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https://www.readbyqxmd.com/read/29332023/autonomic-response-testing-compared-with-immunoglobulin-e-allergy-panel-test-results-preliminary-report
#1
Autumn Frandsen, Mark McClure, Myung Kyu Chung, Patrick J LaRiccia
Context • Chronically ill patients who have failed standard medical assessment and therapies are often assessed by integrative medical providers for atypical manifestations of allergies as the possible source or contributing factor(s) to their condition. Skin testing and immunoglobulin E (IgE) allergy panels increase the cost of care in these patients. Objective • The objective of this study was to determine the accuracy of autonomic response testing (ART) as compared with IgE allergy panel blood tests...
January 15, 2018: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/29320994/promoting-sustainability-in-quality-improvement-an-evaluation-of-a-web-based-continuing-education-program-in-blood-pressure-measurement
#2
Lauren Block, Sarah J Flynn, Lisa A Cooper, Caroline Lentz, Tammie Hull, Katherine B Dietz, Romsai T Boonyasai
BACKGROUND: The accuracy of blood pressure measurement is variable in office-based settings. Even when staff training programs are effective, knowledge and skills decay over time, supporting the need for ongoing staff training. We evaluated whether a web-based continuing education program in blood pressure measurement reinforced knowledge and skills among clinical staff and promoted sustainability of an existing quality improvement program. METHODS: Medical assistants and nurses at six primary care clinics within a health system enrolled in a 30-min online educational program designed to refresh their knowledge of blood pressure measurement...
January 10, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29290177/health-care-resource-utilization-and-costs-among-newly-diagnosed-and-oral-anticoagulant-naive-nonvalvular-atrial-fibrillation-patients-treated-with-dabigatran-or-warfarin-in-the-united-states
#3
Rahul Jain, An-Chen Fu, Jonathan Lim, Cheng Wang, Jessica Elder, Stephen D Sander, Hiangkiat Tan
BACKGROUND: Warfarin has a long history of use to reduce the risk of stroke in patients with atrial fibrillation (AF), but it requires frequent laboratory monitoring to maintain international normalized ratio levels in the therapeutic range. Dabigatran, a novel oral anticoagulant (OAC), has demonstrated efficacy in reducing the risk of stroke and systemic embolism and does not require laboratory monitoring. OBJECTIVE: To compare health care resource utilization (HCRU) and costs of OAC-naive patients newly diagnosed with nonvalvular atrial fibrillation (NVAF), using dabigatran or warfarin...
January 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29290171/health-care-costs-and-thromboembolic-events-in-hydroxyurea-treated-patients-with-polycythemia-vera
#4
Shreekant V Parasuraman, Nianwen Shi, Dilan C Paranagama, Machaon Bonafede
BACKGROUND: Patients with polycythemia vera (PV) are at increased risk of thromboembolic events (TEs), which are key contributors to reduced overall survival compared with the age- and sex-matched general population. In addition to aspirin and phlebotomy to maintain hematocrit level < 45%, many patients receive cytoreduction with hydroxyurea (HU), which is associated with improved survival and may reduce the risk of cardiovascular events and TEs. However, 1 in 4 patients become resistant to or intolerant of HU...
January 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29273946/a-randomized-controlled-trial-of-intensive-case-management-project-bridge-for-hiv-infected-probationers-and-parolees
#5
Michael S Gordon, Erika L Crable, Steven B Carswell, Jessica Leopold, Jennifer Hodo-Powell, Michelle McKenzie, Josiah D Rich
Individuals on probation and parole are disproportionately at high risk for HIV infection and experience significant barriers to accessing health care. This study was a two-group randomized controlled trial conducted at a community corrections office and was designed to link HIV positive probationers/parolees to HIV treatment in the community. HIV positive participants were assigned to one of the two treatment conditions: (1) Project Bridge (PB), an intensive case-management intervention; or (2) treatment as usual (TAU), involving standard referral to treatment...
