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kidney disease quality primary care

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https://www.readbyqxmd.com/read/29726982/a-real-world-cohort-study-on-the-quality-of-potassium-and-creatinine-monitoring-during-initiation-of-mineralocorticoid-receptor-antagonists-in-patients-with-heart-failure
#1
Erik Nilsson, Pietro De Deco, Marco Trevisan, Rino Bellocco, Bengt Lindholm, Lars H Lund, Josef Coresh, Juan J Carrero
AIMS: Clinical heart failure (HF) guidelines recommend monitoring of creatinine and potassium throughout the initial weeks of mineralocorticoid receptor antagonists (MRAs) therapy. We here assessed the extent to which this occurs in our healthcare. METHODS AND RESULTS: Observational study in 2007-2010 HF patients starting MRA therapy in Stockholm, Sweden. Outcomes included potassium and creatinine laboratory testing before MRA initiation and in the early (days 1-10) and extended (days 11-90) post-initiation periods...
May 2, 2018: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29669046/nephrology-comanagement-and-the-quality-of-antibiotic-prescribing-in-primary-care-for-patients-with-chronic-kidney-disease-a-retrospective-cross-sectional-study
#2
Justin X G Zhu, Danielle M Nash, Eric McArthur, Alexandra Farag, Amit X Garg, Arsh K Jain
Background: In primary care, patients with chronic kidney disease (CKD) are frequently prescribed excessive doses of antibiotics relative to their kidney function. We examined whether nephrology comanagement is associated with improved prescribing in primary care. Methods: In a retrospective propensity score-matched cross-sectional study, we studied the appropriateness of antibiotic prescriptions by primary care physicians to Ontarians ≥66 years of age with CKD Stages 4 and 5 (estimated glomerular filtration rate <30 mL/min/1...
April 12, 2018: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/29668213/physician-and-patient-tools-to-improve-chronic-kidney-disease-care
#3
Thomas D Sequist, Alison M Holliday, E John Orav, David W Bates, Bradley M Denker
OBJECTIVES: To determine if electronic health record (EHR) tools and patient engagement can improve the quality of chronic kidney disease (CKD) care. STUDY DESIGN: Randomized controlled trial. METHODS: We enrolled 153 primary care physicians caring for 3947 high-risk and 3744 low-risk patients with stage III CKD across 13 ambulatory health centers in eastern Massachusetts. Intervention physicians received a set of electronic alerts during office visits recommending risk-appropriate CKD care...
April 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29567821/costs-of-cancer-care-across-the-disease-continuum
#4
Deborah R Kaye, Hye Sung Min, Lindsey A Herrel, James M Dupree, Chad Ellimoottil, David C Miller
PURPOSE: The aim of this study was to estimate Medicare payments for cancer care during the initial, continuing, and end-of-life phases of care for 10 malignancies and to examine variation in expenditures according to patient characteristics and cancer severity. MATERIALS AND METHODS: We used linked Surveillance, Epidemiology and End Results-Medicare data to identify patients aged 66-99 years who were diagnosed with one of the following 10 cancers: prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian, from 2007 through 2012...
March 22, 2018: Oncologist
https://www.readbyqxmd.com/read/29567027/a-prospective-randomized-study-of-bovine-carotid-artery-biologic-graft-and-expanded-polytetrafluoroethylene-for-permanent-hemodialysis-access
#5
Hanaa Dakour Aridi, Isibor Arhuidese, Melissa Scudder, Thomas Reifsnyder, Mahmoud B Malas
OBJECTIVE: Arteriovenous grafts (AVGs) remain reliable substitutes for permanent hemodialysis access in scenarios that preclude the placement of native arteriovenous fistulas (AVFs). The majority of AVGs are constructed of expanded polytetrafluoroethylene (ePTFE), which is relatively inexpensive and readily available, but synthetic AVGs have poor patency rates. On the other hand, biologic grafts confer an advantage by virtue of their inherent similarity to the native human vasculature...
