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https://www.readbyqxmd.com/read/28730757/psoriatic-arthritis-treatment-regimens-therapy-duration-and-reasons-for-cessation-in-the-biologics-era-a-multi-centre-australian-study
#1
Kathleen Tymms, Ayano Kelly, Paul Bird, Hedley Griffiths, Julien de Jager, Geoff Littlejohn, Sandra Louw, Lynden Roberts, Peter Youssef, Jane Zochling, Dave Nichols
AIM: To describe the treatment regimens, duration of therapy and reasons for disease-modifying antirheumatic drug (DMARD) cessation in a large psoriatic arthritis (PsA) cohort. METHODS: A retrospective non-interventional multi-centre study using Audit4 electronic medical records, with de-identified, routinely collected clinical data from rheumatology practices in the OPAL consortium (Optimising Patient outcomes in Australian rheumatoLogy) during November 2015. Baseline characteristics, type and duration of conventional and biologic DMARDs (cDMARD and bDMARD, respectively), disease activity (Disease Activity Score of 28 joints C-reactive protein [DAS28-CRP]), and reasons for treatment cessation were recorded...
July 21, 2017: International Journal of Rheumatic Diseases
https://www.readbyqxmd.com/read/28727628/replication-confirms-the-association-of-loci-in-foxe1-pde8b-capzb-and-pde10a-with-thyroid-traits-a-genetics-of-diabetes-audit-and-research-tayside-study
#2
Enrique Soto-Pedre, Moneeza K Siddiqui, Alex S Doney, Colin N A Palmer, Ewan R Pearson, Graham P Leese
OBJECTIVE: Replication of associations in genome-wide association studies is desirable to ensure that such signals are potentially clinically meaningful. This study aimed to replicate associations of selected single-nucleotide polymorphisms (SNPs) with hypothyroidism and serum thyroid-stimulating hormone (TSH) using electronic medical records (EMRs). PATIENTS AND METHODS: A cross-sectional study was carried out among patients of European Caucasian ethnicity from the Genetics of Diabetes Audit and Research Tayside recruited in Tayside (Scotland, UK)...
July 19, 2017: Pharmacogenetics and Genomics
https://www.readbyqxmd.com/read/28725259/cardiovascular-disease-risk-and-prevention-amongst-syrian-refugees-mixed-methods-study-of-m%C3%A3-decins-sans-fronti%C3%A3-res-programme-in-jordan
#3
Dylan R J Collins, Kiran Jobanputra, Thomas Frost, Shoaib Muhammed, Alison Ward, Abed Alrazzaq Shafei, Taissir Fardous, Sadeq Gabashneh, Carl Heneghan
BACKGROUND: The growing burden of non-communicable diseases (NCDs) presented new challenges for medical humanitarian aid and little was known about primary health care approaches for these diseases in humanitarian response. We aimed to evaluate Médecins Sans Frontières (MSF's) use of total CVD risk based prevention strategies amongst Syrian refugees in northern Jordan to identify opportunities to improve total CVD risk based guidance for humanitarian settings. METHODS: We evaluated CVD risk assessment and management in two outpatient NCD clinics in the Irbid governorate of Jordan using a mixed methods design with qualitative and quantitative strands of equal priority, integrated during data collection and interpretation...
2017: Conflict and Health
https://www.readbyqxmd.com/read/28716504/series-pragmatic-trials-and-real-world-evidence-paper-8-data-collection-and-management-data-collection-in-pragmatic-trials
#4
Anna-Katharina Meinecke, Paco Welsing, George Kafatos, Des Burke, Sven Trelle, Maria Kubin, Gaelle Nachbaur, Matthias Egger, Mira Zuidgeest
Pragmatic trials can improve our understanding of how treatments will perform in routine practice. In a series of eight papers, the GetReal Consortium has evaluated the challenges in designing and conducting pragmatic trials and their specific methodological, operational, regulatory and ethical implications. The present final paper of the series discusses the operational and methodological challenges of data collection in pragmatic trials. A more pragmatic data collection needs to balance the delivery of highly accurate and complete data with minimizing the level of interference that data entry and verification induce with clinical practice...
