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https://www.readbyqxmd.com/read/29793213/end-stage-renal-disease-models-in-the-americas-optimizing-resources-to-achieve-better-health-outcomes
#1
Ramiro E Gilardino, Eduardo González-Pier, Claudia Brabata
End-stage renal disease, the last and most severe stage of chronic kidney disease, represents a major and rising concern for countries in Latin America, driven in large part by aging populations and the near-epidemic rises in diabetes, obesity, and hypertension. This places a great clinical, economic, and social burden on the region's health systems. During the ISPOR 6th Latin America Conference held in Sao Paulo, Brazil, in September 2017, an educational forum debated on value-based decision making in the treatment of end-stage renal disease in Latin America...
May 21, 2018: Value in Health Regional Issues
https://www.readbyqxmd.com/read/29792460/the-complexity-diversity-and-science-of-primary-care-teams
#2
Kevin Fiscella, Susan H McDaniel
This article examines the past, present and future of primary care and teamwork. It begins with a definition and description of primary care-its uniqueness, diversity and complexity, including the historical role of teams within primary care. The article then reviews the emergence of innovative primary care teams, including those grounded in new processes such as the Patient-Centered Medical Home and interprofessional teams that include new types of health professionals, particularly psychologists and other integrated behavioral health clinicians...
May 2018: American Psychologist
https://www.readbyqxmd.com/read/29792063/integrating-childhood-obesity-resources-into-the-patient-centered-medical-home-provider-perspectives-in-the-united-states
#3
Samareh G Hill, Thao-Ly T Phan, George A Datto, Jobayer Hossain, Lloyd N Werk, Diane Abatemarco
Pediatric primary care providers play a critical role in managing obesity yet often lack the resources and support systems to provide effective care to children with obesity. The objective of this study was to identify system-level barriers to managing obesity and resources desired to better managing obesity from the perspective of pediatric primary care providers. A 64-item survey was electronically administered to 159 primary care providers from 26 practices within a large pediatric primary care network. Bivariate analyses were performed to compare survey responses based on provider and practice characteristics...
January 1, 2018: Journal of Child Health Care: for Professionals Working with Children in the Hospital and Community
https://www.readbyqxmd.com/read/29790040/building-behavioral-health-homes-clinician-and-staff-perspectives-on-creating-integrated-care-teams
#4
Tracy Anastas, Elizabeth Needham Waddell, Sonya Howk, Mark Remiker, Gretchen Horton-Dunbar, L J Fagnan
Adults with serious mental illness and substance use disorders have elevated risk of mortality and higher healthcare costs compared to the general population. As these disparities have been linked to poor management of co-occurring chronic conditions in primary care, the behavioral health setting may be a preferred setting for routine medical screening and treatment. This qualitative study describes early stages of integrating care teams in emerging medical homes based in mental health and addiction treatment settings...
May 22, 2018: Journal of Behavioral Health Services & Research
https://www.readbyqxmd.com/read/29789318/impact-of-a-pharmacist-physician-collaborative-care-model-on-patient-outcomes-and-health-services-utilization
#5
Gary R Matzke, Leticia R Moczygemba, Karen J Williams, Michael J Czar, William T Lee
PURPOSE: The impact of a pharmacist-physician collaborative care model on patient outcomes and health services utilization is described. METHODS: Six hospitals from the Carilion Clinic health system in southwest Virginia, along with 22 patient-centered medical home (PCMH) practices affiliated with Carilion Clinic, participated in this project. Eligibility criteria included documented diagnosis of 2 or more of the 7 targeted chronic conditions (congestive heart failure, hypertension, hyperlipidemia, diabetes mellitus, asthma, chronic obstructive pulmonary disease, and depression), prescriptions for 4 or more medications, and having a primary care physician in the Carilion Clinic health system...