March 19, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29523571/cognitive-behavioural-therapy-cbt-for-renal-fatigue-bref-a-feasibility-randomised-controlled-trial-of-cbt-for-the-management-of-fatigue-in-haemodialysis-hd-patients
#6
Federica Picariello, Rona Moss-Morris, Iain C Macdougall, Sam Norton, Maria Da Silva-Gane, Ken Farrington, Hope Clayton, Joseph Chilcot
INTRODUCTION: Fatigue is one of the most common and disabling symptoms in end-stage kidney disease, particularly among in-centre haemodialysis patients. This two-arm parallel group feasibility randomised controlled trial will determine whether a fully powered efficacy trial is achievable by examining the feasibility of recruitment, acceptability and potential benefits of a cognitive-behavioural therapy (CBT)-based intervention for fatigue among in-centre haemodialysis patients. METHODS: We aim to recruit 40 adult patients undergoing in-centre haemodialysis at secondary care outpatient dialysis units, who meet clinical levels of fatigue...
March 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29463395/-cardiovascular-protection-of-diabetic-patient-with-chronic-renal-disease-and-particular-case-of-end-stage-renal-disease-in-elderly-patients
#7
P Zaoui, T Hannedouche, C Combe
Type 2 diabetes has an increasing prevalence. Life expectancy is dominated by cardiovascular risk, which is the leading cause of death in these patients. Up to one third of diabetic patients will develop diabetic nephropathy related to micro-angiopathy. Renal impairment further increases cardiovascular risk. Reducing cardiovascular morbidity and mortality is a major public health issue, as well as early preventing and managing chronic kidney disease (CKD). Good glycemic control prevents the micro-vascular complications of the disease (retinopathy, nephropathy, etc...
June 2017: Néphrologie & Thérapeutique
https://www.readbyqxmd.com/read/29452972/does-preoperative-opioid-use-increase-the-risk-of-early-revision-total-hip-arthroplasty
#8
Nicholas A Bedard, David E DeMik, S Blake Dowdle, Jessell M Owens, Steve S Liu, John J Callaghan
BACKGROUND: The purpose of this study is to evaluate the impact of preoperative opioid use on the risk of subsequent revison after primary total hip arthroplasty (THA). METHODS: The Humana database was queried for unilateral THA between 2007-2015. Patients were tracked for the occurrence of an ipsilateral revision THA for 2. Factors analyzed included preoperative opioid use (defined as a history of opioid prescription filled within 3 months preceding primary THA), age, sex, diabetes, anxiety/depression, chronic kidney disease, and obesity (body mass index > 30 kg/m2 )...
February 13, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29443647/system-level-health-care-integration-and-the-costs-of-cancer-care-across-the-disease-continuum
#9
Deborah R Kaye, Hye Sung Min, Edward C Norton, Zaojun Ye, Jonathan Li, James M Dupree, Chad Ellimoottil, David C Miller, Lindsey A Herrel
PURPOSE: Policy reforms in the Affordable Care Act encourage health care integration to improve quality and lower costs. We examined the association between system-level integration and longitudinal costs of cancer care. METHODS: We used linked SEER-Medicare data to identify patients age 66 to 99 years diagnosed with prostate, bladder, esophageal, pancreatic, lung, liver, kidney, colorectal, breast, or ovarian cancer from 2007 to 2012. We attributed each patient to one or more phases of care (ie, initial, continuing, and end of life) according to time from diagnosis until death or end of study interval...
March 2018: Journal of Oncology Practice
https://www.readbyqxmd.com/read/29396034/epidemiology-clinical-characteristics-and-associations-for-symptom-based-rome-iv-functional-dyspepsia-in-adults-in-the-usa-canada-and-the-uk-a-cross-sectional-population-based-study
#10
Imran Aziz, Olafur S Palsson, Hans Törnblom, Ami D Sperber, William E Whitehead, Magnus Simrén
BACKGROUND: The population prevalence, clinical characteristics, and associations for Rome IV functional dyspepsia are not known. Following the publication of the Rome IV criteria for functional gastrointestinal disorders, we aimed to assess the prevalence, characteristics, and associations for symptom-based Rome IV functional dyspepsia in adults across the USA, Canada, and the UK. METHODS: We sent an internet-based cross-sectional health survey to adults in the general population of three English-speaking countries: the USA, Canada, and the UK...
