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https://www.readbyqxmd.com/read/28535109/intranasal-steroid-use-for-otitis-media-with-effusion-ongoing-opportunities-for-quality-improvement
#1
David E Wang, Derek J Lam, Angela M Bellmunt, Richard M Rosenfeld, Allison K Ikeda, Jennifer J Shin
Objectives Our objectives were (1) to assess patterns of intranasal steroid administration when otitis media with effusion (OME) has been diagnosed in children, (2) to investigate whether usage varies according to visit setting, and (3) to determine if practice gaps are such that quality improvement could be tracked. Study Design Cross-sectional analysis of an administrative database. Subjects and Methods National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005 to 2012; univariate, multivariate, and stratified analyses of intranasal steroid usage were performed...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28530521/the-direct-cost-of-managing-a-rare-disease-assessing-medical-and-pharmacy-costs-associated-with-duchenne-muscular-dystrophy-in-the-united-states
#2
Sarah Thayer, Christopher Bell, Craig M McDonald
BACKGROUND: A Duchenne muscular dystrophy (DMD) cohort was identified using a claims-based algorithm to estimate health care utilization and costs for commercially insured DMD patients in the United States. Previous analyses have used broad diagnosis codes that include a range of muscular dystrophy types as a proxy to estimate the burden of DMD. OBJECTIVE: To estimate DMD-associated resource utilization and costs in a sample of patients identified via a claims-based algorithm using diagnosis codes, pharmacy prescriptions, and procedure codes unique to DMD management based on DMD clinical milestones...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28498504/varenicline-versus-nicotine-patch-with-brief-advice-for-smokers-with-substance-use-disorders-with-or-without-depression-effects-on-smoking-substance-use-and-depressive-symptoms
#3
Damaris J Rohsenow, Jennifer W Tidey, Rosemarie A Martin, Suzanne M Colby, Robert M Swift, Lorenzo Leggio, Peter M Monti
AIMS: Varenicline was compared with transdermal nicotine (NRT) for smokers with current substance use disorders (SUD) for effects on 3-month smoking abstinence (primary outcome) and, secondarily, on 3 and 6 month abstinence while adjusting for medication adherence, and on additional smoking and substance use outcomes. Moderation by major depressive disorder history (MDD) and adherence were investigated. DESIGN: Double-blind double-placebo controlled randomized design, stratifying by MDD, gender and nicotine dependence, with 3 and 6 months follow up...
May 12, 2017: Addiction
https://www.readbyqxmd.com/read/28489464/results-of-a-randomized-controlled-pilot-trial-of-intravascular-renal-denervation-for-management-of-treatment-resistant-hypertension
#4
Lotte Jacobs, Alexandre Persu, Qi-Fang Huang, Jean-Philippe Lengelé, Lutgarde Thijs, Frank Hammer, Wen-Yi Yang, Zhen-Yu Zhang, Jean Renkin, Peter Sinnaeve, Fang-Fei Wei, Agnès Pasquet, Fadl Elmula M Fadl Elmula, Marc Carlier, Arif Elvan, Cora Wunder, Sverre E Kjeldsen, Stefan W Toennes, Stefan Janssens, Peter Verhamme, Jan A Staessen
OBJECTIVE: Previous trials of catheter-based renal-artery denervation (RDN) as treatment modality in resistant hypertension (rHT) generated unconvincing results. In the Investigator-Steered Project on Intravascular Denervation for Management of Treatment-Resistant Hypertension (INSPiRED; NCT01505010), we optimized selection and management of rHT patients. METHODS: With ethical clearance to randomize 18 patients, three Belgian hypertension centers screened 29 rHT patients on treatment with ≥3 drugs, of whom 17 after optimization of treatment (age <70 years; systolic/diastolic office blood pressure (BP) ≥ 140/90 mm Hg; 24-h BP ≥130/80 mm Hg; glomerular filtration rate [eGFR] ≥ 45 mL/min/1...
