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https://www.readbyqxmd.com/read/27920118/patients-views-on-general-practitioners-role-during-treatment-and-follow-up-of-colorectal-cancer-a-qualitative-study
#1
Daan Brandenbarg, Carriene Roorda, Michelle Stadlander, Geertruida H de Bock, Marjolein Y Berger, Annette J Berendsen
PURPOSE: To clarify experiences and preferences of patients regarding the current and future role of GPs during treatment and follow-up care of colorectal cancer (CRC). METHODS: Qualitative semi-structured, audio-recorded, face-to-face interviews in patients' homes in the north of the Netherlands were performed. Patients were sampled purposively on age, gender, time since diagnoses and primary health care use. Data were transcribed verbatim and analysed thematically by two independent researchers until saturation was reached...
December 5, 2016: Family Practice
https://www.readbyqxmd.com/read/27916540/correlates-of-caregivers-involvement-in-the-management-of-older-adults-medications
#2
Marwa Noureldin, Kimberly S Plake
BACKGROUND: Family caregivers are actively involved in medication management, yet little is known about factors associated with caregivers' involvement in this role and how that information can be utilized to engage caregivers in the healthcare system. OBJECTIVES: To explore factors associated with caregiver involvement in various aspects of older adults' medication management (i.e., ordering, keeping track or ensuring the correct medication is taken at the correct time, and injecting medications)...
November 11, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27912776/improving-stroke-prevention-therapy-for-patients-with-atrial-fibrillation-in-primary-care-protocol-for-a-pragmatic-cluster-randomized-trial
#3
Theresa M Lee, Noah M Ivers, Sacha Bhatia, Debra A Butt, Paul Dorian, Liisa Jaakkimainen, Kori Leblanc, Dan Legge, Dante Morra, Alissia Valentinis, Laura Wing, Jacqueline Young, Karen Tu
BACKGROUND: The prevalence of atrial fibrillation (AF) is growing as the population ages, and at least 15% of ischemic strokes are attributed to AF. However, many high-risk AF patients are not offered guideline-recommended stroke prevention therapy due to a variety of system, provider, and patient-level barriers. METHODS: We will conduct a pragmatic, cluster-randomized controlled trial randomizing primary care clinics to test a "toolkit" of quality improvement interventions in primary care...
December 3, 2016: Implementation Science: IS
https://www.readbyqxmd.com/read/27903662/patient-engagement-and-self-management-in-pulmonary-arterial-hypertension
#4
REVIEW
Jytte Graarup, Pisana Ferrari, Luke S Howard
Improved care in pulmonary arterial hypertension has led to increased longevity for patients, with a paralleled evolution in the nature of their needs. There is more focus on the impact of the disease on their day-to-day activities and quality of life, and a holistic approach is coming to the front of pulmonary arterial hypertension management, which places the patient at the centre of their own healthcare. Patients are thus becoming more proactive, involved and engaged in their self-care, and this engagement is an important factor if patient outcomes are to improve...
December 2016: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/27903035/the-inherited-chronic-pain-patient
#5
Paul Grinzi
BACKGROUND: The 'inherited' patient, where a patient switches to a new doctor, is a common and potentially challenging scenario, especially where drugs of dependence are involved. There are few resources to guide general practitioners (GPs) with an approach that ensures compassion and rational clinical decision-making. OBJECTIVE: The aim of this article is to guide GPs in an approach to taking over the care of an inherited patient and focuses on considerations of rational prescribing...