April 2018: Lancet. Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/29387461/hypertension-and-frailty-syndrome-in-old-age-current-perspectives
#11
Izabella Uchmanowicz, Anna Chudiak, Beata Jankowska-Polańska, Robbert Gobbens
Hypertension is both a health problem and a financial one globally. It affects nearly 30 % of the general population. Elderly people, aged ≥65 years, are a special group of hypertensive patients. In this group, the overall prevalence of the disease reaches 60 %, rising to 70 % in those aged ≥80 years. In the elderly population, isolated systolic hypertension is quite common. High systolic blood pressure is associated with an increased risk of cardiovascular disease, cerebrovascular disease, peripheral artery disease, cognitive impairment and kidney disease...
November 2017: Cardiac failure review
https://www.readbyqxmd.com/read/29225932/potential-applications-of-telenephrology-to-enhance-global-kidney-care
#12
REVIEW
Mohamed A Osman, Julius Okel, Ikechi G Okpechi, Kailash Jindal, Aminu K Bello
Chronic kidney disease (CKD) is an important public health issue that increasingly affects more patients globally and is associated with adverse clinical consequences with huge economic impact. Effective management of patients with CKD requires delivery of kidney care in a primary care setting where possible and at a higher level with a nephrologist when necessary to improve outcomes. In many instances and for various reasons, it is not possible to follow this pathway of care delivery. With improving telecommunication technologies worldwide, it is hoped that increasing utilisation of electronic communication devices can be used to facilitate kidney care to improve the quality of care delivered to patients, especially those who live in remote regions...
2017: BMJ Global Health
https://www.readbyqxmd.com/read/29181788/mortality-associated-with-metformin-versus-sulfonylurea-initiation-a-cohort-study-of-veterans-with-diabetes-and-chronic-kidney-disease
#13
Zachary A Marcum, Christopher W Forsberg, Kathryn P Moore, Ian H de Boer, Nicholas L Smith, Edward J Boyko, James S Floyd
BACKGROUND: For patients with type 2 diabetes and chronic kidney disease (CKD), high-quality evidence about the relative benefits and harms of oral glucose-lowering drugs is limited. OBJECTIVE: To evaluate whether mortality risk differs after the initiation of monotherapy with either metformin or a sulfonylurea in Veterans with type 2 diabetes and CKD. DESIGN: Observational, national cohort study in the Veterans Health Administration (VHA)...
February 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29142980/effectiveness-of-multifaceted-care-approach-on-adverse-clinical-outcomes-in-nondiabetic-ckd-a-systematic-review-and-meta-analysis
#14
Aminu K Bello, Bilal Qarni, Arian Samimi, Julius Okel, Trish Chatterley, Ikechi G Okpechi, Ben Vandermeer, Branko Braam
Introduction: The risk of major adverse events associated with chronic kidney disease (CKD) could potentially be reduced with effective medical interventions. The impact of multifaceted interventions as compared with usual care in patients with nondiabetic CKD is unclear. We performed a systematic review to analyze the impact of multifaceted interventions on reducing the risk of major adverse events in this population. Methods: Systematic review and meta-analysis...
July 2017: KI Reports
https://www.readbyqxmd.com/read/29084343/uric-acid-lowering-therapies-for-preventing-or-delaying-the-progression-of-chronic-kidney-disease
#15
REVIEW
Anna L Sampson, Richard F Singer, Giles D Walters
BACKGROUND: Non-randomised data have shown a link between hyperuricaemia and the progression or development of chronic kidney disease (CKD). If this is correct, urate lowering therapy might form an important part of chronic kidney disease care, reducing risks for cardiovascular outcomes and end-stage kidney disease. OBJECTIVES: This review aims to study the benefits and harms of uric acid lowering therapy on the progression of CKD and other cardiovascular endpoints...
