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https://www.readbyqxmd.com/read/28230459/estimated-cost-effectiveness-cost-benefit-and-risk-reduction-associated-with-an-endocrinologist-pharmacist-diabetes-intense-medical-management-tune-up-clinic
#1
Jan D Hirsch, Mark Bounthavong, Anisa Arjmand, David R Ha, Christine L Cadiz, Andrew Zimmerman, Heather Ourth, Anthony P Morreale, Steven V Edelman, Candis M Morello
BACKGROUND: In 2012 U.S. diabetes costs were estimated to be $245 billion, with $176 billion related to direct diabetes treatment and associated complications. Although a few studies have reported positive glycemic and economic benefits for diabetes patients treated under primary care physician (PCP)-pharmacist collaborative practice models, no studies have evaluated the cost-effectiveness of an endocrinologist-pharmacist collaborative practice model treating complex diabetes patients versus usual PCP care for similar patients...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230455/outcomes-of-pharmacy-led-hepatitis-c-direct-acting-antiviral-utilization-management-at-a-veterans-affairs-medical-center
#2
Sendra Yang, Rachel B Britt, Mohamed G Hashem, Jamie N Brown
BACKGROUND: The Veterans Affairs Health (VA) Administration has reported hepatitis C virus (HCV) infection rates among veterans to be twice that of the general U.S population. New HCV direct-acting antiviral (DAA) treatment options offer superior sustained virologic response (SVR) rates, improved side-effect profiles, and shortened treatment courses; yet, these new HCV DAAs are expensive, and utilization management strategies are needed to optimize use and improve clinical outcomes. A VA medical center uses pharmacist-led HCV DAA utilization management strategies that includes clinical guidance, optimizing operational flow, budget tracking and forecasting, and patient outcomes tracking...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28230447/effect-of-medicaid-policy-changes-on-medication-adherence-differences-by-baseline-adherence
#3
Krutika Amin, Joel F Farley, Matthew L Maciejewski, Marisa E Domino
BACKGROUND: In 2001, the North Carolina (NC) Medicaid program reduced the number of days prescription supply that enrollees could fill from 100 days to 34 days and increased copayments for brand-name medications. Previous work has shown that a change in these policies led to a decrease in medication adherence from 2.9 to 8.0 percentage points in specific populations with chronic conditions. Studies have also shown that days supply limits and copayment increases have heterogeneous effects based on enrollees' baseline characteristics, including baseline adherence...
March 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28228288/fda-ce-mark-or-something-else-thinking-fast-and-slow
#4
EDITORIAL
Sundeep Mishra
There is a robust debate going on among the Medical Device stake-holders whether FDA is better or CE mark or something else. Currently process of obtaining an FDA approval is bogged down by ever-increasing unpredictability, inconsistency, prolonged time, and huge expense but CE mark has its own problems. Historically, the Japanese review process has tended to be the slowest among the big three but recently with the introduction of accelerated review process there has been a significant progress. While the goal of an innovator/manufacturer is to develop, manufacture and market a medical device that addresses an unmet clinical need, the requisite regulatory approval process can be very confusing...
January 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28226408/which-regional-pain-rating-best-predicts-patient-reported-improvement-in-lumbar-radiculopathy
#5
Mark C Bicket, Paul F Pasquina, Steven P Cohen
OBJECTIVE: To determine the best regional pain score cutoff value that corresponds with patient-reported improvement in lumbosacral radiculopathy (LSR). DESIGN: Retrospective pooled data analysis from 3 randomized, controlled, multicenter trials using similar outcome assessments. All participants were exposed to interventions (epidural injections). SETTING: Military medical centers (6 U.S.A., 1 Germany) and large tertiary care hospitals (4 urban, 1 Veterans Affairs) between 2008 and 2014...