May 10, 2017: Blood Pressure
https://www.readbyqxmd.com/read/28486672/-meet-and-greet-intake-appointments-in-primary-care-a-new-pattern-of-patient-intakes
#5
Emily Gard Marshall, Imhokhai Ogah, Beverley Lawson, Richard J Gibson, Frederick Burge
Background.: Family physicians (FPs) are expected to take on new patients fairly and equitably and to not discriminate based on medical or social history. 'Meet and greet' appointments are initial meetings between physicians and prospective patients to establish fit between patient needs and provider scope of practice. The public often views these appointments as discriminatory; however, there is no empirical evidence regarding their prevalence or outcomes. Objectives...
May 9, 2017: Family Practice
https://www.readbyqxmd.com/read/28485202/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#6
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28453751/the-neurologic-assessment-in-neuro-oncology-nano-scale-a-tool-to-assess-neurologic-function-for-integration-into-the-response-assessment-in-neuro-oncology-rano-criteria
#7
Lakshmi Nayak, Lisa M DeAngelis, Alba A Brandes, David M Peereboom, Evanthia Galanis, Nancy U Lin, Riccardo Soffietti, David R Macdonald, Marc Chamberlain, James Perry, Kurt Jaeckle, Minesh Mehta, Roger Stupp, Alona Muzikansky, Elena Pentsova, Timothy Cloughesy, Fabio M Iwamoto, Joerg-Christian Tonn, Michael A Vogelbaum, Patrick Y Wen, Martin J van den Bent, David A Reardon
Background.: The Macdonald criteria and the Response Assessment in Neuro-Oncology (RANO) criteria define radiologic parameters to classify therapeutic outcome among patients with malignant glioma and specify that clinical status must be incorporated and prioritized for overall assessment. But neither provides specific parameters to do so. We hypothesized that a standardized metric to measure neurologic function will permit more effective overall response assessment in neuro-oncology. Methods...
May 1, 2017: Neuro-oncology
https://www.readbyqxmd.com/read/28448777/effect-of-an-advanced-pharmacy-practice-experience-on-medication-therapy-management-services-in-a-centralized-retail-pharmacy-program
#8
Joseph P Vande Griend, Melissa Rodgers, Wesley Nuffer
BACKGROUND: Medication therapy management (MTM) delivery is increasingly important in managed care. Successful delivery positively affects patient health and improves Centers for Medicare & Medicaid Services star ratings, a measure of health plan quality. As MTM services continue to grow, there is an increased need for efficient and effective care models. The primary objectives of this project were to describe the delivery of MTM services by fourth-year Advanced Pharmacy Practice Experience (APPE) students in a centralized retail pharmacy system and to evaluate and quantify the clinical and financial contributions of the students...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28438479/family-presence-during-resuscitation-fpdr-observational-case-studies-of-emergency-personnel-in-victoria-australia
#9
Joanne E Porter, Nareeda Miller, Anita Giannis, Nicole Coombs
INTRODUCTION: Family Presence During Resuscitation (FPDR), although not a new concept, remains inconsistently implemented by emergency personnel. Many larger metropolitan emergency departments (ED) have instigated a care coordinator role, however these personnel are often from a non-nursing background and have therefore limited knowledge about the clinical aspects of the resuscitation. In rural emergency departments there are simply not enough staff to allocate an independent role. A separate care coordinator role, who is assigned to care for the family and not take part in the resuscitation has been well documented as essential to the successful implementation of FPDR...
April 21, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28436256/clinical-and-economic-impact-of-hyperkalemia-in-patients-with-chronic-kidney-disease-and-heart-failure
#10
Michael Polson, Todd C Lord, Anne Kangethe, Lindsay Speicher, Carolyn Farnum, Melanie Brenner, Nina Oestreicher, Paula Alvarez
BACKGROUND: Hyperkalemia (HK) is a concern for patients with chronic kidney disease (CKD) and heart failure (HF), and for those receiving treatments that inhibit the renin-angiotensin-aldosterone system (RAASi). An analysis of 1.7 million medical records of patients in the United States revealed that among individuals with more than 2 potassium values during 2007 to 2012, HK was detected in 34.6% of patients with CKD and 30.0% of patients with HF. OBJECTIVE: To evaluate the association of HK and use of RAASi therapies at optimal and suboptimal doses in patients with CKD and/or HF with health care resource utilization and overall cost of care in a diverse cohort of commercially insured patients...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28412575/the-role-of-illicit-licit-and-designer-drugs-in-the-traffic-in-hungary
#11
László Institóris, Előd Hidvégi, Adrienn Dobos, Éva Sija, Éva M Kereszty, László Balázs Tajti, Gábor Pál Somogyi, Tibor Varga
The aim of this study was to investigate the prevalence and pattern of psychoactive substances among suspected DUID (Driving Under the Influence of Drugs) drivers in Hungary in 2014 and 2015. Blood and/or urine samples of 1252 suspected drivers (600 in 2014 and 652 in 2015) were analyzed for classical illicit and licit drugs, stimulant designer drugs (SDDs), and for synthetic cannabinoids, with 78.3% and 79.6% positive cases for at least one substance in 2014, and 2015, respectively. Impairment was proven in 39...
