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https://www.readbyqxmd.com/read/28649454/methods-guiding-stakeholder-engagement-in-planning-a-pragmatic-study-on-changing-stroke-systems-of-care
#1
Sabina B Gesell, Karen Potvin Klein, Jacqueline Halladay, Janet Prvu Bettger, Janet Freburger, Doyle M Cummings, Barbara J Lutz, Sylvia Coleman, Cheryl Bushnell, Wayne Rosamond, Pamela W Duncan
BACKGROUND: The Comprehensive Post-Acute Stroke Services (COMPASS) Study is one of the first large pragmatic randomized-controlled clinical trials using comparative effectiveness research methods, funded by the Patient-Centered Outcomes Research Institute. In the COMPASS Study, we compare the effectiveness of a patient-centered, transitional care intervention versus usual care for stroke patients discharged home from acute care. Outcomes include stroke patient post-discharge functional status and caregiver strain 90 days after discharge, and hospital readmissions...
April 2017: Journal of clinical and translational science
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#2
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28645202/effects-of-mobility-and-multimorbidity-on-inpatient-and-post-acute-health-care-utilization
#3
Kristine E Ensrud, Li-Yung Lui, Lisa Langsetmo, Tien N Vo, Brent C Taylor, Peggy M Cawthon, Meredith L Kilgore, Charles E McCulloch, Jane A Cauley, Marcia L Stefanick, Kristine Yaffe, Eric S Orwoll, John T Schousboe
Background: This study examines effects of mobility and multimorbidity on hospitalization and inpatient and post-acute care (PAC) facility days among older men. Methods: Prospective study of 1701 men (mean age 79.3 years) participating in MrOS Study Year 7 (Y7) examination (2007-2008) linked with their Medicare claims. At Y7, mobility ascertained by usual gait speed and categorized as poor, intermediate, or good. Multimorbidity quantified by applying Elixhauser algorithm to inpatient and outpatient claims and categorized as none, mild-moderate, or high...
June 22, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28643571/adaptation-of-the-activity-measure-post-acute-care-am-pac-from-english-to-mandarin-using-the-dual-panel-translation-approach
#4
Feng-Hang Chang, Tsan-Hon Liou, John Brodersen, Jonathan D Comins
PURPOSE: The aims of this study were to translate and adapt the Activity Measure Post-Acute Care (AM-PAC) from US English to Mandarin using the dual-panel method, and to assess its psychometric properties in an outpatient rehabilitation setting. METHODS: The AM-PAC outpatient short forms were translated using the dual-panel method. The translated AM-PAC was tested in 550 Chinese-speaking rehabilitation outpatients. Floor and ceiling effects were evaluated and internal consistency was assessed using Cronbach's alpha...
June 23, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28643219/triple-antithrombotic-therapy-in-atrial-fibrillation-patients-undergoing-pci-a-fading-role
#5
Dimitrios Alexopoulos, Panagiotis Vlachakis, John Lekakis
Triple antithrombotic therapy (TAT), consisting of aspirin, a P2Y12 receptor antagonist and oral anticoagulant (OAC) medication has been considered as an 'unavoidable' strategy for a 1-12 months for atrial fibrillation (AF) patients post acute coronary syndrome or percutaneous coronary angioplasty with stenting. However, TAT has rather poorly been adopted in real life practice, mainly because of an accompanying increased bleeding potential and lack of definitive results of randomized clinical trials. Several registries, meta-analyses and small randomized trials have so far provided the base of guidelines recommendations...
June 22, 2017: Cardiovascular Drugs and Therapy
https://www.readbyqxmd.com/read/28641999/effect-of-pharmacist-care-on-medication-adherence-and-cardiovascular-outcomes-among-patients-post-acute-coronary-syndrome-a%C3%A2-systematic-review
#6
REVIEW
Maguy Saffouh El Hajj, Myriam Jihad Jaam, Ahmed Awaisu
BACKGROUND: The impact of collaborative and multidisciplinary health care on the outcomes of care in patients with acute coronary syndromes (ACS) is well-established in the literature. However, there is lack of high quality evidence on the role of pharmacist care in this setting. OBJECTIVE: This systematic review aimed to evaluate the impact of pharmacist care on patient outcomes (readmission, mortality, emergency visits, and medication adherence) in patients with ACS at or post-discharge...
