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home based primary care

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https://www.readbyqxmd.com/read/27915457/combined-use-of-the-rationalization-of-home-medication-by-an-adjusted-stopp-in-older-patients-rasp-list-and-a-pharmacist-led-medication-review-in-very-old-inpatients-impact-on-quality-of-prescribing-and-clinical-outcome
#1
Lorenz Van der Linden, Liesbeth Decoutere, Karolien Walgraeve, Koen Milisen, Johan Flamaing, Isabel Spriet, Jos Tournoy
BACKGROUND: Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. OBJECTIVES: Our objective was to evaluate the effect of a pharmacist intervention, consisting of the application of the Rationalization of home medication by an Adjusted STOPP in older Patients (RASP) list and a pharmacist-led medication review on polypharmacy, the quality of prescribing, and clinical outcome in geriatric inpatients...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27913873/impact-of-intensity-and-timing-of-integrated-home-palliative-cancer-care-on-end-of-life-hospitalization-in-northern-italy
#2
M Pellizzari, D Hui, E Pinato, M Lisiero, S Serpentini, L Gubian, F Figoli, M Cancian, C De Chirico, E Ferroni, F Avossa, M Saugo
PURPOSE: The Veneto Region implemented a novel integrated home-based palliative cancer care (HPCC) program embedded in primary care. We examined the impact of timing and intensity of this program on the quality of end-of-life (EOL) care. METHODS: We selected adult cancer patients died in the Veneto Region between March and December 2013, excluding those died from haematological malignancies as well as the very elderly (85+ years). We retrieved the claim-based data on hospitalization and homecare visits, and defined two observation windows: 90 to 16 days before death to examine intensity of HPCC exposure, and the last 15 days of life to examine EOL outcomes, including hospital death, any hospital stay for medical reasons and hospital stay ≥7 days for medical reasons...
December 2, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27912740/effectiveness-and-cost-effectiveness-of-an-in-home-respite-care-program-in-supporting-informal-caregivers-of-people-with-dementia-design-of-a-comparative-study
#3
Sophie Vandepitte, Nele Van Den Noortgate, Koen Putman, Sofie Verhaeghe, Lieven Annemans
BACKGROUND: Frequent hospitalization and permanent nursing home placement not only affect the well-being of persons with dementia, but also place great financial strain on society. Therefore, it is important to create effective strategies to support informal caregivers so that they can continue to perform their demanding role. Preliminary qualitative evidence suggests that community-based respite services can actually be important for caregivers, and that the level of evidence should be further established in terms of effectiveness...
December 2, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27911597/evidence-based-psychosocial-treatments-for-pediatric-elimination-disorders
#4
Jaclyn A Shepard, Joseph E Poler, Jesse H Grabman
Pediatric elimination disorders are common in childhood, yet psychosocial correlates are generally unclear. Given the physiological concomitants of both enuresis and encopresis, and the fact that many children with elimination disorders are initially brought to their primary care physician for treatment, medical evaluation and management are crucial and may serve as the first-line treatment approach. Scientific investigation on psychological and behavioral interventions has progressed over the past couple of decades, resulting in the identification of effective treatments for enuresis and encopresis...
December 2, 2016: Journal of Clinical Child and Adolescent Psychology
https://www.readbyqxmd.com/read/27906004/a-quantitative-evidence-base-for-population-health-applying-utilization-based-cluster-analysis-to-segment-a-patient-population
#5
Sabine I Vuik, Erik Mayer, Ara Darzi
BACKGROUND: To improve population health it is crucial to understand the different care needs within a population. Traditional population groups are often based on characteristics such as age or morbidities. However, this does not take into account specific care needs across care settings and tends to focus on high-needs patients only. This paper explores the potential of using utilization-based cluster analysis to segment a general patient population into homogenous groups. METHODS: Administrative datasets covering primary and secondary care were used to construct a database of 300,000 patients, which included socio-demographic variables, morbidities, care utilization, and cost...
November 25, 2016: Population Health Metrics
https://www.readbyqxmd.com/read/27902575/veterans-voice-through-the-lens-of-their-medical-records-what-it-reveals-about-congestive-heart-failure-readmissions
#6
Carl W Stevenson, Kattie Payne
PURPOSE OF STUDY: The medical record is a sea of information that can reveal what patients are trying to tell us about their health condition. It can reveal hints and trends as to why veterans with congestive heart failure (CHF) are being readmitted within 30 days after hospital discharge. These hints and trends lead caregivers to key contributing variables to veterans' readmission. Furthermore, these variables can be used to predict patient outcomes such as readmission and even prognosis...
January 2017: Professional Case Management
https://www.readbyqxmd.com/read/27901404/military-veteran-cancer-survivors-preferences-for-a-program-to-address-lifestyle-change-and-psychosocial-wellness-following-treatment
#7
Gregory P Beehler, Jonathan Novi, Marc T Kiviniemi, Lynn Steinbrenner
OBJECTIVE: This study aimed to understand military veteran cancer survivors' preferences regarding the delivery of post-treatment wellness services. METHODS: Thirty-three military veteran cancer survivors were interviewed about their perceptions of three models of health service delivery (home-, primary care-, and oncology-based services). RESULTS: Conventional qualitative content analysis revealed strengths and weaknesses of each service delivery model's content and structure (e...