December 22, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/29248033/practicing-safety-a-quality-improvement-intervention-to-test-tools-to-enhance-pediatric-psychosocial-care-for-children-0-3-years
#6
Diane J Abatemarco, Ruth S Gubernick, Marianna D LaNoue, Ryan T Pohlig, Sara R Slovin, Jill A Healy, Steven Kairys
BACKGROUND: Child maltreatment is a significant public health issue in the United States. Yet, fewer than half of pediatricians discuss behavioral, developmental, or parenting issues with parents. OBJECTIVE: This paper describes the testing of bundles of tools and processes, part of a larger intervention, Practicing Safety, targeted at changing physician and staff behavior to identify families at risk for child maltreatment, provide anticipatory guidance, refer to community resources, and follow-up and track at-risk families...
December 18, 2017: Primary Health Care Research & Development
https://www.readbyqxmd.com/read/29233720/a-pragmatic-randomized-comparative-effectiveness-trial-of-transitional-care-for-a-socioeconomically-diverse-population-design-rationale-and-baseline-characteristics
#7
Christine Schaeffer, Caroline Teter, Emily A Finch, Courtney Hurt, Mary Kate Keeter, David T Liss, Angela Rogers, Avani Sheth, Ronald Ackermann
Transitional care programs have been widely used to reduce readmissions and improve the quality and safety of the handoff process between hospital and outpatient providers. Very little is known about effective transitional care interventions among patients who are uninsured or with Medicaid. This paper describes the design and baseline characteristics of a pragmatic randomized comparative effectiveness trial of transitional care. Northwestern Medical Group- Transitional Care (NMG-TC) care model was developed to address the needs of patients with multiple medical problems that required lifestyle changes and were amenable to office-based management...
December 9, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29227420/us-state-public-health-departments-special-pathogen-planning
#8
Jocelyn J Herstein, Paul D Biddinger, Shawn G Gibbs, Aurora B Le, Katelyn C Jelden, Angela L Hewlett, John J Lowe
CONTEXT: US state public health departments played key roles in planning for and responding to confirmed and suspected cases of Ebola virus disease (EVD) during the 2014-2016 outbreak, including designating select hospitals as high-level isolation units (HLIUs) for EVD treatment in conjunction with the Centers for Disease Control and Prevention. OBJECTIVE: To identify existing guidelines and perspectives of state health departments pertaining to the management and transport of patients with EVD and other highly hazardous communicable diseases (HHCDs)...
December 7, 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/29224639/a-multinational-clinical-approach-to-assessing-the-effectiveness-of-catheter-based-ultrasound-renal-denervation-the-radiance-htn-and-require-clinical-study-designs
#9
RANDOMIZED CONTROLLED TRIAL
Laura Mauri, Kazuomi Kario, Jan Basile, Joost Daemen, Justin Davies, Ajay J Kirtane, Felix Mahfoud, Roland E Schmieder, Michael Weber, Shinsuke Nanto, Michel Azizi
Catheter-based renal denervation is a new approach to treat hypertension via modulation of the renal sympathetic nerves. Although nonrandomized and small, open-label randomized studies resulted in significant reductions in office blood pressure 6months after renal denervation with monopolar radiofrequency catheters, the first prospective, randomized, sham-controlled study (Symplicity HTN-3) failed to meet its blood pressure efficacy end point. New clinical trials with new catheters have since been designed to address the limitations of earlier studies...
January 2018: American Heart Journal
https://www.readbyqxmd.com/read/29212340/encouragers-and-discouragers-affecting-medical-graduates-choice-of-regional-and-rural-practice-locations
#10
Ann McKillop, Craig Webster, Win Bennett, Barbara O'Connor, Warwick Bagg
INTRODUCTION: Access to health care as near to where people live as possible is desirable. However, not enough medical graduates choose to work in rural and regional areas, especially in general practice. The career decisions of recent medical graduates are known to be affected by a variety of professional, societal and personal factors. Internationally, medical programmes have exposed students to regional and rural experiences partly to encourage them to seek employment in these areas after graduation...
