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https://www.readbyqxmd.com/read/29473945/home-based-primary-care-beyond-extension-of-the-independence-at-home-demonstration
#1
James Rotenberg, Bruce Kinosian, Peter Boling, George Taler
The Independence at Home (IAH) Demonstration Year 2 results confirmed that the first-year savings were 10 times as great as those of the pioneer accountable care organizations during their initial 2 years. We update projected savings from nationwide conversion of the IAH demonstration, incorporating Year 2 results and improving attribution of IAH-qualified (IAH-Q) Medicare beneficiaries to home-based primary care (HBPC) practices. Applying IAH qualifying criteria to beneficiaries in the Medicare 5% claims file, the effect of expanding HBPC to the 2...
February 23, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29472969/student-expenses-in-residency-interviewing
#2
Anne Walling, Kari Nilsen, Paul Callaway, Jill Grothusen, Cole Gillenwater, Samantha King, Gregory Unruh
Background: The student costs of residency interviewing are of increasing concern but limited current information is available. Updated, more detailed information would assist students and residency programs in decisions about residency selection. The study objective was to measure the expenses and time spent in residency interviewing by the 2016 graduating class of the University of Kansas School of Medicine and assess the impact of gender, regional campus location, and primary care application...
August 2017: Kansas Journal of Medicine
https://www.readbyqxmd.com/read/29472515/development-of-a-standardized-approach-for-managing-opioids-in-adults-with-chronic-noncancer-pain
#3
Jessica M Downes, Donald G Klepser, Jennifer Foster, Maggie Nelson
PURPOSE: The implementation of a chronic pain protocol (CPP) and its effects on the management of long-term opioid therapy are described. SUMMARY: The CPP used at a federally qualified health center and primary care clinic was updated in 2015 and included a prescribing ceiling in morphine equivalent dose (MED) per day and standardized the prescribing of chronic opioids. Intermittent urine drug screening performed at least once annually was added as a requirement of the pain management contract between the provider and the patient...
March 1, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29472229/management-of-exertional-heat-stroke-a-practical-update-for-primary-care-physicians
#4
Edward Walter, Kiki Steel
No abstract text is available yet for this article.
March 2018: British Journal of General Practice: the Journal of the Royal College of General Practitioners
https://www.readbyqxmd.com/read/29470861/mini-cog-for-the-diagnosis-of-alzheimer-s-disease-dementia-and-other-dementias-within-a-primary-care-setting
#5
REVIEW
Dallas P Seitz, Calvin Ch Chan, Hailey T Newton, Sudeep S Gill, Nathan Herrmann, Nadja Smailagic, Vasilis Nikolaou, Bruce A Fage
BACKGROUND: Alzheimer's disease and other forms of dementia are becoming increasingly common with the aging of most populations. The majority of individuals with dementia will first present for care and assessment in primary care settings. There is a need for brief dementia screening instruments that can accurately diagnose dementia in primary care settings. The Mini-Cog is a brief, cognitive screening test that is frequently used to evaluate cognition in older adults in various settings...
February 22, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29470455/urban-rural-county-and-state-differences-in-chronic-obstructive-pulmonary-disease-united-states-2015
#6
Janet B Croft, Anne G Wheaton, Yong Liu, Fang Xu, Hua Lu, Kevin A Matthews, Timothy J Cunningham, Yan Wang, James B Holt
Chronic obstructive pulmonary disease (COPD) accounts for the majority of deaths from chronic lower respiratory diseases, the third leading cause of death in the United States in 2015 and the fourth leading cause in 2016.* Major risk factors include tobacco exposure, occupational and environmental exposures, respiratory infections, and genetics.† State variations in COPD outcomes (1) suggest that it might be more common in states with large rural areas. To assess urban-rural variations in COPD prevalence, hospitalizations, and mortality; obtain county-level estimates; and update state-level variations in COPD measures, CDC analyzed 2015 data from the Behavioral Risk Factor Surveillance System (BRFSS), Medicare hospital records, and death certificate data from the National Vital Statistics System (NVSS)...