February 22, 2017: Pain Practice: the Official Journal of World Institute of Pain
https://www.readbyqxmd.com/read/28224939/targeting-access-to-kidney-care-via-telehealth-the-va-experience
#6
REVIEW
Susan T Crowley, Justin Belcher, Devasmita Choudhury, Cassandra Griffin, Raymond Pichler, Brooks Robey, Rajeev Rohatgi, Bessie Mielcarek
The Veterans Affairs (VA) is the largest integrated health care system in the United States and is responsible for the care of a population with a disproportionately high rate of CKD. As such, ensuring access to kidney health services is a VA imperative. One facet of the VA's strategy to reduce CKD is to leverage the use of teletechnology to expand the VA's outreach to Veterans with kidney disease. A wide array of teletechnology services have been deployed to both pull in Veterans and push out kidney health services to Veterans in their preferred health care venue...
January 2017: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/28221274/pharmacy-use-in-the-first-year-of-the-veterans-choice-program-a-mixed-methods-evaluation
#7
Walid F Gellad, Francesca E Cunningham, Chester B Good, Joshua M Thorpe, Carolyn T Thorpe, Brandi Bair, KatieLynn Roman, Susan L Zickmund
BACKGROUND: The Veterans Choice Program (VCP) was created to ensure timely access to health care in the Department of Veterans Affairs (VA). Under this program, medications may be ordered by select non-VA clinicians to be dispensed by VA pharmacies, creating new challenges in ensuring medication safety. OBJECTIVES: To examine pharmaceutical use during the first year of the VCP and to understand barriers and facilitators for VA pharmacists to dispensing medications under the VCP...
February 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28221067/ethical-concerns-for-telemental-health-therapy-amidst-governmental-surveillance
#8
Samuel D Lustgarten, Alexander J Colbow
Technology, infrastructure, governmental support, and interest in mental health accessibility have led to a burgeoning field of telemental health therapy (TMHT). Psychologists can now provide therapy via computers at great distances and little cost for parties involved. Growth of TMHT within the U.S. Department of Veterans Affairs and among psychologists surveyed by the American Psychological Association (APA) suggests optimism in this provision of services (Godleski, Darkins, & Peters, 2012; Jacobsen & Kohout, 2010)...
February 2017: American Psychologist
https://www.readbyqxmd.com/read/28217598/five-year-comparison-of-diabetic-control-between-community-diabetic-center-and-primary-health-care-centers
#9
Mazen S Ferwana, Abdulaziz Alshamlan, Wedad Al Madani, Bader Al Khateeb, Amen Bawazir
CONTEXT: Hyperglycemia is the most important factor for development of complications. A high level of hemoglobin A1c (HbA1c) is linked with such complications of diabetes. AIMS: The aim of this study was to compare diabetic care between community diabetic center (CDC) and primary health centers. SETTINGS AND DESIGN: This was a retrospective cohort study conducted at King Abdulaziz Medical City for National Guard Health Affairs at Riyadh, Saudi Arabia...
July 2016: Journal of Family Medicine and Primary Care
https://www.readbyqxmd.com/read/28214960/axonal-disruption-in-white-matter-underlying-cortical-sulcus-tau-pathology-in-chronic-traumatic-encephalopathy
#10
Laurena Holleran, Joong Hee Kim, Mihika Gangolli, Thor Stein, Victor Alvarez, Ann McKee, David L Brody
Chronic traumatic encephalopathy (CTE) is a progressive degenerative disorder associated with repetitive traumatic brain injury. One of the primary defining neuropathological lesions in CTE, based on the first consensus conference, is the accumulation of hyperphosphorylated tau in gray matter sulcal depths. Post-mortem CTE studies have also reported myelin loss, axonal injury and white matter degeneration. Currently, the diagnosis of CTE is restricted to post-mortem neuropathological analysis. We hypothesized that high spatial resolution advanced diffusion MRI might be useful for detecting white matter microstructural changes directly adjacent to gray matter tau pathology...