December 2017: Rural and Remote Health
https://www.readbyqxmd.com/read/29210970/evaluating-the-implementation-of-a-preemptive-multimodal-analgesia-protocol-in-a-plastic-surgery-office
#11
COMPARATIVE STUDY
Brandi Tinsbloom, Virginia C Muckler, William T Stoeckel, Robert L Whitehurst, Brett Morgan
Many patients undergoing plastic surgery experience significant pain postoperatively. The use of preemptive, multimodal analgesia techniques to reduce postoperative pain has been widely described in the literature. This quality improvement project evaluated the implementation of a preemptive, multimodal analgesia protocol in an office-based plastic surgery facility to decrease postoperative pain, decrease postoperative opioid consumption, decrease postanesthesia care time, and increase patient satisfaction...
October 2017: Plastic Surgical Nursing
https://www.readbyqxmd.com/read/29202742/milestones-based-direct-observation-tools-in-internal-medicine-resident-continuity-clinic
#12
Jonathan P B Berz, Teresa Cheng, Lisa M Quintiliani
BACKGROUND: With milestones-based assessment, there is an increased need for tools to facilitate direct observation of clinical trainees. This study was designed to compare a Mini-CEX tool to new direct observation tools (DOTs) linked to internal medicine milestones. METHODS: A web based survey was used to examine satisfaction and usefulness of DOTs compared to the Mini-CEX. Residents and preceptors were surveyed three times over 6 months with half serving as control (using mini-CEX) compared to those using the DOTs...
December 4, 2017: BMC Medical Education
https://www.readbyqxmd.com/read/29195596/group-based-treatment-of-opioid-use-disorder-with-buprenorphine-a-systematic-review
#13
Randi Sokol, Amy E LaVertu, Diana Morrill, Chiara Albanese, Zev Schuman-Olivier
BACKGROUND: Opioid use disorder (OUD) has become a public health crisis in the U.S., and there is a need to develop effective clinical treatment strategies. Coupling buprenorphine/naloxone (B/N) maintenance with counseling is encouraged as a best practice, yet the efficacy research on individual counseling in B/N-based Office-Based Opioid Treatment (OBOT) has been equivocal to date. In contrast, models for integrating B/N prescribing through group-based counseling could potentially have a differential impact, yet no systematic reviews have focused on examining the extent of the literature on group-based models of B/N delivery...
January 2018: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29174106/a-rapid-qualitative-assessment-of-oral-cholera-vaccine-anticipated-acceptability-in-a-context-of-resistance-towards-cholera-intervention-in-nampula-mozambique
#14
Rachel Démolis, Carlos Botão, Léonard W Heyerdahl, Bradford D Gessner, Philippe Cavailler, Celestino Sinai, Amílcar Magaço, Jean-Bernard Le Gargasson, Martin Mengel, Elise Guillermet
INTRODUCTION: While planning an immunization campaign in settings where public health interventions are subject to politically motivated resistance, designing context-based social mobilization strategies is critical to ensure community acceptability. In preparation for an Oral Cholera Vaccine campaign implemented in Nampula, Mozambique, in November 2016, we assessed potential barriers and levers for vaccine acceptability. METHODS: Questionnaires, in-depth interviews, and focus group discussions, as well as observations, were conducted before the campaign...
November 23, 2017: Vaccine
https://www.readbyqxmd.com/read/29172715/the-rationale-and-design-of-reduction-of-uncontrolled-hypertension-by-remote-monitoring-and-telemedicine-remote-study
#15
Midori Sasaki Yatabe, Junichi Yatabe, Kei Asayama, Jan A Staessen, Blerim Mujaj, Lutgarde Thijs, Kyotaro Ito, Tomohiro Sonoo, Satoshi Morimoto, Atsuhiro Ichihara
PURPOSE: Although self-measurement of home blood pressure (HBP) is common in Japan and HBP telemonitoring via the Internet is possible, whether telemonitoring improves HBP control better than conventional practice remains unclear. Furthermore, hypertension care with online communication using telemonitored HBP is feasible, whereas the efficacy and safety of such telemedicine have not been established. We aim to compare traditional care, care with office visits using HBP telemonitoring, and antihypertensive telemedicine based on HBP telemonitoring...
