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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
#1
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
#2
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
https://www.readbyqxmd.com/read/29142744/-who-has-to-do-it-at-the-end-of-the-day-programme-officials-or-hospital-authorities-airborne-infection-control-at-drug-resistant-tuberculosis-dr-tb-centres-of-karnataka-india-a-mixed-methods-study
#3
Kibballi Madhukeshwar Akshaya, Hemant Deepak Shewade, Ottapura Prabhakaran Aslesh, Sharath Burugina Nagaraja, Abhay Subashrao Nirgude, Anil Singarajipura, Anil G Jacob
Background: Drug resistant tuberculosis (DR-TB) centers admit patients with DR-TB for initiation of treatment and thereby concentrate the patients under one setting. It becomes imperative to assess the compliance of DR-TB centres to national airborne infection control (AIC) guidelines and explore the provider perspectives into reasons for unsatisfactory compliance. Methods: This mixed methods study (triangulation design) was carried out across all the six DR-TB centers of Karnataka state, India, between November 2016 and April 2017...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29139301/design-of-a-24-week-trial-of-empagliflozin-once-daily-in-hypertensive-black-african-american-patients-with-type-2-diabetes-mellitus
#4
Keith C Ferdinand, Leo Seman, Afshin Salsali
OBJECTIVE: Black/African American patients have higher prevalence of type 2 diabetes mellitus (T2DM), diabetes-related complications, and hypertension, but they are often underrepresented in clinical trials. The sodium-glucose co-transporter 2 inhibitor, empagliflozin, was associated with significant improvements in glucose control (via hemoglobin [Hb] A1c) and reductions in blood pressure (BP; via office and ambulatory BP monitoring) in a primarily white population with T2DM and hypertension...
November 15, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29133606/effects-of-bariatric-surgery-in-obese-patients-with-hypertension-the-gateway-randomized-trial-gastric-bypass-to-treat-obese-patients-with-steady-hypertension
#5
Carlos Aurelio Schiavon, Angela Cristine Bersch-Ferreira, Eliana Vieira Santucci, Juliana Dantas Oliveira, Camila Ragne Torreglosa, Priscila Torres Bueno, Julia Caldas Frayha, Renato Nakagawa Santos, Lucas Petri Damian, Patricia Malvina Noujaim, Helio Halpern, Frederico L J Monteiro, Ricardo Vitor Cohen, Carlos H Uchoa, Marcio Gonçalves de Souza, Celso Amodeo, Luiz Bortolotto, Dimas Ikeoka, Luciano F Drager, Alexandre Biasi Cavalcanti, Otavio Berwanger
BACKGROUND : Recent research efforts on bariatric surgery have focused on metabolic and diabetes mellitus resolution. Randomized trials designed to assess the impact of bariatric surgery in patients with obesity and hypertension are needed. METHODS : In this randomized, single-center, nonblinded trial, we included patients with hypertension (using ≥2 medications at maximum doses or >2 at moderate doses) and a body mass index between 30.0 and 39.9 kg/m(2) Patients were randomized to Roux-en-Y gastric bypass plus medical therapy or medical therapy alone...
November 13, 2017: Circulation
https://www.readbyqxmd.com/read/29130810/outcomes-after-angiography-with-sodium-bicarbonate-and-acetylcysteine
#6
Steven D Weisbord, Martin Gallagher, Hani Jneid, Santiago Garcia, Alan Cass, Soe-Soe Thwin, Todd A Conner, Glenn M Chertow, Deepak L Bhatt, Kendrick Shunk, Chirag R Parikh, Edward O McFalls, Mary Brophy, Ryan Ferguson, Hongsheng Wu, Maria Androsenko, John Myles, James Kaufman, Paul M Palevsky
Background Intravenous sodium bicarbonate and oral acetylcysteine are widely used to prevent acute kidney injury and associated adverse outcomes after angiography without definitive evidence of their efficacy. Methods Using a 2-by-2 factorial design, we randomly assigned 5177 patients at high risk for renal complications who were scheduled for angiography to receive intravenous 1.26% sodium bicarbonate or intravenous 0.9% sodium chloride and 5 days of oral acetylcysteine or oral placebo; of these patients, 4993 were included in the modified intention-to-treat analysis...
