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Physician interaction strategies

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https://www.readbyqxmd.com/read/28427405/ceiling-effect-in-emr-system-assimilation-a-multiple-case-study-in-primary-care-family-practices
#1
Marie-Claude Trudel, Josianne Marsan, Guy Paré, Louis Raymond, Ana Ortiz de Guinea, Éric Maillet, Thomas Micheneau
BACKGROUND: There has been indisputable growth in adoption of electronic medical record (EMR) systems in the recent years. However, physicians' progress in using these systems has stagnated when measured with maturity scales. While this so-called ceiling effect has been observed and its consequences described in previous studies, there is a paucity of research on the elements that could explain such an outcome. We first suggest that in the context of EMR systems we are in presence of a "tiered ceiling effect" and then we show why such phenomenon occurs...
April 20, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28418205/it-s-not-just-what-you-know-junior-trainees-approach-to-follow-up-and-documentation
#2
Dani C Cadieux, Mark Goldszmidt
CONTEXT: In teaching hospitals, junior trainees (first-year residents and third-year medical students) are responsible for patient follow-up and documentation under the supervision of senior team members. In order to support trainees in their role, supervisors need to understand how trainees approach these tasks and how they can be coached to develop best practices. OBJECTIVES: The purpose of our study was to explore the range of practices used by junior trainees in clinical settings...
April 18, 2017: Medical Education
https://www.readbyqxmd.com/read/28406971/association-between-physicians-interaction-with-pharmaceutical-companies-and-their-clinical-practices-a-systematic-review-and-meta-analysis
#3
REVIEW
Hneine Brax, Racha Fadlallah, Lina Al-Khaled, Lara A Kahale, Hala Nas, Fadi El-Jardali, Elie A Akl
BACKGROUND: Pharmaceutical company representatives likely influence the prescribing habits and professional behaviors of physicians. The objective of this study was to systematically review the association between physicians' interactions with pharmaceutical companies and their clinical practices. METHODS: We used the standard systematic review methodology. Observational and experimental study designs examining any type of targeted interaction between practicing physicians and pharmaceutical companies were eligible...
2017: PloS One
https://www.readbyqxmd.com/read/28398492/a-proactive-smoking-cessation-intervention-for-socioeconomically-disadvantaged-smokers-the-role-of-smoking-related-stigma
#4
Patrick Hammett, Steven S Fu, David Nelson, Barbara Clothier, Jessie E Saul, Rachel Widome, Elisheva R Danan, Diana J Burgess
Introduction: Smoking de-normalization has been paralleled by reduced smoking prevalence, but smoking rates among socioeconomically disadvantaged populations remain high. The social unacceptability of smoking has also led to increased perceptions of smoking-related stigma. By examining how smoking stigma influences cessation intervention effectiveness, we can better tailor interventions to socioeconomically disadvantaged smokers. Methods: Data are from a randomized controlled trial evaluating the effectiveness of a proactive cessation intervention on abstinence...
April 8, 2017: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
https://www.readbyqxmd.com/read/28385026/scaling-lean-in-primary-care-impacts-on-system-performance
#5
Dorothy Y Hung, Michael I Harrison, Meghan C Martinez, Harold S Luft
OBJECTIVES: We examined a wide range of performance outcomes after Lean methodology-a leading strategy to enhance efficiency and patient value-was implemented and scaled across all primary care clinics in a nonprofit, ambulatory care delivery system. STUDY DESIGN: Using a stepped wedge approach, we assessed changes associated with the phased introduction of Lean-based redesigns across 46 primary care departments in 17 different clinic locations. Longitudinal analysis of operational metrics included: workflow efficiency, physician productivity, operating expenses, clinical quality, and satisfaction among patients, physicians, and staff...
