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https://www.readbyqxmd.com/read/27892723/optimization-and-stratification-of-multiple-sclerosis-treatment-in-fast-developing-economic-countries-a-perspective-from-qatar
#1
Dirk Deleu, Boulenouar Mesraoua, Hisham El Khider, Beatriz Canibano, Gayane Melikyan, Hassan Al Hail, Noha Mhjob, Anjushri Bhagat, Faiza Ibrahim, Yolande Hanssens
OBJECTIVE: The introduction of disease-modifying therapies (DMTs) - with varying degrees of efficacy for reducing annual relapse rate and disability progression - has considerably transformed the therapeutic landscape of relapsing-remitting multiple sclerosis (RRMS). We aim to develop rational evidence-based treatment recommendations and algorithms for the management of clinically isolated syndrome (CIS) and RRMS conform to the healthcare system in a fast-developing economic country such as Qatar...
November 28, 2016: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/27830645/thoughts-about-dying-in-america-enhancing-the-impact-of-one-s-life-journey-and-legacy-by-also-planning-for-the-end-of-life
#2
Philip A Pizzo
This Perspective offers a summary of the recommendations in the Institute of Medicine report Dying in America How we die is a deeply personal issue that each of us will face. However, the approach to end-of-life (EOL) care in the United States needs improvement. Too frequently, healthcare delivery is uncoordinated and has many providers who are not adequately prepared to have meaningful conversations about EOL planning. This is amplified by payment systems and policies that create impediments, misunderstanding, and sometimes misinformation...
November 8, 2016: Proceedings of the National Academy of Sciences of the United States of America
https://www.readbyqxmd.com/read/27730483/patients-future-expectations-for-diabetes-and-hypertension-treatments-through-the-diet%C3%A2-i-think-this-is-going-to-go-away
#3
Paige C Fairchild, Aviva G Nathan, Michael Quinn, Elbert S Huang, Neda Laiteerapong
BACKGROUND: Diabetes and hypertension are chronic conditions for which over 90 % of patients require medication regimens that must be intensified over time. However, delays in intensification are common, and may be partially due to unrealistic patient expectations. OBJECTIVE: To explore whether patient expectations regarding their diabetes and hypertension are congruent with the natural history of these conditions. DESIGN: Qualitative analysis of semi-structured interviews...
October 11, 2016: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/27610179/the-use-of-complementary-and-alternative-medicine-in-children-with-common-neurologic-diseases
#4
REVIEW
Gyu-Min Yeon, Sang Ook Nam
Complementary and alternative medicine (CAM) is a phrase used to describe additional health care methods such as mind/body practices and natural products not regarded as treatments by conventional medicine. The use of CAM in children with common neurologic diseases is more frequent than its use in healthy children (24%-78% vs. 12%). However, less than half of patients report such use to their physicians. The preferred modalities of CAM vary in different countries due to their different cultures and traditions...
August 2016: Korean Journal of Pediatrics
https://www.readbyqxmd.com/read/27585628/information-and-training-needs-regarding-complementary-and-alternative-medicine-a-cross-sectional-study-of-cancer-care-providers-in-germany
#5
Gudrun E Klein, Corina Guethlin
BACKGROUND: Among cancer care providers (CCPs), lack of knowledge constitutes an important barrier to the discussion of complementary and alternative medicine (CAM) use with patients. This study assessed CCPs' needs and preferences regarding CAM information and training (I&T). METHODS: An online survey was completed by 209 general practitioners, 437 medical specialists, 159 oncology nurses and medical assistants, and 244 psychologists and social workers engaged in cancer care...
