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Primary care integration

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https://www.readbyqxmd.com/read/27913873/impact-of-intensity-and-timing-of-integrated-home-palliative-cancer-care-on-end-of-life-hospitalization-in-northern-italy
#1
M Pellizzari, D Hui, E Pinato, M Lisiero, S Serpentini, L Gubian, F Figoli, M Cancian, C De Chirico, E Ferroni, F Avossa, M Saugo
PURPOSE: The Veneto Region implemented a novel integrated home-based palliative cancer care (HPCC) program embedded in primary care. We examined the impact of timing and intensity of this program on the quality of end-of-life (EOL) care. METHODS: We selected adult cancer patients died in the Veneto Region between March and December 2013, excluding those died from haematological malignancies as well as the very elderly (85+ years). We retrieved the claim-based data on hospitalization and homecare visits, and defined two observation windows: 90 to 16 days before death to examine intensity of HPCC exposure, and the last 15 days of life to examine EOL outcomes, including hospital death, any hospital stay for medical reasons and hospital stay ≥7 days for medical reasons...
December 2, 2016: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/27911972/integrating-behavioral-health-into-pediatric-primary-care-implications-for-provider-time-and-cost
#2
Natasha Gouge, Jodi Polaha, Rachel Rogers, Amy Harden
OBJECTIVES: Integrating a behavioral health consultant (BHC) into primary care is associated with improved patient outcomes, fewer medical visits, and increased provider satisfaction; however, few studies have evaluated the feasibility of this model from an operations perspective. Specifically, time and cost have been identified as barriers to implementation. Our study aimed to examine time spent, patient volume, and revenue generated during days when the on-site BHC was available compared with days when the consultant was not...
December 2016: Southern Medical Journal
https://www.readbyqxmd.com/read/27911918/statin-use-and-self-reported-hindering-muscle-complaints-in-older-persons-a-population-based-study
#3
Milly A van der Ploeg, Rosalinde K E Poortvliet, Sophie C E van Blijswijk, Wendy P J den Elzen, Petra G van Peet, Wouter de Ruijter, Jeanet W Blom, Jacobijn Gussekloo
PURPOSE: Statins are widely used by older persons in primary and secondary prevention of cardiovascular disease. Although serious adverse events are rare, many statin users report mild muscle pain and/or muscle weakness. It's unclear what impact statins exert on a patient's daily life. Research on statin related side effects in older persons is relatively scarce. We therefore investigated the relation between statin use and self-reported hindering muscle complaints in older persons in the general population...
2016: PloS One
https://www.readbyqxmd.com/read/27909877/association-between-mental-health-staffing-level-and-primary-care-mental-health-integration-level-on-provision-of-depression-care-in-veteran-s-affairs-medical-facilities
#4
Denise C Cooper, Christian D Helfrich, Stephen M Thielke, Ranak B Trivedi, Karin M Nelson, Gayle E Reiber, Evercita C Eugenio, Kristine Beaver, Julie Nugent-Carney, Vincent S Fan
We examined the association of mental health staffing and the utilization of primary care/mental health integration (PCMHI) with facility-level variations in adequacy of psychotherapy and antidepressants received by Veterans with new, recurrent, and chronic depression. Greater likelihood of adequate psychotherapy was associated with increased (1) PCMHI utilization by recurrent depression patients (AOR 1.02; 95% CI 1.00, 1.03); and (2) staffing for recurrent (AOR 1.03; 95% CI 1.01, 1.06) and chronic (AOR 1.02; 95% CI 1...
December 1, 2016: Administration and Policy in Mental Health
https://www.readbyqxmd.com/read/27904302/the-missing-link-evolving-accessibility-to-formulary-related-information
#5
Alison Van Rossum, Megan Holsopple, Julie Karpinski, Jordan Dow
BACKGROUND: Formulary management is a key component to ensuring the safe, effective, and fiscally responsible use of medications for health systems. One challenge in the formulary management process is making the most relevant formulary information easily accessible to practitioners involved in medication therapy decisions at the point of care. In September 2014, Froedtert and the Medical College of Wisconsin (F&MCW) implemented a commercial formulary management tool (CFMT) to improve accessibility to the recently aligned health-system formulary...
