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https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#1
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28527149/characterisation-of-drug-related-problems-and-associated-factors-at-a-clinical-pharmacist-service-na%C3%A3-ve-hospital-in-northern-sweden
#2
Cecilia Peterson, Maria Gustafsson
BACKGROUND: Polypharmacy and increased sensitivity to side effects cause adverse drug events, drug-drug interactions and medication errors in the elderly. OBJECTIVE: The objective of this study was to investigate the prevalence and type of drug-related problems and associated factors among patients admitted to a clinical pharmacist service-naïve medical ward in an inland hospital in northern Sweden. METHODS: During September-November 2015 and February-April 2016, clinical pharmacists working as part of a ward team on the medical ward conducted 103 medication reviews...
May 19, 2017: Drugs—Real World Outcomes
https://www.readbyqxmd.com/read/28522282/quality-indicators-for-the-use-of-systemic-antibiotics-in-dentistry
#3
Rugzan Jameel Hussein, Robert Krohn, Petra Kaufmann-Kolle, Gerald Willms
BACKGROUND: Risks resulted from using systemic antibiotics such as increasing rates of bacterial resistance, allergy and side effects should be always weighed individually for each patient against any potential benefits. Routine antibiotic prescribing must be therefore discouraged. The Federal Joint Committee ("Gemeinsamer Bundesauschuss", G-BA) commissioned the AQUA-Institute with the development of an external quality assurance procedure, examining systemic antibiotic use in periodontal, conservative and surgical treatments in ambulatory dental health care...
May 15, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28520859/the-role-of-patient-care-items-as-a-fomite-in-healthcare-associated-outbreaks-and-infection-prevention
#4
Hajime Kanamori, William A Rutala, David J Weber
Patient-care items can serve as a source or reservoir for healthcare associated pathogens in hospitals. We reviewed healthcare-associated outbreaks from medical equipment and provided infection prevention recommendations. Multiple healthcare-associated outbreaks via a contaminated patient-care item were identified, including infections with multidrug-resistant organisms. The type of patient-care items implicated as a fomite causing healthcare-associated infections (HAI) has changed over time. Patient populations at risk were most commonly critically ill patients in adult and neonatal ICUs...
May 17, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28520761/antibiotic-use-in-south-korea-from-2007-to-2014-a-health-insurance-database-generated-time-series-analysis
#5
Juhee Park, Euna Han, Soo Ok Lee, Dong-Sook Kim
BACKGROUND: Inappropriate antibiotic use significantly contributes to antibiotic-resistance, resulting in reduced antibiotic efficacy and increasing physical burden and cost of disease. The goal of this study was to explore antibiotic usage patterns in South Korea using 2007-2014 health insurance claims data. METHODS: We used the Health Insurance Review & Assessment Service data, which represents nearly the entire population of South Korea, to discern patterns in antibiotic prescribing practices...
2017: PloS One
https://www.readbyqxmd.com/read/28512768/nursing-home-prices-and-quality-of-care-evidence-from-administrative-data
#6
Arndt R Reichert, Magdalena A Stroka
There is widespread concern about the quality of care in nursing homes. On the basis of administrative data of a large health insurance fund, we investigate whether nursing home prices are associated with relevant quality of care indicators at the resident level. Our results indicate negative associations between price and both inappropriate and psychotropic medication. In contrast, we do not find any relationship between the price and impairments of physical health.
May 17, 2017: Health Economics
https://www.readbyqxmd.com/read/28507653/use-of-potentially-inappropriate-medications-among-ambulatory-home-dwelling-elderly-patients-with-dementia-a-review-of-the-literature
#7
Tejal Patel, Karen Slonim, Linda Lee
BACKGROUND: Older adults with dementia are at high risk for drug-related adverse outcomes. While much is known about potentially inappropriate medication use in older adults, its prevalence and characteristics among those with dementia are not as well elucidated. We conducted a literature review to examine the prevalence of potentially inappropriate medication use among home-dwelling older adults with dementia. Our secondary aim was to determine the most frequently implicated medications and factors associated with potentially inappropriate medication use...
