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https://www.readbyqxmd.com/read/28213597/retrospective-examination-of-lipid-lowering-treatment-patterns-in-a-real-world-high-risk-cohort-in-the-uk-in-2014-comparison-with-the-national-institute-for-health-and-care-excellence-nice-2014-lipid-modification-guidelines
#1
Dylan L Steen, Irfan Khan, David Ansell, Robert J Sanchez, Kausik K Ray
BACKGROUND: In 2014, guidelines from the National Institute for Health and Care Excellence (NICE) provided updated recommendations on lipid-modifying therapy (LMT). We assessed clinical practice contemporaneous to release of these guidelines in a UK general practice setting for secondary and high-risk primary-prevention populations, and extrapolated the findings to UK nation level. METHODS: Patients from The Health Improvement Network database with the following criteria were included: lipid profile in 2014 (index date); ≥20 years of age; ≥2 years representation in database prior to index; ≥1 statin indication either for atherosclerotic cardiovascular disease (ASCVD) or the non-ASCVD conditions high-risk diabetes mellitus and/or chronic kidney disease...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28213596/white-cell-count-in-the-normal-range-and-short-term-and-long-term-mortality-international-comparisons-of-electronic-health-record-cohorts-in-england-and-new-zealand
#2
Anoop Dinesh Shah, Simon Thornley, Sheng-Chia Chung, Spiros Denaxas, Rod Jackson, Harry Hemingway
OBJECTIVES: Electronic health records offer the opportunity to discover new clinical implications for established blood tests, but international comparisons have been lacking. We tested the association of total white cell count (WBC) with all-cause mortality in England and New Zealand. SETTING: Primary care practices in England (ClinicAl research using LInked Bespoke studies and Electronic health Records (CALIBER)) and New Zealand (PREDICT). DESIGN: Analysis of linked electronic health record data sets: CALIBER (primary care, hospitalisation, mortality and acute coronary syndrome registry) and PREDICT (cardiovascular risk assessments in primary care, hospitalisations, mortality, dispensed medication and laboratory results)...
February 17, 2017: BMJ Open
https://www.readbyqxmd.com/read/28202429/virtual-patient-technology-engaging-primary-care-in-quality-improvement-innovations
#3
Amanda C Blok, Christine N May, Rajani S Sadasivam, Thomas K Houston
BACKGROUND: Engaging health care staff in new quality improvement programs is challenging. OBJECTIVE: We developed 2 virtual patient (VP) avatars in the context of a clinic-level quality improvement program. We sought to determine differences in preferences for VPs and the perceived influence of interacting with the VP on clinical staff engagement with the quality improvement program. METHODS: Using a participatory design approach, we developed an older male smoker VP and a younger female smoker VP...
February 15, 2017: JMIR Medical Education
https://www.readbyqxmd.com/read/28202029/sustained-diabetes-risk-reduction-after-real-life-and-primary-health-care-setting-implementation-of-the-diabetes-in-europe-prevention-using-lifestyle-physical-activity-and-nutritional-intervention-de-plan-project
#4
Aleksandra Gilis-Januszewska, Jaana Lindström, Jaakko Tuomilehto, Beata Piwońska-Solska, Roman Topór-Mądry, Zbigniew Szybiński, Markku Peltonen, Peter E H Schwarz, Adam Windak, Alicja Hubalewska-Dydejczyk
BACKGROUND: Real life implementation studies performed in different settings and populations proved that lifestyle interventions in prevention of type 2 diabetes can be effective. However, little is known about long term results of these translational studies. Therefore, the purpose of this study was to examine the maintenance of diabetes type 2 risk factor reduction achieved 1 year after intervention and during 3 year follow-up in primary health care setting in Poland. METHODS: Study participants (n = 262), middle aged, slightly obese, with increased type 2 diabetes risk ((age 55...
