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Chronic care model

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https://www.readbyqxmd.com/read/29673848/overcoming-missed-opportunities-in-diabetes-management-to-improve-outcomes-for-hospitalized-patients-with-diabetes
#1
Michael Oravec, James Salem, Jason Kunz, Michelle Cudnik, Lynn Clough, Robert Woods, Megan Elavsky
AIMS: The purpose of this study is to assess the impact of hospitalization on 6-12 month medication adjustment and glycemic control. METHODS: We conducted a retrospective cohort study of hospitalized and non-hospitalized patients with diabetes of an internal medicine residency continuity clinic. Patients had baseline and outcome HbA1c taken 6-12 months apart. Multivariate linear regression was used to model predictors of HbA1c change from baseline to outcome. Multivariate logistic regression was used to model predictors of medication adjustment between baseline and outcome clinic visits...
April 16, 2018: Diabetes Research and Clinical Practice
https://www.readbyqxmd.com/read/29672720/how-views-of-the-organization-of-primary-care-among-patients-with-hypertension-vary-by-race-or-ethnicity
#2
George L Jackson, Karen M Stechuchak, Morris Weinberger, Hayden B Bosworth, Cynthia J Coffman, Miriam A Kirshner, David Edelman
INTRODUCTION: We assessed potential racial or ethnic differences in the degree to which veterans with pharmaceutically treated hypertension report experiences with their primary care system that are consistent with optimal chronic illness care as suggested by Wagner's Chronic Care Model (CCM). MATERIALS AND METHODS: A cross-sectional analysis of the results of the Patient Assessment of Chronic Illness Care (PACIC), which measured components of the care system suggested by the CCM and was completed at baseline by participants in a hypertension disease management clinical trial...
April 17, 2018: Military Medicine
https://www.readbyqxmd.com/read/29672647/mapping-the-knowledge-structure-of-frailty-in-journal-articles-by-text-network-analysis
#3
Youngji Kim, Soong-Nang Jang
BACKGROUNDS: This study was to understand the trends of frailty research and networking features of keywords from the academic articles focusing on frailty in the last four decades. METHOD: Keywords were extracted from articles (n = 6,424) retrieved from Web of Science, from 1981 to April 2016, using Bibexcel, and a social network analysis was conducted using Net Miner. RESULTS: The core-keywords of research on frailty are constantly changing over the last 40 years...
2018: PloS One
https://www.readbyqxmd.com/read/29671109/the-use-of-start-back-screening-tool-in-emergency-departments-for-patients-with-acute-low-back-pain-a-prospective-inception-cohort-study
#4
Flávia Cordeiro Medeiros, Leonardo Oliveira Pena Costa, Indiara Soares Oliveira, Renan Kendy Oshima, Lucíola Cunha Menezes Costa
PURPOSE: (1) To analyse the clinical utility of the STarT Back Screening Tool (SBST) in emergency departments by describing changes in classification over time and; (2) to identify what would be the best time to use the SBST to predict long-term clinical outcomes in patients with acute nonspecific low back pain (LBP) seeking emergency care. METHODS: A 6 months prospective inception cohort study was conducted. 200 participants with LBP seeking emergency medical treatment were included...
April 18, 2018: European Spine Journal
https://www.readbyqxmd.com/read/29670613/innate-immunity-in-the-persistent-inflammation-immunosuppression-and-catabolism-syndrome-and-its-implications-for-therapy
#5
REVIEW
Hiroyuki Horiguchi, Tyler J Loftus, Russell B Hawkins, Steven L Raymond, Julie A Stortz, McKenzie K Hollen, Brett P Weiss, Elizabeth S Miller, Azra Bihorac, Shawn D Larson, Alicia M Mohr, Scott C Brakenridge, Hironori Tsujimoto, Hideki Ueno, Frederick A Moore, Lyle L Moldawer, Philip A Efron
Clinical and technological advances promoting early hemorrhage control and physiologic resuscitation as well as early diagnosis and optimal treatment of sepsis have significantly decreased in-hospital mortality for many critically ill patient populations. However, a substantial proportion of severe trauma and sepsis survivors will develop protracted organ dysfunction termed chronic critical illness (CCI), defined as ≥14 days requiring intensive care unit (ICU) resources with ongoing organ dysfunction...