November 30, 2016: Journal of Psychosocial Oncology
https://www.readbyqxmd.com/read/27901247/anabolic-steroids-for-rehabilitation-after-hip-fracture-in-older-people
#8
Vaqas Farooqi, Maayken E L van den Berg, Ian D Cameron, Maria Crotty
BACKGROUND: Hip fracture occurs predominantly in older people, many of whom are frail and undernourished. After hip fracture surgery and rehabilitation, most patients experience a decline in mobility and function. Anabolic steroids, the synthetic derivatives of the male hormone testosterone, have been used in combination with exercise to improve muscle mass and strength in athletes. They may have similar effects in older people who are recovering from hip fracture. OBJECTIVES: To examine the effects (primarily in terms of functional outcome and adverse events) of anabolic steroids after surgical treatment of hip fracture in older people...
September 2016: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/27899886/relearning-and-retaining-personally-relevant-words-using-computer-based-flashcard-software-in-primary-progressive-aphasia
#9
William S Evans, Megan Quimby, Michael Walsh Dickey, Bradford C Dickerson
Although anomia treatments have often focused on training small sets of words in the hopes of promoting generalization to untrained items, an alternative is to directly train a larger set of words more efficiently. The current case study reports on a novel treatment for a patient with semantic variant Primary Progressive Aphasia (svPPA), in which the patient was taught to make and practice flashcards for personally-relevant words using an open-source computer program (Anki). Results show that the patient was able to relearn and retain a large subset of her studied words for up to 20 months, the full duration of the study period...
2016: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/27898626/dental-trauma-in-a-pediatric-emergency-department-referral-center
#10
Emily Hall, Patricia Hickey, Thuy Nguyen-Tran, Jeff Louie
OBJECTIVE: The purpose of this study was to describe dental and associated oral injuries in a pediatric population that presents to an emergency department. METHODS: We performed a retrospective study and identified children from January 2007 to September 2011. Charts were reviewed for any subject, age from newborn to younger than 19 years, based on International Classification of Diseases, Ninth Revision codes for any dental or oral injury. Data abstraction included demographics, time of day of presentation, location and identification of tooth (s) injured, management, and disposition...
December 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27894271/effectiveness-of-a-physical-exercise-intervention-program-in-improving-functional-mobility-in-older-adults-after-hip-fracture-in-later-stage-rehabilitation-protocol-of-a-randomized-clinical-trial-reative-study
#11
Camila Astolphi Lima, Catherine Sherrington, Adriana Guaraldo, Suzana Albuquerque de Moraes, Renata Dos Ramos Varanda, Juliana de Araújo Melo, Kodi Edson Kojima, Monica Perracini
BACKGROUND: Hip fractures resulting from falls increase substantially with advancing age and less than half of older hip fracture survivors regain their former levels of mobility. There is increasing evidence that rehabilitation interventions with exercises that goes beyond the sub-acute phase or even in a later stage of care have a positive impact on various functional abilities. The purpose of this study is to determine if exercise program training for people who have suffered a fall-related hip fracture will improve functional mobility when compared with usual care...
November 29, 2016: BMC Geriatrics
https://www.readbyqxmd.com/read/27893954/does-primary-care-model-effect-healthcare-at-the-end-of-life-a-population-based-retrospective-cohort-study
#12
Michelle Howard, Mathieu Chalifoux, Peter Tanuseputro
BACKGROUND: Comprehensive primary care may enhance patient experience at end of life. OBJECTIVE: To examine whether belonging to different models of primary care is associated with end-of-life healthcare use and outcomes. DESIGN: Retrospective population cohort study, using health administrative databases to describe health services and costs in the last six months of life across three primary care models: enrolled to a physician remunerated mainly by capitation, with incentives for comprehensive care and access in some to allied health practitioners (Capitation); remunerated mainly from fee-for-service (FFS) with smaller incentives for comprehensive care (Enhanced FFS); and not enrolled, seeing physicians remunerated solely through FFS (Traditional FFS)...
November 28, 2016: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/27893639/surgical-rescue-the-next-pillar-of-acute-care-surgery
#13
Matthew E Kutcher, Jason L Sperry, Matthew R Rosengart, Deepika Mohan, Marcus K Hoffman, Matthew D Neal, Louis H Alarcon, Gregory A Watson, Juan Carlos Puyana, Graciela M Bauzá, Vaishali D Schuchert, Anisleidy Fombona, Tianhua Zhou, Samuel Zolin, Robert D Becher, Timothy R Billiar, Raquel M Forsythe, Brian S Zuckerbraun, Andrew B Peitzman
BACKGROUND: The evolving field of Acute Care Surgery (ACS) traditionally includes trauma, emergency general surgery, and critical care. However, the critical role of ACS in the rescue of patients with a surgical complication has not been explored. We here describe the role of 'surgical rescue' in the practice of Acute Care Surgery (ACS). METHODS: A prospective, electronic medical record-based ACS registry spanning January 2013 to May 2014 at a large urban academic medical center was screened by ICD-9 codes for acute surgical complications of an operative or interventional procedure...
