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https://www.readbyqxmd.com/read/28453819/evaluation-of-a-care-transition-program-with-pharmacist-provided-home-based-medication-review-for-elderly-singaporeans-at-high-risk-of-readmissions
#1
McVin Hua Heng Cheen, Chong Ping Goon, Wan Chee Ong, Paik Shia Lim, Choon Nam Wan, Mei Yan Leong, Giat Yeng Khee
Objective: This study aimed to determine whether pharmacist-provided home-based medication review (HBMR) can reduce readmissions in the elderly. Design: Retrospective cohort study. Setting: Patient's home. Participants: Records of patients referred to a care transition program from March 2011 through March 2015 were reviewed. Patients aged 60 years and older taking more than 5 medications and had at least 2 unplanned admissions within 3 months preceding the first home visit were included...
April 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28441675/teaching-today-in-the-practice-setting-of-the-future-implementing-innovations-in-graduate-medical-education
#2
Jung G Kim, Carl G Morris, Paul Ford
PROBLEM: Implementing an innovation, such as offering new types of patient-physician encounters through the patient-centered medical home (PCMH) model while maintaining Accreditation Council for Graduate Medical Education (ACGME) accreditation standards (e.g., patient encounter minimums for trainees), is challenging. APPROACH: In 2009, the Group Health Family Medicine Residency (GHFMR) received an ACGME Program Experimentation and Innovation Project (PEIP) exception that redefined the minimum Family Medicine Resident Review Committee requirement to 1,400 face-to-face visits and 250 electronic visits (1 electronic visit defined as 3 secure message or telephone encounters)...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28435754/establishing-successful-patient-centered-medical-homes-in-rural-hawai-i-three-strategies-to-consider
#3
Melissa Nelson Scribner, Kasey Kehoe
The challenges to healthcare delivery posed by Hawai'i's unique geography, physician shortages, and dispersed population are of particular importance in light of implementing the Affordable Care Act (ACA). This study draws on central goals laid out in the ACA - to decrease costs, increase access, and improve patient outcomes. The use of the Patient-Centered Medical Homes (PCMHs) is a care model that has the potential to meet all three goals. How to identify the most effective way to develop PCMHs in the specific context of Hawai'i is the focus of this study...
March 2017: Hawai'i Journal of Medicine & Public Health: a Journal of Asia Pacific Medicine & Public Health
https://www.readbyqxmd.com/read/28434390/how-preferences-for-continuity-and-access-differ-between-multimorbidity-and-healthy-patients-in-a-team-care-setting
#4
Katherine M Ehman, Mark Deyo-Svendsen, Zachary Merten, Anne Marie Kramlinger, Gregory M Garrison
INTRODUCTION: Team-based care has become an essential part of modern medical practice. Patient-centered medical homes often struggle to balance the dual competing goals of acute access and continuity of care. Multimorbidity patients may value continuity more than healthy patients, and thus may prefer to wait to see their primary care physician (PCP). METHODS: A total of 1700 randomly selected healthy adults and multimorbidity patients were asked to rate satisfaction with care and presented with 4 acute and 4 chronic scenarios to choose an access and continuity preference in an anonymous mailed survey...
April 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28431515/the-effectiveness-of-creating-an-online-life-story-book-on-persons-with-early-dementia-and-their-informal-caregivers-a-protocol-of-a-randomized-controlled-trial
#5
Teuntje R Elfrink, Sytse U Zuidema, Miriam Kunz, Gerben J Westerhof
BACKGROUND: Dementia has a high burden for patients, informal caregivers and society. Given changes in care systems, more persons with dementia will live longer at home. However, living at home (with dementia) with a good quality of life is not easy to achieve. Dementia is often accompanied by neuropsychiatric symptoms like apathy, agitation, depression, and anxiety, which have a negative impact on quality of life. Whereas cognitive deterioration can hardly be influenced, it is possible to reduce neuropsychiatric symptoms...
April 21, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28428012/-retrospective-study-of-children-referred-from-paediatric-intensive-care-to-palliative-care-why-and-for-what
#6
Alberto García-Salido, Paula Santos-Herranz, Verónica Puertas-Martín, María Ángeles García-Teresa, Ricardo Martino-Alba, Ana Serrano-González
INTRODUCTION: The creation of paediatric palliative care units (PPCU) could optimise the management of children with palliative focus after admission to a paediatric intensive care unit (PICU). This study describes the clinical and epidemiological characteristics of children referred from PICU to the UCPP of the Autonomous Community of Madrid (CAM). The overall treatment, relapses, re-admissions, and deaths, if occurred, are described. PATIENTS AND METHOD: A retrospective review was performed using the medical records from children transferred from the CAM paediatric intensive care units to the paediatric palliative care unit (1 March 2008-31 January 2015)...