2018: Frontiers in Immunology
https://www.readbyqxmd.com/read/29670486/utilizing-animal-models-of-infantile-spasms
#6
Chris G Dulla
Infantile spasms are a devastating epileptic encephalopathy characterized by early life spasms and later seizures. Clinical outcomes of infantile spasms are poor and therapeutic options are limited with significant adverse effects. Therefore, new strategies to treat infantile spasms are of the utmost importance. Animals models of infantile spasms are a critical component of developing new therapies. Here, we review current chronic animal models of infantile spasms and consider future advances that may help improve patient care, as well as our scientific understanding of this debilitating disease...
March 2018: Epilepsy Currents
https://www.readbyqxmd.com/read/29670391/determining-30-day-readmission-risk-for-heart-failure-patients-the-readmission-after-heart-failure-scale
#7
Ronald S Chamberlain, Jaswinder Sond, Krishnaraj Mahendraraj, Christine Sm Lau, Brianna L Siracuse
Background: Chronic heart failure (CHF), which affects >5 million Americans, accounts for >1 million hospitalizations annually. As a part of the Hospital Readmission Reduction Program, the Affordable Care Act requires that the Centers for Medicare and Medicaid Services reduce payments to hospitals with excess readmissions. This study sought to develop a scale that reliably predicts readmission rates among patients with CHF. Methods: The State Inpatient Database (2006-2011) was utilized, and discharge data including demographic and clinical characteristics on 642,448 patients with CHF from California and New York (derivation cohort) and 365,359 patients with CHF from Florida and Washington (validation cohort) were extracted...
2018: International Journal of General Medicine
https://www.readbyqxmd.com/read/29669907/mild-tbi-and-risk-of-parkinson-disease-a-chronic-effects-of-neurotrauma-consortium-study
#8
Raquel C Gardner, Amy L Byers, Deborah E Barnes, Yixia Li, John Boscardin, Kristine Yaffe
OBJECTIVE: Our aim was to assess risk of Parkinson disease (PD) following traumatic brain injury (TBI), including specifically mild TBI (mTBI), among care recipients in the Veterans Health Administration. METHODS: In this retrospective cohort study, we identified all patients with a TBI diagnosis in Veterans Health Administration databases from October 2002 to September 2014 and age-matched 1:1 to a random sample of patients without TBI. All patients were aged 18 years and older without PD or dementia at baseline...
April 18, 2018: Neurology
https://www.readbyqxmd.com/read/29669707/a-web-based-decision-tool-to-improve-contraceptive-counseling-for-women-with-chronic-medical-conditions-protocol-for-a-mixed-methods-implementation-study
#9
Justine P Wu, Laura J Damschroder, Michael D Fetters, Brian J Zikmund-Fisher, Benjamin F Crabtree, Shawna V Hudson, Mack T Ruffin Iv, Juliana Fucinari, Minji Kang, L Susan Taichman, John W Creswell
BACKGROUND: Women with chronic medical conditions, such as diabetes and hypertension, have a higher risk of pregnancy-related complications compared with women without medical conditions and should be offered contraception if desired. Although evidence based guidelines for contraceptive selection in the presence of medical conditions are available via the United States Medical Eligibility Criteria (US MEC), these guidelines are underutilized. Research also supports the use of decision tools to promote shared decision making between patients and providers during contraceptive counseling...
April 18, 2018: JMIR Research Protocols
https://www.readbyqxmd.com/read/29669086/effects-of-a-home-based-telephone-supported-physical-activity-program-for-older-adult-veterans-with-chronic-low-back-pain
#10
Adam P Goode, Shannon Stark Taylor, Susan N Hastings, Catherine Stanwyck, Cynthia J Coffman, Kelli D Allen
Background: Chronic low back pain (CLBP) is highly prevalent in older adults, leading to functional decline. Objective: The objective of this study was to evaluate physical activity (PA) only and PA plus cognitive-behavioral therapy for pain (CBT-P) among older adult veterans with CLBP. Design: This study was a pilot randomized trial comparing a 12-week telephone-supported PA-only intervention group (PA group) or PA plus CBT-P intervention group (PA + CBT-P group) and a wait-list control group (WL group)...