June 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28633483/an-informatics-research-agenda-to-support-patient-and-family-empowerment-and-engagement-in-care-and-recovery-during-and-after-hospitalization
#7
Sarah Collins, Patricia Dykes, David W Bates, Brittany Couture, Ronen Rozenblum, Jennifer Prey, Kristin O'Reilly, Patricia Q Bourie, Cindy Dwyer, S Ryan Greysen, Jeffery Smith, Michael Gropper, Anuj K Dalal
As part of an interdisciplinary acute care patient portal task force with members from 10 academic medical centers and professional organizations, we held a national workshop with 71 attendees representing over 30 health systems, professional organizations, and technology companies. Our consensus approach identified 7 key sociotechnical and evaluation research focus areas related to the consumption and capture of information from patients, care partners (eg, family, friends), and clinicians through portals in the acute and post-acute care settings...
June 17, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28611229/variation-in-definition-of-prolonged-mechanical-ventilation
#8
Louise Rose, Michael McGinlay, Reshma Amin, Karen Ea Burns, Bronwen Connolly, Nicholas Hart, Philippe Jouvet, Sherri Katz, David Leasa, Cathy Mawdsley, Danny F McAuley, Marcus J Schultz, Bronagh Blackwood
Consistency of definitional criteria for terminology applied to describe subject cohorts receiving mechanical ventilation within ICU and post-acute care settings is important for understanding prevalence, risk stratification, effectiveness of interventions, and projections for resource allocation. Our objective was to quantify the application and definition of terms for prolonged mechanical ventilation. We conducted a scoping review of studies (all designs except single-case study) reporting a study population (adult and pediatric) using the term prolonged mechanical ventilation or a synonym...
June 13, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28596304/pcsk9-inhibition-and-atherosclerotic-cardiovascular-disease-prevention-does-reality-match-the-hype
#9
REVIEW
Savvas Hadjiphilippou, Kausik K Ray
Within this review we look at whether the potential provided by proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibition for prevention of atherosclerotic cardiovascular disease matches the excitement generated. Two fully human monoclonal antibodies to PCSK9 are currently licenced for clinical use both in the USA and the European Union: evolocumab and alirocumab. These reduce low-density lipoprotein cholesterol by over 50% across a range of populations and were generally found to have a safety profile comparable with placebo...
June 8, 2017: Heart: Official Journal of the British Cardiac Society
https://www.readbyqxmd.com/read/28585405/type-of-oral-solid-medication-packaging-and-medication-preparation-time-in-nursing-homes-a-direct-observation-study
#10
C M Cready, C Hudson, K Dreyer
WHAT IS KNOWN AND OBJECTIVE: Medication administration is a substantial portion of the workday in nursing homes, with the medication preparation step being the most time-consuming. However, little is known about how medication preparation time is affected by the type of packaging used for oral solid medications (ie, tablets/capsules). We examined the effects of two types of packaging. As fewer steps are associated with strip packaging compared to bingo card packaging, we hypothesized that the increase in medication preparation seconds per resident with each additional oral solid medication would be smaller when strip packaging was used...
June 5, 2017: Journal of Clinical Pharmacy and Therapeutics
https://www.readbyqxmd.com/read/28583761/bundled-payments-for-care-improvement-boom-or-bust
#11
Brian M Curtin, Robert D Russell, Susan M Odum
BACKGROUND: As early implementors of the Centers for Medicare and Medicaid Services (CMS) Bundled Payments for Care Improvement (BPCI) initiative, our private practice sought to compare our readmission rates, post-acute care utilization, and length of stay for the first year under BPCI compared to baseline data. METHODS: We used CMS data to compare total expenditures of all diagnosis-related groups (DRGs). Medicare patients who underwent orthopedic surgery between 2009 and 2012 were defined as non-BPCI (n = 8415) and were compared to Medicare BPCI patients (n = 4757) who had surgery in 2015...