December 2016: Australian Family Physician
https://www.readbyqxmd.com/read/27894229/-self-reported-experience-in-patients-treated-with-hepatitis-c-direct-acting-antivirals
#6
Irene Cañamares Orbis, Javier Saez de la Fuente, Ismael Escobar Rodriguez, Concepción Esteban Alba, Ana Such Díaz, Ismael Escobar Rodríguez
BACKGROUND AND OBJECTIVE: To learn about and analyze the self-reported treatment experience of HCV patients who started treatment with direct acting antivirals agents (DAA), at a real-time, proactive and integrated into the pharmaceutical care healthcare process, using a prospective questionnaire completed by patients as clinical tool. MATERIAL AND METHODS: Observational and cross-sectional study conducted between April (start of the National Strategic Plan) and December 2015 in the Outpatient Pharmacy Service...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27886949/why-do-chilean-women-choose-to-have-or-not-have-pap-tests
#7
Maria-Teresa Urrutia, Alejandra Araya, Maria-Fernanda Jaque
OBJECTIVE: To describe the perceptions of Chilean women about why women choose to have or not have Pap test screening. DESIGN: Qualitative research using content analysis according to Krippendorf. SETTING: Data were gleaned from 57 Chilean women from a public primary care clinic who participated in an audiotaped focus group. RESULTS: Six themes emerged: Reasons that make it difficult for women schedule an appointment, Characteristics of health professionals that make it difficult to have a Pap test, Characteristics of the test that are barriers to having a Pap test, The relationship of the test with cancer, Family context, and Each woman's personal characteristics...
November 22, 2016: Journal of Obstetric, Gynecologic, and Neonatal Nursing: JOGNN
https://www.readbyqxmd.com/read/27883003/opportunities-to-develop-the-professional-role-of-community-pharmacists-in-the-care-of-patients-with-asthma-a-cross-sectional-study
#8
Kim Watkins, Aline Bourdin, Michelle Trevenen, Kevin Murray, Peter A Kendall, Carl R Schneider, Rhonda Clifford
There are many indications in Australia and globally that asthma management is suboptimal. Ideally, patients need to proactively self-manage the condition with the support of health professionals. Community pharmacists are a highly accessible resource for patients but currently provide inconsistent services. General practitioners also face many barriers to the provision of chronic disease management for asthma patients. The aim of this research was to characterise patients with asthma who present to community pharmacy...
November 24, 2016: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/27882453/-implementation-of-a%C3%A2-proactive-integrated-primary-care-program-for-frail-older-people-from-science-to-evidence-based-practice
#9
Nienke Bleijenberg, Artine de Jonge, Morris P Brand, Caitriona O'Flynn, Marieke J Schuurmans, Niek J de Wit
BACKGROUND: Multimorbidity, functional impairment and frailty among community-dwelling older people are causing increasing complexity in primary care. A proactive integrated primary care approach is therefore essential. Between October 2014-2015, an evidence-based proactive care program for frail older people was implemented in the region Noord-West Veluwe en Zeewolde, the Netherlands. This study evaluated the feasibility of the implementation, having a strong focus on the collaboration between the medical and social domain...
December 2016: Tijdschrift Voor Gerontologie en Geriatrie
https://www.readbyqxmd.com/read/27874181/ags-position-statement-making-medical-treatment-decisions-for-unbefriended-older-adults
#10
Timothy W Farrell, Eric Widera, Lisa Rosenberg, Craig D Rubin, Aanand D Naik, Ursula Braun, Alexia Torke, Ina Li, Caroline Vitale, Joseph Shega
In this position statement, we define unbefriended older adults as patients who: (1) lack decisional capacity to provide informed consent to the medical treatment at hand; (2) have not executed an advance directive that addresses the medical treatment at hand and lack capacity to do so; and (3) lack family, friends or a legally authorized surrogate to assist in the medical decision-making process. Given the vulnerable nature of this population, clinicians, health care teams, ethics committees and other stakeholders working with unbefriended older adults must be diligent when formulating treatment decisions on their behalf...