November 2016: P & T: a Peer-reviewed Journal for Formulary Management
https://www.readbyqxmd.com/read/27904177/a-clinicopathological-analysis-of-primary-cutaneous-lymphomas-a-6-year-observational-study-at-a-tertiary-care-center-of-south-india
#6
Anza Khader, Shiny Padinjarayil Manakkad, Mohammed Shaan, Sarita Sasidharan Pillai, Najeeba Riyaz, P Binitha Manikoth, Muhammed Kunnummel, Sunitha Balakrishnan
BACKGROUND: Little data are available concerning clinical and pathological patterns of cutaneous lymphomas in India. AIM: To analyze the clinical and histopathological characteristics of cutaneous lymphomas in Indian patients. MATERIALS AND METHODS: This is a single-center, prospective, observational study carried out from January 1, 2010, to December 31, 2015. The patients underwent clinical examination, human T-cell lymphotropic virus-1 (HTLV-1) screening, skin biopsy with hematoxylin and eosin and immunohistochemistry staining...
November 2016: Indian Journal of Dermatology
https://www.readbyqxmd.com/read/27903790/association-between-health-related-beliefs-and-oral-health-behaviors-among-uninsured-primary-care-patients
#7
Akiko Kamimura, Bethany Gull, Shannon Weaver, Lindsey Wright, Jeanie Ashby, Lea E Erickson
INTRODUCTION: The collaborations between dental care providers and other health care providers are especially needed for underserved populations. There is a deficit of research focused on underserved populations who utilize a safety net facility such as a free clinic in the United States. The purpose of this study is to examine the association between health-related beliefs and oral health behaviors among uninsured adults utilizing a primary care free clinic providing oral health care...
November 29, 2016: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/27903282/start-now-a-comprehensive-skills-training-programme-for-female-adolescents-with-oppositional-defiant-and-conduct-disorders-study-protocol-for-a-cluster-randomised-controlled-trial
#8
Linda Kersten, Martin Prätzlich, Sandra Mannstadt, Katharina Ackermann, Gregor Kohls, Helena Oldenhof, Daniel Saure, Katrin Krieger, Beate Herpertz-Dahlmann, Arne Popma, Christine M Freitag, Robert L Trestman, Christina Stadler
BACKGROUND: In Europe, the number of females exhibiting oppositional defiant disorder (ODD) and conduct disorder (CD) is growing. Many of these females live in youth welfare institutions. Consequently, there is a great need for evidence-based interventions within youth welfare settings. A recently developed approach targeting the specific needs of girls with ODD and CD in residential care is START NOW. The aim of this group-based behavioural skills training programme is to specifically enhance emotional regulation capacities to enable females with CD or ODD to appropriately deal with daily-life demands...
December 1, 2016: Trials
https://www.readbyqxmd.com/read/27903263/estimating-the-accuracy-of-muscle-response-testing-two-randomised-order-blinded-studies
#9
Anne M Jensen, Richard J Stevens, Amanda J Burls
BACKGROUND: Manual muscle testing (MMT) is a non-invasive assessment tool used by a variety of health care providers to evaluate neuromusculoskeletal integrity, and muscular strength in particular. In one form of MMT called muscle response testing (MRT), muscles are said to be tested, not to evaluate muscular strength, but neural control. One established, but insufficiently validated, application of MRT is to assess a patient's response to semantic stimuli (e.g. spoken lies) during a therapy session...
November 30, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27903142/systematic-literature-review-of-general-health-care-interventions-within-programs-of-assertive-community-treatment
#10
Erik R Vanderlip, Benjamin F Henwood, Debra R Hrouda, Piper S Meyer, Maria Monroe-DeVita, Lynette M Studer, April J Schweikhard, Lorna L Moser
OBJECTIVE: Assertive community treatment (ACT) is one of the few evidence-based practices for adults with severe mental illness. Interest has slowly waned for ACT implementation. Yet ACT remains an appealing services platform to achieve the triple aim of health care reform (improved health outcomes, reduced cost, and improved satisfaction) through integration of primary care and behavioral health services. This review highlights the evidence for ACT to improve general medical outcomes, reduce treatment costs, and increase access to treatment...