September 1, 2016: Integrative Cancer Therapies
https://www.readbyqxmd.com/read/27542754/-it-s-complicated-talking-about-gout-medicines-in-primary-care-consultations-a-qualitative-study
#6
Caroline Morris, Lindsay Macdonald, Maria Stubbe, Anthony Dowell
BACKGROUND: Gout is the most common form of inflammatory arthritis. It is associated with substantial co-morbidity and often managed in primary care. A greater understanding of the communication process between patients and healthcare professionals provides one way of improving the management of this condition. This paper describes communication about gout medicines and treatment between patients and primary care health professionals during routine consultations. METHODS: Video-recordings of 31 individual healthcare consultations between patients and a range of primary care practitioners (general practitioners, practice nurses, podiatrists, dietitians) from an archived database were reviewed...
2016: BMC Family Practice
https://www.readbyqxmd.com/read/27530738/clinical-trials-of-medicinal-cannabis-for-appetite-related-symptoms-from-advanced-cancer-a-survey-of-preferences-attitudes-and-beliefs-among-patients-willing-to-consider-participation
#7
Tim Luckett, Jane Phillips, Nicholas Lintzeris, David Allsop, Jessica Lee, Nadia Solowij, Jennifer Martin, Lawrence Lam, Rajesh Aggarwal, Nicola McCaffrey, David Currow, Richard Chye, Melanie Lovell, Iain McGregor, Meera Agar
BACKGROUND: Australian clinical trials are planned to evaluate medicinal cannabis in a range of clinical contexts. AIMS: To explore the preferences, attitudes and beliefs of patients eligible and willing to consider participation in a clinical trial of medicinal cannabis for poor appetite and appetite-related symptoms from advanced cancer. METHODS: A cross-sectional anonymous survey was administered from July to December 2015 in 8 adult outpatient palliative care and/or cancer services, and online...
August 17, 2016: Internal Medicine Journal
https://www.readbyqxmd.com/read/27502869/understanding-physician-level-barriers-to-the-use-of-individualized-risk-estimates-in-percutaneous-coronary-intervention
#8
Carole Decker, Linda Garavalia, Brian Garavalia, Elizabeth Gialde, Robert W Yeh, John Spertus, Adnan K Chhatriwalla
BACKGROUND: The foundation of precision medicine is the ability to tailor therapy based upon the expected risks and benefits of treatment for each individual patient. In a prior study, we implemented a software platform, ePRISM, to execute validated risk-stratification models for patients undergoing percutaneous coronary intervention and found substantial variability in the use of the personalized estimates to tailor care. A better understanding of physicians' perspectives about the use of individualized risk-estimates is needed to overcome barriers to their adoption...
August 2016: American Heart Journal
https://www.readbyqxmd.com/read/27467454/noninvasive-prenatal-screening-for-fetal-aneuploidy-2016-update-a-position-statement-of-the-american-college-of-medical-genetics-and-genomics
#9
Anthony R Gregg, Brian G Skotko, Judith L Benkendorf, Kristin G Monaghan, Komal Bajaj, Robert G Best, Susan Klugman, Michael S Watson
This statement is designed primarily as an educational resource for clinicians to help them provide quality medical services. Adherence to this statement is completely voluntary and does not necessarily assure a successful medical outcome. This statement should not be considered inclusive of all proper procedures and tests or exclusive of other procedures and tests that are reasonably directed toward obtaining the same results. In determining the propriety of any specific procedure or test, the clinician should apply his or her own professional judgment to the specific clinical circumstances presented by the individual patient or specimen...
October 2016: Genetics in Medicine: Official Journal of the American College of Medical Genetics
https://www.readbyqxmd.com/read/27437065/feasibility-of-population-health-analytics-and-data-visualization-for-decision-support-in-the-infectious-diseases-domain-a-pilot-study
#10
Don Roosan, Guilherme Del Fiol, Jorie Butler, Yarden Livnat, Jeanmarie Mayer, Matthew Samore, Makoto Jones, Charlene Weir
OBJECTIVE: Big data or population-based information has the potential to reduce uncertainty in medicine by informing clinicians about individual patient care. The objectives of this study were: 1) to explore the feasibility of extracting and displaying population-based information from an actual clinical population's database records, 2) to explore specific design features for improving population display, 3) to explore perceptions of population information displays, and 4) to explore the impact of population information display on cognitive outcomes...