July 14, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/28715535/improving-adherence-to-long-term-opioid-therapy-guidelines-to-reduce-opioid-misuse-in-primary-care-a-cluster-randomized-clinical-trial
#5
Jane M Liebschutz, Ziming Xuan, Christopher W Shanahan, Marc LaRochelle, Julia Keosaian, Donna Beers, George Guara, Kristen O'Connor, Daniel P Alford, Victoria Parker, Roger D Weiss, Jeffrey H Samet, Julie Crosson, Phoebe A Cushman, Karen E Lasser
Importance: Prescription opioid misuse is a national crisis. Few interventions have improved adherence to opioid-prescribing guidelines. Objective: To determine whether a multicomponent intervention, Transforming Opioid Prescribing in Primary Care (TOPCARE; http://mytopcare.org/), improves guideline adherence while decreasing opioid misuse risk. Design, Setting, and Participants: Cluster-randomized clinical trial among 53 primary care clinicians (PCCs) and their 985 patients receiving long-term opioid therapy for pain...
July 17, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28714831/improving-the-quality-of-nutrition-in-pediatric-trauma
#6
Alice Wang, Helena Pelletier, Diana Calligan, Angela Coates, Karen Allison Bailey
Purpose Nutrition plays a key role in the recovery of pediatric trauma patients. A catabolic state in trauma patients may hinder recovery and inadequate nutrition may increase morbidity, mortality and length of hospital stay. The purpose of this paper is to review the current nutrition support practices for pediatric trauma patients at McMaster Children's Hospital (MCH), describe patient demographics and identify areas to improve the quality of patient care. Design/methodology/approach A retrospective chart review was conducted on pediatric trauma patients (age<18 years) identified through the trauma registry of MCH...
July 10, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28712738/a-technology-supported-collaboration-between-a-health-plan-and-a-community-pharmacy-to-improve-blood-pressure-control
#7
Caitlin K Frail, Susan Cooper, Tim Gallagher, Josh Sarkis, Laura Topor, Richard J Bruzek
OBJECTIVES: To assess the impact of a health plan and community pharmacy partnership to improve blood pressure control. SETTING: A midwestern health plan and a regional community pharmacy chain. PRACTICE INNOVATION: Health plan members with a hypertension diagnosis and attributed to the pharmacy chain based on prescription claims were invited to participate. Interested patients enrolled in the program at their pharmacies and were assigned a "smart card" for use with a blood pressure kiosk in the pharmacy...
July 14, 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28711345/working-at-the-intersection-of-context-culture-and-technology-provider-perspectives-on-antimicrobial-stewardship-in-the-emergency-department-using-electronic-health-record-clinical-decision-support
#8
Phillip Chung, Jean Scandlyn, Peter S Dayan, Rakesh D Mistry
BACKGROUND: Antibiotic stewardship programs (ASPs) have not been fully developed for the emergency department (ED), in part the result of the barriers characteristic of this setting. Electronic health record-based clinical decision support (EHR CDS) represents a promising strategy to implement ASPs in the ED. We aimed to determine the cultural beliefs and structural barriers and facilitators to implementation of antimicrobial stewardship in the pediatric ED using EHR CDS. METHODS: Interviews and focus groups were conducted with hospital and ED leadership, attending ED physicians, nurse practitioners, physician assistants, and residents at a single health system in Colorado...
July 12, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28708603/monte-carlo-skin-dose-simulation-in-intraoperative-radiotherapy-of-breast-cancer-using-spherical-applicators
#9
Farhad Moradi, Ngie Min Ung, M U Khandaker, Ghafour Amouzad Mahdiraji, Marniza Saad, Rozita Abdul Malik, Anita Zarina Bustam, Zainor Zaili, David A Bradley
The relatively new treatment modality electronic intraoperative radiotherapy (IORT) is gaining popularity, irradiation being obtained within a surgically produced cavity being delivered via a low-energy X-ray source and spherical applicators, primarily for early stage breast cancer. Due to the spatially dramatic dose-rate fall off with radial distance from the source and effects related to changes in the beam quality of the low keV photon spectra, dosimetric account of the Intrabeam system is rather complex...
July 14, 2017: Physics in Medicine and Biology
https://www.readbyqxmd.com/read/28707421/safer-and-more-appropriate-opioid-prescribing-a-large-healthcare-system-s-comprehensive-approach
#10
Jan L Losby, Joel D Hyatt, Michael H Kanter, Grant Baldwin, Denis Matsuoka
RATIONALE, AIMS, AND OBJECTIVES: The United States is in the midst of a public health epidemic with more than 40 people dying each day from prescription opioid overdoses. Health care systems are taking steps to address the opioid overdose epidemic by implementing policy and practice interventions to mitigate the risks of long-term opioid therapy. Kaiser Permanente Southern California launched a comprehensive initiative to transform the way that chronic pain is viewed and treated. Kaiser Permanente Southern California created prescribing and dispensing policies, monitoring and follow-up processes, and clinical coordination through electronic health record integration...