May 22, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29785092/patient-satisfaction-with-care-in-an-urban-tertiary-referral-academic-glaucoma-clinic-in-the-us
#6
Kristen M Peterson, Carrie E Huisingh, Christopher Girkin, Cynthia Owsley, Lindsay A Rhodes
Background: The purpose of this study was to determine the factors associated with glaucoma patients' satisfaction with their medical care by fellowship-trained glaucoma specialists in an urban tertiary referral clinic in the US. Methods: A total of 110 established patients aged ≥60 years with a diagnosis of either primary open angle glaucoma, glaucoma suspect, or ocular hypertension monitored by an ophthalmologist with fellowship training in glaucoma were enrolled at an academic, urban, tertiary referral eye clinic...
2018: Patient Preference and Adherence
https://www.readbyqxmd.com/read/29783928/physical-activity-intervention-for-elderly-patients-with-reduced-physical-performance-after-acute-coronary-syndrome-hulk-study-rationale-and-design-of-a-randomized-clinical-trial
#7
Elisabetta Tonet, Elisa Maietti, Giorgio Chiaranda, Francesco Vitali, Matteo Serenelli, Giulia Bugani, Gianni Mazzoni, Rossella Ruggiero, Jonathan Myers, Giovanni Quinto Villani, Ursula Corvi, Giovanni Pasanisi, Simone Biscaglia, Rita Pavasini, Giulia Ricci Lucchi, Gianluigi Sella, Roberto Ferrari, Stefano Volpato, Gianluca Campo, Giovanni Grazzi
BACKGROUND: Reduced physical performance and impaired mobility are common in elderly patients after acute coronary syndrome (ACS) and they represent independent risk factors for disability, morbidity, hospital readmission and mortality. Regular physical exercise represents a means for improving functional capacity. Nevertheless, its clinical benefit has been less investigated in elderly patients in the early phase after ACS. The HULK trial aims to investigate the clinical benefit of an early, tailored low-cost physical activity intervention in comparison to standard of care in elderly ACS patients with reduced physical performance...
May 21, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29783091/mind-at-home-streamlined-study-protocol-for-a-randomized-trial-of-home-based-care-coordination-for-persons-with-dementia-and-their-caregivers
#8
Quincy M Samus, Betty Smith Black, Melissa Reuland, Jeannie-Marie S Leoutsakos, Laura Pizzi, Kevin D Frick, David L Roth, Laura N Gitlin, Constantine G Lyketsos, Deirdre Johnston
BACKGROUND: Dementia is associated with high health care costs, premature long-term care (LTC) placement, medical complications, reduced quality of life, and caregiver burden. Most health care providers and systems are not yet organized or equipped to provide comprehensive long-term care management for dementia, although a range of effective symptoms and supportive care approaches exist. The Maximizing Independence at Home-Streamlined (MIND-S) is a promising model of home-based dementia care coordination designed to efficiently improve person-centered outcomes, while reducing care costs...
May 18, 2018: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29782601/patient-centered-medical-home-status-and-preparedness-to-assess-resident-milestones-a-cera-study
#9
Thad Wilkins, Wonsuk Yoo, Ralph A Gillies, Julie Dahl-Smith, Jacqueline Dubose, Joseph Hobbs, Selina Smith, Dean A Seehusen
Purpose: The patient-centered medical home (PCMH) model has been proposed as the ideal model for delivering primary care and is focused on improving patient safety and quality, reducing costs, and enhancing patient satisfaction. The mandated Accreditation Council for Graduate Medical Education educational milestones for evaluation of resident competency represent the skills graduates will utilize after graduation. Many of these skills are reflected in the PCMH model. We sought to determine if residency programs whose main family medicine (FM) practice sites have achieved PCMH recognition are therefore more prepared to evaluate milestones...
May 2018: PRiMER: peer-review reports in medical education research
https://www.readbyqxmd.com/read/29781677/community-health-workers-in-lesotho-experiences-of-health-promotion-activities
#10
Thato Seutloali, Lizeka Napoles, Nomonde Bam
BACKGROUND: Lesotho adopted primary health care in 1979, and community health workers (CHWs) were included in the programme to focus on health promotion, particularly to reach people in underserved rural areas. Although the CHW programme has been successful, the heavy burden of disease because of HIV and/or AIDS and tuberculosis shifted resources from health promotion to home-based care. AIM: The study explored the lived experience of CHWs in conducting health promotion activities in Lesotho...