April 17, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/28422906/risk-factors-and-costs-associated-with-nationwide-nonelective-readmission-after-trauma
#7
Joshua Parreco, Jessica Buicko, Nicholas Cortolillo, Nicholas Namias, Rishi Rattan
BACKGROUND: Most prior studies of readmission after trauma have been limited to single institutions while multi-institutional studies have been limited to single states and an inability to distinguish between elective and nonelective readmissions. The purpose of this study was to identify the risk factors and costs associated with nonelective readmission after trauma across the US. METHODS: The Nationwide Readmission Database was queried for all patients with nonelective admissions in 2013 and 2014 with a primary diagnosis of trauma...
April 18, 2017: Journal of Trauma and Acute Care Surgery
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
#8
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/28413364/delivering-integrated-care-to-the-frail-elderly-the-impact-on-professionals-objective-burden-and-job-satisfaction
#9
Benjamin Janse, Robbert Huijsman, Ruben Dennis Maurice de Kuyper, Isabelle Natalina Fabbricotti
BACKGROUND: The impact of integrated working on professionals' objective burden and job satisfaction was examined. An evidence-based intervention targeting frail elderly patients was implemented in the Walcheren region of the Netherlands in 2010. The intervention involved the primary care practice as a single entry point, and included proactive frailty screening, a comprehensive assessment of patient needs, case management, multidisciplinary teams, care plans and protocols, task delegation and task specialisation, a shared information system, a geriatric care network and integrated funding...
August 17, 2016: International Journal of Integrated Care
https://www.readbyqxmd.com/read/28412152/discrepancies-between-home-medication-and-patient-documentation-in-primary-care
#10
Olaf Rose, Ulrich Jaehde, Juliane Köberlein-Neu
No abstract text is available yet for this article.
April 8, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28412054/community-pharmacy-transition-of-care-services-and-rural-hospital-readmissions-a-case-study
#11
Allison P Patton, Yifei Liu, D Matthew Hartwig, Justin R May, Jessica Moon, Steven C Stoner, Kendall D Guthrie
OBJECTIVES: To explore community pharmacist involvement in the transition of care (TOC) process for patients discharged with acute myocardial infarction (AMI), heart failure (HF), pneumonia, chronic obstructive pulmonary disease (COPD), or elective total hip or knee arthroplasty (THA/TKA). SETTING: Patients discharged from a 60-bed acute care hospital located in rural Missouri were seen by a community pharmacist in 2 independent community pharmacy chain locations...
April 12, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28409703/beyond-screening-a-stepped-care-pathway-for-managing-postpartum-depression-in-pediatric-settings
#12
Su-Chin Serene Olin, Mary McCord, Ruth E K Stein, Bonnie D Kerker, Dara Weiss, Kimberly E Hoagwood, Sarah M Horwitz
The negative consequences of untreated postpartum depression (PD) for both the woman and her infant are well established. The impact of maternal depression has led to recommendations on systematic perinatal depression screening. Unfortunately, large-scale initiatives on PD screening have found no benefit unless systems are in place to facilitate appropriate interventions for women who screen positive. Pediatric primary care has been a focus of efforts to support screening and management of PD because pediatric providers, unlike adult healthcare providers, have the most frequent contact with postpartum women through well-child visits...
April 14, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/28408545/reducing-medical-admissions-into-hospital-through-optimising-medicines-remain-home-study-protocol-for-a-stepped-wedge-cluster-randomised-trial
#13
Holly Foot, Christopher Freeman, Karla Hemming, Ian Scott, Ian D Coombes, Ian D Williams, Luke Connelly, Jennifer A Whitty, Nancy Sturman, Sue Kirsa, Caroline Nicholson, Grant Russell, Carl Kirkpatrick, Neil Cottrell
INTRODUCTION: A model of general practitioner (GP) and pharmacist collaboration in primary care may be an effective strategy to reduce medication-related problems and provide better support to patients after discharge. The aim of this study is to investigate whether a model of structured pharmacist and GP care reduces hospital readmissions in high-risk patients. METHODS AND ANALYSIS: This protocol details a stepped-wedge, cluster-randomised trial that will recruit participants over 9 months with a 12-month follow-up...
April 13, 2017: BMJ Open
https://www.readbyqxmd.com/read/28406727/the-experience-of-patients-with-alcohol-misuse-after-surviving-a-critical-illness-a-qualitative-study
#14
Brendan J Clark, Jacqueline Jones, K Diandra Reed, Rachel Marie Hodapp, Ivor S Douglas, David Van Pelt, Ellen L Burnham, Marc Moss
RATIONALE: Alcohol misuse is common in patients admitted to the intensive care unit (ICU) but there is currently no evidence-based approach to address drinking in ICU survivors. OBJECTIVES: We sought to describe the experience of ICU survivors with alcohol misuse during their hospitalization and the 3 months following hospital discharge in order to inform an alcohol specific intervention for this unique population. METHODS: We conducted a descriptive qualitative study of ICU survivors from medical ICUs in three separate hospitals with a positive screening result on the Alcohol Use Disorders Identification Test...
