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https://www.readbyqxmd.com/read/28448781/assessment-of-clinical-pharmacy-interventions-to-reduce-outpatient-use-of-high-risk-medications-in-the-elderly
#1
Sarah C Weddle, A Shaun Rowe, Julie W Jeter, Rachel C Renwick, Shaunta' M Chamberlin, Andrea S Franks
BACKGROUND: Use of high-risk medications in the elderly (HRME) and drug-disease (Rx-DIS) interactions in the elderly, as defined by the Healthcare Effectiveness Data and Information Set (HEDIS) Measures, are significantly associated with mortality, hospital admission, and need for emergency care. No published studies to date evaluate interventions to reduce the use of HEDIS-defined HRME, although many studies have postulated a beneficial effect of such interventions. OBJECTIVE: To evaluate the effect of pharmacist interventions on use of HRME and Rx-DIS interactions in the outpatient elderly population...
May 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28447914/diagnosis-of-life-threatening-alpha-gal-food-allergy-appears-to-be-patient-driven
#2
Mary Grace Flaherty, Samantha Jan Kaplan, Maya R Jerath
OBJECTIVE: Patients exhibiting life-threatening symptoms associated with the alpha-gal food allergy (delayed urticaria or anaphylaxis due to mammalian meat) are frequently undiagnosed, causing unnecessary emergency department (ED) and health care visits, and extensive pain and suffering. This study aimed to determine the path to diagnosis experienced by alpha-gal patients. METHODS: Semistructured interviews were conducted from March to June 2016 with a chronological systematic sample of approximately 10% of patients diagnosed with alpha-gal and treated by the University of North Carolina Allergy and Immunology Clinic (n = 28)...
April 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/28446027/the-prevalence-of-complementary-and-alternative-medicine-use-among-dermatology-outpatients-in-shiraz-iran
#3
Ladan Dastgheib, Saman Farahangiz, Zeinab Adelpour, Alireza Salehi
The objective of this study was to assess complementary and alternative medicine use and its related factors among Iranian dermatology outpatients. In this cross-sectional study, a self-structured questionnaire was administered to 600 dermatology outpatients. Mann-Whitney U test, chi-square test, and binary logistic regression test were used. A total of 188 (31.3%) patients had used one of complementary and alternative medicine methods. The most frequent method used was herbal medicine (89.9%). The mean years of duration of the skin condition were significantly higher in complementary and alternative medicine users compared with nonusers ( P = ...
January 1, 2017: Journal of Evidence-based Complementary & Alternative Medicine
https://www.readbyqxmd.com/read/28445441/mining-productive-associated-periodic-frequent-patterns-in-body-sensor-data-for-smart-home-care
#4
Walaa N Ismail, Mohammad Mehedi Hassan
The understanding of various health-oriented vital sign data generated from body sensor networks (BSNs) and discovery of the associations between the generated parameters is an important task that may assist and promote important decision making in healthcare. For example, in a smart home scenario where occupants' health status is continuously monitored remotely, it is essential to provide the required assistance when an unusual or critical situation is detected in their vital sign data. In this paper, we present an efficient approach for mining the periodic patterns obtained from BSN data...
April 26, 2017: Sensors
https://www.readbyqxmd.com/read/28445277/cancer-studies-based-on-secondary-data-analysis-of-the-taiwan-s-national-health-insurance-research-database-a-computational-text-analysis-and-visualization-study
#5
Jui-Kun Chiang, Chih-Wen Lin, Chun-Lung Wang, Malcolm Koo, Yee-Hsin Kao
There has been a surge in the academic publication output based on secondary analyses of the data from the Taiwan's National Health Insurance claim records. It has become a challenge to comprehend such a rapid expansion of the literature. Therefore, this study aimed to explore the conceptual content of National Health Insurance Research Database-based cancer research, using the abstract of articles extracted from PubMed between 2002 and 2015. Search terms including "National Health Insurance Research Database (NHIRD) AND Taiwan," "Taiwan AND population-based," and "Taiwan AND nationwide" were used to search in PubMed with the publication date limited to between 1997 and 2015...
