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https://www.readbyqxmd.com/read/28733461/should-heart-failure-be-regarded-as-a-terminal-illness-requiring-palliative-care-a-study-of-heart-failure-patients-carers-and-clinicians-understanding-of-heart-failure-prognosis-and-its-management
#1
Rachel Stocker, Helen Close, Helen Hancock, A Pali S Hungin
OBJECTIVES: Communication and planning for heart failure (HF) care near the end of life is known to be complex. Little is known about how the patient experience of palliative assessment and communication needs change over time, and how this might inform management. Our aim was to explore experiences of giving or receiving a prognosis and advanced palliative care planning (ACP) for those with HF. METHODS: We carried out a longitudinal grounded theory study, employing in-depth interviews with 14 clinicians (primary and secondary care) and observations of clinic and home appointments, followed by a series of interviews with 13 patients with HF and 9 carers...
July 21, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28730691/effect-of-abrupt-discontinuation-of-antidepressants-in-critically-ill-hospitalized-adults
#2
Taryn B Bainum, David S Fike, Diana Mechelay, Krystal K Haase
OBJECTIVES: To determine whether discontinuation of chronic antidepressant therapy is associated with a higher risk of antidepressant discontinuation syndrome (ADS) symptoms in patients admitted to the intensive care unit (ICU) when compared with those who were continued on therapy and to identify factors associated with increased risk of ADS in this population. DESIGN: Single-center retrospective observational cohort study. SETTING: ICUs in a tertiary care hospital...
July 21, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28725848/exploring-inpatients-experiences-of-healing-and-healing-spaces-a-mixed-methods-study
#3
Lorissa MacAllister, Dawn Bellanti, Bonnie R Sakallaris
In order to understand a patient's healing experience it is essential to understand the elements that they, the patient, believes contributed to their healing. Previous research has focused on symptom reducers or contributors through environment such as stress. A person's experience of healing happens over time not instantaneous. Therefore, in this study, the interviews with patients happened after forty-eight hours of hospitalization. This mixed methods study describes the experiences of seventeen inpatients from two healthcare systems using a phenomenological approach combined with evidence based design evaluation methods to document the setting...
December 2016: Journal of patient experience
https://www.readbyqxmd.com/read/28723244/evaluation-of-the-national-health-service-nhs-direct-pilot-telehealth-program-cost-effectiveness-analysis
#4
Malcolm Clarke, Joanna Fursse, Nancy Connolly, Urvashi Sharma, Russell Jones
OBJECTIVE: To evaluate the cost-effectiveness of a pilot telehealth program applied to a wide population of patients with chronic obstructive pulmonary disease (COPD). DESIGN: Vital signs data were transmitted from the home of the patient on a daily basis using a patient monitoring system for review by community nurse to assist decisions on management. SETTING: Community services for patients diagnosed with COPD. PARTICIPANTS: Two Primary Care Trusts (PCTs) enrolled 321 patients diagnosed with COPD into the telehealth program...
July 18, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28721691/occupational-therapy-for-adults-with-problems-in-activities-of-daily-living-after-stroke
#5
REVIEW
Lynn A Legg, Sharon R Lewis, Oliver J Schofield-Robinson, Avril Drummond, Peter Langhorne
BACKGROUND: A stroke occurs when the blood supply to part of the brain is cut off. Activities of daily living (ADL) are daily home-based activities that people carry out to maintain health and well-being. ADLs include the ability to: eat and drink unassisted, move, go to the toilet, carry out personal hygiene tasks, dress unassisted, and groom. Stroke causes impairment-related functional limitations that may result in difficulties participating in ADLs independent of supervision, direction, or physical assistance...
July 19, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28720628/the-patient-centered-medical-home-pcmh-framing-typology-for-understanding-the-structure-function-and-outcomes-of-pcmhs
#6
Autumn M Kieber-Emmons, William L Miller
INTRODUCTION: Patient-centered medical homes (PCHMs) aspire to transform today's challenged primary care services. However, it is unclear which PCMH characteristics produce specific outcomes of interest for care delivery. This study tested a novel typology of PCMH practice transformation, the PCMH framing typology, and evaluated measurable outcomes by each type. METHODS: Using the Patient-Centered Primary Care Collaborative 2012 to 2013 Annual Review, this secondary analysis of the published PCMH literature extracted data from publications of 59 PCMHs...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720620/in-this-issue-opiates-tobacco-social-determinants-of-health-social-accountability-for-non-profit-hospitals-more-on-pcmh-and-clinical-topics
#7
EDITORIAL
Marjorie A Bowman, Anne Victoria Neale, Dean A Seehusen
This issue contains several articles about the factors contributing to the complex and deadly interplay between social determinants of health, pain, mental illness, and addictive substances such as opioids and tobacco. One article clearly is a call to action: more than half of opioid prescriptions in the United States are given to patients with mental health problems. Two articles report work on the next steps for social determinants of health in health care settings. Social accountability based on community health needs assessments required of community hospitals should lead to the creation of more family medicine residency positions...