March 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28351655/arterial-hypertension-and-aortic-valve-stenosis-shedding-light-to-a-common-liaison
#6
REVIEW
Charalampos I Liakos, Charalampos A Grassos, Dimitrios P Papadopoulos, Kyriakos S Dimitriadis, Constantinos P Tsioufis, Dimitrios Tousoulis
Arterial hypertension and aortic valve stenosis are common disorders and frequently present as concomitant diseases, especially in the elderly patients. The impact of hypertension in heart hemodynamics is substantial thus affecting the clinical presentation of any coexisting valvulopathy, especially of aortic stenosis. However, the interaction between these 2 entities is not thoroughly discussed in the European or/and American guidelines on the management of hypertension or/and valvular heart disease. The present review summarizes all evidence available on the potential interplay between hypertension and aortic valve stenosis aiming to assist physicians understand the pathophysiology and select the best diagnostic and therapeutic strategies (medical or/and interventional) for the better management of these high risk patients, taking into account the impact on outcome, as well as the risk-benefit-ratio...
March 25, 2017: Hellenic Journal of Cardiology: HJC, Hellēnikē Kardiologikē Epitheōrēsē
https://www.readbyqxmd.com/read/28342107/interactive-segmentation-in-mri-for-orthopedic-surgery-planning-bone-tissue
#7
Firat Ozdemir, Neerav Karani, Philipp Fürnstahl, Orcun Goksel
PURPOSE: Planning orthopedic surgeries is commonly performed in computed tomography (CT) images due to the higher contrast of bony structure. However, soft tissues such as muscles and ligaments that may determine the functional outcome of a procedure are not easy to identify in CT, for which fast and accurate segmentation in MRI would be desirable. To be usable in daily practice, such method should provide convenient means of interaction for modifications and corrections, e.g., during perusal by the surgeon or the planning physician for quality control...
March 24, 2017: International Journal of Computer Assisted Radiology and Surgery
https://www.readbyqxmd.com/read/28304333/improving-communication-between-physicians-and-their-patients-through-mindfulness-and-compassion-based-strategies-a-narrative-review
#8
REVIEW
Alberto Amutio-Kareaga, Javier García-Campayo, Luis Carlos Delgado, Daniel Hermosilla, Cristina Martínez-Taboada
Communication between physicians and patients is a key pillar of psychosocial support for enhancing the healing process of patients and for increasing their well-being and quality of life. Physicians and other health professionals might benefit from interventions that increase their self-care, awareness, compassion, and other-focused concern, and reduce the chances of distress and burnout. There is substantial evidence for the contribution of different management strategies to achieve these aims. The goal of this article is to review the potential effect of mindfulness and compassion-based strategies for the improvement of physician-patient interactions...
March 17, 2017: Journal of Clinical Medicine
https://www.readbyqxmd.com/read/28292225/discussing-out-of-pocket-expenses-during-clinical-appointments-an-observational-study-of-patient-psychiatrist-interactions
#9
Gregory D Brown, Wynn G Hunter, Ashley Hesson, J Kelly Davis, Christine Kirby, Jamison A Barnett, Dmytro Byelmac, Peter A Ubel
OBJECTIVE: High out-of-pocket expenses for medical treatment have been associated with worse quality of life, decreased treatment adherence, and increased risk of adverse health outcomes. Treatment of depression potentially has high out-of-pocket expenses. Limited data characterize psychiatrist-patient conversations about health care costs. METHODS: The authors conducted content analysis from 422 outpatient psychiatrist-patient visits for medication management of major depressive disorder in community-based private practices nationwide from 2010 to 2014...
March 15, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28260600/trends-in-population-blood-pressure-and-determinant-factors-for-population-blood-pressure
#10
Ulla Overgaard Andersen
Strategies to reduce the burden of blood pressure attributable diseases require knowledge of secular trend in PBP and its determinants. The issues were investigated in the Copenhagen City Heart Study. The design of CCHS is a repeated measures study. Such designs are uniquely suited to studying changes of an outcome and what risk factors may be associated with that outcome. Repeated measures studies are very well suited for trend analysis by using mixed effect analyses. SBP decreased about 2 mmHg in 25 years...