April 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28444760/vancomycin-levels-are-frequently-subtherapeutic-in-critically-ill-patients-a-prospective-observational-study
#6
V Bakke, H Sporsem, E Von der Lippe, I Nordøy, Y Lao, H C Nyrerød, L Sandvik, K R Hårvig, J F Bugge, E Helset
BACKGROUND: Appropriate utilization of vancomycin is important to attain therapeutic targets while avoiding clinical failure and the development of antimicrobial resistance. Our aim was to observe the use of vancomycin in an intensive care population, with the main focus on achievement of therapeutic serum concentrations (15-20 mg/l) and to evaluate how this was influenced by dose regimens, use of guidelines and therapeutic drug monitoring. METHODS: A prospective observational study was carried out in the intensive care units at two tertiary hospitals in Norway...
April 25, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28444155/hospitalization-rates-among-people-with-hiv-aids-in-new-york-city-2013
#7
Rachael Lazar, Laura Kersanske, Qiang Xia, Demetre Daskalakis, Sarah L Braunstein
Background: Hospitalizations are an important indicator of health care quality and access for people with HIV/AIDS. This study assesses hospitalization rates among people with HIV/AIDS in New York City. Methods: We performed a deterministic match between people in the New York City HIV surveillance registry alive as of 1/1/2013 and diagnosed with HIV as of 12/31/2013 and patient-level inpatient hospitalization records during 2013. Event-level data were analyzed to determine characteristics of and reasons for hospitalizations...
April 24, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28444056/care-for-young-victims-of-assault-in-public-emergency-services-in-2011-sex-differences
#8
Alice Cristina Medeiros Melo, Leila Posenato Garcia
This article aims to describe the characteristics of assaults among youth victims of violence treated in Public Emergency Departments, according to sex. This is a descriptive study using data from the Brazilian Violence and Accidents Surveillance System based on a multicenter survey conducted by the Ministry of Health in 71 public emergency departments, located in 24 state capitals and the Federal District in 2011. Male subjects predominated among the victims (75.1%) and also among aggressors (83.1% and 69...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444025/risk-of-misinterpretation-of-trends-in-hospital-admissions-for-primary-care-sensitive-conditions-in-local-contexts-itabora%C3%A3-rio-de-janeiro-state-brazil-2006-2011
#9
Janaina Furtado Botelho, Margareth Crisóstomo Portela
The study's objectives were to describe hospital admissions for primary care sensitive conditions (PCSCs) among residents of Itaboraí, a municipality in Rio de Janeiro State, Brazil, with a high rate of such admissions, to identify associated factors, and to explore the impact from closing a hospital. The ultimate aim was to contribute to the debate on the indicator's indiscriminate use for inferences on the expansion and quality of primary care. The study was based on data from the Hospital Information System of the Brazilian Unified National Health System...
April 20, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28442924/a-framework-for-measuring-self-management-effectiveness-and-health-care-use-among-pediatric-asthma-patients-and-families
#10
REVIEW
Pavani Rangachari
Asthma is associated with substantial health care expenditures, including an estimated US$56 billion per year in direct costs. A recurring theme in the asthma management literature is that costly asthma symptoms, including hospitalizations and multiple emergency department (ED)/outpatient visits, can often be prevented through patient/family adherence to the national (National Institutes of Health Expert Panel Report-3) guidelines for effective self-management of asthma, specifically 1) medication adherence and 2) environmental trigger avoidance, as outlined in the patient's personalized Asthma-Action Plan...
2017: Journal of Asthma and Allergy
https://www.readbyqxmd.com/read/28441374/fever-in-patients-with-cancer
#11
Yanina Pasikhova, Steven Ludlow, Aliyah Baluch
BACKGROUND: The definition of fever is flexible and depends on the clinical context. Fever is frequently observed in patients with cancer. METHODS: Infectious and noninfectious causes of fever in patients with various oncological and hematological malignancies and the usefulness of biomarkers are discussed. RESULTS: To treat patients in a timely manner and to minimize morbidity and mortality, it is paramount that health care professionals determine the cause of fever...