November 12, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/29129193/experiences-of-three-states-implementing-the-medicaid-health-home-model-to-address-opioid-use-disorder-case-studies-in-maryland-rhode-island-and-vermont
#7
Lisa Clemans-Cope, Jane B Wishner, Eva H Allen, Nicole Lallemand, Marni Epstein, Brenda C Spillman
PURPOSE: The United States is facing an unprecedented opioid epidemic. The Affordable Care Act (ACA) included several provisions designed to increase care coordination in state Medicaid programs and improve outcomes for those with chronic conditions, including substance use disorders. Three states-Maryland, Rhode Island, and Vermont - adopted the ACA's optional Medicaid health home model for individuals with opioid use disorder. The model coordinates opioid use disorder treatment that features opioid agonist therapy provided at opioid treatment programs (OTPs) and Office-based Opioid Treatment (OBOT) with medical and behavioral health care and other services, including those addressing social determinants of health...
December 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29101937/an-organization-model-to-assist-individual-physicians-scientists-and-senior-health-care-administrators-with-personal-and-professional-needs
#8
REVIEW
Tait D Shanafelt, Deborah J Lightner, Christopher R Conley, Steven P Petrou, Jarrett W Richardson, Pamela J Schroeder, William A Brown
Working as a physician, scientist, or senior health care administrator is a demanding career. Studies have demonstrated that burnout and other forms of distress are common among individuals in these professions, with potentially substantive personal and professional consequences. In addition to system-level interventions to promote well-being globally, health care organizations must provide robust support systems to assist individuals in distress. Here, we describe the 15-year experience of the Mayo Clinic Office of Staff Services (OSS) providing peer support to physicians, scientists, and senior administrators at one center...
November 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29083972/inhaled-corticosteroid-containing-treatment-escalation-and-outcomes-for-patients-with-asthma-in-a-u-s-health-care-organization
#9
Lindsay G S Bengtson, Yanni Yu, Weijia Wang, Feng Cao, Erin M Hulbert, Ryan Wolbeck, Caitlin A Elliott, Ami R Buikema
BACKGROUND: Asthma is a common disorder that affects approximately 8% of the U.S. POPULATION: Treatment guidelines indicate inhaled corticosteroids (ICS) as the mainstay treatment, yet poor asthma control is common among ICS-treated patients. Treatment escalation (ICS dose increase and other controller therapy add-ons) is used to manage symptoms. Real-world studies of postescalation outcomes may inform treatment decisions. OBJECTIVES: To (a) describe characteristics and treatment patterns among asthma patients who escalated treatment and (b) assess outcomes (exacerbations, uncontrolled asthma, and health care resource utilization [HCRU]) after escalation...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29083971/patient-outcomes-health-care-resource-use-and-costs-associated-with-high-versus-low-hedis-asthma-medication-ratio
#10
Allan T Luskin, Evgeniya N Antonova, Michael S Broder, Eunice Chang, Karina Raimundo, Paul G Solari
BACKGROUND: The Healthcare Effectiveness Data and Information Set (HEDIS) quality measures for asthma include the asthma medication ratio (AMR) as a marker of quality of care for patients with asthma. Few data are available to describe the association between health care use and costs in patients with high versus low AMR. OBJECTIVE: To characterize health care use and costs associated with high versus low AMR in patients participating in commercial health plans...