May 2017: Canadian Pharmacists Journal: CPJ, Revue des Pharmaciens du Canada: RPC
https://www.readbyqxmd.com/read/28506977/development-of-a-medication-review-service-for-patients-with-enteral-tubes-in-a-community-teaching-hospital
#8
Tracey Li, Alison Eisenhart, Jennifer Costello
PURPOSE: The results of a study to develop a hospital-wide medication review service for patients with enteral tubes to improve patient safety are presented. SUMMARY: Inappropriate enteral administration of medications can result in occluded tubes, altered clinical response, and an increase in adverse effects. At Saint Barnabas Medical Center, a 600-bed community teaching hospital located in Livingston, New Jersey, a medication review service for patients with an enteral tube was developed...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28506569/-identifying-potentially-inappropriate-prescriptions-in-patients-over-65-years-old-using-original-beers-criteria-and-their-spanish-adaptation
#9
Josep Pastor Cano, Ana Aranda García, Juan José Gascón Cánovas, José Francisco Sánchez Ruiz, Víctor José Rausell Rausell, Mariana Tobaruela Soto
OBJECTIVE: To compare the detection of potentially inappropriate medication (PIM) using the original Beers criteria, a global reference for evaluating prescriptions in the elderly, and their Spanish version. DESIGN: Retrospective observational study LOCATION: A Primary Care area in the province of Murcia, Spain. PARTICIPANTS: A total of 7,856 subjects aged 65 and over, with at least one drug prescribed in a Primary Care Area of Spain during study period...
May 13, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28504934/vision-based-surgical-field-defogging
#10
Xiongbiao Luo, A McLeod, Stephen Pautler, Christopher Schlachta, Terry Peters
Fogged surgical field visualization that is a common and potentially harmful problem can lead to inappropriate device use and incorrectly targeted tissue and increase surgical risks in endoscopic surgery. This work aims to remove fog or smoke on endoscopic video sequences to augment and maintain a direct and clear visualization of the operating field. A new visibilitydriven fusion defogging framework is proposed for surgical endoscopic video processing. This framework first recovers the visibility and enhances the contrast of hazy images...
May 11, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28501291/use-and-dependence-on-opioid-drugs-in-the-spanish-population-with-chronic-pain-prevalence-and-differences-according-to-sex
#11
A Coloma-Carmona, J L Carballo, J Rodríguez-Marín, A Pérez-Carbonell
OBJECTIVES: To analyse the prevalence in the use and dependence on opioid drugs in the Spanish population with chronic pain and evaluate the differences according to sex. PATIENTS AND METHODS: The demographic variables, opioid treatment characteristics and use of other substances were assessed in 229 users of opioid drugs. A descriptive bivariate analysis of the data was performed. RESULTS: Forty-six percent of the patients met the criteria of dependence on opioid drugs (Diagnostic and Statistical Manual of Mental Disorders, 4th Edition [DSM-IV-TR])...
May 10, 2017: Revista Clínica Española
https://www.readbyqxmd.com/read/28499354/patient-and-care-characteristics-of-self-referrals-treated-by-the-general-practitioner-cooperative-at-emergency-care-access-points-in-the-netherlands
#12
Martijn Rutten, Fieke Vrielink, Marleen Smits, Paul Giesen
BACKGROUND: In the Netherlands, out-of-hours primary care is provided in general practitioner-cooperatives (GPCs). These are increasingly located on site and in collaboration with emergency departments of hospitals (ED). At such sites, also called emergency-care-access-points (ECAP), the GPC is generally responsible for the triage and treatment of self-referrals who used to attend the ED. To evaluate the effects and safety of this novel organisation, we studied the characteristics and the quality of care given by GPCs to self-referrals at ECAPs...
May 12, 2017: BMC Family Practice
https://www.readbyqxmd.com/read/28494806/what-makes-weekend-allied-health-services-effective-and-cost-effective-or-not-in-acute-medical-and-surgical-wards-perceptions-of-medical-nursing-and-allied-health-workers
#13
Lisa O'Brien, Deb Mitchell, Elizabeth H Skinner, Romi Haas, Marcelle Ghaly, Fiona McDermott, Kerry May, Terry Haines
BACKGROUND: There is strong public support for acute hospital services to move to genuine 7-day models, including access to multidisciplinary team assessment. This study aimed to identify factors that might enable an effective and cost-effective weekend allied health services on acute hospital wards. METHODS: This qualitative study included 22 focus groups within acute wards with a weekend allied health service and 11 telephone interviews with weekend service providers...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28494619/improving-quality-of-care-for-end-stage-respiratory-disease-changes-in-attitude-changes-in-service
#14
D Robin Taylor, Scott A Murray
The illness trajectory for many patients with severe respiratory disease is characterized by steady decline. Yet most healthcare resources are poured into managing acute exacerbations that are only temporarily effective. Further, 'bad deaths' can result from inappropriate medical interventions at times of crisis. In this article, we describe a range of changes in attitudes, behaviour and service provision that together focus on improving quality of care for respiratory patients with frequent crises. These changes include prognostic conversations, developing and implementing anticipatory care plans both in hospital and in the outpatient settings, and establishing a supportive care clinic devoted to complex disease and optimizing palliative care...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28492914/antibiotic-prescribing-for-nonbacterial-acute-upper-respiratory-infections-in-elderly-persons
#15
Michael Silverman, Marcus Povitz, Jessica M Sontrop, Lihua Li, Lucie Richard, Sonny Cejic, Salimah Z Shariff
Background: Reducing inappropriate antibiotic prescribing for acute upper respiratory tract infections (AURIs) requires a better understanding of the factors associated with this practice. Objective: To determine the prevalence of antibiotic prescribing for nonbacterial AURIs and whether prescribing rates varied by physician characteristics. Design: Retrospective analysis of linked administrative health care data. Setting: Primary care physician practices in Ontario, Canada (January-December 2012)...
