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https://www.readbyqxmd.com/read/28530519/does-a-one-size-fits-all-cost-sharing-approach-incentivize-appropriate-medication-use-a-roundtable-on-the-fairness-and-ethics-associated-with-variable-cost-sharing
#1
Jennifer S Graff, Chuck Shih, Thomas Barker, Gabriela Dieguez, Cheryl Larson, Helen Sherman, Robert W Dubois
BACKGROUND: Tiered formularies, in which patients pay copays or coinsurance out-of-pocket (OOP), are used to manage costs and encourage more efficient health care resource use. Formulary tiers are typically based on the cost of treatment rather than the medical appropriateness for the patient. Cost sharing may have unintended consequences on treatment adherence and health outcomes. Use of higher-cost, higher-tier medications can be due to a variety of factors, including unsuccessful treatment because of lack of efficacy or side effects, patient clinical or genetic characteristics, patient preferences to avoid potential side effects, or patient preferences based on the route of administration...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28528258/epidemiology-and-management-of-chronic-thromboembolic-pulmonary-hypertension-experience-from-two-expert-centers
#2
Maria Anna Bazmpani, Alexandra Arvanitaki, Maria Toumpourleka, Georgia Pitsiou, Evaggelia Panagiotidou, Sophia Anastasia Mouratoglou, Georgios Sianos, Stavros Hadjimiltiades, Antonios Pitsis, Eckhard Mayer, Ioannis Stanopoulos, Haralambos Karvounis, George Giannakoulas
BACKGROUND: Chronic thromboembolic pulmonary hypertension (CTEPH) is a rare, distinct pulmonary vascular disease, and, therefore, there is lack of data regarding its clinical presentation, diagnosis and management at a national basis. Our objective was to describe the demographics and management of CTEPH patients in Northern Greece. METHODS: We conducted a retrospective, observational study with a joint collaboration from two pulmonary hypertension expert centers in Greece and included patients diagnosed with CTEPH...
May 17, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28524904/metastatic-lung-cancer-and-distress-use-of-the-distress-thermometer-for-patient-assessment
#3
Victoria Sherry, Carmen Guerra, Anjana Ranganathan, Susan M Schneider
BACKGROUND: Patients with metastatic lung cancer experience high levels of distress related to their disease trajectory and treatment. Oncology nurses are experts in patient care and symptom management, giving them an opportunity to screen and treat patients' distress.
. OBJECTIVES: The objectives of this study were to screen patients for distress and manage their symptoms to positively affect their quality of life, treatment adherence, and clinical outcomes, and to reduce healthcare costs...
June 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28524737/utilizing-next-generation-sequencing-in-the-management-of-multiple-myeloma
#4
Marta Lionetti, Antonino Neri
Multiple myeloma (MM) is a bone marrow plasma cell malignancy characterized by wide clinical presentation and heterogeneous genetic background. Despite the recent advances in patient outcome, new markers are needed for improving risk prediction and choice of a more appropriate therapy. In this perspective, the genetic makeup of MM cells is being better characterized by means of next-generation sequencing (NGS) technologies. Areas covered: The authors discuss how the application of NGS has improved our knowledge of MM biology by discovering its mutational landscape, identifying the operating mutational processes, and revealing the clonal composition of tumors and the dynamics of its evolution; and how this can have important clinical implications in terms of prognostication, therapeutic choices, and response assessment...
May 19, 2017: Expert Review of Molecular Diagnostics
https://www.readbyqxmd.com/read/28523862/transatlantic-medical-consultation-and-second-opinion-in-pediatric-cardiology-has-benefit-past-patient-care-a-case-study-in-videoconferencing
#5
Lubica Kovacikova, Martin Zahorec, Peter Skrak, Brian D Hanna, R Lee Vogel
BACKGROUND: Telemedicine is a rapidly evolving form of modern information and communication technology used to deliver clinical services and educational activities. OBJECTIVE: The aim of this article is to report and analyze our experience with transatlantic consultation via videoconferencing in pediatric cardiology. METHODS: In February, 2013, videoconferencing project was launched between a medium-volume pediatric cardiac center in Bratislava, Slovakia and subspecialty experts from a high-volume pediatric cardiac program at The Children's Hospital of Philadelphia (CHOP), USA...
