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https://www.readbyqxmd.com/read/29343041/forgoing-life-sustaining-treatments-in-the-icu-to-withhold-or-to-withdraw-is-that-the-question
#1
Giuseppe R Gristina, Francesca Baroncelli, Marco Vergano
In the last decades, mortality from severe acute illnesses has considerably declined thanks to the advances in intensive care medicine. Meanwhile, critical care physicians realized that lifesustaining treatments (LST) may not be appropriate for every patient, and end-of-life care in the Intensive Care Unit (ICU) started to receive growing attention. Most deaths occurring in the ICU now follow a decision to forgo life-sustaining treatments (DFLST), which can be implemented either by withdrawing (WDLST) or withholding (WHLST) life-sustaining treatments...
January 17, 2018: Minerva Anestesiologica
https://www.readbyqxmd.com/read/29339938/understanding-cancer-survivors-information-needs-and-information-seeking-behaviors-for-complementary-and-alternative-medicine-from-short-to-long-term-survival-a-mixed-methods-study
#2
Lou Ann Scarton, Guilherme Del Fiol, Ingrid Oakley-Girvan, Bryan Gibson, Robert Logan, T Elizabeth Workman
Objective: The research examined complementary and alternative medicine (CAM) information-seeking behaviors and preferences from short- to long-term cancer survival, including goals, motivations, and information sources. Methods: A mixed-methods approach was used with cancer survivors from the "Assessment of Patients' Experience with Cancer Care" 2004 cohort. Data collection included a mail survey and phone interviews using the critical incident technique (CIT)...
January 2018: Journal of the Medical Library Association: JMLA
https://www.readbyqxmd.com/read/29330242/patient-perspectives-on-discussions-of-electronic-cigarettes-in-primary-care
#3
Mark P Doescher, Ming Wu, Elizabeth Rainwater, Ali S Khan, Dorothy A Rhoades
PURPOSE: Patient preferences regarding the role of the primary care provider (PCP) in discussing electronic cigarette (e-cigarette) use are unknown. METHODS: We administered a cross-sectional survey to 568 adult patients in a family medicine clinic to explore e-cigarette use, sources of information on e-cigarettes, perceived knowledge about e-cigarette health effects, views regarding PCP knowledge of e-cigarettes, interest in discussing e-cigarettes with PCPs and preferred format for e-cigarette information...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29306268/addressing-overuse-in-emergency-medicine-evidence-of-a-role-for-greater-patient-engagement
#4
REVIEW
Erika H Newton
Overuse of health care refers to tests, treatments, and even health care settings when used in circumstances where they are unlikely to help. Overuse is not only wasteful, it threatens patient safety by exposing patients to a greater chance of harm than benefit. It is a widespread problem and has proved resistant to change. Overuse of diagnostic testing is a particular problem in emergency medicine. Emergency physicians cite fear of missing a diagnosis, fear of law suits, and perceived patient expectations as key contributors...
December 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/29278544/self-management-strategies-in-chronic-obstructive-pulmonary-disease-a-first-step-toward-personalized-medicine
#5
Miriam Barrecheguren, Jean Bourbeau
PURPOSE OF REVIEW: Self-management has gained increased relevance in the management of chronic obstructive pulmonary disease patients. The heterogeneity in self-management interventions has complicated the development of recommendations for clinical practice. In this review, we present the latest findings regarding conceptual definition, effectiveness of self-management interventions and self-management strategies in chronic obstructive pulmonary disease as a first step toward personalized medicine: what, how and to whom? RECENT FINDINGS: Self-management interventions have shown benefits in improving health-related quality of life and reducing hospital admissions...
December 22, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29152842/cross-sectional-survey-of-patients-need-for-information-and-support-with-medicines-after-discharge-from-hospital
#6
Adam J Mackridge, Ruth Rodgers, Dan Lee, Charles W Morecroft, Janet Krska
BACKGROUND: Most patients experience changes to prescribed medicines during a hospital stay. Ensuring they understand such changes is important for preventing adverse events post-discharge and optimising patient understanding. However, little work has explored the information that patients receive about medicines or their perceived needs for information and support after discharge. OBJECTIVES: To determine information that hospital inpatients who experience medicine changes receive about their medicines during admission and their needs and preferences for, and use of, post-discharge support...
