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https://www.readbyqxmd.com/read/28817294/heterogeneity-of-nonadherent-buprenorphine-patients-subgroup-characteristics-and-outcomes
#1
Charles Ruetsch, Joseph Tkacz, Vijay R Nadipelli, Brenna L Brady, Naoko Ronquest, Hyong Un, Joseph Volpicelli
OBJECTIVES: To examine patient characteristics and outcomes associated with nonadherence to buprenorphine and to identify specific patterns of nonadherent behavior. STUDY DESIGN: Cross-sectional, retrospective analysis of health claims data. METHODS: Aetna's administrative claims data were used to categorize incident opioid use disorder (OUD) patients based on buprenorphine medication possession ratio (MPR) into adherent (n = 172) and nonadherent (n = 305) groups...
June 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28815325/stumbling-blocks-at-the-clinic-experiences-of-seeking-hiv-treatment-and-care-in-south-africa
#2
Brendan Maughan-Brown, Caroline Kuo, Omar Galárraga, Philip Smith, Mark N Lurie, Linda-Gail Bekker, Abigail Harrison
Prompt antiretroviral therapy (ART) initiation maximises the therapeutic and prevention benefits of a treat-all strategy for HIV therapy. Using in-depth semi-structured interviews with men and women 18 years and older (N = 41), who were highly motivated and seeking treatment, this study examined salient factors that were associated with delays in treatment access and initiation. Results revealed clinic-related barriers including an onerous, inefficient multi-step process to initiate ART. Participants experienced additional delays due to difficulties accessing care (e...
August 16, 2017: AIDS and Behavior
https://www.readbyqxmd.com/read/28812979/truth-in-research-labelling
#3
John H Noble
This report describes the background and context of a currently circulating petition to the US Congress that seeks amendment of Section 801 of the Public Health Services Act (42 U.S.C. 282) to close a loophole in existing law which makes possible post hoc adjustment of randomised controlled trial (RCT) results reported to the Food and Drug Administration that differ from those reported to ClinicalTrials.gov and to medical journals. The report describes the petition's rationale, underlying assumptions, and support for its proposed remedy in deontological, consequentialist, and casuist philosophical ethics theories...
July 2017: Indian Journal of Medical Ethics
https://www.readbyqxmd.com/read/28812815/stakeholders-perspectives-on-the-success-drivers-in-ghana-s-national-health-insurance-scheme-identifying-policy-translation-issues
#4
Adam Fusheini, Gordon Marnoch, Ann Marie Gray
BACKGROUND: Ghana's National Health Insurance Scheme (NHIS), established by an Act of Parliament (Act 650), in 2003 and since replaced by Act 852 of 2012 remains, in African terms, unprecedented in terms of growth and coverage. As a result, the scheme has received praise for its associated legal reforms, clinical audit mechanisms and for serving as a hub for knowledge sharing and learning within the context of South-South cooperation. The scheme continues to shape national health insurance thinking in Africa...
October 1, 2016: International Journal of Health Policy and Management
https://www.readbyqxmd.com/read/28810267/incidence-of-discomfort-during-pure-tone-audiometry-and-measurement-of-uncomfortable-loudness-levels-among-people-seeking-help-for-tinnitus-and-or-hyperacusis
#5
Hashir Aazh, Brian C J Moore
Purpose: The aim of this study was to assess the proportion of patients seen in a tinnitus and hyperacusis therapy clinic for whom presentation levels based on the British Society of Audiology (BSA)-recommended procedures for pure-tone audiometry and determination of uncomfortable loudness levels (ULLs) exceed ULLs, leading to discomfort during administration of these procedures. Method: This was a retrospective cross-sectional study of 362 consecutive patients who attended a National Health Service audiology clinic for tinnitus and/or hyperacusis rehabilitation...