May 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29669081/prediction-of-persistent-musculoskeletal-pain-at-12-months-a-secondary-analysis-of-the-optimal-screening-for-prediction-of-referral-and-outcome-ospro-validation-cohort-study
#11
Jason M Beneciuk, Trevor A Lentz, Ying He, Samuel S Wu, Steven Z George
Background: Musculoskeletal pain is a societal epidemic because it is highly prevalent and a leading contributor to disability; however, physical therapists are still challenged when predicting which patients are at high risk for persistent symptoms. Objective: The objectives of this study were to identify patient characteristics predictive of persistent musculoskeletal pain 12 months following physical therapist care and to determine the influence of anatomical region...
May 1, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29668214/financial-burden-of-healthcare-utilization-in-consumer-directed-health-plans
#12
Xinke Zhang, Erin Trish, Neeraj Sood
OBJECTIVES: To evaluate the impact of enrollment in a consumer-directed health plan (CDHP) on out-of-pocket (OOP) spending and on the financial burden associated with healthcare utilization. STUDY DESIGN: Using commercial claims data from 2011 through 2013, we estimated difference-in-differences models that compared changes in outcomes for individuals who switched to CDHPs (CDHP group) with outcome changes for individuals who remained in traditional plans (traditional plan group)...
April 1, 2018: American Journal of Managed Care
https://www.readbyqxmd.com/read/29667452/the-feasibility-of-employing-a-home-healthcare-model-for-education-and-treatment-of-opioid-overdose-using-a-naloxone-auto-injector-in-a-private-practice-pain-medicine-clinic
#13
Anthony Dragovich, Fred Brason, Thomas Beltran, Amy McCoart, Anthony R Plunkett
OBJECTIVES: The purpose of this study was to determine if employing a home healthcare model for education and treatment of opioid overdose using Evzio® (Naloxone)* auto-injector in a private practice pain clinic. METHODS: A prospective survey was used to determine the feasibility of integrating a naloxone auto-injector within the patient's home with a home care training model. Twenty moderate or high-risk patients were enrolled from our chronic pain clinic. Patients who were moderate or high risk completed an evaluation survey...
April 18, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29665826/association-between-afterhours-admission-to-the-intensive-care-unit-strained-capacity-and-mortality-a-retrospective-cohort-study
#14
Adam M Hall, Henry T Stelfox, Xioaming Wang, Guanmin Chen, Danny J Zuege, Peter Dodek, Allan Garland, Damon C Scales, Luc Berthiaume, David A Zygun, Sean M Bagshaw
BACKGROUND: Admission to the intensive care unit (ICU) outside daytime hours has been shown to be variably associated with increased morbidity and mortality. We aimed to describe the characteristics and outcomes of patients admitted to the ICU afterhours (22:00-06:59 h) in a large Canadian health region. We further hypothesized that the association between afterhours admission and mortality would be modified by indicators of strained ICU capacity. METHODS: This is a population-based cohort study of 12,265 adults admitted to nine ICUs in Alberta from June 2012 to December 2014...
April 17, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29661929/arginase-1-expression-in-myeloid-cells-regulates-s-aureus-planktonic-but-not-biofilm-infection
#15
Kelsey J Yamada, Cortney E Heim, Amy L Aldrich, Casey M Gries, Anna G Staudacher, Tammy Kielian
S. aureus is a leading cause of device-associated biofilm infections, which represent a serious health care concern based on their chronicity and antibiotic resistance. We previously reported that S. aureus biofilms preferentially recruit myeloid-derived suppressor cells (MDSCs), which promote monocyte and macrophage anti-inflammatory properties. This is associated with increased myeloid arginase-1 (Arg-1) expression, which has been linked to anti-inflammatory and pro-fibrotic activity that are observed during S...