May 19, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28521830/evidence-based-policy-responses-to-strengthen-health-community-and-legislative-systems-that-care-for-women-in-australia-with-female-genital-mutilation-cutting
#6
REVIEW
Nesrin Varol, John J Hall, Kirsten Black, Sabera Turkmani, Angela Dawson
BACKGROUND: The physical and psychological impact of female genital mutilation / cutting (FGM/C) can be substantial, long term, and irreversible. Parts of the health sector in Australia have developed guidelines in the management of FGM/C, but large gaps exist in community and professional knowledge of the consequences and treatment of FGM/C. The prevalence of FGM/C amongst Australian women is unknown. Our article reviews the literature on research on FGM/C in Australia, which focuses on health system response to women and girls with FGM/C...
May 18, 2017: Reproductive Health
https://www.readbyqxmd.com/read/28515957/a-psychologically-informed-audiologist-delivered-manualised-intervention-for-tinnitus-protocol-for-a-randomised-controlled-feasibility-trial-tin-man-study
#7
John A Taylor, Deborah A Hall, Dawn-Marie Walker, Mary McMurran, Amanda Casey, David Stockdale, Debbie Featherstone, Dean M Thompson, Carol MacDonald, Derek J Hoare
BACKGROUND: Chronic tinnitus is a common incurable condition often associated with depression, anxiety, insomnia and reduced quality of life. Within National Health Service (NHS) audiology in the United Kingdom (UK), no standard protocol currently exists for the treatment of tinnitus. Counselling is only available in less than half of audiology departments, and there is no agreed standard for what constitutes tinnitus counselling. There is substantial evidence from systematic reviews for the clinical benefit of cognitive behaviour therapy (CBT) for tinnitus delivered by clinical psychologists or psychiatrists, but no studies have sufficiently evidenced the NHS model of tinnitus care where management is increasingly being delivered by audiology professionals...
2017: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28515674/perioperative-management-of-patients-on-direct-oral-anticoagulants
#8
REVIEW
Virginie Dubois, Anne-Sophie Dincq, Jonathan Douxfils, Brigitte Ickx, Charles-Marc Samama, Jean-Michel Dogné, Maximilien Gourdin, Bernard Chatelain, François Mullier, Sarah Lessire
Direct oral anticoagulants (DOACs) have been licensed worldwide for several years for various indications. Each year, 10-15% of patients on oral anticoagulants will undergo an invasive procedure and expert groups have issued several guidelines on perioperative management in such situations. The perioperative guidelines have undergone numerous updates as clinical experience of emergency management has increased and perioperative studies including measurement of residual anticoagulant levels have been published...
2017: Thrombosis Journal
https://www.readbyqxmd.com/read/28515041/multidisciplinary-evaluation-of-interstitial-lung-diseases-current-insights-number-1-in-the-series-radiology-edited-by-nicola-sverzellati-and-sujal-desai
#9
Simon L F Walsh
Multidisciplinary team (MDT) diagnosis is regarded as the diagnostic reference standard for interstitial lung disease (ILD). Several studies have reported that MDT diagnosis is associated with higher levels of diagnostic confidence and better interobserver agreement when compared to the individual components of the MDT in isolation. Although this recommendation is widely accepted, no guideline statement specifies what constitutes an MDT meeting and how its participants should govern it. Furthermore, the precise role of an MDT meeting in the setting of ILD may vary from one group to another...
June 30, 2017: European Respiratory Review: An Official Journal of the European Respiratory Society
https://www.readbyqxmd.com/read/28514878/anticoagulant-cessation-following-atrial-fibrillation-ablation-limits-of-the-ecg-guided-approach
#10
Matteo Anselmino, Chiara Rovera, Giovanni Marchetto, Federico Ferraris, Davide Castagno, Fiorenzo Gaita
Long-term cessation of oral anticoagulation (OAC) following successful catheter or surgical ablation of atrial fibrillation (AF) is debated. Usually, in the presence of sinus rhythm at serial ECG recordings, the CHADS2, CHA2DS2VASc, and HAS-BLED scores are adopted to guide decision regarding OAC management. Areas covered: The safety of OAC cessation in patients without recurrent AF but with historically elevated risk for thromboembolism remains largely unknown. Taking the cue from two clinical cases, we provide an updated summary of the latest evidence regarding how to manage OAC after a successful atrial fibrillation ablation...
