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https://www.readbyqxmd.com/read/27893144/effectiveness-of-shared-medical-appointments-targeting-the-triple-aim-among-patients-with-overweight-obesity-or-diabetes
#1
Kristi H Trickett, Paul M Matiaco, Kathryn Jones, Bernadette Howlett, Kathaleen Briggs Early
BACKGROUND: Obesity and diabetes are epidemic in the United States, with many treatment options having limited long-term efficacy. A possible effective medical management tool is the shared medical appointment (SMA), which offers an efficient and cost-effective approach to behavior change and aligns with the Triple Aim (reduce costs, improve population health, and improve patient care experience) set forth by the Institute for Healthcare Improvement. OBJECTIVES: To assess the effectiveness of SMAs to achieve the Triple Aim and to improve the management of overweight/obesity or diabetes...
December 1, 2016: Journal of the American Osteopathic Association
https://www.readbyqxmd.com/read/27880049/understanding-clinicians-attitudes-toward-a-mobile-health-strategy-to-childhood-asthma-management-a-qualitative-study
#2
Jessica P Hollenbach, Anna Cushing, Emilie Melvin, Bryanna McGowan, Michelle M Cloutier, Melissa Manice
OBJECTIVES: Mobile technology for childhood asthma can provide real-time data to enhance care. What real-time adherence information clinicians want, how they may use it, and if the data meet their clinical needs has not been fully explored. Our goal was to determine whether pediatric primary care and pulmonary clinicians believe a sensor-based mobile intervention is useful in caring for patients with asthma. METHODS: We recruited participants from 3 urban, primary care and 1 pulmonary practice from July to September 2015 in Hartford, CT...
November 23, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/27869583/patient-facing-technology-for-identification-of-copd-in-primary-care
#3
David Kevin Ahern, Donna Parker, Charles Eaton, Caitlin Rafferty, Joseph Wroblewski, Roberta Goldman
BACKGROUND: The proliferation of mobile devices and emergence of interoperable 'mHealth' apps is accelerating development and deployment of patient-facing risk assessments in primary care. The present study describes a user-centered design and an agile development approach to creation of an app for assessing lungfunction as part of a randomized controlled trial for the   dentification of chronic obstructive lung disease in primary care. METHOD: Seventeen patients recruited from a hospital-based, ambulatory family medicine clinic agreed to be videotaped while using the app, Lung Age, on a first-generation iPad prior to their provideR encounter...
July 15, 2016: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/27864833/structured-clinical-documentation-in-the-electronic-medical-record-to-improve-quality-and-to-support-practice-based-research-in-epilepsy
#4
Jaishree Narayanan, Sofia Dobrin, Janet Choi, Susan Rubin, Anna Pham, Vimal Patel, Roberta Frigerio, Darryck Maurer, Payal Gupta, Lourdes Link, Shaun Walters, Chi Wang, Yuan Ji, Demetrius M Maraganore
OBJECTIVE: Using the electronic medical record (EMR) to capture structured clinical data at the point of care would be a practical way to support quality improvement and practice-based research in epilepsy. METHODS: We describe our stepwise process for building structured clinical documentation support tools in the EMR that define best practices in epilepsy, and we describe how we incorporated these toolkits into our clinical workflow. RESULTS: These tools write notes and capture hundreds of fields of data including several score tests: Generalized Anxiety Disorder-7 items, Neurological Disorders Depression Inventory for Epilepsy, Epworth Sleepiness Scale, Quality of Life in Epilepsy-10 items, Montreal Cognitive Assessment/Short Test of Mental Status, and Medical Research Council Prognostic Index...
November 19, 2016: Epilepsia
https://www.readbyqxmd.com/read/27858865/medical-care-utilization-and-costs-on-end-of-life-cancer-patients-the-role-of-hospice-care
#5
Hsiao-Ting Chang, Ming-Hwai Lin, Chun-Ku Chen, Tzeng-Ji Chen, Shu-Lin Tsai, Shao-Yi Cheng, Tai-Yuan Chiu, Shih-Tzu Tsai, Shinn-Jang Hwang
Although there are 3 hospice care programs for terminal cancer patients in Taiwan, the medical utilization and expenses for these patients by programs have not been well-explored. The aim of this study was to examine the medical utilization and expenses of terminal cancer patients under different programs of hospice care in the last 90, 30, and 14 days of life.This was a retrospective observational study by secondary data analysis. By using the National Health Insurance claim database and Hospice Shared Care Databases...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27849653/the-role-of-aspirin-desensitization-in-the-management-of-aspirin-exacerbated-respiratory-disease
#6
Bobby A Tajudeen, Joseph S Schwartz, John V Bosso
PURPOSE OF REVIEW: Aspirin-exacerbated respiratory disease (AERD) is a progressive inflammatory disease of the upper and lower airways characterized by marked eosinophilic nasal polyposis, asthma, and respiratory reactions to medications that inhibit the cyclooxygenase pathway. Aspirin desensitization has proven to be an effective tool in the management of this disease when used in a multidisciplinary setting. The purpose of this article is to review the current literature regarding AERD, aspirin desensitization, and share our opinion regarding the most optimal multidisciplinary approach to these complex patients...