February 23, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29468635/strategies-to-improve-recruitment-to-randomised-trials
#7
REVIEW
Shaun Treweek, Marie Pitkethly, Jonathan Cook, Cynthia Fraser, Elizabeth Mitchell, Frank Sullivan, Catherine Jackson, Tyna K Taskila, Heidi Gardner
BACKGROUND: Recruiting participants to trials can be extremely difficult. Identifying strategies that improve trial recruitment would benefit both trialists and health research. OBJECTIVES: To quantify the effects of strategies for improving recruitment of participants to randomised trials. A secondary objective is to assess the evidence for the effect of the research setting (e.g. primary care versus secondary care) on recruitment. SEARCH METHODS: We searched the Cochrane Methodology Review Group Specialised Register (CMR) in the Cochrane Library (July 2012, searched 11 February 2015); MEDLINE and MEDLINE In Process (OVID) (1946 to 10 February 2015); Embase (OVID) (1996 to 2015 Week 06); Science Citation Index & Social Science Citation Index (ISI) (2009 to 11 February 2015) and ERIC (EBSCO) (2009 to 11 February 2015)...
February 22, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29466531/association-of-increased-chronicity-of-depression-with-hiv-appointment-attendance-treatment-failure-and-mortality-among-hiv-infected-adults-in-the-united-states
#8
Brian W Pence, Jon C Mills, Angela M Bengtson, Bradley N Gaynes, Tiffany L Breger, Robert L Cook, Richard D Moore, David J Grelotti, Conall O'Cleirigh, Michael J Mugavero
Importance: Depression commonly affects adults with HIV and complicates the management of HIV. Depression among individuals with HIV tends to be chronic and cyclical, but the association of this chronicity with HIV outcomes (and the related potential for screening and intervention to shorten depressive episodes) has received little attention. Objective: To examine the association between increased chronicity of depression and multiple HIV care continuum indicators (HIV appointment attendance, treatment failure, and mortality)...
February 21, 2018: JAMA Psychiatry
https://www.readbyqxmd.com/read/29465596/tianma-gouteng-decoction-for-essential-hypertension-protocol-for-a-systematic-review-and-meta-analysis
#9
Benjian Chen, Yuanping Wang, Zhuogen He, Dawei Wang, Xia Yan, Pingchang Xie
BACKGROUND: Essential hypertension is one of the most common chronic diseases, as well as one of the leading risk factors for cardio-cerebrovascular diseases. Tianma Gouteng decoction has been commonly used in clinical practice for patients with essential hypertension. It is important to update the search and evaluation to provide the best available evidence for essential hypertension. Here, we provide a protocol to evaluate the efficacy and safety of Tianma Gouteng decoction (TGD) for essential hypertension...
February 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29465150/frailty-screening-and-assessment-tools-a-review-of-characteristics-and-use-in-public-health
#10
F Gilardi, A Capanna, M Ferraro, P Scarcella, M C Marazzi, L Palombi, G Liotta
INTRODUCTION: Frailty screening and assessment are a fundamental issue in Public Health in order to plan prevention programs and services. METHODOLOGY: By a narrative review of the literature employing the International Narrative Systematic Assessment tool, the authors aims to develop an updated framework for the main procedures and measurement tools to assess frailty in older adults, paying attention to the use in the primary care setting. RESULTS: The study selected 10 reviews published between January 2010 and December 2016 that define some characteristics of the main tools used to measure the frailty...
March 2018: Annali di Igiene: Medicina Preventiva e di Comunità
https://www.readbyqxmd.com/read/29462307/-artlift-arts-on-referral-intervention-in-uk-primary-care-updated-findings-from-an-ongoing-observational-study
#11
Diane M Crone, Rachel C Sumner, Colin M Baker, Elizabeth A Loughren, Samantha Hughes, David V B James
Background: Arts for health interventions are an accepted option for medical management of mental wellbeing in health care. Updated findings are presented from a prospective longitudinal follow-up (observational) design study of an arts on referral programme in UK general practice, over a 7-year period (2009-2016). Methods: Primary care process and mental wellbeing outcomes were investigated, including progress through the intervention, changes in mental wellbeing, and factors associated with those outcomes...