April 2017: Cancer Control: Journal of the Moffitt Cancer Center
https://www.readbyqxmd.com/read/28438724/toward-a-more-usable-home-based-video-telemedicine-system-a-heuristic-evaluation-of-the-clinician-user-interfaces-of-home-based-video-telemedicine-systems
#12
Sruthy Agnisarman, Shraddhaa Narasimha, Kapil Chalil Madathil, Brandon Welch, Fnu Brinda, Aparna Ashok, James McElligott
BACKGROUND: Telemedicine is the use of technology to provide and support health care when distance separates the clinical service and the patient. Home-based telemedicine systems involve the use of such technology for medical support and care connecting the patient from the comfort of their homes with the clinician. In order for such a system to be used extensively, it is necessary to understand not only the issues faced by the patients in using them but also the clinician. OBJECTIVES: The aim of this study was to conduct a heuristic evaluation of 4 telemedicine software platforms-Doxy...
April 24, 2017: JMIR Human Factors
https://www.readbyqxmd.com/read/28438226/n-of-1-trials-and-the-optimal-individualisation-of-drug-treatments-a-systematic-review-protocol
#13
Weyinmi A Demeyin, Julia Frost, Obioha C Ukoumunne, Simon Briscoe, Nicky Britten
BACKGROUND: Guidelines and evidence-based drug treatment recommendations are usually based on the results of clinical trials, which have limited generalisability in routine clinical settings due to their restrictive eligibility criteria. These trials are also conducted in ideal and rigorously controlled settings. N of 1 trials, which are single patient multiple crossover studies, offer a means of increasing the evidence base and individualising care for individuals in clinical practice...
April 24, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/28437793/mindfulness-based-stress-reduction-for-treating-low-back-pain-a-systematic-review-and-meta-analysis
#14
Dennis Anheyer, Heidemarie Haller, Jürgen Barth, Romy Lauche, Gustav Dobos, Holger Cramer
Background: Mindfulness-based stress reduction (MBSR) is frequently used to treat pain-related conditions, but its effects on low back pain are uncertain. Purpose: To assess the efficacy and safety of MBSR in patients with low back pain. Data Sources: Searches of MEDLINE/PubMed, Scopus, the Cochrane Library, and PsycINFO to 15 June 2016. Study Selection: Randomized controlled trials (RCTs) that compared MBSR with usual care or an active comparator and assessed pain intensity or pain-related disability as a primary outcome in patients with low back pain...
April 25, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28435481/a-patient-centered-emergency-department-management-strategy-for-sickle-cell-disease-super-utilizers
#15
Grant G Simpson, Hallie R Hahn, Alex A Powel, Robert R Leverence, Linda A Morris, Lara G Thompson, Marc S Zumberg, Deepa J Borde, Joseph A Tyndall, Jonathan J Shuster, Donald M Yealy, Brandon R Allen
INTRODUCTION: A subpopulation of sickle-cell disease patients, termed super-utilizers, presents frequently to emergency departments (EDs) for vaso-occlusive events and may consume disproportionate resources without broader health benefit. To address the healthcare needs of this vulnerable patient population, we piloted a multidisciplinary intervention seeking to create and use individualized patient care plans that alter utilization through coordinated care. Our goals were to assess feasibility primarily, and to assess resource use secondarily...
April 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28435320/identification-prevalence-and-treatment-of-painful-diabetic-neuropathy-in-patients-from-a-rural-area-in-south-carolina
#16
Jimmy Pruitt, Carolina Moracho-Vilrriales, Tiffaney Threatt, Sarah Wagner, Jun Wu, E Alfonso Romero-Sandoval
Diabetic peripheral neuropathy (DPN) represents significant burdens to many patients and the public health-care system. Patients with diabetes in rural areas have higher risk of developing complications and having less access to proper treatment. We studied a rural population of patients with diabetes who attended a pharmacist-led free clinic for a diabetic education program. Our objectives were to 1) determine the prevalence of DPN and painful diabetic neuropathy (p-DN) in patients with type 2 diabetes; 2) assess the proportion of patients with DPN and p-DN left undocumented upon physician referral to a pharmacist-led free clinic; and 3) determine the appropriateness of pain medication regimen...
