assess differences in demographics, medical history, treatment times, and follow-up status among patients with ST-elevation myocardial infarction (STEMI), who were transported to the hospital by emergency medical services (EMS) or by private vehicle, or were transferred from other medical facilities. METHODS: This multicenter study involved the collection of both retrospective and prospective data from 455 patients admitted to four hospitals in Abu Dhabi...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435342/patient-web-portals-disease-management-and-primary-prevention
#3
REVIEW
Steven S Coughlin, Judith J Prochaska, Lovoria B Williams, Gina M Besenyi, Vahé Heboyan, D Stephen Goggans, Wonsuk Yoo, Gianluca De Leo
BACKGROUND: Efforts aimed at health care reform and continued advances in information technologies have prompted interest among providers and researchers in patient web portals. Patient web portals are password-protected online websites that offer the patients 24-hour access to personal health information from anywhere with an Internet connection. METHODS: This article, which is based upon bibliographic searches in PubMed, reviews important developments in web portals for primary and secondary disease prevention, including patient web portals tethered to electronic medical records, disease-specific portals, health disparities, and health-related community web portals...
2017: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/28435100/montreal-accord-on-patient-reported-outcomes-use-series-paper-5-patient-reported-outcomes-pro-can-be-linked-to-epidemiologic-measures-to-monitor-populations-and-inform-public-health-decisions
#4
Hiroshi Mamiya, Lisa M Lix, William Gardner, Susan J Bartlett, Sara Ahmed, David Buckeridge
BACKGROUND: Comprehensive picture of population health status can be captured by the incorporation of patient reported outcome measures into population health monitoring. OBJECTIVE: To identify current state, opportunities, and future research related to the utilization of patient reported outcome measures for population health monitoring in Canada. DISCUSSIONS: Patient reported outcome measures can help to identify community health needs in public health topics including injury, chronic disease, and communicable disease...
April 20, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28423809/use-of-a-nationwide-personally-controlled-electronic-health-record-by-healthcare-professionals-and-patients-a-case-study-with-the-french-dmp
#5
Brigitte Seroussi, Jacques Bouaud
If the wide adoption of electronic health records (EHRs) is necessary to address health information sharing and care coordination issues, it is not sufficient. In order to address health information sharing, some countries, among which, France, have implemented a centralized framework with "new" nationwide care records. The French DMP is a centralized, nationally shared, electronic medical record, created according to the opt-in model. More than five years after the launching of the DMP project, DMPs have been created for 1...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28420358/healthcare-utilization-in-older-patients-using-personal-emergency-response-systems-an-analysis-of-electronic-health-records-and-medical-alert-data-brief-description-a-longitudinal-retrospective-analyses-of-healthcare-utilization-rates-in-older-patients-using
#6
Stephen Agboola, Sara Golas, Nils Fischer, Mariana Nikolova-Simons, Jorn Op den Buijs, Linda Schertzer, Joseph Kvedar, Kamal Jethwani
BACKGROUND: Personal Emergency Response Systems (PERS) are traditionally used as fall alert systems for older adults, a population that contributes an overwhelming proportion of healthcare costs in the United States. Previous studies focused mainly on qualitative evaluations of PERS without a longitudinal quantitative evaluation of healthcare utilization in users. To address this gap and better understand the needs of older patients on PERS, we analyzed longitudinal healthcare utilization trends in patients using PERS through the home care management service of a large healthcare organization...
April 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28420158/intelligent-medical-garments-with-graphene-functionalized-smart-cloth-ecg-sensors
#7
Murat Kaya Yapici, Tamador Elboshra Alkhidir
Biopotential signals are recorded mostly by using sticky, pre-gelled electrodes, which are not ideal for wearable, point-of-care monitoring where the usability of the personalized medical device depends critically on the level of comfort and wearability of the electrodes. We report a fully-wearable medical garment for mobile monitoring of cardiac biopotentials from the wrists or the neck with minimum restriction to regular clothing habits. The wearable prototype is based on elastic bands with graphene functionalized, textile electrodes and battery-powered, low-cost electronics for signal acquisition and wireless transmission...
April 16, 2017: Sensors
https://www.readbyqxmd.com/read/28410981/predicting-healthcare-trajectories-from-medical-records-a-deep-learning-approach
#8
Trang Pham, Truyen Tran, Dinh Phung, Svetha Venkatesh
Personalized predictive medicine necessitates the modeling of patient illness and care processes, which inherently have long-term temporal dependencies. Healthcare observations, stored in electronic medical records are episodic and irregular in time. We introduce DeepCare, an end-to-end deep dynamic neural network that reads medical records, stores previous illness history, infers current illness states and predicts future medical outcomes. At the data level, DeepCare represents care episodes as vectors and models patient health state trajectories by the memory of historical records...