March 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28258866/-peripheral-neuropathies-diagnostic-strategy
#11
L Magy
Diagnosing a peripheral neuropathy is sometimes challenging, as the causes are diverse and the clinical pictures heterogeneous. Overall, diagnosing a patient with peripheral neuropathy will require some knowledge in almost every field of medicine. Therefore, it appears crucial to adopt a diagnostic strategy that is based on solid clinical and neurophysiological grounds. The present paper describes a three-step diagnostic strategy: (1) to delineate a clinico-pathologic entity from clinical and electrodiagnostic findings; (2) to propose a list of plausible causes based on step one, history and clinical context; (3) to use appropriate workup in order to determine the cause or mechanism of the neuropathy...
February 28, 2017: La Revue de Médecine Interne
https://www.readbyqxmd.com/read/28230582/motivating-physicians-to-report-adverse-medical-events-in-china-stick-or-carrot
#12
Yajiong Xue, Jing Yang, Jing Zhang, Mengyun Luo, Zhiruo Zhang, Huigang Liang
BACKGROUND: Adverse medical events (AMEs) pose serious threats to patient safety. One of the major challenges of AME reporting is low physician engagement. This study attempted to examine how punishment and reward can improve physicians' AME reporting in China. METHODS: A survey was conducted in a large hospital with 1693 beds in China. Data were collected from 311 physicians. Ordinal and binary logistic regression was used for data analysis. RESULTS: This study reveals that both punishment and reward are positively associated with intention to report AMEs...
February 22, 2017: Journal of Patient Safety
https://www.readbyqxmd.com/read/28226033/effectiveness-of-pharmacovigilance-multifaceted-educational-intervention-related-to-the-knowledge-skills-and-attitudes-of-multidisciplinary-hospital-staff
#13
Fabiana Rossi Varallo, Cleopatra S Planeta, Patricia de Carvalho Mastroianni
OBJECTIVES: Most educational interventions in pharmacovigilance are designed to encourage physicians to report adverse drug reactions. However, multidisciplinary teams may play an important role in reporting drug-related problems. This study assessed the impact of a multifaceted educational intervention in pharmacovigilance on the knowledge, skills and attitudes of hospital professionals. METHOD: This prospective, open-label, non-randomized study was performed in a medium-complexity hospital in São Paulo, Brazil...
January 1, 2017: Clinics
https://www.readbyqxmd.com/read/28214353/association-of-gastro-oesophageal-reflux-and-chronic-rhinosinusitis-systematic-review-and-meta-analysis
#14
S R Leason, H P Barham, G Oakley, J Rimmer, J M DelGaudio, J M Christensen, R Sacks, R J Harvey
INTRODUCTION: Gastro-oesophageal reflux disease (GORD) has been implicated in the development of chronic rhinosinusitis (CRS). The association of GORD with CRS is systematically assessed from the medical literature. METHODOLOGY: Embase and MEDLINE were searched using a comprehensive strategy limited to English language and Human subjects. Any study with original data on the experimental, diagnostic, treatment or prognostic association of CRS with GORD was included...
March 1, 2017: Rhinology
https://www.readbyqxmd.com/read/28202028/management-of-everolimus-associated-adverse-events-in-patients-with-tuberous-sclerosis-complex-a-practical-guide
#15
REVIEW
Mark Davies, Anurag Saxena, John C Kingswood
Tuberous sclerosis complex (TSC) is a genetic disorder characterised by highly variable comorbid dysfunction and subsequent morbidity. The mTOR inhibitor everolimus is indicated for the treatment of adult TSC patients with renal angiomyolipomas (AMLs) and for subependymal giant astrocytoma (SEGA) in both adults and children, based on data from the EXIST-1 and EXIST-2 trials. However, due to the historical predominance of everolimus in the oncology setting, some physicians who treat TSC patients may be unfamiliar with everolimus-associated adverse events (AEs) and appropriate management strategies...