May 15, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28566545/long-term-unmet-needs-and-associated-factors-in-stroke-or-tia-survivors-an-observational-study
#12
Muideen T Olaiya, Dominique A Cadilhac, Joosup Kim, Mark R Nelson, Velandai K Srikanth, Nadine E Andrew, Christopher F Bladin, Richard P Gerraty, Sharyn M Fitzgerald, Thanh Phan, Judith Frayne, Amanda G Thrift
OBJECTIVE: To extensively investigate long-term unmet needs in survivors of stroke or TIA and to identify factors associated with these unmet needs. METHODS: Community-dwelling adults were invited to participate in a survey ≥2 years after discharge for stroke/TIA. Unmet needs were assessed across 5 domains: activities and participation, environmental factors, body functions, post-acute care, and secondary prevention. Factors associated with unmet needs were determined with multivariable negative binomial regression...
May 31, 2017: Neurology
https://www.readbyqxmd.com/read/28561255/-total-hip-and-knee-arthroplasty-utilization-of-postoperative-rehabilitation
#13
S Ritter, J Dannenmaier, S Jankowiak, R Kaluscha, G Krischak
Background After total hip and knee arthroplasty, patients have different options of subsequent treatment: an early postoperative rehabilitation, with or without a period at home, or only outpatient services. The aim of this study was to identify factors predicting the utilization of an early postoperative rehabilitation. Methods This cross-sectoral analysis is based on claims data of AOK Baden-Württemberg (Statutory Health Insurance), Deutsche Rentenversicherung Bund and Deutsche Rentenversicherung Baden-Württemberg (German Pension Insurance)...
May 30, 2017: Die Rehabilitation
https://www.readbyqxmd.com/read/28553237/a-longitudinal-study-of-relationships-between-identity-continuity-and-anxiety-following-brain-injury
#14
R S Walsh, Orla T Muldoon, Donal G Fortune, Stephen Gallagher
Objective: Anxiety is of particular importance following acquired brain injury (ABI), because anxiety has been identified as a significant predictor of functional outcomes. Continuity of self has been linked to post ABI adjustment and research has linked self-discrepancy to anxiety. This longitudinal study investigates the impact of affiliative and 'self as doer' self-categorisations anxiety. Materials and Methods: Data was collected at two time points. Fifty-three adult ABI survivors participating in post-acute community neuro-rehabilitation participated at time one and 32 of these participated at time two...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28551043/improving-transitions-to-post-acute-care-for-elderly-patients-using-a-novel-video-conferencing-program-echo-care-transitions
#15
Amber B Moore, J Elyse Krupp, Alyssa B Dufour, Mousumi Sircar, Thomas G Travison, Alan Abrams, Grace Farris, Melissa L P Mattison, Lewis A Lipsitz
PURPOSE: Within 30 days of hospital discharge to a skilled nursing facility, older adults are at high risk for death, re-hospitalization and high-cost healthcare. The purpose of this study was to examine whether a novel videoconference program called Extension for Community Health Outcomes-Care Transitions (ECHO-CT) that connects an interdisciplinary hospital-based team with clinicians at skilled nursing facilities, reduces patient mortality, hospital readmission, skilled nursing facility length of stay and 30-day health care costs...
May 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28549708/chronic-obstructive-pulmonary-disease-in-post-acute-long-term-care-settings-seizing-opportunities-to-individualize-treatment-and-device-selection
#16
Meenakshi Patel, Karl Steinberg, Manuel Suarez-Barcelo, Dana Saffel, Rick Foley, Chad Worz
INTRODUCTION: The burden of chronic obstructive pulmonary disease (COPD) in post-acute/long-term care (PA/LTC) settings is high, and many patients do not receive guideline-recommended care. METHODS: An interprofessional expert panel of PA/LTC professionals convened to discuss the unmet medical needs in patients with COPD in PA/LTC settings, and to make recommendations for the assessment of COPD patients to individualize the selection of maintenance treatment. RESULTS: Unmet needs observed in patients with COPD are described in addition to new tools for assessing individual patient abilities and appropriate device selection for maintenance treatment...