April 11, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28406708/pack-year-cigarette-smoking-history-for-determination-of-lung-cancer-screening-eligibility-comparison-of-the-electronic-medical-record-versus-a-shared-decision-making-conversation
#9
Hannah E Modin, Joelle T Fathi, Christopher R Gilbert, Candice L Wilshire, Andrew K Wilson, Ralph W Aye, Alexander S Farivar, Brian E Louie, Eric Vallières, Jed A Gorden
RATIONALE: Implementation of lung cancer screening programs is occurring across the United States. Programs vary in approaches to patient identification and shared decision making. The eligibility of persons referred to screening programs, the outcomes of eligibility determination during shared decision making, and the potential for the electronic medical record to identify eligible individuals have not been well described. OBJECTIVES: Our objectives were to assess the eligibility of individuals referred for lung cancer screening, and compare information extracted from the electronic medical record to information derived from a shared decision making conversation for the determination of eligibility for lung cancer screening...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28401731/impact-of-early-personal-history-characteristics-on-the-pace-of-aging-implications-for-clinical-trials-of-therapies-to-slow-aging-and-extend-healthspan
#10
Daniel W Belsky, Avshalom Caspi, Harvey J Cohen, William E Kraus, Sandhya Ramrakha, Richie Poulton, Terrie E Moffitt
Therapies to extend healthspan are poised to move from laboratory animal models to human clinical trials. Translation from mouse to human will entail challenges, among them the multifactorial heterogeneity of human aging. To inform clinical trials about this heterogeneity, we report how humans' pace of biological aging relates to personal-history characteristics. Because geroprotective therapies must be delivered by midlife to prevent age-related disease onset, we studied young-adult members of the Dunedin Study 1972-73 birth cohort (n = 954)...
April 12, 2017: Aging Cell
https://www.readbyqxmd.com/read/28387314/analysis-of-free-text-in-electronic-health-records-for-identification-of-cancer-patient-trajectories
#11
Kasper Jensen, Cristina Soguero-Ruiz, Karl Oyvind Mikalsen, Rolv-Ole Lindsetmo, Irene Kouskoumvekaki, Mark Girolami, Stein Olav Skrovseth, Knut Magne Augestad
With an aging patient population and increasing complexity in patient disease trajectories, physicians are often met with complex patient histories from which clinical decisions must be made. Due to the increasing rate of adverse events and hospitals facing financial penalties for readmission, there has never been a greater need to enforce evidence-led medical decision-making using available health care data. In the present work, we studied a cohort of 7,741 patients, of whom 4,080 were diagnosed with cancer, surgically treated at a University Hospital in the years 2004-2012...
April 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28375750/implementing-trauma-informed-partner-violence-assessment-in-family-planning-clinics
#12
Michele R Decker, Sarah Flessa, Ruchita V Pillai, Rebecca N Dick, Jamie Quam, Diana Cheng, Raegan McDonald-Mosley, Kamila A Alexander, Charvonne N Holliday, Elizabeth Miller
OBJECTIVE: Intimate partner violence (IPV) and reproductive coercion (RC) are associated with poor reproductive health. Little is known about how family planning clinics implement brief IPV/RC assessment interventions in practice. We describe the uptake and impact of a brief, trauma-informed, universal IPV/RC assessment and education intervention. METHODS: Intervention implementation was evaluated via a mixed methods study among women ages 18 and up receiving care at one of two family planning clinics in greater Baltimore, MD...
April 4, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28373173/prognosis-of-undiagnosed-chest-pain-linked-electronic-health-record-cohort-study
#13
MULTICENTER STUDY
Kelvin P Jordan, Adam Timmis, Peter Croft, Danielle A van der Windt, Spiros Denaxas, Arturo González-Izquierdo, Richard A Hayward, Pablo Perel, Harry Hemingway
Objective To ascertain long term cardiovascular outcomes in patients whose chest pain remained undiagnosed six months after first presentation.Design Cohort study.Setting UK electronic health record database (CALIBER) linking primary care, secondary care, coronary registry, and death registry information.Participants 172 180 adults aged ≥18 from 223 general practices presenting with a first episode of recorded chest pain, classified from medical records as diagnosed (non-coronary condition or angina) or undiagnosed (cause unattributed) at first consultation between 2002 and 2009 and with no previous record of cardiovascular disease...
April 3, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28370246/electronic-health-records-and-the-disappearing-patient
#14
Linda M Hunt, Hannah S Bell, Allison M Baker, Heather A Howard
With rapid consolidation of American medicine into large-scale corporations, corporate strategies are coming to the forefront in health care delivery, requiring a dramatic increase in the amount and detail of documentation, implemented through use of electronic health records (EHRs). EHRs are structured to prioritize the interests of a myriad of political and corporate stakeholders, resulting in a complex, multi-layered, and cumbersome health records system, largely not directly relevant to clinical care. Drawing on observations conducted in outpatient specialty clinics, we consider how EHRs prioritize institutional needs manifested as a long list of requisites that must be documented with each consultation...