February 27, 2018: African Journal of Primary Health Care & Family Medicine
https://www.readbyqxmd.com/read/29773778/a-collaboration-to-teach-us-mph-students-about-cuba-s-health-care-system
#11
Joan O'Connell, Ana María Gálvez-González, Jean Scandlyn, María R Sala-Adam, Xiomara Martín-Linares
In 2011, the US Department of the Treasury changed its regulations to allow US students to participate in short-term education programs in Cuba. Beginning in 2012, and each year thereafter, Cuba's National School of Public Health and the Colorado School of Public Health have jointly taught a class on the Cuban public health system. The program goals are to provide US students with an opportunity to learn about the Cuban national health system's focus on 1) prevention and primary health care services; 2) financial and geographic access to services and health equity; 3) continuum of care across the home, family doctor-and-nurse offices, polyclinics and hospitals; 4) data collection at all levels to understand health risks, including outbreaks, and to guide resource allocation; 5) assessing patients' health and risks using a comprehensive definition of health; 6) multisectoral collaborations between the Ministry of Public Health and other Cuban agencies and organizations to address population health risks; 7) disaster preparedness, response and recovery; and 8) provision of international health assistance...
April 2018: MEDICC Review
https://www.readbyqxmd.com/read/29767802/sitting-together-and-reaching-to-play-start-play-protocol-for-a-multisite-randomized-controlled-efficacy-trial-on-intervention-for-infants-with-neuromotor-disorders
#12
Regina T Harbourne, Stacey C Dusing, Michele A Lobo, Sarah Westcott-McCoy, James Bovaird, Susan Sheridan, James C Galloway, Hui-Ju Chang, Lin-Ya Hsu, Natalie Koziol, Emily C Marcinowski, Iryna Babik
Background: There is limited research examining the efficacy of early physical therapy on infants with neuromotor dysfunction. In addition, most early motor interventions have not been directly linked to learning, despite the clear association between motor activity and cognition during infancy. Objective: The aim of this project is to evaluate the efficacy of Sitting Together And Reaching To Play (START-Play), an intervention designed to target sitting, reaching, and motor-based problem solving to advance global development in infants with motor delays or neuromotor dysfunction...
June 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29766761/use-of-home-and-community-based-services-in-taiwan-s-national-10-year-long-term-care-plan
#13
Hsiao-Wei Yu, Yu-Kang Tu, Po-Hsiu Kuo, Ya-Mei Chen
We aimed to understand the relationships between care recipients' profiles and home- and community-based services (HCBS use patterns. Data were from the 2010 to 2013 Long-Term Care Service Management System in Taiwan ( N = 78,205). We used latent class analysis and multinomial logistic regression analyses. Three HCBS use patterns were found. Care recipients who lived alone, lived in less urbanized areas, and had instrumental activities of daily living disabilities were more likely to be in the home-based personal care group...
May 1, 2018: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/29765699/feasibility-and-effects-of-a-home-based-intervention-using-activity-trackers-on-achievement-of-individual-goals-quality-of-life-and-motor-performance-in-patients-with-paediatric-cancer
#14
Miriam Götte, Sabine Verena Kesting, Joachim Gerss, Dieter Rosenbaum, Joachim Boos
Objectives: Supervised exercise interventions during inpatient care are feasible. The objective was to evaluate the usability of activity trackers and centralised monitoring to conduct a home-based exercise intervention during cancer treatment. The primary endpoint and confirmatory analysis was achievement of individual goals for daily steps, compared (A) in the intervention group (IG) over time and (B) between the IG and control group (CG). Secondary endpoints included achievement of goals for active minutes and effects on motor performance and health-related quality of life (hrQoL)...