November 15, 2016: Current Opinion in Otolaryngology & Head and Neck Surgery
https://www.readbyqxmd.com/read/27821397/medication-reconciliation-interventions-in-ambulatory-care-a-scoping-review
#7
Lisa McCarthy, Xinru Wendy Su, Natalie Crown, Jennifer Turple, Thomas E R Brown, Kate Walsh, Jessica John, Paula Rochon
PURPOSE: The published literature on medication reconciliation (MR) interventions, outcomes, and facilitators in ambulatory care settings is reviewed. METHODS: A scoping review was conducted to characterize ambulatory care-based MR research in terms of study design, elements of interventions, and outcomes examined. English-language articles on comparative studies of MR programs targeting adults in ambulatory care settings were identified using data sources including MEDLINE, PreMEDLINE, EMBASE, and International Pharmaceutical Abstracts...
November 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27803090/percutaneous-coronary-intervention-choice-decision-aid-for-stable-coronary-artery-disease-a-randomized-trial
#8
Megan Coylewright, Sara Dick, Becky Zmolek, Jason Askelin, Edward Hawkins, Megan Branda, Jonathan W Inselman, Claudia Zeballos-Palacios, Nilay D Shah, Erik P Hess, Annie LeBlanc, Victor M Montori, Henry H Ting
BACKGROUND: Percutaneous coronary intervention (PCI) for stable coronary artery disease does not reduce the risk of death and myocardial infarction compared with optimal medical therapy (OMT), but many patients think otherwise. PCI Choice, a decision aid (DA), was designed for use during the clinical visit and includes information on quality of life and mortality outcomes for PCI with OMT versus OMT alone for stable coronary artery disease. METHODS AND RESULT: We conducted a randomized trial to assess the impact of the PCI Choice DA compared with usual care when there is a choice between PCI and optimal medical therapy...
November 1, 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27749543/higher-cost-sharing-for-visiting-general-hospitals-and-the-changing-trend-in-the-first-visited-healthcare-organization-among-newly-diagnosed-hypertension-patients
#9
Jaeyong Shin, Young Choi, Sang Gyu Lee, Tae Hyun Kim, Eun-Cheol Park
Unnecessary use of high-quality resources in general hospitals hinders treatment of patients with urgent and complicated conditions. Thus, the Korean Government has sought to reduce general hospital visiting of patients with 52 mild diseases, including hypertension. The higher cost sharing for medical expenses and medications from general hospitals were enacted in 2009 and 2011, respectively.We determined whether these regulations were effective through evaluating changing trends in first-visited healthcare organizations and defined the first visiting healthcare organization level (primary clinics, hospital, and general hospital) as an outcome measure...
October 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27732780/mass-spectrometry-based-visualization-of-molecules-associated-with-human-habitats
#10
Daniel Petras, Louis-Félix Nothias, Robert A Quinn, Theodore Alexandrov, Nuno Bandeira, Amina Bouslimani, Gabriel Castro-Falcón, Liangyu Chen, Tam Dang, Dimitrios J Floros, Vivian Y H Hook, Neha Garg, Nicole Hoffner, Yike Jiang, Clifford A Kapono, Irina Koester, Rob Knight, Christopher A Leber, Tiejun Ling, Tal Luzzatto-Knaan, Laura-Isobel McCall, Aaron Philip McGrath, Michael J Meehan, Jonathan K Merritt, Robert H Mills, Jamie Morton, Sonia Podvin, Ivan Protsyuk, Trevor Purdy, Kendall Satterfield, Stephen Searles, Sahil Shah, Sarah Shires, Dana Steffen, Margot White, Jelena Todoric, Robert Tuttle, Aneta Wojnicz, Valerie Sapp, Fernando Vargas, Jin Yang, Chao Zhang, Pieter C Dorrestein
The cars we drive, the homes we live in, the restaurants we visit, and the labs and offices we work in are all a part of the modern human habitat. Remarkably, little is known about the diversity of chemicals present in these environments and to what degree molecules from our bodies influence the built environment that surrounds us and vice versa. We therefore set out to visualize the chemical diversity of five built human habitats together with their occupants, to provide a snapshot of the various molecules to which humans are exposed on a daily basis...