November 20, 2017: International Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28943987/hospital-discharge-what-are-the-problems-information-needs-and-objectives-of-community-pharmacists-a-mixed-method-approach
#7
Lea D Brühwiler, Kurt E Hersberger, Monika Lutters
BACKGROUND: After hospital discharge, community pharmacists are often the first health care professionals the discharged patient encounters. They reconcile and dispense prescribed medicines and provide pharmaceutical care. Compared to the roles of general practitioners, the pharmacists' needs to perform these tasks are not well known. OBJECTIVE: This study aims to a) Identify community pharmacists' current problems and roles at hospital discharge, b) Assess their information needs, specifically the availability and usefulness of information, and c) Gain insight into pharmacists' objectives and ideas for discharge optimisation...
July 2017: Pharmacy Practice
https://www.readbyqxmd.com/read/28923007/patients-beliefs-regarding-informed-consent-for-low-risk-pragmatic-trials
#8
Rafael Dal-Ré, Antonio J Carcas, Xavier Carné, David Wendler
BACKGROUND: The requirement to obtain written informed consent may undermine the potential of pragmatic randomized clinical trials (pRCTs) to improve evidence-based care. This requirement could compromise trials statistical power or even force it to close them down prematurely. However, recent data from the U.S. and Spain suggest that a majority of the public endorses written consent for low-risk pRCTs. The present manuscript assesses whether this view is shared by patients. METHODS: This was a cross-sectional, probability-based survey, with a 2 × 2 factorial design, assessing support for written informed consent versus verbal consent or general notification for two low-risk pRCTs in hypertension, one comparing 2 drugs with similar risk/benefit profiles and the other comparing the same drug being taken in the morning or at night...
September 18, 2017: BMC Medical Research Methodology
https://www.readbyqxmd.com/read/28862129/duration-of-intravenous-antibiotic-therapy-for-children-with-acute-osteomyelitis-or-septic-arthritis-a-feasibility-study
#9
Hans de Graaf, Priya Sukhtankar, Barbara Arch, Nusreen Ahmad, Amanda Lees, Abigail Bennett, Catherine Spowart, Helen Hickey, Annmarie Jeanes, Kate Armon, Andrew Riordan, Jethro Herberg, Scott Hackett, Carrol Gamble, Delane Shingadia, Ann Pallett, Stuart C Clarke, Philip Henman, Marieke Emonts, Mike Sharland, Adam Finn, Andrew J Pollard, Colin Powell, Peter Marsh, Claire Ballinger, Paula R Williamson, Nicholas Mp Clarke, Saul N Faust
BACKGROUND: There is little current consensus regarding the route or duration of antibiotic treatment for acute osteomyelitis (OM) and septic arthritis (SA) in children. OBJECTIVE: To assess the overall feasibility and inform the design of a future randomised controlled trial (RCT) to reduce the duration of intravenous (i.v.) antibiotic use in paediatric OM and SA. DESIGN: (1) A prospective service evaluation (cohort study) to determine the current disease spectrum and UK clinical practice in paediatric OM/SA; (2) a prospective cohort substudy to assess the use of targeted polymerase chain reaction (PCR) in diagnosing paediatric OM/SA; (3) a qualitative study to explore families' views and experiences of OM/SA; and (4) the development of a core outcome set via a systematic review of literature, Delphi clinician survey and stakeholder consensus meeting...
September 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28745941/veterans-preferences-for-remote-management-of-chronic-conditions
#10
Erica Sedlander, Katherine C Barboza, Ashley Jensen, Nicole Skursky, Katelyn Bennett, Scott Sherman, Mark Schwartz
BACKGROUND: The Veterans Health Administration (VA) is investing considerable resources into providing remote management care to patients for disease prevention and management. Remote management includes online patient portals, e-mails between patients and providers, follow-up phone calls, and home health devices to monitor health status. However, little is known about patients' attitudes and preferences for this type of care. This qualitative study was conducted to better understand patient preferences for receiving remote care...