April 16, 2018: Infection and Immunity
https://www.readbyqxmd.com/read/29660743/-rehabilitation-after-multiple-trauma
#16
Stefan Simmel
Many polytrauma patients report significant long-term impairments to their physical and mental health, resulting in a reduction of their quality of life. In addition to the obvious physical accident sequences, psychological influences and the individual context factors pose special challenges to the rehabilitation team and the infrastructure of the facility. Professional reintegration and chronic pain are particularly common problems in the trauma rehabilitation. The central task of rehabilitation after accidents is the restoration or substantial improvement of the functional health and thus the reintegration into the social and professional environment...
April 2018: Die Rehabilitation
https://www.readbyqxmd.com/read/29660211/effectiveness-and-cost-effectiveness-of-interventions-targeting-harm-reduction-and-chronic-hepatitis-c-cascade-of-care-in-people-who-inject-drugs-the-case-of-france
#17
Anthony Cousien, Viet Chi Tran, Sylvie Deuffic-Burban, Marie Jauffret-Roustide, Guillaume Mabileau, Jean-Stéphane Dhersin, Yazdan Yazdanpanah
Direct-acting antivirals (DAAs) represent an opportunity to improve hepatitis C virus (HCV) care cascade. This, combined with improved harm reduction interventions may lead to HCV elimination especially in people who inject drugs (PWID). We assessed the effectiveness/cost-effectiveness of improvements in harm reduction and chronic hepatitis C (CHC) care cascade in PWID in France. We used a dynamic model of HCV transmission and CHC natural history and evaluated: improved needle/syringe programs-opioid substitution therapies, faster diagnosis/linkage to care, earlier treatment initiation, alone and in combination among active PWID (mean age=36)...
April 16, 2018: Journal of Viral Hepatitis
https://www.readbyqxmd.com/read/29659863/frequent-use-of-emergency-departments-by-older-people-a-comparative-cohort-study-of-characteristics-and-outcomes
#18
Maryann Street, Debra Berry, Julie Considine
Objective: To characterise older people who frequently use emergency departments (EDs) and compare patient outcomes with older non-frequent ED attenders. Design: Retrospective comparative cohort study. Logistic regression modelling of patient characteristics and health service usage, comparing older frequent ED attenders (≥4 ED attendances in 12 months) to non-frequent ED attenders. Setting: Three Australian public hospital EDs, with a total of 143 327 emergency attendances in the 12 months...
April 12, 2018: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29659728/racial-disparities-in-invasive-methicillin-resistant-staphylococcus-aureus-infections-2005-2014
#19
Nicole Gualandi, Yi Mu, Wendy M Bamberg, Ghinwa Dumyati, Lee H Harrison, Lindsey Lesher, Joelle Nadle, Sue Petit, Susan M Ray, William Schaffner, John Townes, Mariana McDonald, Isaac See
Background: Despite substantial attention to the individual topics, little is known about the relationship between racial disparities and antimicrobial-resistant and/or healthcare-associated infection trends, such as infections due to methicillin-resistant Staphylococcus aureus (MRSA). Methods: We analyzed CDC's Emerging Infections Program 2005-2014 surveillance data (9 U.S. states) to determine whether reductions in invasive MRSA incidence (isolated from normally sterile body sites) affected racial disparities in rates...
April 5, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29658847/non-face-to-face-chronic-care-management-a-qualitative-study-assessing-the-implementation-of-a-new-cms-reimbursement-strategy
#20
Valerie A Yeager, Mary Kristina Wharton, Alisha Monnette, Eboni G Price-Haywood, Elizabeth Nauman, Rebekah S M Angove, Lizheng Shi
Diabetes and its comorbidities are leading causes of morbidity and mortality in the United States and disproportionately in Louisiana. Chronic care management (CCM) efforts, such as care coordination models, are important initiatives in mitigating the impact of diabetes, such as poorer health outcomes and increased costs. This study examined one such effort, the Centers for Medicare & Medicaid Services' non-face-to-face CCM reimbursement program, for patients with diabetes and at least 1 other chronic condition in Louisiana...
April 16, 2018: Population Health Management
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