August 15, 2017: American Journal of Audiology
https://www.readbyqxmd.com/read/28810128/the-association-of-mental-health-program-characteristics-and-patient-satisfaction
#6
Austin B Frakt, Jodie Trafton, Steven D Pizer
OBJECTIVES: Satisfaction with care is an important patient-centered domain of health system quality. However, satisfaction measures are costly to collect and not directly modifiable. Therefore, we assessed the relationships between veterans' satisfaction and measures of modifiable aspects of Veterans Health Administration (VHA) mental health care programs. STUDY DESIGN: For a sample of 6990 patients who received mental health care from the VHA in 2013, we used survey and administrative data to investigate the association of a suite of access and encounter satisfaction measures with a large collection of measures of program characteristics...
May 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28808856/validation-of-veterans-affairs-electronic-medical-record-smoking-data-among-iraq-and-afghanistan-era-veterans
#7
Patrick S Calhoun, Sarah M Wilson, Jeffrey S Hertzberg, Angela C Kirby, Scott D McDonald, Paul A Dennis, Lori A Bastian, Eric A Dedert, Jean C Beckham
BACKGROUND: Research using the Veterans Health Administration (VA) electronic medical records (EMR) has been limited by a lack of reliable smoking data. OBJECTIVE: To evaluate the validity of using VA EMR "Health Factors" data to determine smoking status among veterans with recent military service. DESIGN: Sensitivity, specificity, area under the receiver-operating curve (AUC), and kappa statistics were used to evaluate concordance between VA EMR smoking status and criterion smoking status...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28807634/-severity-assessment-strategies-based-on-administrative-data-using-stroke-as-an-example
#8
Ingrid Schubert, Antje Hammer, Ingrid Köster
BACKGROUND AND OBJECTIVES: Information on disease severity is relevant for many studies with claims data in health service research, but only limited information is available in routine data. Stroke serves as an example, to analyse whether the combination of different information in claims data can provide insight into the severity of a disease. METHOD: As a first step, a literature search was conducted. Strategies to assess the severity of a disease by means of routine data were examined with regards and applicability to German sickness fund data...
August 11, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28806374/long-acting-reversible-contraception-among-homeless-women-veterans-with-chronic-health-conditions-a-retrospective-cohort-study
#9
Lori M Gawron, Andrew Redd, Ying Suo, Warren Pettey, David K Turok, Adi V Gundlapalli
BACKGROUND: US women Veterans are at increased risk of homelessness and chronic health conditions associated with unintended pregnancy. Veterans Health Administration (VHA) provision of long-acting reversible contraception (LARC) can assist in healthy pregnancy planning. OBJECTIVES: To evaluate perinatal risk factors and LARC exposure in ever-homeless women Veterans. RESEARCH DESIGN: A retrospective cohort study of women Veterans using VHA administrative data from fiscal years 2002-2015...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806373/patient-aligned-care-team-engagement-to-connect-veterans-experiencing-homelessness-with-appropriate-health-care
#10
Adi V Gundlapalli, Andrew Redd, Daniel Bolton, Megan E Vanneman, Marjorie E Carter, Erin Johnson, Matthew H Samore, Jamison D Fargo, Thomas P O'Toole