November 22, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/27872166/consistency-of-medical-record-reporting-of-a-set-of-indicators-for-proactive-palliative-care-in-patients-with-chronic-obstructive-pulmonary-disease-a-pilot-study
#11
Ria G Duenk, Stans C Verhagen, Mireille Ae Janssen, Richard Pnr Dekhuijzen, Kris Cp Vissers, Yvonne Engels, Yvonne Heijdra
To identify patients hospitalized for an acute exacerbation of chronic obstructive pulmonary disease (COPD) who have a poor prognosis and might benefit from proactive palliative care, a set of indicators had been developed from the literature. A patient is considered eligible for proactive palliative care when meeting ≥2 criteria of the proposed set of 11 indicators. In order to develop a doctor-friendly and patient-convenient tool, our primary objective was to examine whether these indicators are documented consistently in the medical records...
November 21, 2016: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/27870547/prescribers-perceptions-of-medication-discontinuation-survey-instrument-development-and-validation
#12
Amy Linsky, Steven R Simon, Kelly Stolzmann, Barbara G Bokhour, Mark Meterko
OBJECTIVES: Primary care providers (PCPs) and clinical pharmacists have concerns about the adverse consequences of using medications inappropriately and generally support the notion of reducing unnecessary drugs. Despite this attitude, many factors impede clinicians' ability to discontinue medication in clinical settings. We sought to develop a survey instrument that assesses PCPs' and pharmacists' experiences, attitudes, and beliefs toward medication discontinuation. STUDY DESIGN: Survey development and psychometric assessment...
November 2016: American Journal of Managed Care
https://www.readbyqxmd.com/read/27864204/integrating-pharmacogenomics-into-electronic-health-records-with-clinical-decision-support
#13
J Kevin Hicks, Henry M Dunnenberger, Karl F Gumpper, Cyrine E Haidar, James M Hoffman
PURPOSE: Existing pharmacogenomic informatics models, key implementation steps, and emerging resources to facilitate the development of pharmacogenomic clinical decision support (CDS) are described. SUMMARY: Pharmacogenomics is an important component of precision medicine. Informatics, especially CDS in the electronic health record (EHR), is a critical tool for the integration of pharmacogenomics into routine patient care. Effective integration of pharmacogenomic CDS into the EHR can address implementation challenges, including the increasing volume of pharmacogenomic clinical knowledge, the enduring nature of pharmacogenomic test results, and the complexity of interpreting results...
December 1, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27855058/is-the-australian-75-health-assessment-person-centred-a-qualitative-descriptive-study-of-older-people
#14
Kay Price, Karen Grimmer, Jan Foot
Objective The aim of the present study was to explore the perspectives of older people following their recent participation in a 75+ Health Assessment (75+HA) and interrogate these perspectives using a person-centred lens.Methods A qualitative descriptive study design was used within a larger study funded by the Australian Primary Health Care Research Institute. Nineteen participants from four different general practices in one Australian state described their perceptions of the 75+HA in a face-to-face interview...
November 18, 2016: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/27853623/developing-the-gripes-tool-for-junior-doctors-to-report-concerns-a-pilot-study
#15
S Carr, T Mukherjee, A Montgomery, M Durbridge, C Tarrant
BACKGROUND: Junior doctors often have concerns about quality and safety but show low levels of engagement with incident reporting systems. We aimed to develop and pilot a web-based reporting tool for junior doctors to proactively report concerns about quality and safety of care, and optimise it for future use. METHODS: We developed the gripes tool with input from junior doctors and piloted it at a large UK teaching hospital trust. We evaluated the tool through an analysis of concerns reported over a 3-month pilot period, and through interviews with five stakeholders and two focus groups with medical students and junior doctors about their views of the tool...
September 29, 2016: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/27835632/nonlinear-dynamics-forecasting-of-obstructive-sleep-apnea-onsets
#16
Trung Q Le, Satish T S Bukkapatnam
Recent advances in sensor technologies and predictive analytics are fueling the growth in point-of-care (POC) therapies for obstructive sleep apnea (OSA) and other sleep disorders. The effectiveness of POC therapies can be enhanced by providing personalized and real-time prediction of OSA episode onsets. Previous attempts at OSA prediction are limited to capturing the nonlinear, nonstationary dynamics of the underlying physiological processes. This paper reports an investigation into heart rate dynamics aiming to predict in real time the onsets of OSA episode before the clinical symptoms appear...