October 30, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29081837/new-ways-of-working-delivering-better-care-for-people-with-long-term-conditions
#16
Victoria Tzortziou Brown, Irem Patel, Nicola Thomas, James Tomlinson, Rachel Roberts, Hugh Rayner, Neil Ashman, Sally Hull
BACKGROUND: The cost-effectiveness of the traditional outpatient model for specialist care provision is increasingly being questioned in view of the changing patient needs, workforce challenges and technological advances. SETTING: This report summarises two RCGP London events showcasing new ways of delivering care for long-term conditions. QUESTIONS: What are the alternative approaches to the traditional outpatient model and do they have common themes? What are the challenges and opportunities of these new models of care? METHODS: Presentation of examples of new ways of long-term condition care delivery and round-table facilitative discussion and reflection on the challenges and solutions around service re-design and implementation, the commissioning and funding of new models of care, the facilitation of system-wide learning and the collection of data for evaluation...
September 2017: London Journal of Primary Care
https://www.readbyqxmd.com/read/29057734/provider-perspectives-on-chronic-kidney-disease-diagnosis-delivery
#17
Hannah Tiu, Angela Fagerlin, Meghan Roney, Ev Kerr, Akinlolu Ojo, Ed Rothman, Julie Wright Nunes
AIMS: Lack of clear provider communication has been suggested as a reason for low patient awareness of their chronic kidney disease (CKD) diagnosis. Using quality improvement methods, we performed one-on-one provider interviews about CKD diagnosis delivery. MATERIALS AND METHODS: Interviews were audio-recorded, transcribed, and examined using mixed methods. We used thematic analysis to code and analyze transcripts, and Fisher's exact test to examine differences comparing nephrologist and primary care provider (PCP) perspectives...
March 2018: Clinical Nephrology
https://www.readbyqxmd.com/read/28979782/elderly-patients-with-chronic-kidney-disease-do-they-really-need-referral-to-the-nephrology-clinic
#18
Mark McClure, Thomas Jorna, Laura Wilkinson, Joanne Taylor
INTRODUCTION: Chronic kidney disease (CKD) is becoming increasingly common, especially in the elderly. In the UK, there has been a marked increase in the awareness and detection of CKD over the last decade. This is largely attributable to the introduction of automated estimated glomerular filtration rate (eGFR) reporting and renal indicators in the primary care Quality and Outcomes Framework (QOF) initiative, both of which were introduced in 2006. These two initiatives have had a significant impact on referral patterns to renal services...
October 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/28893206/efficacy-of-blood-flow-restriction-exercise-during-dialysis-for-end-stage-kidney-disease-patients-protocol-of-a-randomised-controlled-trial
#19
Matthew J Clarkson, Steve F Fraser, Paul N Bennett, Lawrence P McMahon, Catherine Brumby, Stuart A Warmington
BACKGROUND: Exercise during haemodialysis improves strength and physical function. However, both patients and clinicians are time poor, and current exercise recommendations add an excessive time burden making exercise a rare addition to standard care. Hypothetically, blood flow restriction exercise performed during haemodialysis can provide greater value for time spent exercising, reducing this time burden while producing similar or greater outcomes. This study will explore the efficacy of blood flow restriction exercise for enhancing strength and physical function among haemodialysis patients...
September 11, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28878150/multimorbidity-in-chronic-conditions-public-primary-care-patients-in-four-greater-mekong-countries
#20
Supa Pengpid, Karl Peltzer
The aim of this study was to explore the prevalence, pattern, and social determinants of chronic conditions multimorbidity among chronic disease primary care patients in four Greater Mekong countries (Cambodia, Myanmar, Thailand, and Vietnam). In a cross-sectional survey, chronic disease patients accessing primary care were recruited if they had been diagnosed with any of 21 chronic conditions in the past 12 months, and were interviewed with a structured questionnaire on anxiety, depression, alcohol use, tobacco use, dietary behaviour, physical activity, and quality of life...
September 6, 2017: International Journal of Environmental Research and Public Health
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