December 1, 2016: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/27902919/geographic-distribution-of-point-in-time-access-to-subsidised-dental-services-in-western-australia
#11
Yevgeni Dudko, Estie Kruger, Marc Tennant
Dental Health Services (DHS) is the largest public primary oral healthcare provider in WA. The objective of this study was to calculate probable distance patients are expected to travel to the nearest clinic, gauge utilisation rates and predict the direction of likely changes in future demand for subsidised dental care. Eligible population data was collected from the Department of Human Services and the Australian Bureau of Statistics websites and integrated with the waiting list and the recall list data provided by the DHS...
December 1, 2016: Australian Journal of Primary Health
https://www.readbyqxmd.com/read/27902549/integration-of-medical-scribes-in-the-primary-care-setting-improving-satisfaction
#12
Brian H Imdieke, Marc L Martel
There are little published data on the use of medical scribes in the primary care setting. We assessed the feasibility of incorporating medical scribes in our ambulatory clinic to support provider documentation in the electronic medical record. In our convenience sampling of patient, provider, and staff perceptions of scribes, we found that patients were comfortable having scribes in the clinic. Overall indicators of patient satisfaction were slightly decreased. Providers found scribe support to be valuable and overall clinician documentation time was reduced by more than 50% using scribes...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27899153/can-integrated-health-services-delivery-have-an-impact-on-hypertension-management-a-cross-sectional-study-in-two-cities-of-china
#13
Haitao Li, Ying Sun, Dongfu Qian
BACKGROUND: Policy makers require information regarding performance of different primary care delivery models in managing hypertension, which can be helpful for better hypertension management. This study aims to compare continuity of care among hypertensive patients between Direct Management (DM) Model of community health centers (CHCs) in Wuhan and Loose Collaboration (LC) Model in Nanjing. METHODS: A cross-sectional questionnaire survey was conducted. Four CHCs in each city were randomly selected as study settings...
November 30, 2016: International Journal for Equity in Health
https://www.readbyqxmd.com/read/27897406/integrated-care-for-geriatric-frailty-and-sarcopenia-a-randomized-control-trial
#14
Ding-Cheng Derrick Chan, Hsiao-Hui Tsou, Chirn-Bin Chang, Rong-Sen Yang, Jau-Yih Tsauo, Ching-Yu Chen, Chin-Fu Hsiao, Ya-Ting Hsu, Chia-Hui Chen, Shu-Fang Chang, Chao Agnes Hsiung, Ken N Kuo
BACKGROUND: Exercise, nutrition, and psychological interventions may all have positive impacts on frailty and sarcopenia. However, it is not known whether an integrated care programme with all three components can be beneficial and the intensity of such programme is also not certain. In this study, we aim to determine the effectiveness of two levels of integrated care on frailty and sarcopenia. METHODS: A randomized control trial was conducted at two community hospitals in Taiwan...
August 26, 2016: Journal of Cachexia, Sarcopenia and Muscle
https://www.readbyqxmd.com/read/27896797/a-telephone-based-intervention-to-promote-physical-activity-during-smoking-cessation-a-randomized-controlled-proof-of-concept-study
#15
Uma S Nair, Freda Patterson, Daniel Rodriguez, Bradley N Collins
Smoking and physical inactivity contribute to disproportionate disease burden among underserved adults. Telephone-based interventions (quitlines) are becoming the standard care for addressing smoking. There is increasing interest to determine whether quitlines can be utilized to administer interventions for other unhealthy behaviors. This study aims to examine the proof-of-concept and potential efficacy of a telephone-based behavioral counseling intervention to boost daily low-to-moderate physical activity among low-income, physically inactive smokers...