March 31, 2017: Medical Anthropology Quarterly
https://www.readbyqxmd.com/read/28364355/population-health-management-for-diabetes-health-care-system-level-approaches-for-improving-quality-and-addressing-disparities
#15
REVIEW
Julie A Schmittdiel, Anjali Gopalan, Mark W Lin, Somalee Banerjee, Christopher V Chau, Alyce S Adams
PURPOSE OF REVIEW: Population care approaches for diabetes have the potential to improve the quality of care and decrease diabetes-related mortality and morbidity. Population care strategies are particularly relevant as accountable care organizations (ACOs), patient-centered medical homes (PCMH), and integrated delivery systems are increasingly focused on managing chronic disease care at the health system level. This review outlines the key elements of population care approaches for diabetes in the current health care environment...
May 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28362957/low-pressure-hydrocephalus-in-children-a-case-series-and-review-of-the-literature
#16
Zachary S Smalley, Garrett T Venable, Stephanie Einhaus, Paul Klimo
BACKGROUND: Low-pressure hydrocephalus (LPH) is a rare phenomenon characterized by a clinical picture consistent with elevated intracranial pressure (ICP) and ventricular enlargement, but also a well-functioning shunt and low or negative ICP. OBJECTIVE: To report our experience in evaluating this challenging problem. METHODS: Patients with LPH were identified from several sources, including institutional procedural databases and personal case logs...
March 1, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28361731/health-information-technology-as-a-universal-donor-to-bioethics-education
#17
Kenneth W Goodman
Health information technology, sometimes called biomedical informatics, is the use of computers and networks in the health professions. This technology has become widespread, from electronic health records to decision support tools to patient access through personal health records. These computational and information-based tools have engendered their own ethics literature and now present an opportunity to shape the standard medical and nursing ethics curricula. It is suggested that each of four core components in the professional education of clinicians-privacy, end-of-life care, access to healthcare and valid consent, and clinician-patient communication-offers an opportunity to leverage health information technology for curricular improvement...
April 2017: Cambridge Quarterly of Healthcare Ethics: CQ: the International Journal of Healthcare Ethics Committees
https://www.readbyqxmd.com/read/28355138/ultrasound-to-detect-pressure-related-deep-tissue-injuries-in-adults-admitted-via-the-emergency-department-a-prospective-descriptive-pilot-study
#18
Jonathan Scheiner, Karen Farid, Mark Raden, Seleshi Demisse
Stage 4 pressure ulcers (PUs) start with tissue death at the level of the bone, also known as deep tissue injury (DTI). Studies have shown the appearance of DTI on the skin is delayed for several days after the original pressure-related injury to the deep soft tissues. Studies also suggest DTI can be seen using ultrasound (US) technology. A prospective, descriptive, correlational pilot study was conducted to evaluate the use of US technology to detect DTI in the soft tissues that are not visible on the skin upon hospital admission...
March 2017: Ostomy/wound Management
https://www.readbyqxmd.com/read/28351394/higher-education-in-gerodontology-in-european-universities
#19
Anastassia Kossioni, Gerry McKenna, Frauke Müller, Martin Schimmel, Jacques Vanobbergen
BACKGROUND: The rapid aging of the European population and the subsequent increase in the oral care needs in older adults necessitates adequate training of dental professionals in Gerodontology (Geriatric Dentistry). This study was designed to investigate the current status of Gerodontology teaching amongst European dental schools at the undergraduate, postgraduate and continuing education levels. METHODS: An electronic questionnaire was developed by a panel of experts and emailed to the Deans or other contact persons of 216 dental schools across 39 European countries...
March 28, 2017: BMC Oral Health
https://www.readbyqxmd.com/read/28347987/outcome-prioritisation-tool-for-medication-review-in-older-patients-with-multimorbidity-a-pilot-study-in-general-practice
#20
Jojanneke Jgt van Summeren, Jan Schuling, Flora M Haaijer-Ruskamp, Petra Denig
BACKGROUND: Several methods have been developed to conduct and support medication reviews in older persons with multimorbidity. Assessing the patient's priorities for achieving specific health outcomes can guide the medication review process. Little is known about the impact of conducting such assessments. AIM: This pilot study aimed to determine proposed and observed medication changes when using an outcome prioritisation tool (OPT) during a medication review in general practice...
March 27, 2017: British Journal of General Practice: the Journal of the Royal College of General Practitioners
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