May 18, 2017: Expert Review of Cardiovascular Therapy
https://www.readbyqxmd.com/read/28514331/-diagnosis-and-treatment-of-migraine-recommendations-of-the-russian-experts
#11
V V Osipova, E G Filatova, A R Artemenko, E R Lebedeva, Yu Ye Azimova, N V Latysheva, A V Sergeev, A V Amelin, M I Koreshkina, K V Skorobogatyh, E V Ekusheva, M V Naprienko, Ye D Isaguljan, A P Rachin, Al B Danilov, O V Kurushina, V A Parfenov, G R Tabeeva, A B Gekht, N N Yahno
These recommendations on the diagnosis and treatment of migraine were elaborated by Russian headache experts in accordance with the evidence-based practice. Together with the latest classification, diagnostic principles and criteria of different clinical sub-forms the consensus contains basic data on migraine epidemiology, pathophysiological mechanisms, differential diagnosis and most effective and evidence based approaches to pharmacological and non-pharmacological management of migraine patients.
2017: Zhurnal Nevrologii i Psikhiatrii Imeni S.S. Korsakova
https://www.readbyqxmd.com/read/28513820/intra-abdominal-hypertension-and-abdominal-compartment-syndrome-in-acute-pancreatitis-hepato-pancreato-biliary-operations-and-liver-transplantation
#12
Alexsander K Bressan, Chad G Ball
Intra-abdominal hypertension, even preceding the onset of abdominal compartment syndrome, is still recognized as an adverse prognostic factor. Unfortunately, most of the current supporting evidence within the critical care environment remains observational in nature. In acute pancreatitis, an active role for intra-abdominal hypertension early in the disease process follows a strong intuitive basis, and it is corroborated by preliminary evidence from animal models. Additional studies are needed to better characterize the optimal fluid resuscitation strategy, as well as the importance of intra-abdominal hypertension as an early therapeutic target...
May 17, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28513067/interventions-for-cutaneous-molluscum-contagiosum
#13
REVIEW
Johannes C van der Wouden, Renske van der Sande, Emma J Kruithof, Annet Sollie, Lisette Wa van Suijlekom-Smit, Sander Koning
BACKGROUND: Molluscum contagiosum is a common skin infection that is caused by a pox virus and occurs mainly in children. The infection usually resolves within months in people without immune deficiency, but treatment may be preferred for social and cosmetic reasons or to avoid spreading the infection. A clear evidence base supporting the various treatments is lacking.This is an update of a Cochrane Review first published in 2006, and updated previously in 2009. OBJECTIVES: To assess the effects of specific treatments and management strategies, including waiting for natural resolution, for cutaneous, non-genital molluscum contagiosum in people without immune deficiency...
May 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28511597/understanding-sleep-wake-mechanisms-and-drug-discovery
#14
Ana Clementina Equihua-Benítez, Khalil Guzmán-Vásquez, René Drucker-Colín
Although not discernible at first glance, sleep is a highly active and regulated brain state. Although we spend practically one third of our lifetimes in this stage, its importance is often taken for granted. Sleep loss can lead to disease, error and economic loss. Our understanding of how sleep is achieved has greatly advanced in recent years, and with that, the management of sleep disorders has improved. Nevertheless, there is still room for improvement and recently many new compounds have reached clinical trials with a few being approved for commercial use...
May 17, 2017: Expert Opinion on Drug Discovery
https://www.readbyqxmd.com/read/28510496/comparison-of-the-treatment-guidelines-for-actinic-keratosis-a-critical-appraisal-and-review
#15
Patrick Fleming, Stephanie Zhou, Robert Bobotsis, Charles Lynde
There are currently several reputable guidelines on the treatment of actinic keratosis (AK) from groups in Canada, the United Kingdom, and Europe. These recommendations, based on evidence or expert consensus, offer clinicians a variety of treatment options for the different clinical presentations of AKs. Although the guidelines are similar in some regards, variations exist in treatment options, duration, and strength of recommendation. Some guidelines also lack input on specific therapies and certain types of AK, such as hypertrophic or thin presentations...
