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https://www.readbyqxmd.com/read/29755917/sharing-is-caring-minimizing-the-disruption-with-palliative-care
#1
EDITORIAL
Abd Moain Abu Dabrh, Robert P Shannon, Richard J Presutti
There is an upward trend incidence of multiple chronic life-limiting conditions with a well-documented associated impact on patients and their caregivers. When patients approach the end of life, they are often faced with a challenging multidimensional burden while navigating a complex health care system. Patients and families/caregivers are faced with daily decisions, often with little or no frame of reference or medical knowledge. The "what, how, when, and where" puzzle during this challenging time can be overwhelming for patients and their families, and when clinicians do not contemplate this associated workload's impact on patients and caregivers' capacity for self-care, patients and caregivers scramble to find compensatory solutions, often putting their health care at lower priority...
March 13, 2018: Curēus
https://www.readbyqxmd.com/read/29743054/australian-integrative-oncology-services-a-mixed-method-study-exploring-the-views-of-cancer-survivors
#2
Jennifer Hunter, Jane Ussher, Chloe Parton, Andrew Kellett, Caroline Smith, Geoff Delaney, Eleanor Oyston
BACKGROUND: The significant use of traditional and complementary medicine (T&CM) by cancer survivors is well documented. The aim of this study was to explore cancer survivors' views on integrating T&CM services with conventional cancer care. METHOD: A mixed-method study design with an emphasis on qualitative methodology was used to conduct and analyse four focus group interviews and an on-line survey. Purposive sampling recruited 33 cancer survivors and caregivers from Arabic, Vietnamese, Chinese and Anglo-European Australian backgrounds who participated in one of four focus group interviews, and 121 cancer survivors who responded to an on-line survey...
May 9, 2018: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/29690893/inclusion-and-definition-of-acute-renal-dysfunction-in-critically-ill-patients-in-randomized-controlled-trials-a-systematic-review
#3
Rogerio da Hora Passos, Joao Gabriel Rosa Ramos, André Gobatto, Juliana Caldas, Etienne Macedo, Paulo Benigno Batista
BACKGROUND: In evidence-based medicine, multicenter, prospective, randomized controlled trials (RCTs) are the gold standard for evaluating treatment benefits and ensuring the effectiveness of interventions. Patient-centered outcomes, such as mortality, are most often the preferred evaluated outcomes. While there is currently agreement on how to classify renal dysfunction in critically ill patients , the application frequency of this new classification system in RCTs has not previously been evaluated...
April 24, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29681030/through-patients-eyes-regulation-technology-privacy-and-the-future
#4
Carolyn Petersen
Privacy is commonly regarded as a regulatory requirement achieved via technical and organizational management practices. Those working in the field of informatics often play a role in privacy preservation as a result of their expertise in information technology, workflow analysis, implementation science, or related skills. Viewing privacy from the perspective of patients whose protected health information is at risk broadens the considerations to include the perceived duality of privacy; the existence of privacy within a context unique to each patient; the competing needs inherent within privacy management; the need for particular consideration when data are shared; and the need for patients to control health information in a global setting...
April 22, 2018: Yearbook of Medical Informatics
https://www.readbyqxmd.com/read/29659552/improving-pharmacists-targeting-of-patients-for-medication-review-and-deprescription
#5
Vanessa Marvin, Emily Ward, Barry Jubraj, Mark Bower, Iñaki Bovill
Background: In an acute hospital setting, a multi-disciplinary approach to medication review can improve prescribing and medicine selection in patients with frailty. There is a need for a clear understanding of the roles and responsibilities of pharmacists to ensure that interventions have the greatest impact on patient care. Aim: To use a consensus building process to produce guidance for pharmacists to support the identification of patients at risk from their medicines, and to articulate expected actions and escalation processes...