November 27, 2017: Blood Pressure
https://www.readbyqxmd.com/read/29165644/-the-money-can-be-a-motivator-to-me-a-little-but-mostly-pbf-just-helps-me-to-do-better-in-my-job-an-exploration-of-the-motivational-mechanisms-of-performance-based-financing-for-health-workers-in-malawi
#16
Julia Lohmann, Danielle Wilhelm, Christabel Kambala, Stephan Brenner, Adamson S Muula, Manuela De Allegri
Performance-based financing (PBF) is assumed to improve health care delivery by motivating health workers to enhance their work performance. However, the exact motivational mechanisms through which PBF is assumed to produce such changes are poorly understood to date. Although PBF is increasingly recognized as a complex health systems intervention, its motivational effect for individual health workers is still often reduced to financial 'carrots and sticks' in the literature and discourse. Aiming to contribute to the development of a more comprehensive understanding of the motivational mechanisms, we explored how PBF impacted health worker motivation in the context of the Malawian Results-based Financing for Maternal and Newborn Health (RBF4MNH) Initiative...
November 20, 2017: Health Policy and Planning
https://www.readbyqxmd.com/read/29155688/characteristics-of-visits-to-primary-care-physicians-by-adults-diagnosed-with-hypertension
#17
Jill J Ashman, Pinyao Rui, Susan M Schappert, Alexander Strashny
Objective-This report describes the demographic, state, and regional differences in hypertension control and pharmaceutical treatment among visits to primary care physicians made by hypertensive adults during 2013-2014. Methods-Data are from the 2013-2014 National Ambulatory Medical Care Survey (NAMCS), a nationally representative survey of visits to nonfederal, office-based physicians. The sample design for the 2013-2014 NAMCS included oversampling in selected states. Estimates are provided for the 18 states oversampled in both years...
September 2017: National Health Statistics Reports
https://www.readbyqxmd.com/read/29155035/utility-of-anesthetic-block-for-endometrial-ablation-pain-a%C3%A2-randomized-controlled-trial
#18
Jordan S Klebanoff, Nima R Patel, Nancy L Sloan
BACKGROUND: Second-generation endometrial ablation has been demonstrated safe for abnormal uterine bleeding treatment, in premenopausal women who have completed childbearing, in short-stay surgical centers and in physicians' offices. However, no standard regarding anesthesia exists, and practice varies depending on physician or patient preference and hospital policy and setting. OBJECTIVE: The aim of this study was to evaluate whether local anesthetic, in combination with general anesthesia, affects postoperative pain and associated narcotic use following endometrial ablation...
November 15, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29148968/collecting-practice-level-data-in-a-changing-physician-office-based-ambulatory-care-environment-a-pilot-study-examining-the-physician-induction-interview-component-of-the-national-ambulatory-medical-care-survey
#19
Meghan C Halley, Katharine A Rendle, Brian Gugerty, Denys T Lau, Harold S Luft
Objective This report examines ways to improve National Ambulatory Medical Care Survey (NAMCS) data on practice and physician characteristics in multispecialty group practices. Methods From February to April 2013, the National Center for Health Statistics (NCHS) conducted a pilot study to observe the collection of the NAMCS physician interview information component in a large multispecialty group practice. Nine physicians were randomly sampled using standard NAMCS recruitment procedures; eight were eligible and agreed to participate...
November 2017: Vital and Health Statistics. Series 2, Data Evaluation and Methods Research
https://www.readbyqxmd.com/read/29144156/upmc-prescription-for-wellness-a-quality-improvement-case-study-for-supporting-patient-engagement-and-health-behavior-change
#20
Rebecca J Maners, Eric Bakow, Michael D Parkinson, Gary S Fischer, Geoffrey R Camp
Addressing patient health and care behaviors that underlie much of chronic disease continues to challenge providers, medical practices, health systems, and insurers. Improving health and care as described by the Quadruple Aim requires innovation at the front lines of clinical care: the doctor-patient interaction and office practice. This article describes the use of Lean Six Sigma in a quality improvement (QI) effort to design an effective and scalable method for physicians to prescribe health coaching for healthy behaviors in a primary care medical home within a large integrated delivery and financing system...
November 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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