April 13, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28403338/needs-of-family-caregivers-in-home-care-for-older-adults
#15
Carla Cristiane Becker Kottwitz Bierhals, Naiana Oliveira Dos Santos, Fernanda Laís Fengler, Kamila Dellamora Raubustt, Dorothy Anne Forbes, Lisiane Manganelli Girardi Paskulin
Objective: to reveal the felt and normative needs of primary family caregivers when providing instrumental support to older adults enrolled in a Home Care Program in a Primary Health Service in the South of Brazil. Methods: using Bradshaw's taxonomy of needs to explore the caregiver's felt needs (stated needs) and normative needs (defined by professionals), a mixed exploratory study was conducted in three steps: Descriptive quantitative phase with 39 older adults and their caregiver, using a data sheet based on patient records; Qualitative exploratory phase that included 21 caregiver interviews, analyzed by content analysis; Systematic observation, using an observation guide with 16 caregivers, analyzed by descriptive statistics...
April 6, 2017: Revista Latino-americana de Enfermagem
https://www.readbyqxmd.com/read/28396108/augmented-nurse-care-management-in-ckd-stages-4-to-5-a%C3%A2-randomized-trial
#16
Steven Fishbane, Sofia Agoritsas, Alessandro Bellucci, Candice Halinski, Hitesh H Shah, Vipul Sakhiya, Leah Balsam
BACKGROUND: Outcomes for patients with late-stage chronic kidney disease (CKD) in the United States are suboptimal. There is poor education and preparation for end-stage kidney disease, as well as a high rate of hospitalization in this group of patients. STUDY DESIGN: A randomized, parallel-group, 2-arm, controlled trial. SETTING & PARTICIPANTS: The study was conducted at 3 sites: a clinic of an academic medical center, a public hospital academic clinic, and a community-based private practice...
April 7, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28387979/prescription-contraception-use-and-adherence-by-women-with-substance-use-disorders
#17
Gillian Griffith, Tara Kumaraswami, Stavroula A Chrysanthopoulou, Kristin M Mattocks, Robin E Clark
BACKGROUND AND AIMS: Unintended pregnancy rates are high among women with substance use disorders (SUDs), which could be partly explained by lower use of and adherence to contraception. We aimed to test: (1) the association of SUD with prescription contraceptive use, contraceptive method selection, and adherence; (2) whether practices participating in the Patient-Centered Medical Home Initiative (PCMHI) had better contraceptive use and adherence for patients with SUD; (3) for differences in the association of SUD with adherence by type of contraceptive used...
April 7, 2017: Addiction
https://www.readbyqxmd.com/read/28387598/patient-experiences-with-care-differ-with-chronic-care-management-in-a-federally-qualified-community-health-center
#18
Claude M Setodji, Denise D Quigley, Marc N Elliott, Q Burkhart, Michael E Hochman, Alex Y Chen, Ron D Hays
This study compares patient experience among practices that vary in adoption of the chronic care management (CCM) dimension of the patient-centered medical home (PCMH) model that focuses on care coordination and management of chronic diseases. Study participants were 2903 adult patients (ages 18 years or older) at 14 primary care centers in California. Seven of the sites were classified as high (more CCM) and the other 7 low on a CCM index. Hypotheses were tested using ordinary least squares regression models...
April 7, 2017: Population Health Management
https://www.readbyqxmd.com/read/28385024/patient-experience-midway-through-a-large-primary-care-practice-transformation-initiative
#19
Kaylyn E Swankoski, Deborah N Peikes, Stacy B Dale, Nancy A Clusen, Nikkilyn Morrison, John J Holland, Timothy J Day, Randall S Brown
OBJECTIVES: To determine how the multipayer Comprehensive Primary Care (CPC) initiative that transforms primary care delivery affects the patient experience of Medicare fee-for-service beneficiaries. The study examines how experience changed between the first and second years of CPC, how ratings of CPC practices have changed relative to ratings of comparison practices, and areas in which practices still have opportunities to improve patient experience. STUDY DESIGN: Prospective study using 2 serial cross-sectional samples of more than 25,000 Medicare fee-for-service beneficiaries attributed to 496 CPC practices and nearly 9000 beneficiaries attributed to 792 comparison practices...
March 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28382415/the-case-for-the-genetic-nurse-in-south-africa
#20
REVIEW
Helen L Malherbe, Arnold L Christianson, David Woods, Colleen Aldous
The care and prevention of congenital disorders (CDs) is an emerging but unprioritised health need in South Africa (SA). Inadequate empirical data and underreporting conceal the true burden of CDs while medical genetic services to confront the problem have regressed. Positive epidemiological transition in the country now demands these services are improved to significantly further reduce child mortality. Current sector capacity in SA is inadequate and required personnel targets will not be reached quickly enough to meet the growing health need even if relevant posts are designated...
April 2017: Journal of Community Genetics
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