October 12, 2016: Analytical Chemistry
https://www.readbyqxmd.com/read/27673722/patients-attending-shared-medical-appointments-for-metabolic-stone-prevention-have-decreased-stone-risk-factors
#11
R Allan Jhagroo, Stephen Y Nakada, Kristina L Penniston
INTRODUCTION: Shared medical appointments (SMAs) have decreased patients' wait time to initial stone clinic appointment, standardized education, and increased exposure to nutrition therapy. We assessed the effectiveness of SMAs in reducing patients' urinary stone risk factors. METHODS: Patients who established care in our stone clinic in a SMA between 3/2012 and 8/2015 were sequentially identified. After eliminating those without follow-up urine collections or whose urinary creatinine excretion between the 2 collections varied by >40%, 113 patients were included (M:F 63:50; 54±15 y; BMI 30...
September 27, 2016: Journal of Endourology
https://www.readbyqxmd.com/read/27649264/medication-adherence-in-patients-undergoing-methadone-maintenance-treatment-in-xi-an-china
#12
Kaina Zhou, Hengxin Li, Xiaoli Wei, Xiaomei Li, Guihua Zhuang
OBJECTIVES: To identify medication adherence and its influencing factors among patients of 14 methadone maintenance treatment (MMT) clinics in Xi'an, China. METHODS: Data were obtained from the National AIDS Information System-Community Methadone Maintenance Treatment. All patients registered in the system were not permitted to take methadone at home without professionals' supervision. Medication adherence was assessed using categorical (ie, dropout or retained) and continuous (ie, treatment time, methadone use time, and percentage of methadone use days) variables...
September 19, 2016: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/27643885/effects-of-vilazodone-on-sexual-functioning-in-healthy-adults-results-from-a-randomized-double-blind-placebo-controlled-and-active-controlled-study
#13
Anita H Clayton, Suresh Durgam, Dayong Li, Changzheng Chen, Laishun Chen, Maju Mathews, Carl P Gommoll, Armin Szegedi
The aim of this study is to evaluate the effects of vilazodone on sexual functioning in healthy, sexually active adults and assess the impact of medication nonadherence in this type of trial. Participants were randomized to vilazodone (20 or 40 mg/day), paroxetine (20 mg/day), or placebo for 5 weeks of double-blind treatment. The primary endpoint was change from baseline to day 35 in Change in Sexual Functioning Questionnaire (CSFQ) total score in the intent-to-treat (ITT) population. Post-hoc analyses were carried out in modified intent-to-treat (mITT) populations that excluded participants in the active-treatment groups with undetectable plasma drug concentrations at all visits (mITT-I) or at least one visit (mITT-II)...
January 2017: International Clinical Psychopharmacology
https://www.readbyqxmd.com/read/27631706/using-nurse-practitioner-comanagement-to-reduce-hospitalizations-and-readmissions-within-a-home-based-primary-care-program
#14
Masha G Jones, Linda V DeCherrie, Yasmin S Meah, Cameron R Hernandez, Eric J Lee, David M Skovran, Theresa A Soriano, Katherine A Ornstein
Nurse practitioner (NP) comanagement involves an NP and physician sharing responsibility for the care of a patient. This study evaluates the impact of NP comanagement for clinically complex patients in a home-based primary care program on hospitalizations, 30-day hospital readmissions, and provider satisfaction. We compared preenrollment and postenrollment hospitalization and 30-day readmission rates of home-bound patients active in the Nurse Practitioner Co-Management Program within the Mount Sinai Visiting Doctors Program (MSVD) (n = 87) between January 1, 2012, and July 1, 2013...