July 26, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28745564/patient-and-clinician-perspectives-of-an-integrated-electronic-medication-prescribing-and-dispensing-system-a-qualitative-study-at-a-multisite-australian-hospital-network
#11
Grace Lau, Jayde Ho, Susan Lin, Karen Yeoh, Tiffany Wan, Marisa Hodgkinson
BACKGROUND: While clinician attitudes towards electronic prescribing (e-prescribing) systems have been widely studied, little is known about the perspectives of patients, despite being the primary beneficiaries of these systems. OBJECTIVE: The objective of this study is to explore and compare patient and clinician attitudes towards an integrated e-prescribing and dispensing system, in order to guide improvements in system implementation, service delivery and enhancements to system functionality...
January 1, 2017: HIM Journal
https://www.readbyqxmd.com/read/28737045/pharmacist-s-demand-for-optimal-primary-care-service-delivery-in-a-community-pharmacy-the-optipharm-study
#12
Mark A Munger, Michael Walsh, Jon Godin, Michael Feehan
BACKGROUND: The US population continues to expand providing the need for primary health care services. Community pharmacies integrated with medicine may provide greater access while providing high quality care. OBJECTIVE: To gauge pharmacists' demand for primary health care services delivered through community pharmacies. METHODS: An online survey was administered to determine community pharmacists' preferences for varying primary care services that could be offered in the community pharmacy setting...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28677021/a-survey-of-patients-perspectives-on-outpatient-hiv-care-in-the-netherlands
#13
Esther A N Engelhard, Colette Smit, Frank P Kroon, Pythia T Nieuwkerk, Peter Reiss, Kees Brinkman, Suzanne E Geerlings
INTRODUCTION: Responding to patients' needs and preferences is important in the delivery of outpatient care. Recent and systematically collected data reflecting human immunodeficiency virus (HIV)-infected patients' opinions on how their outpatient care should be delivered are lacking. Our aim was to identify aspects of care that people with HIV in outpatient care in The Netherlands consider important and to evaluate the extent to which the received care meets their expectations. METHODS: We measured patient preferences and experiences in a nationwide sample of HIV-infected patients using a modified, previously validated questionnaire (QUOTE-HIV)...
September 2017: Infectious Diseases and Therapy
https://www.readbyqxmd.com/read/28645968/development-of-a-meta-algorithm-for-guiding-primary-care-encounters-for-patients-with-multimorbidity-using-evidence-based-and-case-based-guideline-development-methodology
#14
Cathleen Muche-Borowski, Dagmar Lühmann, Ingmar Schäfer, Rebekka Mundt, Hans-Otto Wagner, Martin Scherer
OBJECTIVE: The study aimed to develop a comprehensive algorithm (meta-algorithm) for primary care encounters of patients with multimorbidity. We used a novel, case-based and evidence-based procedure to overcome methodological difficulties in guideline development for patients with complex care needs. STUDY DESIGN: Systematic guideline development methodology including systematic evidence retrieval (guideline synopses), expert opinions and informal and formal consensus procedures...
June 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/28526079/patient-needs-and-preferences-for-herb-drug-disease-interaction-alerts-a-structured-interview-study
#15
Carrie M Christensen, Rebecca S Morris, Seraphine Chepkemoi Kapsandoy, Melissa Archer, Jinqiu Kuang, Laura Shane-McWhorter, Bruce E Bray, Qing Zeng-Treitler
BACKGROUND: While complementary and alternative medicine (CAM) is commonly used in the United States and elsewhere, and hazardous interactions with prescription drugs can occur, patients do not regularly communicate with physicians about their CAM use. The objective of this study was to discover patient information needs and preferences for herb-drug-disease interaction alerts. METHODS: We recruited 50 people from several locations within the University of Utah Hospital to participate in this structured interview study...