November 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29073129/receipt-of-selected-preventive-health-services-for-women-and-men-of-reproductive-age-united-states-2011-2013
#11
Karen Pazol, Cheryl L Robbins, Lindsey I Black, Katherine A Ahrens, Kimberly Daniels, Anjani Chandra, Anjel Vahratian, Lorrie E Gavin
PROBLEM/CONDITION: Receipt of key preventive health services among women and men of reproductive age (i.e., 15-44 years) can help them achieve their desired number and spacing of healthy children and improve their overall health. The 2014 publication Providing Quality Family Planning Services: Recommendations of CDC and the U.S. Office of Population Affairs (QFP) establishes standards for providing a core set of preventive services to promote these goals. These services include contraceptive care for persons seeking to prevent or delay pregnancy, pregnancy testing and counseling, basic infertility services for those seeking to achieve pregnancy, sexually transmitted disease (STD) services, and other preconception care and related preventive health services...
October 27, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/29062596/exploring-the-psychological-health-of-emergency-dispatch-centre-operatives-a-systematic-review-and-narrative-synthesis
#12
Sarah E Golding, Claire Horsfield, Annette Davies, Bernadette Egan, Martyn Jones, Mary Raleigh, Patricia Schofield, Allison Squires, Kath Start, Tom Quinn, Mark Cropley
BACKGROUND: The study objective was to investigate and synthesize available evidence relating to the psychological health of Emergency Dispatch Centre (EDC) operatives, and to identify key stressors experienced by EDC operatives. METHODS: Eight electronic databases (Embase, PubMed, Medline, CINAHL, PsycInfo, PsycArticles, The Psychology and Behavioural Sciences Collection, and Google Scholar) were searched. All study designs were included, and no date limits were set...
2017: PeerJ
https://www.readbyqxmd.com/read/29050932/characteristics-of-patients-using-specialty-medications
#13
Taehwan Park, Scott K Griggs, Paul D Chung
BACKGROUND: Specialty medications include innovative drugs and biologic agents requiring special handling and close monitoring. Although specialty medications have been widely used for various chronic conditions, increased use of these medications has contributed a growing share of total health care expenditures. OBJECTIVE: The aim of this study was to examine patient characteristics related to specialty medication use. METHODS: Using Medical Expenditure Panel Survey (MEPS) data from 2000 through 2013, this study identified U...
October 14, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28963112/disparities-in-the-intensity-of-end-of-life-care-for-children-with-cancer
#14
Emily E Johnston, Elysia Alvarez, Olga Saynina, Lee Sanders, Smita Bhatia, Lisa J Chamberlain
BACKGROUND: Many adult patients with cancer who know they are dying choose less intense care; additionally, high-intensity care is associated with worse caregiver outcomes. Little is known about intensity of end-of-life care in children with cancer. METHODS: By using the California Office of Statewide Health Planning and Development administrative database, we performed a population-based analysis of patients with cancer aged 0 to 21 who died between 2000 and 2011...
October 2017: Pediatrics
https://www.readbyqxmd.com/read/28961653/utilizing-actionable-data-analytics-to-support-patient-navigation-enrollment-and-retention-within-federally-qualified-health-centers
#15
Melody M Robinson, Gregory Stone, Stephanie Tokarz, Benjamin Wortham
INTRODUCTION: Emergency departments (EDs) have become the primary source of care for increasing number of patients, leading to treatment of nonemergent cases, which divert resources from true emergency situations and represent poor cost-effectiveness for treating such cases. There is evidence that suggests that patient navigation (PN) integrated into the ED and other case management techniques can help reduce the number of primary care-related ED visits and these navigation programs are more cost-effective than the ED visits themselves...