July 14, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28705931/proof-of-concept-design-and-initial-evaluation-of-a-new-device-to-measure-gastrointestinal-transit-time
#11
Robert H Wagner, Bital Savir-Baruch, James Halama, Mukund Venu, Medhat Gabriel, Davide Bova
Chronic constipation and gastrointestinal motility disorders constitute a large part of a gastroenterology practice and represent a significant impact on patient quality of life and lifestyle. In most cases, medications are prescribed to alleviate symptoms without an objective measurement of response. Commonly used current investigations of gastrointestinal transit times are limited to radiopaque markers or electronic capsules. Repeated use of these techniques is limited due to radiation exposure or the significant cost of the devices...
July 13, 2017: Journal of Nuclear Medicine Technology
https://www.readbyqxmd.com/read/28704407/variations-in-achievement-of-evidence-based-high-impact-quality-indicators-in-general-practice-an-observational-study
#12
Thomas A Willis, Robert West, Bruno Rushforth, Tim Stokes, Liz Glidewell, Paul Carder, Simon Faulkner, Robbie Foy
BACKGROUND: There are widely recognised variations in the delivery and outcomes of healthcare but an incomplete understanding of their causes. There is a growing interest in using routinely collected 'big data' in the evaluation of healthcare. We developed a set of evidence-based 'high impact' quality indicators (QIs) for primary care and examined variations in achievement of these indicators using routinely collected data in the United Kingdom (UK). METHODS: Cross-sectional analysis of routinely collected, electronic primary care data from a sample of general practices in West Yorkshire, UK (n = 89)...
2017: PloS One
https://www.readbyqxmd.com/read/28700358/antihyperglycemic-treatment-in-patients-with-type-2-diabetes-in-italy-the-impact-of-age-and-kidney-function
#13
Sandro Gentile, Pamela Piscitelli, Francesca Viazzi, Giuseppina Russo, Antonio Ceriello, Carlo Giorda, Piero Guida, Paola Fioretto, Roberto Pontremoli, Felice Strollo, Salvatore De Cosmo, The Amd-Annals Study Group
We describe AHA utilization pattern according to age and renal function in type 2 diabetes mellitus (T2DM), in real-life conditions.The analysis was performed using the data set of electronic medical records collected between 1 January and 31 December, 2011 in 207 Italian diabetes centers. The study population consisted of 157,595 individuals with T2DM. The AHA treatment regimens was evaluated. Kidney function was assessed by eGFR, estimated using the CKD-EPI formula. Other determinations: HbA1c, blood pressure (BP), low- density lipoprotein (LDL-c), total and high density lipoprotein cholesterol (TC and HDL-c), triglycerides (TG) and serum uric acid (SUA)...
June 28, 2017: Oncotarget
https://www.readbyqxmd.com/read/28699084/egfr-mutation-testing-of-non-squamous-nsclc-impact-and-uptake-during-implementation-of-testing-guidelines-in-a-population-based-registry-cohort-from-northern-new-zealand
#14
Mark McKeage, Mark Elwood, Sandar Tin Tin, Prashannata Khwaounjoo, Phyu Aye, Angie Li, Karen Sheath, Phillip Shepherd, George Laking, Nicola Kingston, Christopher Lewis, Donald Love
BACKGROUND: Since 2013, clinical practice guidelines recommend EGFR mutation testing of non-squamous NSCLC to select advanced-stage patients for first-line treatment using EGFR-TKIs. OBJECTIVE: We aimed to determine population-based trends in the real-world uptake and impact in routine practice of these recently updated testing guidelines. PATIENTS AND METHODS: A population-based observational study was conducted of notifications to the New Zealand Cancer Registry of patients eligible for EGFR testing diagnosed in northern New Zealand between January 2010 and April 2014...
July 11, 2017: Targeted Oncology
https://www.readbyqxmd.com/read/28697871/patterns-of-antimicrobial-agent-prescription-in-a-sentinel-population-of-canine-and-feline-veterinary-practices-in-the-united-kingdom
#15
D A Singleton, F Sánchez-Vizcaíno, S Dawson, P H Jones, P J M Noble, G L Pinchbeck, N J Williams, A D Radford
Antimicrobial resistance is an increasingly important global health threat and the use of antimicrobial agents is a key risk factor in its development. This study describes antimicrobial agent prescription (AAP) patterns over a 2year period using electronic health records (EHRs) from booked consultations in a network of 457 sentinel veterinary premises in the United Kingdom. A semi-automated classification methodology was used to map practitioner defined product codes in 918,333 EHRs from 413,870 dogs and 352,730 EHRs from 200,541 cats, including 289,789 AAPs...