September 13, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27625405/regional-learning-collaboratives-produce-rapid-and-sustainable-improvements-in-stroke-thrombolysis-times
#15
Shyam Prabhakaran, Jungwha Lee, Kathleen O'Neill
BACKGROUND: Reduction in door-to-needle (DTN) times in patients with acute ischemic stroke treated with tissue-type plasminogen activator is associated with improved outcomes. We hypothesized that a learning collaborative would rapidly reduce DTN times at Chicago's primary stroke centers. METHODS AND RESULTS: We analyzed data from all adult patients with out-of-hospital ischemic stroke hospitalized between January 1, 2010 and March 31, 2015 and who received tissue-type plasminogen activator in the emergency department at 15 primary stroke centers in Chicago and 15 primary stroke centers in St...
September 2016: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/27617099/prescription-medicine-sharing-exploring-patients-beliefs-and-experiences
#16
Kebede Beyene, Trudi Aspden, Janie Sheridan
BACKGROUND: Prescription medicine sharing has been defined as the lending of medicines (giving prescription medicines to someone else) or borrowing of medicines (being given and using a medicine prescribed for another person). This qualitative study explored the views of patients, to elicit information regarding factors influencing medicine sharing behaviours, their experiences of the consequences of prescription medicine sharing, and their risk assessment strategies when deciding to share...
2016: Journal of Pharmaceutical Policy and Practice
https://www.readbyqxmd.com/read/27612178/effect-of-a-patient-centered-communication-intervention-on-oncologist-patient-communication-quality-of-life-and-health-care-utilization-in-advanced-cancer-the-voice-randomized-clinical-trial
#17
Ronald M Epstein, Paul R Duberstein, Joshua J Fenton, Kevin Fiscella, Michael Hoerger, Daniel J Tancredi, Guibo Xing, Robert Gramling, Supriya Mohile, Peter Franks, Paul Kaesberg, Sandy Plumb, Camille S Cipri, Richard L Street, Cleveland G Shields, Anthony L Back, Phyllis Butow, Adam Walczak, Martin Tattersall, Alison Venuti, Peter Sullivan, Mark Robinson, Beth Hoh, Linda Lewis, Richard L Kravitz
Importance: Observational studies demonstrate links between patient-centered communication, quality of life (QOL), and aggressive treatments in advanced cancer, yet few randomized clinical trials (RCTs) of communication interventions have been reported. Objective: To determine whether a combined intervention involving oncologists, patients with advanced cancer, and caregivers would promote patient-centered communication, and to estimate intervention effects on shared understanding, patient-physician relationships, QOL, and aggressive treatments in the last 30 days of life...
September 9, 2016: JAMA Oncology
https://www.readbyqxmd.com/read/27609732/a-review-of-treatment-options-for-graves-disease-why-total-thyroidectomy-is-a-viable-option-in-selected-patients
#18
Vinuta Mohan, Robert Lind
Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease...
2016: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/27579915/impact-of-a-value-based-formulary-on-medication-utilization-health-services-utilization-and-expenditures
#19
Kai Yeung, Anirban Basu, Ryan N Hansen, John B Watkins, Sean D Sullivan
BACKGROUND: Value-based benefit design has been suggested as an effective approach to managing the high cost of pharmaceuticals in health insurance markets. Premera Blue Cross, a large regional health plan, implemented a value-based formulary (VBF) for pharmaceuticals in 2010 that explicitly used cost-effectiveness analysis (CEA) to inform medication copayments. OBJECTIVE OF THE STUDY: The objective of the study was to determine the impact of the VBF. DESIGN: Interrupted time series of employer-sponsored plans from 2006 to 2013...
August 30, 2016: Medical Care
https://www.readbyqxmd.com/read/27566597/cardiac-rehabilitation-after-acute-coronary-syndrome-comparing-adherence-and-risk-factor-modification-in-a-community-based-shared-care-model-versus-hospital-based-care-in-a-randomised-controlled-trial-with-12-months-of-follow-up
#20
Jannik B Bertelsen, Jens Refsgaard, Helle Kanstrup, Søren P Johnsen, Ina Qvist, Bo Christensen, Kent L Christensen
AIM: To investigate whether phase II cardiac rehabilitation (CR) conducted by a community model of shared care CR (SC-CR) including health care centres and general practice was feasible and provided acceptable results and to compare SC-CR to hospital-based CR (H-CR) in a randomised controlled trial. METHODS: Patients were randomised to H-CR or SC-CR after admission for acute coronary syndrome. In SC-CR, the general practitioner took over the responsibility of the remaining rehabilitation, pharmacological treatment and risk factor management after the initial visit to the hospital outpatient clinic...
August 26, 2016: European Journal of Cardiovascular Nursing
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