November 28, 2016: Translational Behavioral Medicine
https://www.readbyqxmd.com/read/27894466/relationships-between-adult-emotional-states-and-indicators-of-health-care-utilization-findings-from-the-national-health-interview-survey-2006-2014
#16
Judith D Weissman, David Russell, Jeannette Beasley, Melanie Jay, Dolores Malaspina
OBJECTIVE: Adults with serious psychological distress have a high likelihood of mental health problems severe enough to cause serious impairment in social and occupational functioning requiring treatment. These adults visit doctors frequently yet have poor health compared to adults without serious psychological distress. This study examined associations between emotional states of serious psychological distress in relationship to healthcare utilization indicators. A guiding hypothesis was that somatization underlying emotional states contributes to excessive healthcare seeking among adults with serious psychological distress...
December 2016: Journal of Psychosomatic Research
https://www.readbyqxmd.com/read/27894227/multidisciplinary-teams-involved-detection-of-drug-related-problems-through-continuity-of-care
#17
Elena Yaiza Romero-Ventosa, Marisol Samartín-Ucha, Alicia Martín-Vila, María Lucía Martínez-Sánchez, Isabel Rey Gómez-Serranillos, Guadalupe Pineiro-Corrales
OBJECTIVE: To quantify Drug-Related problems (DRPs) by establishing a Strategic Continuity of Care Program (e-Conecta- Concilia Program; e-CC) focused on the drug therapy of patients within an Integrated Management Structure, in order to guarantee the therapeutical efficiency, safety and traceability of patients. METHOD: A prospective study at 8 months. The project included 22 Hospital Pharmacists and 12 Primary Care Pharmacists. Electronic clinical records were used, which can be accessed by all healthcare levels...
November 1, 2016: Farmacia Hospitalaria
https://www.readbyqxmd.com/read/27893953/leveraging-telehealth-to-bring-volunteer-physicians-into-underserved-communities
#18
Lori Uscher-Pines, Robert Rudin, Ateev Mehrotra
Many disadvantaged communities lack sufficient numbers of local primary care and specialty physicians. Yet tens of thousands of physicians, in particular those who are retired or semiretired, desire meaningful volunteer opportunities. Multiple programs have begun to use telehealth to bridge the gap between volunteer physicians and underserved patients. In this brief, we describe programs that are using this model and discuss the promise and pitfalls. Physician volunteers in these programs report that the work can be fulfilling and exciting, a cutting-edge yet convenient way to remain engaged and contribute...
November 28, 2016: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/27893947/challenges-in-the-uptake-of-telemedicine-in-dentistry
#19
Mohamed Estai, Estie Kruger, Marc Tennant, Stuart Bunt, Yogesan Kanagasingam
With the availability of oral care services very unevenly distributed in rural or remote areas, underserved people seek oral care from non-dental care providers. Against this backdrop, and coupled with the decreasing cost of and innovations in technology, there is a growing interest in the adoption of telemedicine services. Regardless of the lack of good-quality evidence supporting the cost-effectiveness of telemedicine, evidence already indicates that telemedicine, even with extra costs, helps in reducing the inequalities in the provision of primary health care...
October 2016: Rural and Remote Health
https://www.readbyqxmd.com/read/27893519/effects-of-hospital-systems-on-medical-home-transformation-in-primary-care-residency-training-practices
#20
Kyle Knierim, Tristen Hall, Douglas Fernald, Thomas J Staff, Emilie Buscaj, Jessica Cornett Allen, Mary Onysko, W Perry Dickinson
Most primary care residency training practices have close financial and administrative relationships with teaching hospitals and health systems. Many residency practices have begun integrating the core principles of the patient-centered medical home (PCMH) into clinical workflows and educational experiences. Little is known about how the relationships with hospitals and health systems affect these transformation efforts. Data from the Colorado Residency PCMH Project were analyzed. Results show that teaching hospitals and health systems have significant opportunities to influence residency practices' transformation, particularly in the areas of supporting team-based care, value-based payment reforms, and health information technology...
November 23, 2016: Journal of Ambulatory Care Management
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