February 15, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28198962/myocardial-revascularization-factors-intervening-in-the-reference-and-counter-reference-in-primary-health-care
#5
Kamylla Santos da Cunha, Giovana Dorneles Callegaro Higashi, Alacoque Lorenzini Erdmann, Carolina Kahl, Cintia Koerich, Betina Hörner Schlindwein Meirelles
OBJECTIVE: Understanding the factors that influence the reference and counter-reference process of people indicated/submitted to Myocardial Revascularization surgery in the Primary Health Care scenario. METHOD: A qualitative research anchored in the Grounded Theory, totaling 41 participants subdivided into three groups (patients, health professionals and managers) in the Metropolitan and West Region of Santa Catarina. RESULTS: Two categories elucidate the intervening factors found, contrasting the potentialities and obstacles in (creating) the bond between people affected by cardiovascular diseases and primary health care for the reference process, highlighting weaknesses in the primary health care services provided, with failures in the counter-reference for people submitted to myocardial revascularization surgery...
November 2016: Revista da Escola de Enfermagem da U S P
https://www.readbyqxmd.com/read/28198939/compliance-with-the-prescription-of-antihypertensive-medications-and-blood-pressure-control-in-primary-care
#6
Mayra Faria Novello, Maria Luiza Garcia Rosa, Ranier Tagarro Ferreira, Icaro Gusmão Nunes, Antonio José Lagoeiro Jorge, Dayse Mary da Silva Correia, Wolney de Andrade Martins, Evandro Tinoco Mesquita
Background: Hypertension is the most prevalent risk factor for cardiovascular disease, and its proper control can prevent the high morbidity and mortality associated with this disease. Objective: To assess the degree of compliance of antihypertensive prescriptions with the VI Brazilian Guidelines on Hypertension and the blood pressure control rate in primary care. Methods: Cross-sectional study conducted between August 2011 and November 2012, including 332 adults ≥ 45 years registered in the Family Doctor Program in Niteroi and selected randomly...
February 13, 2017: Arquivos Brasileiros de Cardiologia
https://www.readbyqxmd.com/read/28196524/financial-barriers-and-adverse-clinical-outcomes-among-patients-with-cardiovascular-related-chronic-diseases-a-cohort-study
#7
David J T Campbell, Braden J Manns, Robert G Weaver, Brenda R Hemmelgarn, Kathryn M King-Shier, Claudia Sanmartin
BACKGROUND: Some patients with cardiovascular-related chronic diseases such as diabetes and heart disease report financial barriers to achieving optimal health. Previous surveys report that the perception of having a financial barrier is associated with self-reported adverse clinical outcomes. We sought to confirm these findings using linked survey and administrative data to determine, among patients with cardiovascular-related chronic diseases, if there is an association between perceived financial barriers and the outcomes of: (1) disease-related hospitalizations, (2) all-cause mortality and (3) inpatient healthcare costs...
February 15, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28195501/psychological-mediators-related-to-clinical-outcome-in-cognitive-behavioural-therapy-for-coronary-heart-disease-a-sub-analysis-from-the-suprim-trial
#8
Fredrika Norlund, Erik Mg Olsson, Ronnie Pingel, Claes Held, Kurt Svärdsudd, Mats Gulliksson, Gunilla Burell
Background The Secondary Prevention in Uppsala Primary Healthcare Project (SUPRIM) was a randomized controlled trial of a group-based cognitive behavioural therapy stress management programme for patients with coronary heart disease. The project was successful in reducing the risk of fatal or non-fatal first recurrent cardiovascular events. The aim of this study was to analyse the effect of cognitive behavioural therapy on self-rated stress, somatic anxiety, vital exhaustion and depression and to study the associations of these factors with the reduction in cardiovascular events...
January 1, 2017: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/28185637/early-identification-of-cardiovascular-diseases-in-people-with-spinal-cord-injury-key-information-for-primary-care-providers
#9
Ceren Yarar-Fisher, Patricia Heyn, Jeanne M Zanca, Susie Charlifue, Jean Hsieh, David M Brienza
No abstract text is available yet for this article.
February 6, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28185201/increased-access-to-professional-interpreters-in-the-hospital-improves-informed-consent-for-patients-with-limited-english-proficiency
#10
Jonathan S Lee, Eliseo J Pérez-Stable, Steven E Gregorich, Michael H Crawford, Adrienne Green, Jennifer Livaudais-Toman, Leah S Karliner
BACKGROUND: Language barriers disrupt communication and impede informed consent for patients with limited English proficiency (LEP) undergoing healthcare procedures. Effective interventions for this disparity remain unclear. OBJECTIVE: Assess the impact of a bedside interpreter phone system intervention on informed consent for patients with LEP and compare outcomes to those of English speakers. DESIGN: Prospective, pre-post intervention implementation study using propensity analysis...