May 19, 2017: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/28490923/multigene-expression-profile-testing-in-breast-cancer-is-there-a-role-for-family-physicians
#16
M A O'Brien, J C Carroll, D P Manca, B Miedema, P A Groome, T Makuwaza, J Easley, N Sopcak, L Jiang, K Decker, M L McBride, R Moineddin, J A Permaul, R Heisey, E A Eisenhauer, M K Krzyzanowska, S Pruthi, C Sawka, N Schneider, J Sussman, R Urquhart, C Versaevel, E Grunfeld
BACKGROUND: Family physicians (fps) play a role in aspects of personalized medicine in cancer, including assessment of increased risk because of family history. Little is known about the potential role of fps in supporting cancer patients who undergo tumour gene expression profile (gep) testing. METHODS: We conducted a mixed-methods study with qualitative and quantitative components. Qualitative data from focus groups and interviews with fps and cancer specialists about the role of fps in breast cancer gep testing were obtained during studies conducted within the pan-Canadian canimpact research program...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28426677/information-ranks-highest-expectations-of-female-adolescents-with-a-rare-genital-malformation-towards-health-care-services
#17
Elisabeth Simoes, Alexander N Sokolov, Andrea Kronenthaler, Hanna Hiltner, Norbert Schaeffeler, Katharina Rall, Esther Ueding, Monika A Rieger, Anke Wagner, Leonie S Poesch, Marie-Christin Baur, Judith Kittel, Sara Y Brucker
BACKGROUND: Access to highly specialized health care services and support to meet the patient's specific needs is critical for health outcome, especially during age-related transitions within the health care system such as with adolescents entering adult medicine. Being affected by an orphan disease complicates the situation in several important respects. Long distances to dedicated institutions and scarcity of knowledge, even among medical doctors, may present major obstacles for proper access to health care services and health chances...
2017: PloS One
https://www.readbyqxmd.com/read/28426597/accommodating-immigrant-women-s-preferences-for-female-health-care-providers
#18
Christa Aubrey, Zubia Mumtaz, Patrick B Patterson, Radha Chari, B F Peter Mitchell
OBJECTIVE: To investigate obstetricians' perspectives of the importance, effect, and challenges of providing intrapartum care to immigrant women who request a female obstetrician. METHODS: A focused ethnography was conducted at a large teaching hospital, which serves a high proportion of immigrant clientele (predominantly North or East African, Middle Eastern, and South Asian) in Edmonton, Alberta, Canada. Data collection comprised single, semistructured interviews with a purposive sample of 20 obstetric health care providers (10 resident and 10 staff obstetricians)...
May 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28383381/accommodating-immigrant-women-s-preferences-for-female-health-care-providers
#19
Christa Aubrey, Zubia Mumtaz, Patrick B Patterson, Radha Chari, B F Peter Mitchell
OBJECTIVE: To investigate obstetricians' perspectives of the importance, effect, and challenges of providing intrapartum care to immigrant women who request a female obstetrician. METHODS: A focused ethnography was conducted at a large teaching hospital, which serves a high proportion of immigrant clientele (predominantly North or East African, Middle Eastern, and South Asian) in Edmonton, Alberta, Canada. Data collection comprised single, semistructured interviews with a purposive sample of 20 obstetric health care providers (10 resident and 10 staff obstetricians)...
April 4, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28261901/discussing-prognosis-and-treatment-goals-with-patients-with-advanced-cancer-a-qualitative-analysis-of-oncologists-language
#20
Wen-Ying Sylvia Chou, Lauren M Hamel, Chan L Thai, David Debono, Robert A Chapman, Terrance L Albrecht, Louis A Penner, Susan Eggly
BACKGROUND: The National Academy of Medicine recommends that cancer patients be knowledgeable of their prognosis to enable them to make informed treatment decisions, but research suggests few patients receive this information. OBJECTIVE: This qualitative study describes oncologists' language during discussions of prognosis and treatment goals in clinical interactions with African American patients diagnosed with cancer. DESIGN: We analysed transcripts from video recordings of clinical interactions between patients with Stage III or IV cancer (n=26) and their oncologists (n=9)...
October 2017: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
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