2016: Applied Clinical Informatics
https://www.readbyqxmd.com/read/27398990/improving-communication-about-serious-illness-in-primary-care-a-review
#11
Joshua R Lakin, Susan D Block, J Andrew Billings, Luca A Koritsanszky, Rebecca Cunningham, Lisa Wichmann, Doreen Harvey, Jan Lamey, Rachelle E Bernacki
IMPORTANCE: The Institute of Medicine recently called for systematic improvements in clinician-led conversations about goals, values, and care preferences for patients with serious and life-threatening illnesses. Studies suggest that these conversations are associated with improved outcomes for patients and their families, enhanced clinician satisfaction, and lower health care costs; however, the role of primary care clinicians in driving conversations about goals and priorities in serious illness is not well defined...
September 1, 2016: JAMA Internal Medicine
https://www.readbyqxmd.com/read/27388345/multicountry-survey-of-emergency-and-critical-care-medicine-physicians-fluid-resuscitation-practices-for-adult-patients-with-early-septic-shock
#12
Lauralyn McIntyre, Brian H Rowe, Timothy S Walsh, Alasdair Gray, Yaseen Arabi, Anders Perner, Anthony Gordon, John Marshall, Deborah Cook, Alison Fox-Robichaud, Sean M Bagshaw, Robert Green, Irwin Schweitzer, Alexis Turgeon, Ryan Zarychanski, Shane English, Michaël Chassé, Ian Stiell, Dean Fergusson
OBJECTIVES: Evidence to guide fluid resuscitation evidence in sepsis continues to evolve. We conducted a multicountry survey of emergency and critical care physicians to describe current stated practice and practice variation related to the quantity, rapidity and type of resuscitation fluid administered in early septic shock to inform the design of future septic shock fluid resuscitation trials. METHODS: Using a web-based survey tool, we invited critical care and emergency physicians in Canada, the UK, Scandinavia and Saudi Arabia to complete a self-administered electronic survey...
July 7, 2016: BMJ Open
https://www.readbyqxmd.com/read/27284125/frailty-polypharmacy-and-deprescribing
#13
(no author information available yet)
Multimorbidity and associated polypharmacy present a significant and increasing challenge to patients, carers and healthcare professionals.(1,2) While it is recognised that polypharmacy can be beneficial, there is considerable potential for harm, particularly through drug interactions, adverse drug events and non-adherence.(1) Such harms are amplified in people who are frail and who may require interventions to be tailored to their individual needs rather than strictly following guidance designed to manage single diseases...
June 2016: Drug and Therapeutics Bulletin
https://www.readbyqxmd.com/read/27199223/putting-meaning-into-meaningful-use-a-roadmap-to-successful-integration-of-evidence-at-the-point-of-care
#14
Thomas McGinn
Pressures to contain health care costs, personalize patient care, use big data, and to enhance health care quality have highlighted the need for integration of evidence at the point of care. The application of evidence-based medicine (EBM) has great promise in the era of electronic health records (EHRs) and health technology. The most successful integration of evidence into EHRs has been complex decision tools that trigger at a critical point of the clinical visit and include patient specific recommendations...
2016: JMIR Medical Informatics
https://www.readbyqxmd.com/read/27103153/periviable-birth-interim-update
#15
Jeffrey L Ecker, Anjali Kaimal, Brian M Mercer, Sean C Blackwell, Raye Ann O deRegnier, Ruth M Farrell, William A Grobman, Jamie L Resnik, Anthony C Sciscione
Approximately 0.5% of all births occur before the third trimester of pregnancy, and these very early deliveries result in the majority of neonatal deaths and more than 40% of infant deaths. A recent executive summary of proceedings from a joint workshop defined periviable birth as delivery occurring from 20 0/7 weeks to 25 6/7 weeks of gestation. When delivery is anticipated near the limit of viability, families and health care teams are faced with complex and ethically challenging decisions. Multiple factors have been found to be associated with short-term and long-term outcomes of periviable births in addition to gestational age at birth...