May 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/28508778/supporting-molecular-tumor-boards-in-molecular-guided-decision-making-the-current-status-of-five-german-university-hospitals
#16
Marc Hinderer, Melanie Boerries, Florian Haller, Sebastian Wagner, Stefanie Sollfrank, Till Acker, Hans-Ulrich Prokosch, Jan Christoph
BACKGROUND: German university hospitals have started to establish molecular tumor boards in order to enable physicians to make molecular-guided decisions. OBJECTIVE: Our aim was to describe the organizational structure and procedures which are currently supporting the molecular tumor boards of five German university hospitals. METHODS: We conducted semi-structured interviews with experts of five university hospitals between December 2016 and February 2017...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28508703/increased-risk-of-arterial-thromboembolic-events-with-combination-lenalidomide-dexamethasone-therapy-for-multiple-myeloma
#17
Satish Maharaj, Simone Chang, Karan Seegobin, Ivan Serrano-Santiago, Lara Zuberi
Cancer associated thrombosis is a leading cause of morbidity and mortality. Research and guidelines have focused on venous thromboembolic events (VTE). Within the past decade, combination lenalidomide and dexamethasone has become a standard of therapy for multiple myeloma and is now widely used. In these patients, the risk of arterial thromboembolic events (ATE) has not been addressed to the same extent as VTE. Areas discussed: Presented is a targeted review of published data on ATE in MM patients on combination lenalidomide/dexamethasone therapy...
May 16, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28507746/guidelines-on-eosinophilic-esophagitis-evidence-based-statements-and-recommendations-for-diagnosis-and-management-in-children-and-adults
#18
REVIEW
Alfredo J Lucendo, Javier Molina-Infante, Ángel Arias, Ulrike von Arnim, Albert J Bredenoord, Christian Bussmann, Jorge Amil Dias, Mogens Bove, Jesús González-Cervera, Helen Larsson, Stephan Miehlke, Alexandra Papadopoulou, Joaquín Rodríguez-Sánchez, Alberto Ravelli, Jukka Ronkainen, Cecilio Santander, Alain M Schoepfer, Martin A Storr, Ingrid Terreehorst, Alex Straumann, Stephen E Attwood
INTRODUCTION: Eosinophilic esophagitis (EoE) is one of the most prevalent esophageal diseases and the leading cause of dysphagia and food impaction in children and young adults. This underlines the importance of optimizing diagnosys and treatment of the condition, especially after the increasing amount of knowledge on EoE recently published. Therefore, the UEG, EAACI ESPGHAN, and EUREOS deemed it necessary to update the current guidelines regarding conceptual and epidemiological aspects, diagnosis, and treatment of EoE...
April 2017: United European Gastroenterology Journal
https://www.readbyqxmd.com/read/28506194/the-use-of-systemic-therapies-to-prevent-progression-of-inflammatory-breast-cancer-which-targeted-therapies-to-add-on-cytotoxic-combinations
#19
Anthony Gonçalves, Audrey Monneur, Patrice Viens, François Bertucci
Inflammatory breast cancer is a rare but frequently fatal disease, essentially because of its high ability to develop distant metastases. Even though the prognosis of IBC was significantly improved by multimodal management, including the systematic use of cytotoxic-based induction, the prognosis remains largely dismal. Areas covered: This review presents the main achievements in the systemic treatment of IBC during the past 30 years. It focuses more specifically on recent results obtained with targeted therapies, including anti-HER2 and anti-angiogenic agents...
May 16, 2017: Expert Review of Anticancer Therapy
https://www.readbyqxmd.com/read/28505029/treatment-options-for-failed-back-surgery-syndrome-fbss-patients-with-refractory-chronic-pain-an-evidence-based-approach
#20
Kasra Amirdelfan, Lynn Webster, Lawrence Poree, Vishad Sukul, Porter McRoberts
STUDY DESIGN: A significant number of lumbar post-surgical patients continue to suffer persistent pain and limited function and are termed to have "Failed back surgery syndrome" (FBSS). This review evaluates clinical trial data for the treatment of FBSS patients. OBJECTIVE: Using an evidence-based approach to evaluate FBSS treatments will assist clinicians in choosing the most effective options for FBSS patients. Furthermore, reducing the utilization of less effective therapies may result in substantial financial savings for this patient population...
April 12, 2017: Spine
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