April 3, 2017: Forensic Science International
https://www.readbyqxmd.com/read/28394705/establishment-of-a-cohort-for-deep-phenotyping-of-the-immune-response-to-influenza-vaccination-among-elderly-individuals-recruited-from-the-general-population
#12
Manas K Akmatov, Peggy Riese, Marcus May, Leonhard Jentsch, Malik W Ahmed, Damaris Werner, Anja Rösel, Megan Tyler, Kevin Pessler, Jana Prokein, Inga Bernemann, Norman Klopp, Blair Prochnow, Stephanie Trittel, Aravind Tallam, Thomas Illig, Christoph Schindler, Carlos A Guzmán, Frank Pessler
Elderly individuals have the highest burden of disease from influenza infection but also the lowest immune response to influenza vaccination. A better understanding of the host response to influenza vaccination in the elderly is therefore urgently needed. We conducted a biphasic prospective, population-based study from Dec. 2014 to May 2015 (pilot study) and Sept. 2015 to May 2016 (main study). Individuals 65-80 y of age were randomly selected from the residents' registration office in Hannover, Germany, for the pilot (n = 34) and main study (n = 200)...
April 10, 2017: Human Vaccines & Immunotherapeutics
https://www.readbyqxmd.com/read/28371960/a-model-for-the-management-of-female-sexual-dysfunctions
#13
Lúcia Alves da Silva Lara, Sandra Cristina Poerner Scalco, Júlia Kefalás Troncon, Gerson Pereira Lopes
Introduction Sexual pleasure is fundamental for the maintenance of health and well-being, but it may be adversely affected by medical and psychosocial conditions. Many patients only feel that their health is fully restored after they resume normal sexual activities. Any discussion of sexuality in a doctor's office is typically limited, mainly because of a lack of models or protocols available to guide the discussion of the topic. Objectives To present a model designed to guide gynecologists in the management of female sexual complaints...
April 2017: Revista Brasileira de Ginecologia e Obstetrícia
https://www.readbyqxmd.com/read/28345443/economic-burden-of-irritable-bowel-syndrome-with-diarrhea-retrospective-analysis-of-a-u-s-commercially-insured-population
#14
Jessica L Buono, Kush Mathur, Amelia J Averitt, David A Andrae
BACKGROUND: The economic burden associated with irritable bowel syndrome with diarrhea (IBS-D) is not well understood. OBJECTIVES: To (a) evaluate total annual all-cause, gastrointestinal (GI)-related, and symptom-related (i.e., IBS, diarrhea, abdominal pain) health care resource use and costs among IBS-D patients in a U.S. commercially insured population and (b) estimate incremental all-cause health care costs of IBS-D patients versus matched controls. METHODS: Patients aged ≥ 18 years with 12 months of continuous medical and pharmacy benefit eligibility in 2013 were identified from the Truven Health MarketScan research database...
April 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28339494/facility-type-and-primary-care-performance-in-sub-district-health-promotion-hospitals-in-northern-thailand
#15
Nithra Kitreerawutiwong, Sue Jordan, David Hughes
BACKGROUND: Poor and middle-income Thai people rely heavily on primary care health services. These are staffed by a range of professionals. However, it is unknown whether the performance of primary care varies according to the staffing and organization of local service delivery units. Tambon (sub-district) health promotion hospitals (THPHs) were introduced in 2009 to upgrade the services offered by the previous health centres, but were faced with continuing shortages of doctors and nurses...