February 18, 2017: Acta Neuropathologica
https://www.readbyqxmd.com/read/28214229/-iso%C3%A2-9001%C3%A2-certification-of-innovation-and-clinical-research-departments-extending-the-scope-of-health-assessment
#11
C Sambou, S Guillemaut, M Morelle, A Achache, A-G Le Corroller, D Perol, L Perrier
BACKGROUND: The International organization for standardization (ISO) is the world leader in providing industrial and commercial standards and certifications. Beyond medical devices, four French clinical research and innovation departments have received an ISO 9001 certification (the standard for quality management). Simultaneously, medico-economic studies have become increasingly important in the public decision process. Using the clinical research and innovation department from the Léon-Bérard Cancer Center as an example, the purpose of this article is to show how the scope of the ISO 9001 certification has been extended to cover medico-economic studies...
February 14, 2017: Revue D'épidémiologie et de Santé Publique
https://www.readbyqxmd.com/read/28214073/older-adults-with-ptsd-brief-state-of-research-and-evidence-based-psychotherapy-case-illustration
#12
Joan M Cook, Elissa McCarthy, Steven R Thorp
Although lifetime exposure to potentially traumatic events among older adults is fairly high, rates of full-blown post-traumatic stress disorder (PTSD) are estimated at about 4.5%, a rate lower than that for middle-aged and young adults. Nevertheless, PTSD seems to be an under-recognized and under-treated condition in older adults. Assessment and treatment can be challenging in this population for various reasons, including potential cognitive or sensory decline and comorbid mental and physical disorders. This article provides highlights of the empirical research on PTSD in late life, including information on its effects on cognition and physical health...
January 4, 2017: American Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28213212/a-sensitive-bisphenol-a-voltammetric-sensor-relying-on-aupd-nanoparticles-graphene-composites-modified-glassy-carbon-electrode
#13
Bingyuan Su, Huilin Shao, Na Li, Xiaomei Chen, Zhixiong Cai, Xi Chen
In this work, a sensitive bisphenol A (BPA) electrochemical sensor was assembled using a surfactant-free AuPd nanoparticles-loaded graphene nanosheets (AuPdNPs/GNs) modified electrode. The AuPdNPs monodispersed on GNs were successfully prepared by the spontaneous redox reaction between bimetallic precursors and GNs. Because no surfactant or halide ions were involved in the proposed synthesis, the prepared composite was enabled to directly modify a glassy carbon electrode without any pre-treatments. Moreover, due to the synergetic effect of Au and Pd, AuPdNPs/GNs displayed high electrochemical activity with well-defined voltammetric peaks of BPA oxidation and lower overpotential compared with monometallic PdNPs and AuNPs supported GNs...
May 1, 2017: Talanta
https://www.readbyqxmd.com/read/28211937/patterns-of-computed-tomography-surveillance-in-survivors-of-colorectal-cancer-at-veterans-health-administration-facilities
#14
Amikar Sehdev, Eric A Sherer, Siu L Hui, Jingwei Wu, David A Haggstrom
BACKGROUND: Annual computed tomography (CT) scans are a component of the current standard of care for the posttreatment surveillance of survivors of colorectal cancer (CRC) after curative-intent resection. The authors conducted a retrospective study with the primary aim of assessing patient, physician, and organizational characteristics associated with the receipt of CT surveillance among veterans. METHODS: The Department of Veterans Affairs Central Cancer Registry was used to identify patients diagnosed with AJCC collaborative stage I to III CRC between 2001 and 2009...
February 17, 2017: Cancer
https://www.readbyqxmd.com/read/28206888/evidence-based-clinical-practice-guideline-for-the-use-of-pit-and-fissure-sealants
#15
(no author information available yet)
BACKGROUND: This article presents evidence-based clinical recommendations for the use of pit-and-fissure sealants on the occlusal surfaces of primary and permanent molars in children and adolescents. A guideline panel convened by the American Dental Association (ADA) Council on Scientific Affairs and the American Academy of Pediatric Dentistry conducted a systematic review and formulated recommendations to address clinical questions in relation to the efficacy, retention, and potential side effects of sealants to prevent dental caries; their efficacy compared with fluoride varnishes; and a head-to-head comparison of the different types of sealant material used to prevent caries on pits-and-fissures of occlusal surfaces...