July 2017: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/28720114/effects-of-the-equip-quasi-experimental-study-testing-a-collaborative-quality-improvement-approach-for-maternal-and-newborn-health-care-in-tanzania-and-uganda
#8
P Waiswa, F Manzi, G Mbaruku, A K Rowe, M Marx, G Tomson, T Marchant, B A Willey, J Schellenberg, S Peterson, C Hanson
BACKGROUND: Quality improvement is a recommended strategy to improve implementation levels for evidence-based essential interventions, but experience of and evidence for its effects in low-resource settings are limited. We hypothesised that a systemic and collaborative quality improvement approach covering district, facility and community levels, supported by report cards generated through continuous household and health facility surveys, could improve the implementation levels and have a measurable population-level impact on coverage and quality of essential services...
July 18, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/28718325/collaborative-care-for-psychiatric-disorders-in-older-adults-a-systematic-review
#9
Pallavi Dham, Sarah Colman, Karen Saperson, Carrie McAiney, Lillian Lourenco, Nick Kates, Tarek K Rajji
OBJECTIVE: To evaluate the mode of implementation, clinical outcomes, cost-effectiveness, and the factors influencing uptake and sustainability of collaborative care for psychiatric disorders in older adults. DESIGN: Systematic review. SETTING: Primary care, home health care, seniors' residence, medical inpatient and outpatient. PARTICIPANTS: Studies with a mean sample age of 60 years and older. INTERVENTION: Collaborative care for psychiatric disorders...
January 1, 2017: Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie
https://www.readbyqxmd.com/read/28716351/effect-of-provision-of-home-based-curative-health-services-by-public-sector-health-care-providers-on-neonatal-survival-a-community-based-cluster-randomised-trial-in-rural-pakistan
#10
Sajid Soofi, Simon Cousens, Ali Turab, Yaqub Wasan, Shah Mohammed, Shabina Ariff, Zaid Bhatti, Imran Ahmed, Steve Wall, Zulfiqar A Bhutta
BACKGROUND: Although the effectiveness of community mobilisation and promotive care delivered by community health workers in reducing perinatal and neonatal mortality is well established, evidence in support of home-based neonatal resuscitation and infection management is mixed. We assessed the effectiveness of adding training in neonatal bag and mask resuscitation and oral antibiotic therapy for suspected neonatal infections to a basic preventive and promotive interventions package delivered by public sector community-based lady health workers (LHWs) in rural Pakistan...
August 2017: Lancet Global Health
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#11
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28710700/enhancing-state-medical-home-capacity-through-a-care-coordination-technical-assistance-model
#12
Susan Berry, Patti Barovechio, Emily Mabile, Tri Tran
Introduction A practice-based care coordination (CC) model was developed by Louisiana's Title V Children's Special Health Services (CSHS) program to meet the overwhelming needs of the New Orleans post-Katrina population. The pilot clinic demonstrated an improvement in medical home (MH) capacity over the course of 3 months. The purpose of the current study is to evaluate the replicability of the model and sustainability of MH improvement over at least 2 years, while identifying factors that may modify the effect of the intervention...
July 14, 2017: Maternal and Child Health Journal
https://www.readbyqxmd.com/read/28707258/-connecting-the-dots-a-qualitative-study-of-home-health-nurse-perspectives-on-coordinating-care-for-recently-discharged-patients
#13
Christine D Jones, Jacqueline Jones, Angela Richard, Kathryn Bowles, Dana Lahoff, Rebecca S Boxer, Frederick A Masoudi, Eric A Coleman, Heidi L Wald
BACKGROUND: In 2012, nearly one-third of adults 65 years or older with Medicare discharged to home after hospitalization were referred for home health care (HHC) services. Care coordination between the hospital and HHC is frequently inadequate and may contribute to medication errors and readmissions. Insights from HHC nurses could inform improvements to care coordination. OBJECTIVE: To describe HHC nurse perspectives about challenges and solutions to coordinating care for recently discharged patients...
July 13, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28707110/what-factors-are-associated-with-90-day-episode-of-care-payments-for-younger-patients-with-total-joint-arthroplasty
#14
Shweta Pathak, Cecilia M Ganduglia, Samir S Awad, Wenyaw Chan, John M Swint, Robert O Morgan
BACKGROUND: Total joint arthroplasty (TJA) has been identified as a procedure with substantial variations in inpatient and postacute care payments. Most studies in this area have focused primarily on the Medicare population and rarely have characterized the younger commercially insured populations. Understanding the inpatient and postdischarge care service-component differences across 90-day episodes of care and factors associated with payments for younger patients is crucial for successful implementation of bundled payments in TJA in non-Medicare populations...