2017: PloS One
https://www.readbyqxmd.com/read/28339444/a-review-of-long-term-pain-relief-after-genicular-nerve-radiofrequency-ablation-in-chronic-knee-osteoarthritis
#16
Ferdinand Iannaccone, Samuel Dixon, Andrew Kaufman
BACKGROUND: Studies of radiofrequency ablation (RFA) of genicular nerves have reportedly significantly decreased pain up to 3 months post ablation, but no longer term effects have been reported. We performed an analysis of long-term pain relief of 31 RFA procedures of the genicular nerves to analyze the degree of pain relief past 3 months, culminating at 6 months. STUDY DESIGN: Chart review and study design was approved by Newark Health Sciences Institutional Review Board (IRB)...
March 2017: Pain Physician
https://www.readbyqxmd.com/read/28288637/exploring-implementation-practices-in-results-based-financing-the-case-of-the-verification-in-benin
#17
Matthieu Antony, Maria Paola Bertone, Olivier Barthes
BACKGROUND: Results-based financing (RBF) has been introduced in many countries across Africa and a growing literature is building around the assessment of their impact. These studies are usually quantitative and often silent on the paths and processes through which results are achieved and on the wider health system effects of RBF. To address this gap, our study aims at exploring the implementation of an RBF pilot in Benin, focusing on the verification of results. METHODS: The study is based on action research carried out by authors involved in the pilot as part of the agency supporting the RBF implementation in Benin...
March 14, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28267470/rationale-and-design-of-a-cluster-randomized-controlled-trial-to-evaluate-the-effects-of-a-community-health-worker-based-program-for-cardiovascular-risk-factor-control-in-india
#18
Aditya Khetan, Raghunandan Purushothaman, Melissa Zullo, Rishab Gupta, Vittal Hejjaji, Sushil Agarwal, Sri Krishna Madan Mohan, Richard Josephson
BACKGROUND: The increasing burden of cardiovascular disease (CVD) in low- and middle-income countries is largely driven by the increasing prevalence of hypertension, diabetes, and tobacco use. We hypothesize that the utilization of community health workers (CHWs) to screen for and manage these 3 determinants of CVD in an integrated manner would be an effective approach to favorably affecting public health. METHODS: We have designed and set up the infrastructure to implement a 2-year community-based cluster randomized controlled trial in an underserved region of West Bengal, India...
March 2017: American Heart Journal
https://www.readbyqxmd.com/read/28257397/translating-comparative-effectiveness-research-into-practice-effects-of-interventions-on-lifestyle-medication-adherence-and-self-care-for-type-2-diabetes-hypertension-and-obesity-among-black-hispanic-and-asian-residents-of-chicago-and-houston-2010-to-2013
#19
Jamila R Rashid, Brenda A Leath, Benedict I Truman, Donna Durant Atkinson, Lisa C Gary, Nanmathi Manian
CONTEXT: In the United States, racial/ethnic minorities account for disproportionate disease and death from type 2 diabetes, hypertension, and obesity; however, interventions with measured efficacy in comparative effectiveness research are often not adopted or used widely in those communities. OBJECTIVE: To assess implementation and effects of comparative effectiveness research-proven interventions translated for minority communities. DESIGN: Mixed-method assessment with pretest-posttest single-group evaluation design...
March 1, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28252979/relations-among-race-ethnicity-gender-and-mental-health-status-in-primary-care-use
#20
Shreyasi Deb, Nancy A Miller
OBJECTIVE: Many working-age individuals with a serious mental health disability go without primary care. Gender and racial/ethnic disparities have been found in primary care utilization. This article examines whether the interaction of gender and race/ethnicity with serious mental health disability is associated with primary care use among working-age individuals. METHOD: We pooled data from the Medical Expenditure Panel Survey-Household Component (MEPS-HC) panels for the years 2001 to 2007 creating a sample of 34,199 individuals, 1,605 of whom had serious mental health disability...
March 2, 2017: Psychiatric Rehabilitation Journal
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