BACKGROUND: Veterans experiencing homelessness frequently use emergency and urgent care (ED). OBJECTIVE: To examine the effect of a Patient-aligned Care Team (PACT) model tailored to the unique needs of Veterans experiencing homelessness (H-PACT) on frequency and type of ED visits in Veterans Health Administration (VHA) medical facilities. RESEARCH DESIGN: During a 12-month period, ED visits for 3981 homeless Veterans enrolled in (1) H-PACT at 20 VHA medical centers (enrolled) were compared with those of (2) 24,363 homeless Veterans not enrolled in H-PACT at the same sites (nonenrolled), and (3) 23,542 homeless Veterans at 12 non-H-PACT sites (usual care) using a difference-in-differences approach...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806368/increased-health-care-utilization-and-costs-among-veterans-with-a-positive-screen-for-military-sexual-trauma
#11
Emily Brignone, Adi V Gundlapalli, Rebecca K Blais, Rachel Kimerling, Tyson S Barrett, Richard E Nelson, Marjorie E Carter, Matthew H Samore, Jamison D Fargo
BACKGROUND: The effects of sexual trauma on long-term health care utilization and costs are not well understood due to infrequent documentation of sexual trauma history in health care systems. The Veteran's Health Administration provides a unique opportunity to address this constraint as sexual trauma is actively screened for as part of routine care. METHODS: We used a retrospective cohort design to analyze Veteran's Health Administration mental health and medical service utilization and costs as a function of a positive screen for exposure to military sexual trauma (MST) among Veterans of recent conflicts in Iraq and Afghanistan...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806364/racial-and-ethnic-variation-in-perceptions-of-va-mental-health-providers-are-associated-with-treatment-retention-among-veterans-with-ptsd
#12
Michele Spoont, David Nelson, Michelle van Ryn, Margarita Alegria
BACKGROUND: Veterans with posttraumatic stress disorder (PTSD) who seek mental health care in the Veterans Health Administration frequently discontinue treatment prematurely. Early discontinuation of mental health treatment is more common among Veterans with PTSD who are of minority race or ethnicity. OBJECTIVES: To determine whether retention in individual therapy or pharmacotherapy among Veterans with PTSD are associated with patients' ratings of their mental health providers, and if those associations differ depending on Veteran race or ethnicity...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806363/clinical-epidemiology-of-single-versus-multiple-substance-use-disorders-polysubstance-use-disorder
#13
Ish P Bhalla, Elina A Stefanovics, Robert A Rosenheck
OBJECTIVE: While research on substance abuse has largely focused on people who have a single substance use disorder (SUD), many people abuse multiple substances. Studies have yet to examine the distinctive characteristics of patients diagnosed with more than 1 SUD and how those with polysubstance use disorder (PSUD) differ from those with a single SUD. METHODS: National Veterans Health Administration data from fiscal year 2012 were used to compare veterans diagnosed 1 SUD to veterans diagnosed with 2-3, and >3 SUDs on demographic characteristics, psychiatric and medical diagnoses, medical and psychiatric service utilization, and psychotropic medication fills...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28806361/health-disparities-in-veterans-a-map-of-the-evidence
#14
Karli Kondo, Allison Low, Teresa Everson, Christine D Gordon, Stephanie Veazie, Crystal C Lozier, Michele Freeman, Makalapua Motu'apuaka, Aaron Mendelson, Mark Friesen, Robin Paynter, Caroline Friesen, Johanna Anderson, Erin Boundy, Somnath Saha, Ana Quiñones, Devan Kansagara
BACKGROUND: Goals for improving the quality of care for all Veterans and eliminating health disparities are outlined in the Veterans Health Administration Blueprint for Excellence, but the degree to which disparities in utilization, health outcomes, and quality of care affect Veterans is not well understood. OBJECTIVES: To characterize the research on health care disparities in the Veterans Health Administration by means of a map of the evidence. RESEARCH DESIGN: We conducted a systematic search for research studies published from 2006 to February 2016 in MEDLINE and other data sources...