October 15, 2016: Pediatric Dentistry
https://www.readbyqxmd.com/read/28206801/burden-and-mental-health-among-caregivers-of-veterans-with-traumatic-brain-injury-polytrauma
#16
Joan M Griffin, Minji K Lee, Lauren R Bangerter, Courtney Harold Van Houtven, Greta Friedemann-Sánchez, Sean M Phelan, Kathleen F Carlson, Laura A Meis
Veterans who survive multiple traumatic injuries, including traumatic brain injuries (TBI), must often rely on family caregivers for ongoing care and support with reintegration. Understanding factors associated with caregiving that help or harm caregivers' health is critical for identifying appropriate and effective interventions that support caregiver health and promote the provision of quality care to veterans. This study utilized cross-sectional data from the Family and Caregiver Experiences Study, a survey of 564 caregivers caring for veterans who served after September 11, 2001, survived TBI/polytrauma during service, and received inpatient rehabilitation care in a Veterans Affairs Polytrauma Rehabilitation Center...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28206800/perspectives-of-veterans-with-mild-traumatic-brain-injury-on-community-reintegration-making-sense-of-unplanned-separation-from-service
#17
Alexander V Libin, Manon Maitland Schladen, Ellen Danford, Samantha Cichon, Dwan Bruner, Joel Scholten, Maria Llorente, Slavomir Zapata, Alexander W Dromerick, Marc R Blackman, Kathryn M Magruder
For veterans separated from the military as a result of acquired mild traumatic brain injury (mTBI), the transition from a military identity to a civilian one is complicated by health, cognitive, and psychosocial factors. We conducted in-depth interviews with 8 veterans with mTBI to understand how they perceived the experience of departure from the military, rehabilitation services provided at a Department of Veterans Affairs (VA) Polytrauma Network Site, and reentry into civilian life. Two distinct patterns of thinking about community reintegration emerged...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28206798/facilitating-reintegration-for-military-service-personnel-veterans-and-their-families-an-introduction-to-the-special-issue
#18
Christine A Elnitsky, Ryan P Kilmer
As service members return from active duty and, in some cases, exit the military, they face a process of reintegration (also referred to as community reintegration) as they seek to resume participation in their life roles as civilians. Facilitating this dynamic process of reintegration for service members, veterans, and their families-including outlining potential strategies for supporting this return to civilian life and its demands, roles, and responsibilities-is the focus of this Special Issue. Reintegration has been framed as a national priority (U...
2017: American Journal of Orthopsychiatry
https://www.readbyqxmd.com/read/28204876/continuous-positive-airway-pressure-adherence-in-patients-with-obstructive-sleep-apnea-symptomatic-bph
#19
Ramesh V V S Metta, Awais Zaka, Vincent C Lee, M Jeffery Mador
Purpose To determine the short-term and long-term adherence rates with continuous positive airway pressure (CPAP) therapy in sleep apnea patients with benign prostatic hyperplasia (BPH) compared to matched controls. Methods A case-control retrospective analysis was performed in a veterans affairs hospital. All symptomatic patients with BPH (n = 107) ever started on CPAP therapy between 2006 and 2012 were compared with controls matched for severity of sleep apnea (AHI). Adherence measures were obtained at the third and twelfth month visits...
February 16, 2017: Lung
https://www.readbyqxmd.com/read/28203055/resident-surgeon-efficiency-in-femtosecond-laser-assisted-cataract-surgery
#20
Andrew C Pittner, Brian R Sullivan
PURPOSE: Comparison of resident surgeon performance efficiencies in femtosecond laser-assisted cataract surgery (FLACS) versus conventional phacoemulsification. PATIENTS AND METHODS: A retrospective cohort study was conducted on consecutive patients undergoing phacoemulsification cataract surgery performed by senior ophthalmology residents under the supervision of 1 attending physician during a 9-month period in a large Veterans Affairs medical center. Medical records were reviewed for demographic information, preoperative nucleus grade, femtosecond laser pretreatment, operative procedure times, total operating room times, and surgical complications...
2017: Clinical Ophthalmology
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