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Shared Medical Visit

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https://www.readbyqxmd.com/read/29325548/a-pre-post-study-testing-a-lung-cancer-screening-decision-aid-in-primary-care
#1
Daniel S Reuland, Laura Cubillos, Alison T Brenner, Russell P Harris, Bailey Minish, Michael P Pignone
BACKGROUND: The United States Preventive Services Task Force (USPSTF) issued recommendations for older, heavy lifetime smokers to complete annual low-dose computed tomography (LDCT) scans of the chest as screening for lung cancer. The USPSTF recommends and the Centers for Medicare and Medicaid Services require shared decision making using a decision aid for lung cancer screening with annual LDCT. Little is known about how decision aids affect screening knowledge, preferences, and behavior...
January 12, 2018: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/29317849/is-medical-treatment-of-alcohol-withdrawal-syndrome-a-stag-hunt-challenges-and-opportunities-in-managing-risk-and-uncertainty-in-addiction-cessation
#2
Roger Lee Mendoza
Purpose: While the individual and social costs of alcoholism or alcohol use disorder are well established, few are aware that medical problems can arise during detoxification, some of which can be life-threatening. This study determines if sustained treatment for Alcohol Withdrawal Syndrome (AWS) might be based on the strategic choices and expectations of patients and health care providers alike, as well as the risk mitigation options available to them. Design/approach: AWS was modeled as a Stag Hunt to explain both risk and decision-making in medical treatments for detoxification, since it can deduce a set of equilibrium strategies available to both patient and provider...
2018: Risk Management and Healthcare Policy
https://www.readbyqxmd.com/read/29298192/helping-older-adults-improve-their-medication-experience-home-by-addressing-medication-regimen-complexity-in-home-healthcare
#3
Orla C Sheehan, Hadi Kharrazi, Kimberly J Carl, Bruce Leff, Jennifer L Wolff, David L Roth, Jennifer Gabbard, Cynthia M Boyd
In skilled home healthcare (SHHC), communication between nurses and physicians is often inadequate for medication reconciliation and needed changes to the medication regimens are rarely made. Fragmentation of electronic health record (EHR) systems, transitions of care, lack of physician-nurse in-person contact, and poor understanding of medications by patients and their families put patients at risk for serious adverse outcomes. The aim of this study was to develop and test the HOME tool, an informatics tool to improve communication about medication regimens, share the insights of home care nurses with physicians, and highlight to physicians and nurses the complexity of medication schedules...
January 2018: Home Healthcare Now
https://www.readbyqxmd.com/read/29290564/adherence-to-adjuvant-endocrine-therapy-in-women-with-breast-cancer-a-prospective-observational-study-in-japanese-women
#4
Sayaka Kuba, Shigeto Maeda, Megumi Matsumoto, Kosho Yamanouchi, Hiroshi Yano, Michi Morita, Chika Sakimura, Toshiko Hatachi, Yukiko Tokai, Mitsuhisa Takatsuki, Hikaru Fujioka, Naomi Hayashida, Takeshi Nagayasu, Susumu Eguchi
INTRODUCTION: Nonadherence to adjuvant endocrine therapy has been poorly studied in Asian patients with breast cancer. We therefore assessed adherence to endocrine therapy among women with breast cancer in Japan. PATIENTS AND METHODS: We conducted a prospective observational study among Japanese women with hormone receptor-positive breast cancer. Patients brought their pill packets to visits for 1 year and answered a questionnaire. We also examined prescription records during the study period...
December 12, 2017: Clinical Breast Cancer
https://www.readbyqxmd.com/read/29277423/engaging-nurses-in-smoking-cessation-challenges-and-opportunities-in-turkey
#5
Mimi Nichter, Aslı Çarkoğlu, Mark Nichter, Şeyda Özcan, M Atilla Uysal
This paper discusses the training of nurses in smoking cessation as part of routine patient care in Turkey. Formative research was carried out prior to training to identify challenges faced by smokers when trying to quit. Site visits to government hospitals and cessation clinics were conducted to observe health care provider-patient interactions involving behavior change. Four culturally sensitive cessation training workshops for nurses (n = 54) were conducted in Istanbul. Following training, nurses were debriefed on their experiences delivering cessation advice...
December 20, 2017: Health Policy
https://www.readbyqxmd.com/read/29276763/a-description-of-patient-and-provider-experience-and-clinical-outcomes-after-heart-failure-shared-medical-appointment
#6
Lisa B Cohen, Melanie Parent, Tracey H Taveira, Sandesh Dev, Wen-Chih Wu
Background: Shared medical appointments (SMAs) are clinical visits in which several patients meet with 1 or more providers at the same time. Objective: To describe the outcomes of an interdisciplinary SMA for veterans recently discharged for heart failure (HF). Methods: A retrospective chart review for patients' readmission rates, survival, medication adherence, and medication-related problems. For qualitative outcomes, we performed semistructured interviews on 12 patients who had undergone HF SMAs and their respective caregivers focusing on care satisfaction, HF knowledge, disease self-care, medication reconciliation, and peer support...