August 2016: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/26929431/listening-to-the-consumer-voice-developing-multilingual-cancer-information-resources-for-people-affected-by-liver-cancer
#16
Monica C Robotin, Mamta Porwal, Max Hopwood, Debbie Nguyen, Minglo Sze, Carla Treloar, Jacob George
BACKGROUND: In Australia, liver cancer incidence is rising, particularly among people born in hepatitis B-endemic countries. We sought to build an understanding of the information needs of people affected by liver cancer, to inform the design of in-language consumer information resources. METHODS: We searched the World Wide Web for available in-language consumer information and conducted a literature search on consumers' information needs and their preferred means of accessing it...
February 29, 2016: Health Expectations: An International Journal of Public Participation in Health Care and Health Policy
https://www.readbyqxmd.com/read/26915314/shared-decision-making-in-endocrinology-present-and-future-directions
#17
REVIEW
Rene Rodriguez-Gutierrez, Michael R Gionfriddo, Naykky Singh Ospina, Spyridoula Maraka, Shrikant Tamhane, Victor M Montori, Juan P Brito
In medicine and endocrinology, there are few clinical circumstances in which clinicians can accurately predict what is best for their patients. As a result, patients and clinicians frequently have to make decisions about which there is uncertainty. Uncertainty results from limitations in the research evidence, unclear patient preferences, or an inability to predict how treatments will fit into patients' daily lives. The work that patients and clinicians do together to address the patient's situation and engage in a deliberative dialogue about reasonable treatment options is often called shared decision making...
August 2016: Lancet Diabetes & Endocrinology
https://www.readbyqxmd.com/read/26869774/japanese-physicians-preferences-for-decision-making-in-rheumatoid-arthritis-treatment
#18
Akiko Aoki, Sadayoshi Ohbu
BACKGROUND: Rheumatoid arthritis (RA) is a complex chronic illness requiring continued medical care. During the past decade, the therapeutic options for RA have increased significantly; these often have a higher risk of adverse effects and are more expensive than traditional drugs. Rheumatologists may hence face difficulties when deciding on the optimal modality in initiating or changing treatment. The aim of this study was to explore the Japanese physicians' usual style of and preferences for decision making regarding RA treatment...
2016: Patient Preference and Adherence
https://www.readbyqxmd.com/read/26630949/developing-and-implementing-a-complex-complementary-and-alternative-cam-nursing-intervention-for-breast-and-gynecologic-cancer-patients-undergoing-chemotherapy-report-from-the-congo-complementary-nursing-in-gynecologic-oncology-study
#19
Nadja Klafke, Cornelia Mahler, Cornelia von Hagens, Gisela Blaser, Martina Bentner, Stefanie Joos
PURPOSE/OBJECTIVES: The purpose of this study was to develop a complex nursing intervention including complementary and alternative medicine (CAM) for breast and gynecologic cancer patients during chemotherapy to improve quality of life. METHODS: Data sources Theoretical framework and concepts, practical nursing knowledge, and evidence-based studies were compiled in interprofessional meetings. Data synthesis The final complex intervention consists of three autonomous, but interacting components: (1) CAM nursing package, (2) resource-oriented counseling, and (3) evidence-based information material on CAM...
May 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/26600703/role-of-communication-for-pediatric-cancer-patients-and-their-family
#20
Rajesh Kumar Singh, Aditya Raj, Sujata Paschal, Shahab Hussain
BACKGROUND: Communication is a key component in medical practice. The area of pediatric palliative care is emotionally distressing for families and healthcare providers. Inadequate communication can increase the stress and lead to mistrust or miscommunication. MATERIALS AND METHODS: Reviewing the literature on communication between physicians, patients, and their family; we identified several barriers to communication such as paternalism in medicine, inadequate training in communication skills, knowledge of the grieving process, special issues related to care of children, and cultural barriers...
September 2015: Indian Journal of Palliative Care
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