2017: Journal of Pain Research
https://www.readbyqxmd.com/read/28434855/health-care-use-before-a-first-demyelinating-event-suggestive-of-a-multiple-sclerosis-prodrome-a-matched-cohort-study
#17
José M A Wijnands, Elaine Kingwell, Feng Zhu, Yinshan Zhao, Tanja Högg, Karen Stadnyk, Okechukwu Ekuma, Xinya Lu, Charity Evans, John D Fisk, Ruth Ann Marrie, Helen Tremlett
BACKGROUND: Degenerative processes in neurodegenerative diseases can start years before clinical manifestation. We aimed to establish whether a multiple sclerosis prodromal period exists by examining patterns of health-care use before a first demyelinating event. METHODS: In this matched cohort study, we used data from linked health administrative and clinical databases from four Canadian provinces (British Columbia, Saskatchewan, Manitoba, and Nova Scotia) to compare hospital, physician, and prescription use data from people with multiple sclerosis and matched general population controls in the 5 years before the first demyelinating disease claim (health administrative index date) or clinically reported symptom onset (clinical index date)...
April 20, 2017: Lancet Neurology
https://www.readbyqxmd.com/read/28434459/becoming-parent-and-nurse-high-fidelity-simulation-in-teaching-ambulatory-central-line-infection-prevention-to-parents-of-children-with-cancer
#18
Carol E Heiser Rosenberg, Mary F Terhaar, Judith A Ascenzi, Anna Walbert, K Michelle Kokoszka, Julianne S Perretta, Marlene R Miller
BACKGROUND: Ambulatory central-line infections in children with cancer are life-threatening. Infections are two to three times more frequent in outpatients than inpatients, for whom evidence-based bundles have decreased morbidity. Most cancer care now takes place at home, where parents perform many of the same tasks as nurses. However, parents often feel stressed and unprepared. To address this, high-fidelity simulation, which has been effective for teaching novice nurses, was evaluated for parent central-line education...
May 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28433398/multi-state-survey-of-healthcare-associated-infections-in-acute-care-hospitals-in-brazil
#19
C Magno Castelo Branco Fortaleza, M C Padoveze, C R Veiga Kiffer, A L Barth, Irna C do Rosário Souza Carneiro, H I Garcia Giamberardino, J L Nobre Rodrigues, L Santos Filho, M J Gonçalves de Mello, M Severino Pereira, P Pinto Gontijo Filho, M Rocha, E A Servolo de Medeiros, A C Campos Pignatari
BACKGROUND: Healthcare-associated infections (HCAIs) challenge public health in developing countries such as Brazil, which harbour social inequalities and variations in the complexity of healthcare and regional development. AIM: To describe the prevalence of HCAIs in hospitals in a sample of hospitals in Brazil. METHODS: A prevalence survey conducted in 2011-13 enrolled 152 hospitals from the five macro-regions in Brazil. Hospitals were classified as large (≥200 beds), medium (50-199 beds) or small sized (<50 beds)...
March 23, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28433120/additional-cost-because-of-pneumonia-in-nursing-home-residents-results-from-the-incidence-of-pneumonia-and-related-consequences-in-nursing-home-resident-study
#20
Nadège Costa, Emiel O Hoogendijk, Michael Mounié, Robert Bourrel, Yves Rolland, Bruno Vellas, Laurent Molinier, Matteo Cesari
OBJECTIVES: Pneumonia is a frequent condition in older people. Our aim was to examine the total healthcare cost related to pneumonia in nursing home (NH) residents over a 1-year follow-up period. DESIGN: This was a prospective, longitudinal, observational, and multicenter study that was a part of the Incidence of Pneumonia and related Consequences in Nursing Home Resident study. SETTING: Thirteen NHs located in Languedoc Roussillon and Midi-Pyrénées regions in France were included...
May 1, 2017: Journal of the American Medical Directors Association
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