February 9, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28184153/multimorbidity-as-specific-disease-combinations-an-important-predictor-factor-for-mortality-in-octogenarians-the-octabaix-study
#11
Assumpta Ferrer, Francesc Formiga, Héctor Sanz, Jesús Almeda, Glòria Padrós
BACKGROUND: The population is aging and multimorbidity is becoming a common problem in the elderly. OBJECTIVE: To explore the effect of multimorbidity patterns on mortality for all causes at 3- and 5-year follow-up periods. MATERIALS AND METHODS: A prospective community-based cohort (2009-2014) embedded within a randomized clinical trial was conducted in seven primary health care centers, including 328 subjects aged 85 years at baseline. Sociodemographic variables, sensory status, cardiovascular risk factors, comorbidity, and geriatric tests were analyzed...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28181212/prevalence-and-characteristic-of-osafed-syndrome-in-atrial-fibrillation-primary-care-patients
#12
Jacek Wolf, Tadeusz Dereziński, Anna Szyndler, Krzysztof Narkiewicz
BACKGROUND: Atrial fibrillation (AF) constitutes the most prevalent arrhythmia affecting up-to 2% percent of general population. Apart from well-established risk factors which increase the odds for the development of AF e.g. age or arterial hypertension, recent analyses indicated that obstructive sleep apnea (OSA) may independently, negatively modify arrhythmia occurrence profile. Concurrently, erectile dysfunction (ED) is commonly neglected, potent marker of cardiovascular risk which considerably worsens men's psychological state...
February 9, 2017: Kardiologia Polska
https://www.readbyqxmd.com/read/28178928/measurement-of-blood-pressure-for-the-diagnosis-and-management-of-hypertension-in-different-ethnic-groups-one-size-fits-all
#13
Paramjit Gill, M Sayeed Haque, Una Martin, Jonathan Mant, Mohammed A Mohammed, Gurdip Heer, Amanpreet Johal, Ramandeep Kaur, Claire Schwartz, Sally Wood, Sheila M Greenfield, Richard J McManus
BACKGROUND: Hypertension is a major risk factor for cardiovascular disease and prevalence varies by ethnic group. The diagnosis and management of blood pressure are informed by guidelines largely based on data from white populations. This study addressed whether accuracy of blood pressure measurement in terms of diagnosis of hypertension varies by ethnicity by comparing two measurement modalities (clinic blood pressure and home monitoring) with a reference standard of ambulatory BP monitoring in three ethnic groups...
February 8, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28174820/effect-of-a-novel-clinical-decision-support-tool-on-the-efficiency-and-accuracy-of-treatment-recommendations-for-cholesterol-management
#14
Marianne R Scheitel, Maya E Kessler, Jane L Shellum, Steve G Peters, Dawn S Milliner, Hongfang Liu, Ravikumar Komandur Elayavilli, Karl A Poterack, Timothy A Miksch, Jennifer Boysen, Ron A Hankey, Rajeev Chaudhry
BACKGROUND: The 2013 American College of Cardiology / American Heart Association Guidelines for the Treatment of Blood Cholesterol emphasize treatment based on cardiovascular risk. But finding time in a primary care visit to manually calculate cardiovascular risk and prescribe treatment based on risk is challenging. We developed an informatics-based clinical decision support tool, MayoExpertAdvisor, to deliver automated cardiovascular risk scores and guideline-based treatment recommendations based on patient-specific data in the electronic heath record...