December 2017: Journal of Patient Experience
https://www.readbyqxmd.com/read/29275883/health-care-use-and-associated-time-and-out-of-pocket-expenditures-for-patients-with-cardiovascular-disease-in-a-publicly-funded-health-care-system
#7
Saba Ali, Mahshid Moghei, Murray Krahn, Caroline Chessex, Sherry L Grace
BACKGROUND: The objectives of this study were to describe (1) health care use and associated patient time and out of pocket (OOP) costs over 2 years after a cardiac diagnosis, (2) the sociodemographic and clinical drivers of these costs, and (3) patient costs related to cardiac rehabilitation (CR) participation. METHODS: Secondary analysis was conducted in an observational prospective CR program evaluation cohort in Ontario, which has a publicly funded health care system...
January 2018: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/29242086/women-s-experiences-of-their-pre-abortion-ultrasound-image-printout
#8
Katrina Kimport, Nicole E Johns, Ushma D Upadhyay
OBJECTIVES: We know little about women's interest in and experiences with a printout of their pre-abortion ultrasound image. METHODS: We conducted a mixed methods study at a large volume abortion-providing facility where patients are offered the opportunity to receive their ultrasound printout, using two years of abstracted medical chart data on demographics and printout acceptance and interviews with patients about whether they took a printout and, if they did, why and what they did with it...
December 11, 2017: Contraception
https://www.readbyqxmd.com/read/29241511/increasing-patient-recall-of-nurse-leader-rounding
#9
Sally W Gillam, Andrew R Gillam, Tricia L Casler, Katie Cook
Nursing staff in a medical/surgical acute care 34-bed hospital unit were challenged by low percentages of patients able to recall nurse leader rounding activity (NLR). NLR occurred daily for all patients, yet many did not recall visits by nursing leaders when surveyed at discharge. Care giver credibility suffered as non-nursing executives questioned if NLR consistently occurred. Several mechanisms were used to facilitate patient NLR recall: scripted NLR verbiage/keywords, nursing uniform leadership insignia and white lab coats, sharing of business cards, handwritten notes on patient communication white boards, multimedia leadership insignia on leader e-tablets, and visits with family members: patient NLR recall did not improve...
December 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/29237650/needs-of-cancer-patients-in-palliative-care-during-medical-visits-qualitative-study
#10
Dominik Melhem, Serge Daneault
OBJECTIVE: To explore the needs of cancer patients in palliative care and to determine how care providers, including family physicians, could meet these needs more fully. DESIGN: Qualitative study performed using semistructured interviews. SETTING: Palliative care departments (ambulatory and intrahospital). PARTICIPANTS: Twelve patients with a diagnosis of cancer deemed to be in the palliative phase, who had already received either chemotherapy or radiation treatment...
December 2017: Canadian Family Physician Médecin de Famille Canadien
https://www.readbyqxmd.com/read/29230977/scleral-buckling-using-a-non-contact-wide-angle-viewing-system-with-a-25-gauge-chandelier-endoilluminator
#11
Jaehyuck Jo, Byung Gil Moon, Joo Yong Lee
PURPOSE: To report the outcome of scleral buckling using a non-contact wide-angle viewing system with a 25-gauge chandelier endoilluminator. METHODS: Retrospective analyses of medical records were performed for 17 eyes of 16 patients with primary rhegmatogenous retinal detachment (RRD) without proliferative vitreoretinopathy who had undergone conventional scleral buckling with cryoretinopexy using the combination of a non-contact wide-angle viewing system and chandelier endoillumination...
December 2017: Korean Journal of Ophthalmology: KJO
https://www.readbyqxmd.com/read/29217503/impact-of-an-electronic-health-record-integrated-personal-health-record-on-patient-participation-in-health-care-development-and-randomized-controlled-trial-of-myhealthkeeper
#12
Borim Ryu, Nari Kim, Eunyoung Heo, Sooyoung Yoo, Keehyuck Lee, Hee Hwang, Jeong-Whun Kim, Yoojung Kim, Joongseek Lee, Se Young Jung
BACKGROUND: Personal health record (PHR)-based health care management systems can improve patient engagement and data-driven medical diagnosis in a clinical setting. OBJECTIVE: The purpose of this study was (1) to demonstrate the development of an electronic health record (EHR)-tethered PHR app named MyHealthKeeper, which can retrieve data from a wearable device and deliver these data to a hospital EHR system, and (2) to study the effectiveness of a PHR data-driven clinical intervention with clinical trial results...
December 7, 2017: Journal of Medical Internet Research
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/29192004/effectiveness-of-a-comprehensive-case-management-service-for-children-with-medical-complexity
#14
RANDOMIZED CONTROLLED TRIAL
Tamara D Simon, Kathryn B Whitlock, Wren Haaland, Davene R Wright, Chuan Zhou, John Neff, Waylon Howard, Brian Cartin, Rita Mangione-Smith
OBJECTIVES: To assess whether children with medical complexity (CMC) exposed to a hospital-based comprehensive case management service (CCMS) experience improved health care quality, improved functional status, reduced hospital-based utilization, and/or reduced overall health care costs. METHODS: Eligible CMC at Seattle Children's Hospital were enrolled in a cluster randomized controlled trial between December 1, 2010, and September 29, 2014. Participating primary care providers (PCPs) were randomly assigned, and CMC either had access to an outpatient hospital-based CCMS or usual care directed by their PCP...