2018: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/29764869/tele-upcat-study-protocol-of-a-randomised-controlled-trial-of-a-home-based-tele-monitored-upper-limb-children-action-observation-training-for-participants-with-unilateral-cerebral-palsy
#15
Giuseppina Sgandurra, Francesca Cecchi, Elena Beani, Irene Mannari, Martina Maselli, Francesco Paolo Falotico, Emanuela Inguaggiato, Silvia Perazza, Elisa Sicola, Hilde Feys, Katrijn Klingels, Adriano Ferrari, Paolo Dario, Roslyn N Boyd, Giovanni Cioni
INTRODUCTION: A new rehabilitative approach, called UPper Limb Children Action Observation Training (UPCAT), based on the principles of action observation training (AOT), has provided promising results for upper limb rehabilitation in children with unilateral cerebral palsy (UCP). This study will investigate if a new information and communication technology platform, named Tele-UPCAT, is able to deliver AOT in a home setting and will test its efficacy on children and young people with UCP...
May 14, 2018: BMJ Open
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#16
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29759058/impact-of-medical-homes-on-expenditures-and-utilization-for-beneficiaries-with-behavioral-health-conditions
#17
Melissa A Romaire, Vincent Keyes, William J Parish, Konny Kim
OBJECTIVE: Individuals with behavioral health conditions may benefit from enhanced care management provided by a patient-centered medical home (PCMH). In late 2011 and early 2012 Medicare began participating in PCMH initiatives in eight states through the Multi-Payer Advanced Primary Care Practice (MAPCP) demonstration. This study examined how the initiatives addressed the needs of patients with behavioral health conditions and the impacts of the demonstration on expenditures and utilization for this population...
May 15, 2018: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/29757818/surrogates-experiences-of-engaging-in-physician-orders-for-life-sustaining-treatment-discussions-for-persons-with-advanced-dementia
#18
Hyejin Kim, Christine Bradway, Susan E Hickman, Mary Ersek
BACKGROUND AND PURPOSE: Little is known about surrogates' experiences of engaging in Physician Orders for Life-Sustaining Treatment (POLST) discussions. This study describes family surrogates' experiences when engaging in POLST discussions with primary care providers. METHODS: Semistructured interviews were conducted with 10 family surrogates of individuals with advanced dementia who were enrolled in a Program of All-Inclusive Care for the Elderly or resided in a nursing home...
February 2018: Journal of the American Association of Nurse Practitioners
https://www.readbyqxmd.com/read/29749948/a-population-based-cohort-study-evaluating-outcomes-and-costs-for-syncope-presentations-to-the-emergency-department
#19
Roopinder K Sandhu, Dat T Tran, Robert S Sheldon, Padma Kaul
OBJECTIVES: This study sought to examine outcomes and costs of patients with syncope admitted and discharged from the emergency department (ED). BACKGROUND: ED visits for syncope are common, yet the impact on health care utilization is relatively unknown. METHODS: A total of 51,831 consecutive patients presented to the ED with a primary diagnosis of syncope (International Classification of Diseases-9 code 780.2 and International Classification of Diseases-10 code R55) in Alberta, Canada from 2006 to 2014...
February 2018: JACC. Clinical Electrophysiology
https://www.readbyqxmd.com/read/29743221/measuring-and-managing-blood-pressure-in-a-primary-care-setting-a-pragmatic-implementation-study
#20
John Doane, Jenni Buu, M Jason Penrod, Michelle Bischoff, Molly B Conroy, Barry Stults
BACKGROUND: Accurate blood pressure (BP) measurement is essential to hypertension diagnosis and management. Automated office blood pressure (AOBP) and home blood pressure measurement (HBPM) may improve assessment, but barriers exist in primary care settings. METHODS: We implemented an AOBP/HBPM program in a primary care clinic in 2015 to 2016. Patients with elevated BP determined by guideline-quality observed BP measurement and/or AOBP entered the HBPM program. Patients with average home BP ≥ 135/85 mm Hg provided HBPM results for medication adjustment...
May 2018: Journal of the American Board of Family Medicine: JABFM
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