February 8, 2017: Applied Clinical Informatics
https://www.readbyqxmd.com/read/28174659/making-an-impakt-improving-care-of-chronic-kidney-disease-patients-in-the-community-through-collaborative-working-and-utilizing-information-technology
#15
Gang Xu, Rupert Major, David Shepherd, Nigel Brunskill
Chronic kidney disease (CKD) is a serious long-term condition, which if left untreated causes significant cardiovascular sequele. It is well recognized management of modifiable risk factors, such as blood pressure (BP), can lead to improved long-term outcomes. A novel information technology (IT) solution presents a possible solution to help clinicians in the community identify and manage at risk patients more efficiently. The IMproving Patient care and Awareness of Kidney disease progression Together (IMPAKT) IT tool was used to identify patients with CKD and uncontrolled hypertension in the community...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28174052/a-randomised-trial-of-expedited-transfer-to-a-cardiac-arrest-centre-for-non-st-elevation-ventricular-fibrillation-out-of-hospital-cardiac-arrest-the-arrest-pilot-randomised-trial
#16
Tiffany Patterson, Gavin D Perkins, Jubin Joseph, Karen Wilson, Laura Van Dyck, Steven Roberston, Hanna Nguyen, Hannah McConkey, Mark Whitbread, Rachael Fothergill, Joanne Nevett, Miles Dalby, Roby Rakhit, Philip MacCarthy, Divaka Perera, Jerry P Nolan, Simon R Redwood
BACKGROUND: Wide variation exists in inter-hospital survival from out-of-hospital cardiac arrest (OHCA). Regionalisation of care into cardiac arrest centres (CAC)may improve this. We report a pilot randomised trial of expedited transfer to a CAC following OHCA without ST-elevation.The objective was to assess the feasibility of performing a large-scale randomised controlled trial. METHODS: Adult witnessed ventricular fibrillation OHCA of presumed cardiac cause were randomised 1:1 to either: 1) treatment: comprising expedited transfer to a CAC for goal-directed therapy including access to immediate reperfusion, or 2) control: comprising current standard of care involving delivery to the geographically closest hospital...
February 4, 2017: Resuscitation
https://www.readbyqxmd.com/read/28166765/optitrain-a-randomised-controlled-exercise-trial-for-women-with-breast-cancer-undergoing-chemotherapy
#17
Y Wengström, K A Bolam, S Mijwel, C J Sundberg, M Backman, M Browall, J Norrbom, H Rundqvist
BACKGROUND: Women with breast cancer undergoing chemotherapy suffer from a range of detrimental disease and treatment related side-effects. Exercise has shown to be able to counter some of these side-effects and improve physical function as well as quality of life. The primary aim of the study is to investigate and compare the effects of two different exercise regimens on the primary outcome cancer-related fatigue and the secondary outcomes muscle strength, function and structure, cardiovascular fitness, systemic inflammation, skeletal muscle gene activity, health related quality of life, pain, disease and treatment-related symptoms in women with breast cancer receiving chemotherapy...
February 6, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28164826/cardiovascular-health-disparities-in-underserved-populations
#18
REVIEW
Charles P Mouton, Michael Hayden, Janet H Southerland
African Americans are at increased risk for hypertension, hyperlipidemia, obesity, and diabetes, which contribute to the burden of cardiovascular disease (CVD). The disparities of CVD in underserved populations require targeted attention from primary care clinicians to eliminate. Primary care can provide this targeted care for their patients by assessing cardiovascular risk, addressing blood pressure control, and selecting appropriate intervention strategies. Using community resources is also effective for addressing CVD disparities in the underserved population...
March 2017: Primary Care
https://www.readbyqxmd.com/read/28164815/climate-change-and-underserved-communities
#19
REVIEW
Carol Ziegler, Vincent Morelli, Omotayo Fawibe
Climate change is the greatest global health threat of the twenty-first century, yet it is not widely understood as a health hazard by primary care providers in the United States. Aside from increasing displacement of populations and acute trauma resulting from increasing frequency of natural disasters, the impact of climate change on temperature stress, vector-borne illnesses, cardiovascular and respiratory illnesses, and mental health is significant, with disproportionate impact on underserved and marginalized populations...
March 2017: Primary Care
https://www.readbyqxmd.com/read/28164259/five-year-mortality-in-patients-treated-for-severe-community-acquired-pneumonia-a-retrospective-study
#20
H Lenz, G O Norby, V Dahl, T E Ranheim, R E Haagensen
BACKGROUND: The mortality rate in patients with severe community-acquired pneumonia (SCAP) is high. We investigated the 5-year mortality rate and causes of death in a patient population treated for SCAP in our intensive care unit (ICU), and compared the mortality rate in patients with or without chronic obstructive pulmonary disease (COPD) as comorbidity. METHODS: This retrospective study, which covers a period of 10 years, included patients aged > 18 years admitted to our ICU with SCAP as primary diagnosis and in need of mechanical ventilation for more than 24 h...
February 5, 2017: Acta Anaesthesiologica Scandinavica
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