November 2017: Journal of Public Health Management and Practice: JPHMP
https://www.readbyqxmd.com/read/28956000/accurate-clinical-genetic-testing-for-autoinflammatory-diseases-using-the-next-generation-sequencing-platform-miseq
#16
Manabu Nakayama, Hirotsugu Oda, Kenji Nakagawa, Takahiro Yasumi, Tomoki Kawai, Kazushi Izawa, Ryuta Nishikomori, Toshio Heike, Osamu Ohara
Autoinflammatory diseases occupy one of a group of primary immunodeficiency diseases that are generally thought to be caused by mutation of genes responsible for innate immunity, rather than by acquired immunity. Mutations related to autoinflammatory diseases occur in 12 genes. For example, low-level somatic mosaic NLRP3 mutations underlie chronic infantile neurologic, cutaneous, articular syndrome (CINCA), also known as neonatal-onset multisystem inflammatory disease (NOMID). In current clinical practice, clinical genetic testing plays an important role in providing patients with quick, definite diagnoses...
March 2017: Biochemistry and Biophysics Reports
https://www.readbyqxmd.com/read/28944731/the-fda-unapproved-drugs-initiative-an-observational-study-of-the-consequences-for-drug-prices-and-shortages-in-the-united-states
#17
Ravi Gupta, Sanket S Dhruva, Erin R Fox, Joseph S Ross
BACKGROUND: Hundreds of drug products are currently marketed in the United States without approval from the FDA. The 2006 Unapproved Drugs Initiative (UDI) requires manufacturers to remove these drug products from the market or obtain FDA approval by demonstrating evidence of safety and efficacy. Once the FDA acts against an unapproved drug, fewer manufacturers remain in the market, potentially enabling drug price increases and greater susceptibility to drug shortages. There is a need for systematic study of the UDI's effect on prices and shortages of all targeted drugs...
October 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28938966/high-screen-failure-rate-in-patients-with-resistant-hypertension-findings-from-symplicity-htn-3
#18
RANDOMIZED CONTROLLED TRIAL
Ron Waksman, George L Bakris, Arie Steinvil, Hector Garcia-Garcia, Angela L Brown, William DiFilippo, Thomas Scott, Jasvindar Singh, Vanessa DeBruin, Denise Jones, Dan Jolivette, Deepak L Bhatt
BACKGROUND: The SYMPLICITY HTN-3 trial, which randomized subjects to renal denervation (RDN) or sham control, was designed to evaluate the efficacy and safety of RDN for the treatment of resistant hypertension. Outcomes were previously reported. This retrospective analysis evaluated reasons for screen failure (SF) for randomization in the trial. METHODS: SYMPLICITY HTN-3 enrolled subjects with office systolic blood pressure (SBP) ≥160 mmHg on stable and maximal doses of ≥3 antihypertensive medication classes...
October 2017: American Heart Journal
https://www.readbyqxmd.com/read/28889402/social-freezing-in-medical-practice-experiences-and-attitudes-of-gynecologists-in-germany
#19
Maximilian Schochow, Giovanni Rubeis, Grit Büchner-Mögling, Hansjakob Fries, Florian Steger
Surveys of the German public have revealed a high acceptance of social freezing, i.e. oocyte conservation without medical indication. Up to now, there are no investigations available on the experiences and attitudes of health professionals towards social freezing. Between August 2015 and January 2016, we surveyed gynecologists Germany-wide on the topic social freezing. Five gynecologists specialized in reproductive medicine and five office-based gynecologists in standard care were chosen for the survey. The survey was conducted with an explorative, qualitative research design...
September 9, 2017: Science and Engineering Ethics
https://www.readbyqxmd.com/read/28886977/an-optimization-model-for-collection-haul-transfer-treatment-and-disposal-of-infectious-medical-waste-application-to-a-greek-region
#20
Gerasimos Mantzaras, Evangelos A Voudrias
The objective of this work was to develop an optimization model to minimize the cost of a collection, haul, transfer, treatment and disposal system for infectious medical waste (IMW). The model calculates the optimum locations of the treatment facilities and transfer stations, their design capacities (t/d), the number and capacities of all waste collection, transport and transfer vehicles and their optimum transport path and the minimum IMW management system cost. Waste production nodes (hospitals, healthcare centers, peripheral health offices, private clinics and physicians in private practice) and their IMW production rates were specified and used as model inputs...
November 2017: Waste Management
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