December 2017: Pediatrics
https://www.readbyqxmd.com/read/29181504/patient-sharing-networks-of-physicians-and-health-care-utilization-and-spending-among-medicare-beneficiaries
#15
Bruce E Landon, Nancy L Keating, Jukka-Pekka Onnela, Alan M Zaslavsky, Nicholas A Christakis, A James O'Malley
Importance: Physicians are embedded in informal networks in which they share patients, information, and behaviors. Objective: We examined the association between physician network properties and health care spending, utilization, and quality of care among Medicare beneficiaries. Design, Setting, and Participants: In this cross-sectional study, we applied methods from social network analysis to Medicare administrative data from 2006 to 2010 for an average of 3 761 223 Medicare beneficiaries per year seen by 40 241 physicians practicing in 51 hospital referral regions (HRRs) to identify networks of physicians linked by shared patients...
November 27, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29177408/organizing-and-implementing-a-multidisciplinary-fast-track-oncology-clinic
#16
Y L Basta, K M A J Tytgat, H H Greuter, J H G Klinkenbijl, P Fockens, J Strikwerda
Quality problem: Patients with gastrointestinal malignancies often need multiple appointments with different medical specialists, causing waiting times to accrue. Initial assessment: In our hospital, care is organized in a sequential manner, causing long waiting times. To reduce this, a fast track outpatient clinic (FTC) was implemented. Choice of solution: The FTC was organized within the hospital's existing structure. Patient centered care was achieved by ensuring that the medical specialists visit the patient, implementing nurse coordinators and considering patient wishes and co-morbidities when formulating a treatment plan...
November 21, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29157058/tramadol-prescription-patterns-in-patients-followed-by-general-practitioners-and-orthopedists-in-germany-in-the-year-2015
#17
Karel Kostev, Christian von Vultée, Dienthard M Usinger, Jens-Peter Reese
OBJECTIVES: The aim of this study was to analyze tramadol prescription patterns in acute pain patients followed by general practitioners and orthopedists in Germany. METHODS: This study included patients ≥18 years diagnosed with acute pain who received at least one tramadol prescription each in one of 1,129 general or 179 orthopedic practices in Germany between January and December 2015 (index date). Patients were excluded if they had received a prescription for another analgesic in the year prior to the index date, had a follow-up of less than 15 months after the index date, or were prescribed tramadol for a period of more than three months...
November 20, 2017: Postgraduate Medicine
https://www.readbyqxmd.com/read/29151022/quality-of-care-for-people-with-multimorbidity-a-case-series
#18
Michaela L Schiøtz, Dorte Høst, Mikkel B Christensen, Helena Domínguez, Yasmin Hamid, Merete Almind, Kim L Sørensen, Thomas Saxild, Rikke Høgsbro Holm, Anne Frølich
BACKGROUND: Multimorbidity is becoming increasingly prevalent and presents challenges for healthcare providers and systems. Studies examining the relationship between multimorbidity and quality of care report mixed findings. The purpose of this study was to investigate quality of care for people with multimorbidity in the publicly funded healthcare system in Denmark. METHODS: To investigate the quality of care for people with multimorbidity different groups of clinicians from the hospital, general practice and the municipality reviewed records from 23 persons with multimorbidity and discussed them in three focus groups...
November 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/29125902/asthma-in-children-of-mothers-with-systemic-lupus-erythematosus-and-the-role-of-preterm-birth
#19
Marios Rossides, Cathina Nguyen, Elizabeth V Arkema, Julia F Simard
OBJECTIVE: Systemic lupus erythematosus (SLE) and asthma share inheritable IgE-related pathophysiology, but the association between maternal SLE and asthma in the offspring has not been explored. Our aim was to investigate the association between maternal SLE during pregnancy and childhood asthma and examine the role of preterm birth as a mediator of the association using Swedish register data. METHODS: Information on 12000 singleton live births (2001-2013) was collected from the Medical Birth Register...
November 10, 2017: Arthritis Care & Research
https://www.readbyqxmd.com/read/29119824/an-innovative-health-care-delivery-model-for-children-with-medical-complexity
#20
Anne Elizabeth Glassgow, Molly A Martin, Rachel Caskey, Melishia Bansa, Michael Gerges, Mary Johnson, Monika Marko, Kenita Perry-Bell, Heather J Risser, Peter J Smith, Benjamin Van Voorhees
Children with medical complexity (CMC) account for a disproportionate share of pediatric health-care utilization and cost that is largely attributable to long hospitalizations, frequent hospital readmissions, and high use of emergency departments. In response, the Centers for Medicare and Medicaid Services Health Care Innovation Center supports the development and testing of innovative health-care payment and service delivery models. The purpose of this article is to describe the CMS-funded coordinated health care for complex kids (CHECK) program, an innovative system of health-care delivery that provides improved, comprehensive, and well-coordinated services to CMC...
September 2017: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
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