2016: PloS One
https://www.readbyqxmd.com/read/27833396/strengthening-the-coordination-of-pediatric-mental-health-and-medical-care-piloting-a-collaborative-model-for-freestanding-practices
#17
Carolyn A Greene, Julian D Ford, Barbara Ward-Zimmerman, Lisa Honigfeld, Anne E Pidano
BACKGROUND: Collaborative pediatric mental health and primary care is increasingly recognized as optimal for meeting the needs of children with mental health problems. This paper describes the challenges faced by freestanding specialty mental health clinics and pediatric health practices to provide such coordinated mind-and-body treatment. It describes critical elements of a proactive approach to achieving collaborative pediatric care under real-world circumstances using the patient-centered medical home neighborhood (PCMH-N) model...
October 2016: Child & Youth Care Forum
https://www.readbyqxmd.com/read/27830232/improving-evaluation-to-address-the-unintended-consequences-of-health-information-technology-a-position-paper-from-the-working-group-on-technology-assessment-quality-development
#18
F Magrabi, E Ammenwerth, H Hyppönen, N de Keizer, P Nykänen, M Rigby, P Scott, J Talmon, A Georgiou
BACKGROUND AND OBJECTIVES: With growing use of IT by healthcare professionals and patients, the opportunity for any unintended effects of technology to disrupt care health processes and outcomes is intensified. The objectives of this position paper by the IMIA Working Group (WG) on Technology Assessment and Quality Development are to highlight how our ongoing initiatives to enhance evaluation are also addressing the unintended consequences of health IT. METHODS: Review of WG initiatives Results: We argue that an evidence-based approach underpinned by rigorous evaluation is fundamental to the safe and effective use of IT, and for detecting and addressing its unintended consequences in a timely manner...
November 10, 2016: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/27826697/development-of-a-behavior-change-intervention-to-encourage-timely-cancer-symptom-presentation-among-people-living-in-deprived-communities-using-the-behavior-change-wheel
#19
Stephanie Smits, Grace McCutchan, Fiona Wood, Adrian Edwards, Ian Lewis, Michael Robling, Shantini Paranjothy, Ben Carter, Julia Townson, Kate Brain
BACKGROUND: Targeted public awareness interventions are needed to improve earlier cancer diagnosis and reduce socioeconomic inequalities in cancer outcomes. The health check (intervention) is a touchscreen questionnaire delivered by trained lay advisors that aims to raise awareness of cancer symptoms and risk factors and encourage timely help seeking. PURPOSE: This study aimed to apply the Behavior Change Wheel to intervention refinement by identifying barriers and facilitators to timely symptom presentation among people living in socioeconomically deprived communities...
November 8, 2016: Annals of Behavioral Medicine: a Publication of the Society of Behavioral Medicine
https://www.readbyqxmd.com/read/27823751/female-sexual-dysfunction-fsd-prevalence-and-impact-on-quality-of-life-qol
#20
REVIEW
Prof Rossella E Nappi, Laura Cucinella, Silvia Martella, Margherita Rossi, Lara Tiranini, Ellis Martini
Female sexual dysfunction (FSD) and quality of life (QOL) are both multidimensional and have a bidirectional relationship across the reproductive life span and beyond. Methodological difficulties exist in estimating the real prevalence of FSD because it is hard to determine the level of distress associated with sexual symptoms in a large-scale survey. Approximately 40-50% of all women report at least one sexual symptom, and some conditions associated with hormonal changes at menopause, such as vulvovaginal atrophy (VVA) and hypoactive sexual desire disorder (HSDD), have a significant impact on sexual function and QOL...
December 2016: Maturitas
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