February 15, 2017: Orphanet Journal of Rare Diseases
https://www.readbyqxmd.com/read/28181846/attitudes-and-preferences-concerning-interprofessional-education-of-first-year-students-and-experienced-medical-and-nursing-staff
#16
Stephan Kolb, Thomas Vasilakis, Barbara Stein, Jessica Stadelmann, Angelika Münzinger, Gabriele Fley, Isabel Hach, Marco Jassmann, Jürgen Härlein
In order to enhance patient outcome and patient safety in healthcare, interprofessional education (IPE) has over the years become a specific area of interest focusing on teaching concepts, research methods, and implementation strategies. To achieve commitment and positive attitudes as part of the institutional readiness towards IPE, the adoption of change management aspects can support its early implementation. This short report presents results of a baseline survey on attitudes and preferences for IPE among first-year students in medicine and nursing, as well as among chief physicians, nurse directors, and administrative directors at the associated university hospital...
March 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28145987/factors-related-to-depression-symptoms-among-working-women-in-menoufia-egypt
#17
Zeinab A Kasemy, Amal A Salama, Mahmoud E Abo Salem, Noha Negm
BACKGROUND: Lifetime prevalence rates for any psychological disorder are higher than previously thought. Depression in the workplace may lower work productivity and increase maladjustment in daily professional life. AIM OF THE STUDY: The study aimed to investigate the prevalence of depression symptoms and the work-related risk factors in Egyptian working women. PATIENTS AND METHODS: A cross-sectional study was carried out on 600 working women in family health facilities in Tala district, Menoufia governorate in 2015...
December 2016: Journal of the Egyptian Public Health Association
https://www.readbyqxmd.com/read/28143539/money-s-not-on-my-mind-a-qualitative-study-of-how-staff-and-managers-understand-health-care-s-triple-aim
#18
Marie Höjriis Storkholm, Pamela Mazzocato, Mairi Savage, Carl Savage
BACKGROUND: The "Triple Aim" - provision of a better care experience and improved population health at a lower cost - may be theoretically sound, but paradoxical in practice as it forces together the logics of management and medicine. The aim of this study was to explore how staff and managers understand the change imperative inherent to the Triple Aim and the mental models underlying their understanding. METHODS: This qualitative study builds on thirty semi-structured interviews conducted with managers, nurses, midwives, medical secretaries, and physicians at a department of Gynecology and Obstetrics in Denmark who successfully cut costs through staff and bed reductions and, from what we can ascertain, maintained care quality...
January 31, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28135804/the-interaction-between-equipoise-and-logistics-in-clinical-trials-a-case-study
#19
Meredith G Warshaw, Vincent J Carey, Elizabeth J McFarland, Liza Dawson, Elaine Abrams, Ann Melvin, Lee Fairlie, Hans Spiegel, Jonathan Jay, Allison L Agwu
INTRODUCTION: Equipoise is usually discussed as an ethical issue in clinical trials. However, it also has practical implications. BACKGROUND: Clinical equipoise is usually construed to mean uncertainty or disagreement among the expert clinician community. However, an individual physician's sense of equipoise may vary by location, based on the local standard of care or availability of specific treatment options, and these differences can affect providers' willingness to enroll participants into clinical trials...
January 1, 2017: Clinical Trials: Journal of the Society for Clinical Trials
https://www.readbyqxmd.com/read/28118869/telemedicine-applications-in-sleep-disordered-breathing-thinking-out-of-the-box
#20
REVIEW
Johan Verbraecken
Telemedicine as a means of remote patient-physician interaction is growing and virtual consultations with sleep specialists are feasible. Potential benefits of telemedicine include improved access to health care, reduced waiting time for appointments, and increased adherence to treatment plans. Telematic communications and new information technologies could also be useful to establish diagnostic and therapeutic strategies. It is important to install cost-efficient technologies for an initial simple diagnosis, rapid treatment initiation and for long-term monitoring of treatment adherence and compliance...
December 2016: Sleep Medicine Clinics
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