November 23, 2016: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/27893519/effects-of-hospital-systems-on-medical-home-transformation-in-primary-care-residency-training-practices
#14
Kyle Knierim, Tristen Hall, Douglas Fernald, Thomas J Staff, Emilie Buscaj, Jessica Cornett Allen, Mary Onysko, W Perry Dickinson
Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology...
November 23, 2016: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27893087/targeting-functional-decline-in-alzheimer-disease-a-randomized-trial
#15
Christopher M Callahan, Malaz A Boustani, Arlene A Schmid, Michael A LaMantia, Mary G Austrom, Douglas K Miller, Sujuan Gao, Denisha Y Ferguson, Kathleen A Lane, Hugh C Hendrie
Background: Alzheimer disease results in progressive functional decline, leading to loss of independence. Objective: To determine whether collaborative care plus 2 years of home-based occupational therapy delays functional decline. Design: Randomized, controlled clinical trial. (ClinicalTrial.gov: NCT01314950). Setting: Urban public health system. Patients: 180 community-dwelling participants with Alzheimer disease and their informal caregivers...
November 22, 2016: Annals of Internal Medicine
https://www.readbyqxmd.com/read/27893060/association-between-allergen-exposure-in-inner-city-schools-and-asthma-morbidity-among-students
#16
William J Sheehan, Perdita Permaul, Carter R Petty, Brent A Coull, Sachin N Baxi, Jonathan M Gaffin, Peggy S Lai, Diane R Gold, Wanda Phipatanakul
Importance: Home aeroallergen exposure is associated with increased asthma morbidity in children, yet little is known about the contribution of school aeroallergen exposures to such morbidity. Objective: To evaluate the effect of school-specific aeroallergen exposures on asthma morbidity among students, adjusting for home exposures. Design, Setting, and Participants: The School Inner-City Asthma Study was a prospective cohort study evaluating 284 students aged 4 to 13 years with asthma who were enrolled from 37 inner-city elementary schools in the northeastern United States between March 1, 2008, and August 31, 2013...
November 21, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27892423/a-european-study-on-effectiveness-and-sustainability-of-current-cardiac-rehabilitation-programmes-in-the-elderly-design-of-the-eu-care-randomised-controlled-trial
#17
Eva Prescott, Esther P Meindersma, Astrid E van der Velde, Jose R Gonzalez-Juanatey, Marie Christine Iliou, Diego Ardissino, Giuseppe Biondi Zoccai, Uwe Zeymer, Leonie F Prins, Arnoud Wj Van't Hof, Matthias Wilhelm, Ed P de Kluiver
BACKGROUND: Cardiac rehabilitation (CR) is an evidence-based intervention to increase survival and quality of life. Yet studies consistently show that elderly patients are less frequently referred to CR, show less uptake and more often drop out of CR programmes. DESIGN: The European study on effectiveness and sustainability of current cardiac rehabilitation programmes in the elderly (EU-CaRE) project consists of an observational study and an open prospective, investigator-initiated multicentre randomised controlled trial (RCT) involving mobile telemonitoring guided CR (mCR)...
October 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27888984/efficacy-of-a-minimal-home-based-psychoeducative-intervention-in-patients-with-advanced-copd-a-randomised-controlled-trial
#18
D G Bove, K Lomborg, A K Jensen, D Overgaard, B Ø Lindhardt, J Midtgaard
BACKGROUND: Anxiety is a common comorbidity in patients with advanced Chronic Obstructive Pulmonary Disease (COPD) with major impact on quality of life and associated with increased risk of death. The objective of this randomised controlled trial was to test the efficacy of a minimal home-based psychoeducative intervention versus usual care for reducing symptoms of anxiety in patients with advanced COPD. METHODS: The trial included 66 participants with advanced COPD and symptoms of anxiety...
December 2016: Respiratory Medicine
https://www.readbyqxmd.com/read/27884300/teen-preferences-for-clinic-based-behavior-screens-who-where-when-and-how
#19
Carolyn Bradner Jasik, Mark Berna, Maria Martin, Elizabeth M Ozer
PURPOSE: Previous research examining computer-based adolescent risk behavior screening was done before widespread adoption of smartphones and merits updating. METHODS: This is a cross-sectional survey among 115 adolescents seeking primary care age 12-18 years. It is a diverse sample with 59% female, 51% white, 18% African-American, and 27% Latino. Respondents were asked level of comfort and honesty (1 = strongly disagree, 5 = strongly agree) when answering health behavior questions by paper, interview, or electronic device...
December 2016: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/27880049/understanding-clinicians-attitudes-toward-a-mobile-health-strategy-to-childhood-asthma-management-a-qualitative-study
#20
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
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