February 16, 2018: European Journal of Public Health
https://www.readbyqxmd.com/read/29461916/outpatient-management-of-fever-and-neutropenia-in-adults-treated-for-malignancy-american-society-of-clinical-oncology-and-infectious-diseases-society-of-america-clinical-practice-guideline-update
#12
Randy A Taplitz, Erin B Kennedy, Eric J Bow, Jennie Crews, Charise Gleason, Douglas K Hawley, Amelia A Langston, Loretta J Nastoupil, Michelle Rajotte, Kenneth Rolston, Lynne Strasfeld, Christopher R Flowers
Purpose To provide an updated joint ASCO/Infectious Diseases Society of American (IDSA) guideline on outpatient management of fever and neutropenia in patients with cancer. Methods ASCO and IDSA convened an Update Expert Panel and conducted a systematic review of relevant studies. The guideline recommendations were based on the review of evidence by the Expert Panel. Results Six new or updated meta-analyses and six new primary studies were added to the updated systematic review. Recommendations Clinical judgment is recommended when determining which patients are candidates for outpatient management, using clinical criteria or a validated tool such as the Multinational Association of Support Care in Cancer risk index...
February 20, 2018: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/29461621/core-outcome-set-for-trials-aimed-at-improving-the-appropriateness-of-polypharmacy-in-older-people-in-primary-care
#13
Audrey Rankin, Cathal A Cadogan, Cristín Ryan, Barbara Clyne, Susan M Smith, Carmel M Hughes
OBJECTIVES: To develop a core outcome set (COS) for use in effectiveness trials of interventions aiming to improve the appropriateness of polypharmacy in older people in primary care. DESIGN: Standard COS development methodology was followed, comprising identification of outcomes of studies from an update of a Cochrane systematic review and previously collected qualitative data and an online Delphi consensus exercise involving three rounds. PARTICIPANTS: An international panel of 160 stakeholders comprising 120 healthcare experts and a public participant panel of 40 older people...
February 20, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29460487/systematic-review-probiotics-in-the-management-of-lower-gastrointestinal-symptoms-an-updated-evidence-based-international-consensus
#14
REVIEW
A P S Hungin, C R Mitchell, P Whorwell, C Mulligan, O Cole, L Agréus, P Fracasso, C Lionis, J Mendive, J-M Philippart de Foy, B Seifert, K-A Wensaas, C Winchester, N de Wit
BACKGROUND: In 2013, a systematic review and Delphi consensus reported that specific probiotics can benefit adult patients with irritable bowel syndrome (IBS) and other gastrointestinal (GI) problems. AIM: To update the consensus with new evidence. METHODS: A systematic review identified randomised, placebo-controlled trials published between January 2012 and June 2017. Evidence was graded, previously developed statements were reassessed by an 8-expert panel, and agreement was reached via Delphi consensus...
February 20, 2018: Alimentary Pharmacology & Therapeutics
https://www.readbyqxmd.com/read/29453190/testing-behavior-change-techniques-to-encourage-primary-care-physicians-to-access-cancer-screening-audit-and-feedback-reports-protocol-for-a-factorial-randomized-experiment-of-email-content
#15
Gratianne Vaisson, Holly O Witteman, Zachary Bouck, Caroline A Bravo, Laura Desveaux, Diego Llovet, Justin Presseau, Marianne Saragosa, Monica Taljaard, Shama Umar, Jeremy M Grimshaw, Jill Tinmouth, Noah M Ivers
BACKGROUND: Cancer Care Ontario's Screening Activity Report (SAR) is an online audit and feedback tool designed to help primary care physicians in Ontario, Canada, identify patients who are overdue for cancer screening or have abnormal results requiring follow-up. Use of the SAR is associated with increased screening rates. To encourage SAR use, Cancer Care Ontario sends monthly emails to registered primary care physicians announcing that updated data are available. However, analytics reveal that 50% of email recipients do not open the email and less than 7% click the embedded link to log in to their report...