June 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28542226/german-validation-of-quality-of-life-after-brain-injury-qolibri-assessment-and-associated-factors
#17
Nicole von Steinbüchel, Ruben G L Real, Nadine Sasse, Lindsay Wilson, Christiane Otto, Ryan Mullins, Robert Behr, Wolfgang Deinsberger, Ramon Martinez-Olivera, Wolfgang Puschendorf, Werner Petereit, Veit Rohde, Holger Schmidt, Stephan Sehmisch, Klaus Michael Stürmer, Klaus von Wild, Henning Gibbons
The consequences of traumatic brain injury (TBI) for health-related quality of life (HRQoL) are still poorly understood, and no TBI-specific instrument has hitherto been available. This paper describes in detail the psychometrics and validity of the German version of an internationally developed, self-rated HRQoL tool after TBI-the QOLIBRI (Quality of Life after Brain Injury). Factors associated with HRQoL, such as the impact of cognitive status and awareness, are specifically reported. One-hundred seventy-two participants after TBI were recruited from the records of acute clinics, most of whom having a Glasgow Coma Scale (GCS) 24-hour worst score and a Glasgow Outcome Scale (GOSE) score...
2017: PloS One
https://www.readbyqxmd.com/read/28525587/assessing-the-psychedelic-after-glow-in-ayahuasca-users-post-acute-neurometabolic-and-functional-connectivity-changes-are-associated-with-enhanced-mindfulness-capacities
#18
Frederic Sampedro, Mario de la Fuente Revenga, Marta Valle, Natalia Roberto, Elisabet Domínguez-Clavé, Matilde Elices, Luís Eduardo Luna, José Alexandre S Crippa, Jaime E C Hallak, Draulio B de Araujo, Pablo Friedlander, Steven A Barker, Enrique Álvarez, Joaquim Soler, Juan C Pascual, Amanda Feilding, Jordi Riba
Background: Ayahuasca is a plant tea containing the psychedelic 5-HT2A agonist N,N-dimethyltryptamine (DMT) and harmala monoamine-oxidase inhibitors. Acute administration leads to neurophysiological modifications in brain regions of the default mode network (DMN), purportedly through a glutamatergic mechanism. Post-acutely, ayahuasca potentiates mindfulness capacities in volunteers, and induces rapid and sustained antidepressant effects in treatment-resistant patients. However, the mechanisms underlying these fast and maintained effects are poorly understood...
May 19, 2017: International Journal of Neuropsychopharmacology
https://www.readbyqxmd.com/read/28523471/quantification-of-left-atrial-volume-and-phasic-function-using-cardiovascular-magnetic-resonance-imaging-comparison-of-biplane-area-length-method-and-simpson-s-method
#19
Laura Kristin Wandelt, Johannes Tammo Kowallick, Andreas Schuster, Rolf Wachter, Thomas Stümpfig, Christina Unterberg-Buchwald, Michael Steinmetz, Christian Oliver Ritter, Joachim Lotz, Wieland Staab
Left atrial (LA) enlargement and dysfunction are markers of chronic diastolic dysfunction and an important predictor of adverse cardiovascular and cerebrovascular outcomes. Accordingly, accurate quantification of left atrial volume (LAV) and function is needed. In routine clinical cardiovascular magnetic resonance (CMR) imaging the biplane area-length method (Bi-ALM) is frequently applied due to time-saving image acquisition and analysis. However, given the varying anatomy of the LA we hypothesized that the diagnostic accuracy of the Bi-ALM is not sufficient and that results would be different from a precise volumetric assessment of transversal multi-slice cine images using Simpson's method...
May 18, 2017: International Journal of Cardiovascular Imaging
https://www.readbyqxmd.com/read/28520672/sertraline-for-major-depression-during-the-year-following-traumatic-brain-injury-a-randomized-controlled-trial
#20
Jesse R Fann, Charles H Bombardier, Nancy Temkin, Peter Esselman, Catherine Warms, Jason Barber, Sureyya Dikmen
OBJECTIVE: Major depressive disorder (MDD) is common and associated with impaired functioning after traumatic brain injury (TBI). Few placebo-controlled antidepressant trials exist in this population. We evaluated the efficacy and tolerability of sertraline for MDD within 1 year of sustaining a TBI. SETTING: Level I trauma center. PARTICIPANTS: Adults with MDD within 1 year of hospitalization for complicated mild to severe TBI. DESIGN: Randomized, double-blind, placebo-controlled trial...
May 17, 2017: Journal of Head Trauma Rehabilitation
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