June 2017: Veterinary Journal
https://www.readbyqxmd.com/read/28697492/incidence-and-causes-for-early-ticagrelor-discontinuation-a-real-world-dutch-registry-experience
#16
Thomas O Bergmeijer, Paul W A Janssen, Mathijs van Oevelen, Dymphie van Rooijen, Thea C Godschalk, Johannes C Kelder, Vera H M Deneer, Victor L Serebruany, Jurriën M Ten Berg
OBJECTIVES: The PLATO trial revealed superiority of ticagrelor over clopidogrel for the prevention of atherothrombotic events in patients with acute coronary syndrome. However, adverse events such as bleeding, dyspnea, and bradycardia were frequently reported, potentially leading to excess early ticagrelor discontinuation (ETD), later confirmed in the PEGASUS trial. We here evaluated the incidence and causes for ETD in a real-world patient cohort in a high-volume nonacademic percutaneous coronary intervention center in the Netherlands...
July 12, 2017: Cardiology
https://www.readbyqxmd.com/read/28697295/using-electronic-medical-records-to-assess-the-rate-of-treatment-for-osteoporosis-in-australia
#17
Megan Elliott-Rudder, Catherine Harding, Joseph McGirr, Alexa Seal, Louis Pilotto
BACKGROUND: Despite available Medicare Benefits Schedule subsidies, it has been suggested that screening and treatment for osteoporosis are under-accessed in Australia, particularly in patients ≥70 years. This study describes the rate of osteoporosis treatment in those aged ≥70 years in regional New South Wales as identified in the electronic medical records (EMR) of 11 general practices. METHODS: EMR data were extracted using a Canning Tool adaptation. The prevalence of osteoporosis, fracture and bone-active medication prescriptions were described, and associations examined...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28696803/thai-pediatricians-current-practice-toward-childhood-asthma
#18
Harutai Kamalaporn, Pongpan Chawalitdamrong, Aroonwan Preutthipan
BACKGROUND: Childhood asthma is a substantial health burden in Thailand. Due to a lack of pediatric respiratory specialists (pediatric pulmonologists and allergists; RS), most Thai children are cared for by general pediatricians (pediatric primary care providers (PCP)). OBJECTIVES: We investigated whether current practices of Thai pediatricians complied with asthma guidelines and compared practices (diagnosis and treatments) provided by PCP and RS. METHODS: A cross-sectional study was conducted using electronic surveys including four case scenarios of different asthma phenotypes distributed to Thai pediatricians...
July 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28696416/cytochrome-p450-interactions-are-common-and-consequential-in-massachusetts-hospital-discharges
#19
T H McCoy, V M Castro, A Cagan, L Snapper, A Roberson, R H Perlis
Despite the recognition that drug-drug interactions contribute substantially to preventable health-care costs, the prevalence of such interactions related to the cytochrome P450 system in clinical practice remains poorly characterized. This study drew retrospective hospital discharge cohorts from a large health claims data set and a large health system data set. For every hospital discharge, frequency of co-occurrence of substrates and inducers or inhibitors at cytochrome P450 2D6, 2C19, 3A4 and 1A2 were determined...
July 11, 2017: Pharmacogenomics Journal
https://www.readbyqxmd.com/read/28693744/changes-in-use-of-anticoagulation-in-patients-with-atrial-fibrillation-within-a-primary-care-network-associated-with-the-introduction-of-direct-oral-anticoagulants
#20
Jeffrey M Ashburner, Daniel E Singer, Steven A Lubitz, Leila H Borowsky, Steven J Atlas
Atrial fibrillation (AF) and the decision to anticoagulate is a common problem faced by primary care physicians. Oral anticoagulation (OAC) is underused, despite its clear benefits with regard to stroke prevention. We examined OAC usage between 2010 and 2015, following the introduction of direct oral anticoagulants (DOACs) and specifically assessed whether more patients were anticoagulated over time. The study cohort included adult patients aged 18 and older with AF cared for in an 18-practice primary care network between 2010 and 2015...
June 15, 2017: American Journal of Cardiology
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