February 16, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29447718/no-240-cytomegalovirus-infection-in-pregnancy
#16
Yoav Yinon, Dan Farine, Mark H Yudin
OBJECTIVES: To review the principles of prenatal diagnosis of congenital cytomegalovirus (CMV) infection and to describe the outcomes of the affected pregnancies. OUTCOMES: Effective management of fetal infection following primary and secondary maternal CMV infection during pregnancy. Neonatal signs include intrauterine growth restriction (IUGR), microcephaly, hepatosplenomegaly, petechiae, jaundice, chorioretinitis, thrombocytopenia and anemia, and long-term sequelae consist of sensorineural hearing loss, mental retardation, delay of psychomotor development, and visual impairment...
February 2018: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/29447091/obesity-in-pregnancy-a-comparison-of-four-national-guidelines
#17
Dana Vitner, Kristin Harris, Cynthia Maxwell, M D Farine
BACKGROUND: Obesity in pregnancy has become one of the most important challenges in obstetrical care given its prevalence and potential adverse impact on both mother and fetus. The primary objective of this descriptive review is to identify common themes and distinctions within the current recommendations for maternal obesity in the most updated version of four published national guidelines. METHODS: We reviewed the following guidelines for obesity in pregnancy: American College of Obstetricians and Gynecologists (ACOG) 2015, Royal Australian and New Zealand College of Obstetricians and Gynecologists (RANZCOG) 2013, Royal College of Obstetrics and Gynecology (RCOG) 2010, and Society of Obstetrics and Gynecologists of Canada (SOGC) 2010...
February 15, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29438575/primary-care-professionals-providing-non-urgent-care-in-hospital-emergency-departments
#18
REVIEW
Daniela Gonçalves-Bradley, Jaspreet K Khangura, Gerd Flodgren, Rafael Perera, Brian H Rowe, Sasha Shepperd
BACKGROUND: In many countries emergency departments (EDs) are facing an increase in demand for services, long waits, and severe crowding. One response to mitigate overcrowding has been to provide primary care services alongside or within hospital EDs for patients with non-urgent problems. However, it is unknown how this impacts the quality of patient care and the utilisation of hospital resources, or if it is cost-effective. This is the first update of the original Cochrane Review published in 2012...
February 13, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29432623/a-time-motion-study-of-primary-care-physicians-work-in-the-electronic-health-record-era
#19
Richard A Young, Sandra K Burge, Kaparaboyna A Kumar, Jocelyn M Wilson, Daniela F Ortiz
BACKGROUND AND OBJECTIVES: Electronic health records (EHRs) have had mixed effects on the workflow of ambulatory primary care. In this study, we update previous research on the time required to care for patients in primary care clinics with EHRs. METHODS: We directly observed family physician (FP) attendings, residents, and their ambulatory patients in 982 visits in clinics affiliated with 10 residencies of the Residency Research Network of Texas. The FPs were purposely chosen to reflect a diversity of patient care styles...
February 2018: Family Medicine
https://www.readbyqxmd.com/read/29427898/psychological-interventions-for-anxiety-in-adult-primary-care-patients-a-review-and-recommendations-for-future-research
#20
REVIEW
Robyn L Shepardson, Laura J Buchholz, Risa B Weisberg, Jennifer S Funderburk
Anxiety symptoms are prevalent in primary care, yet treatment rates are low. The integration of behavioral health providers into primary care via the Primary Care Behavioral Health (PCBH) model offers a promising way to improve treatment options by adding a team member with the necessary skillset to deliver evidence-based psychological interventions for anxiety. We conducted a narrative review of psychological interventions for anxiety applied within adult primary care settings (k = 44) to update the literature and evaluate the fit of existing interventions with the PCBH model...
January 2, 2018: Journal of Anxiety Disorders
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