May 9, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28492121/south-african-medical-students-perceptions-and-knowledge-about-antibiotic-resistance-and-appropriate-prescribing-are-we-providing-adequate-training-to-future-prescribers
#16
Sean Wasserman, Samantha Potgieter, Evan Shoul, Deborah Constant, Annemie Stewart, Marc Mendelson, Tom H Boyles
BACKGROUND: Education of medical students has been identified by the World Health Organization as an important aspect of antibiotic resistance (ABR) containment. Surveys from high-income countries consistently reveal that medical students recognise the importance of antibiotic prescribing knowledge, but feel inadequately prepared and require more education on how to make antibiotic choices. The attitudes and knowledge of South African (SA) medical students regarding ABR and antibiotic prescribing have never been evaluated...
April 25, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28490380/living-with-hypertrophic-cardiomyopathy-and-an-implantable-defibrillator
#17
Peter Magnusson, Jessica Jonsson, Stellan Mörner, Lennart Fredriksson
BACKGROUND: ICDs efficiently terminate life-threatening arrhythmias, but complications occur during long-term follow-up. Patients' own perspective is largely unknown. The aim of the study was to describe experiences of hypertrophic cardiomyopathy (HCM) patients with implantable defibrillators (ICDs). METHODS: We analyzed 26 Swedish patient interviews using hermeneutics and latent content analysis. RESULTS: Patients (aged 27-76 years) were limited by HCM especially if it deteriorates into heart failure...
May 10, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28487010/benzodiazepine-prescribing-in-the-elderly-in%C3%A2-germany-and-korea-a-comparison-of-two%C3%A2-observational-studies%C3%A2
#18
Barry Woodcock, Karel Kostev, Ju-Young Shin
OBJECTIVES: To identify differences and similarities in benzodiazepine (BZD) prescribing patterns in elderly patients reported in two separate and independent investigations, one from Germany for the year 2014 and the other from Korea for the year 2013. METHODS: Data on patients over 65 years, who were prescribed at least one BZD, were obtained from population databases. The design and characteristics of the two studies were similar. RESULTS: The use of BZDs in the elderly in Korea was several-fold higher than in Germany depending on the age stratification...
May 10, 2017: International Journal of Clinical Pharmacology and Therapeutics
https://www.readbyqxmd.com/read/28486815/incident-use-of-a-potentially-inappropriate-medication-and-hip-fracture-in-community-dwelling-older-persons-with-alzheimer-s-disease
#19
Virva Hyttinen, Heidi Taipale, Anna-Maija Tolppanen, Antti Tanskanen, Jari Tiihonen, Sirpa Hartikainen, Hannu Valtonen
BACKGROUND: Potentially inappropriate medications (PIMs) increase the risk of adverse drug reactions and events and have been associated with greater health care service use, such as an increased risk of hospitalization. OBJECTIVE: The aim of this study is to evaluate the association between PIM use and hip fractures in a nationwide cohort of community-dwelling persons ≥65 years old with Alzheimer's disease (AD). METHODS: The study, which is based on the Finnish nationwide MEDALZ cohort, included all persons diagnosed with AD between 2005 and 2011 (n = 70 718)...
May 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28484587/reducing-error-in-anticoagulant-dosing-via-multidisciplinary-team-rounding-at-point-of-care
#20
Munish Sharma, Mahesh Krishnamurthy, Richard Snyder, James Mauro
The incorporation of a clinical pharmacist in daily rounding can help identify and correct errors related to anticoagulation dosing. Inappropriate anticoagulant dosing increases the risk of developing significant bleeding diathesis. Conversely, inappropriate dosing may also fail to produce a therapeutic response. We retrospectively reviewed electronic medical records of 41 patients to confirm and analyze the errors related to various anticoagulants. A clinical pharmacist in an integrated rounding between the period of February 2016 and April 2016 collected this data...
April 6, 2017: Clinics and Practice
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