July 13, 2017: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/28705187/analysis-of-home-based-rehabilitation-in-patients-with-motor-impairment-in-primary-care-a-prospective-observational-study
#15
Francisco Antonio Vega-Ramírez, Remedios López-Liria, Genoveva Granados-Gámez, Jose Manuel Aguilar-Parra, David Padilla-Góngora
BACKGROUND: The purpose of health and social policies is to encourage older people more longevity, remain free of disability and experience quality of life while living in their homes. The aim of this study was to describe the characteristics of 473 patients diagnosed with motor impairment in primary care, the objectives of home-based rehabilitation and its functional impact. METHODS: This prospective observational study was conducted in the Almería Health District...
July 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28701576/estimated-impact-of-emergency-medical-service-triage-of-stroke-patients-on-comprehensive-stroke-centers-an-urban-population-based-study
#16
Brian S Katz, Opeolu Adeoye, Heidi Sucharew, Joseph P Broderick, Jason McMullan, Pooja Khatri, Michael Widener, Kathleen S Alwell, Charles J Moomaw, Brett M Kissela, Matthew L Flaherty, Daniel Woo, Simona Ferioli, Jason Mackey, Sharyl Martini, Felipe De Los Rios la Rosa, Dawn O Kleindorfer
BACKGROUND AND PURPOSE: The American Stroke Association recommends that Emergency Medical Service bypass acute stroke-ready hospital (ASRH)/primary stroke center (PSC) for comprehensive stroke centers (CSCs) when transporting appropriate stroke patients, if the additional travel time is ≤15 minutes. However, data on additional transport time and the effect on hospital census remain unknown. METHODS: Stroke patients ≥20 years old who were transported from home to an ASRH/PSC or CSC via Emergency Medical Service in 2010 were identified in the Greater Cincinnati area population of 1...
July 12, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/28698325/the-scottish-school-leavers-cohort-linkage-of-education-data-to-routinely-collected-records-for-mortality-hospital-discharge-and-offspring-birth-characteristics
#17
Catherine H Stewart, Ruth Dundas, Alastair H Leyland
PURPOSE: The Scottish school leavers cohort provides population-wide prospective follow-up of local authority secondary school leavers in Scotland through linkage of comprehensive education data with hospital and mortality records. It considers educational attainment as a proxy for socioeconomic position in young adulthood and enables the study of associations and causal relationships between educational attainment and health outcomes in young adulthood. PARTICIPANTS: Education data for 284 621 individuals who left a local authority secondary school during 2006/2007-2010/2011 were linked with birth, death and hospital records, including general/acute and mental health inpatient and day case records...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28698319/the-supporting-patient-activation-in-transition-to-home-spath-intervention-a-study-protocol-of-a-randomised-controlled-trial-using-motivational-interviewing-to-decrease-re-hospitalisation-for-patients-with-copd-or-heart-failure
#18
Maria Flink, Marléne Lindblad, Oscar Frykholm, Åsa Kneck, Per Nilsen, Kristofer Årestedt, Mirjam Ekstedt
INTRODUCTION: Deficient hospital discharging and patients struggling to handle postdischarge self-management have been identified as potential causes of re-hospitalisation rates. Despite an increased interest in interventions aiming to reduce re-hospitalisation rates, there is yet no best evidence on how to support patients in being active participants in their self-management postdischarge. The aim of this paper is to describe the study protocol for an upcoming randomised controlled trial (RCT) of the Supporting Patient in Activation to Home (sPATH) intervention...
July 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28697620/is-it-just-religious-practice-exploring-patients-reasons-for-choosing-a-faith-based-primary-health-clinic-over-their-local-public-sector-primary-health-clinic
#19
James D Porter, Graham Bresick
BACKGROUND: Person-centred, re-engineered primary health care (PHC) is a national and global priority. Faith-based health care is a significant provider of PHC in sub-Saharan Africa, but there is limited published data on the reasons for patient choice of faith-based health care, particularly in South Africa. AIM: The primary objective was to determine and explore the reasons for patient choice of a faith-based primary care clinic over their local public sector primary care clinic, and secondarily to determine to what extent these reasons were influenced by demography...
June 29, 2017: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/28693520/strengthening-primary-health-care-teams-with-palliative-care-leaders-protocol-for-a-cluster-randomized-clinical-trial
#20
Joan Llobera, Noemí Sansó, Amador Ruiz, Merce Llagostera, Estefania Serratusell, Carlos Serrano, María Luisa Martín Roselló, Enric Benito, Eusebio J Castaño, Alfonso Leiva
BACKGROUND: The objective of the Balearic Islands Palliative Care (PC) Program is to improve the quality of PC through a shared model consisting of primary health care professionals, home-based PC teams, and PC units in hospitals. According to the World Health Organization (WHO), patients with advanced cancer and other terminal diseases benefit from early identification and proactive PC. We will evaluate the effectiveness of an intervention in which a PC leader is established in the primary health care center, and assess the effect of this intervention on the early identification of patients in need of PC, the efficient use of health care services, and direct health care costs...
July 10, 2017: BMC Palliative Care
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