April 16, 2018: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/29567281/-multidisciplinary-oncopalliative-meeting-aims-and-pratical-recommendations
#6
François Goldwasser, Nathalie Nisenbaum, Pascale Vinant, Elisabeth Balladur, Sarah Dauchy, Idriss Farota-Romejko, Isabelle Colombet, Marie-Laure Alby, Julie Giroux, Anne Larrouy, Elisabeth Destaintot, Luc Garcon, Danièle Legrand, Isabelle Marin
Progress leads to increase life duration at the metastatic stage but metastatic disease is most often lethal. Decision-making is necessary for an increasing period of care, beyond evidence-based medicine, dealing with complexity and uncertain benefit/risk ratio. This requires to inform the patient realistically, to discuss prognostication, to develop anticipated written preferences. These changes mean to pass from a medicine based on informed consent to medicine based on respect of the patient wishes even if it can be complex to determine...
March 19, 2018: Bulletin du Cancer
https://www.readbyqxmd.com/read/29484218/personalized-cancer-screening-helping-primary-care-rise-to-the-challenge
#7
Kevin Selby, Gillian Bartlett-Esquilant, Jacques Cornuz
With their longitudinal patient relationships, primary care physicians and their care teams are uniquely situated to promote preventive medicine, including cancer screening. A confluence of forces is driving the demand for the personalization of cancer screening recommendations. Recommendations are increasingly based on individual patient preferences, medical history, genetic and environmental risk factors, and level of interaction with the healthcare system. Current examples include choices between colonoscopy, fecal testing, and emerging tests for colorectal cancer (CRC) screening; the use of genetic information and availability of home self-testing in cervical cancer screening; the integration of multiple risk factors and patient preferences to decide the intensity and length of breast cancer screening; and the issues of smoking cessation and competing priorities when deciding whether or not to pursue lung cancer screening...
2018: Public Health Reviews
https://www.readbyqxmd.com/read/29474574/evidence-based-medicine-and-big-genomic-data
#8
John P A Ioannidis, Muin J Khoury
Genomic and other related big data (Big Genomic Data, BGD for short) are ushering a new era of precision medicine. This overview discusses whether principles of evidence-based medicine hold true for BGD and how they should be operationalized in the current era. Major evidence-based medicine principles include the systematic identification, description and analysis of the validity and utility of BGD, the combination of individual clinical expertise with individual patient needs and preferences, and the focus on obtaining experimental evidence, whenever possible...
May 1, 2018: Human Molecular Genetics
https://www.readbyqxmd.com/read/29445521/a-method-for-co-creation-of-an-evidence-based-patient-workbook-to-address-alcohol-use-when-quitting-smoking-in-primary-care-a-case-study
#9
Nadia Minian, Aliya Noormohamed, Laurie Zawertailo, Dolly Baliunas, Norman Giesbrecht, Bernard Le Foll, Jürgen Rehm, Andriy Samokhvalov, Peter L Selby
Plain English summary: The purpose of this paper is to describe a patient engagement event designed to create an educational workbook with smokers who drink alcohol at harmful levels. The goal was to create a workbook that combined scientific evidence with patients' values, preferences, and needs. Fourteen adult smokers who drink alcohol were invited to the Centre for Addiction and Mental Health (CAMH) to take part in a four-hour event to help design the workbook with the CAMH research team...
2018: Research involvement and engagement
https://www.readbyqxmd.com/read/29410750/women-s-sleep-disorders-integrative-care
#10
Cristina Frange, Carolina Vicente Banzoli, Ana Elisa Colombo, Marcele Siegler, Glaury Coelho, Andréia Gomes Bezerra, Marcelo Csermak, Maria Fernanda Naufel, Cristiana Cesar-Netto, Monica Levy Andersen, Manoel João Batista Castelo Girão, Sergio Tufik, Helena Hachul
The integrative care model is rooted in a biopsychosocial approach. Integrative is a term which refers to increasing the harmony and coherence of your whole being, and integrative care is therefore focused on the person, not on either the disease or a therapy. It is provided collaboratively by a health team comprising physicians, psychologists, physiotherapists, acupuncturists, and meditation, nutrition, and floral therapy. Previous studies have demonstrated that interventions based on the integrative care model improved womens lifestyle and quality of life...
October 2017: Sleep Science
https://www.readbyqxmd.com/read/29343041/forgoing-life-sustaining-treatments-in-the-icu-to-withhold-or-to-withdraw-is-that-the-question
#11
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
#12
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
#13
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
#14
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
#15
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...
March 2018: 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
#16
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
#17
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
#18
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
#19
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
#20
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
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