September 2017: Medical Care
https://www.readbyqxmd.com/read/28805423/patterns-of-psychiatric-emergency-department-utilization-among-community-dwelling-medicare-beneficiaries-under-65
#15
Jingjing Qian, Saranrat Wittayanukorn, Richard A Hansen
This study estimated patterns and trends in all-cause (any reason, including psychiatry related) and psychiatric emergency department (ED) utilization among Medicare beneficiaries under 65 who were residing in community settings (i.e., noninstitutionalized or in their own homes). Medicare beneficiaries under the age of 65 enrolled in Medicare for Social Security Disability Insurance (SSDI) due to permanent physical or mental disabilities are a population with poor health conditions and high utilization of health services; however, this vulnerable population has received limited attention from researchers and policymakers compared to the Medicare beneficiaries 65 years and older...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805411/rural-american-indian-and-alaska-native-veterans-telemental-health-a-model-of-culturally-centered-care
#16
Cynthia W Goss, W J Buck Richardson, Nancy Dailey, Byron Bair, Herbert Nagamoto, Spero M Manson, Jay H Shore
American Indian and Alaska Native (AI/AN) veterans living in rural areas have unique health care needs and face numerous barriers to accessing health care services. Among these needs is a disproportionate prevalence of posttraumatic stress disorder and other mental illnesses. Since 2001, 14 rural communities have partnered with the U.S. Department of Veterans Affairs and the Centers for American Indian and Alaska Native Health at the University of Colorado Anschutz Medical Campus to extend telemental health clinics to American Indian veterans...
August 2017: Psychological Services
https://www.readbyqxmd.com/read/28805178/socioeconomic-inequalities-in-duration-of-untreated-psychosis-evidence-from-administrative-data-in-england
#17
A Reichert, R Jacobs
BACKGROUND: Duration of untreated psychosis (DUP) is an important measure of access to care as it predicts prognosis and treatment outcomes. Little is known about potential socioeconomic inequalities in DUP. The aim of this study was to investigate inequalities in DUP associated with socioeconomic deprivation in a national cohort in England. METHOD: We analysed a cohort of 887 patients with a first-episode in psychosis using the administrative Mental Health Services Dataset in England for 2012/13-2014/15...
August 14, 2017: Psychological Medicine
https://www.readbyqxmd.com/read/28800054/end-user-and-implementer-experiences-of-mhealth-technologies-for-noncommunicable-chronic-disease-management-in-young-adults-a-qualitative-systematic-review-protocol
#18
Helen Slater, Andrew Briggs, Jennifer Stinson, Jared M Campbell
The objective of this review is to systematically identify, review and synthesize relevant qualitative research on end user and implementer experiences of mobile health (mHealth) technologies developed for noncommunicable chronic disease management in young adults. "End users" are defined as young people aged 15-24 years, and "implementers" are defined as health service providers, clinicians, policy makers and administrators.The two key questions we wish to systematically explore from identified relevant qualitative studies or studies with qualitative components are...
August 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28799430/genesis-of-an-employee-wellness-program-at-a-large-university
#19
Lisa K Lloyd, Sylvia H Crixell, Janet R Bezner, Katherine Forester, Carolyn Swearingen
University employee wellness programs have potential to support positive changes in employee health, thereby improving productivity and mitigating the rise in health care costs. The purpose of this article is to describe a theory-driven approach to systematically planning, developing, and implementing a comprehensive university employee wellness program. Long-term program goals were to improve employee health, well-being, and productivity by focusing on decreasing sedentary behavior, increasing physical activity, improving dietary habits, and reducing stress...
August 1, 2017: Health Promotion Practice
https://www.readbyqxmd.com/read/28796596/design-and-operation-of-the-national-survey-of-children-s-health-2011-2012
#20
Matthew D Bramlett, Stephen J Blumberg, Benjamin Zablotsky, Jacquelyn M George, A Elizabeth Ormson, Alicia M Frasier, Danielle M Vstecka, Kim L Williams, Benjamin J Skalland, Heather M Morrison, Kathleen B Santos, Steven Pedlow, Fang Wang
Objectives This report presents the development, plan, and operation of the 2011-2012 National Survey of Children's Health, a module of the State and Local Area Integrated Telephone Survey, conducted by the National Center for Health Statistics. Funding was provided by the Maternal and Child Health Bureau, Health Resources and Services Administration. The survey was designed to produce national and state prevalence estimates of the physical and emotional health of children aged 0-17 years, as well as factors that may relate to child well-being including medical homes, family interactions, parental health, school and after-school experiences, and neighborhood characteristics...
July 2017: Vital and Health Statistics. Ser. 1, Programs and Collection Procedures
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