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https://www.readbyqxmd.com/read/29154919/patient-reported-outcomes-and-opioid-use-by-outpatient-cancer-patients
#1
N Moryl, V Dave, P Glare, A Bokhari, V T Malhotra, A Gulati, J Hung, V Puttanniah, Y Griffo, R Tickoo, A Wiesenthal, S D Horn, C E Inturrisi
The Memorial Sloan-Kettering Pain Registry contains patient characteristics, treatments, and outcomes for a prospective cohort of 1534 chronic pain cancer patients who were seen at outpatient pain service clinics. Average pain intensity (Brief Pain Inventory) was reported as mild by 24.6% of patients, moderate by 41.5%, and severe by 33.9%. The patient's report of average percent pain relief and health state (EQ-5D) was inversely related to average pain intensity category, while measures of pain interference, number of worst pain locations, and physical and psychological distress were directly related to pain intensity category...
November 14, 2017: Journal of Pain: Official Journal of the American Pain Society
https://www.readbyqxmd.com/read/29154724/understanding-how-a-palliative-specific-patient-reported-outcome-intervention-works-to-facilitate-patient-centred-care-in-advanced-heart-failure-a-qualitative-study
#2
Pauline M Kane, Clare I Ellis-Smith, Barbara A Daveson, Karen Ryan, Niall G Mahon, Brendan McAdam, Regina McQuillan, Cecelia Tracey, Christine Howley, Geraldine O'Gara, Caroline Raleigh, Irene J Higginson, Fliss Em Murtagh, Jonathan Koffman
BACKGROUND: Palliative care needs of patients with chronic heart failure are poorly recognised. Policy makers advise a patient-centred approach to holistically assess patients' needs and care goals. Patient-reported outcome measures are proposed to facilitate patient-centred care. AIM: To explore whether and how a palliative care-specific patient-reported outcome intervention involving the Integrated Palliative care Outcome Scale influences patients' experience of patient-centred care in nurse-led chronic heart failure disease management clinics...
November 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/29154443/long-term-outcomes-of-patients-with-type-2-diabetes-attending-a-multidisciplinary-diabetes-kidney-disease-clinic
#3
Serena Low, Su Chi Lim, Jiexun Wang, Lee Ying Yeoh, Yan Lun Liu, Eng Kuang Lim, Yan Li Shao, Winnie Chui, Sharon Fun, Chin Lian Chua, Tavintharan Subramaniam, Chee Fang Sum
BACKGROUND: The best model of care to retard diabetic kidney disease (DKD) in the clinic is under-unexplored. We investigated the long-term renal outcomes of a joint endocrinologist-nephrologist clinic. METHODS: This was a nested case-control study derived from a cohort of patients with type 2 diabetes mellitus (T2DM) seen prospectively at a secondary care Diabetes Centre (DC). Cases ("DKD clinic group") are patients seen at the CKD clinic after being referred by physicians in DC for management of DKD...
November 20, 2017: Journal of Diabetes
https://www.readbyqxmd.com/read/29154064/living-with-chronic-pain-evaluating-patient-experiences-with-a-medical-group-visit-focused-on-mindfulness-and-non-pharmacological-strategies
#4
Anna Sophia Lestoquoy, Lance D Laird, Suzanne Mitchell, Katherine Gergen-Barnett, N Lily Negash, Kelly McCue, Racquel Enad, Paula Gardiner
OBJECTIVES: Little is known about the acceptance of non-pharmacological group strategies delivered to low income racially diverse patients with chronic pain and depression. This paper examines how the Integrative Medical Group Visit (IMGV) addresses many of the deficits identified with usual care. DESIGN AND SETTING: Six IMGVs cohorts were held at a safety net hospital and two federally funded community health centres. Data was gathered through focus groups. Transcripts were analysed using both a priori codes and inductive coding...
December 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/29153847/effect-of-incentive-payments-on-chronic-disease-management-and-health-services-use-in-british-columbia-canada-interrupted-time-series-analysis
#5
M Ruth Lavergne, Michael R Law, Sandra Peterson, Scott Garrison, Jeremiah Hurley, Lucy Cheng, Kimberlyn McGrail
We studied the effects of incentive payments to primary care physicians for the care of patients with diabetes, hypertension, and Chronic Obstructive Pulmonary Disease (COPD) in British Columbia, Canada. We used linked administrative health data to examine monthly primary care visits, continuity of care, laboratory testing, pharmaceutical dispensing, hospitalizations, and total h ealth care spending. We examined periods two years before and two years after each incentive was introduced, and used segmented regression to assess whether there were changes in level or trend of outcome measures across all eligible patients following incentive introduction, relative to pre-intervention periods...
November 10, 2017: Health Policy
https://www.readbyqxmd.com/read/29153758/will-use-of-patient-portals-help-to-educate-and-communicate-with-patients-with-diabetes
#6
Sara L Jackson, Catherine M DesRoches, Dominick L Frosch, Sue Peacock, Natalia V Oster, Joann G Elmore
OBJECTIVE: Chronic disease management can require daily attention, and increased levels of patient activation and engagement. We examined whether patients with diabetes perceive a greater benefit to having electronic access to their doctors' clinic notes compared to patients without diabetes. We hypothesized that easy electronic access to these notes may help patients with self-care by improving education and communication. METHODS: Survey of patients with and without diabetes in Massachusetts and Pennsylvania about perceptions of potential benefits and risks of reading their visit notes via an electronic patient information portal...
November 8, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/29153296/use-of-self-management-interventions-for-chronic-pain-management-a-comparison-between-rural-and-nonrural-residents
#7
Linda H Eaton, Dale J Langford, Alexa R Meins, Tessa Rue, David J Tauben, Ardith Z Doorenbos
Individuals with chronic pain who live in rural communities often lack access to pain specialists and rely on primary care providers who may be less prepared. Research has indicated that rural residents with chronic pain are more likely to receive an opioid prescription than nonrural residents. Although self-management approaches are available for chronic pain management, it is unclear to what extent rural residents use these interventions. This study compares usage of self-management interventions and opioid-based analgesics for chronic pain management between rural and nonrural residents...
November 15, 2017: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29152990/gastroduodenal-lesions-detected-during-small-bowel-capsule-endoscopy-incidence-diagnostic-and-therapeutic-impact
#8
José Francisco Juanmartiñena Fernández, Ignacio Fernández-Urien Sainz, Beatriz Zabalza Ollo, Cristina Saldaña Dueñas, Marta Montañés Guimera, Alfonso Elosua González, Juan José Vila Costas
BACKGROUND: Capsule endoscopy was primarily designed for the investigation of the small bowel. However, it may also identify lesions in other segments of the gastrointestinal tract. The aim of the current study was to evaluate the incidence of gastroduodenal abnormalities during small bowel capsule endoscopy and its impact on patient diagnosis and management. PATIENTS AND METHODS: This study is a retrospective analysis of data from 2,217 consecutive capsule endoscopy procedures performed at a single tertiary-care center between January 2008 and February 2016...
November 20, 2017: Revista Española de Enfermedades Digestivas
https://www.readbyqxmd.com/read/29152261/copd-management-as-a-model-for-all-chronic-respiratory-conditions-report-of-the-4-th-consensus-conference-in-respiratory-medicine
#9
Stefano Nardini, Fernando De Benedetto, Claudio M Sanguinetti, Salvatore Bellofiore, Stefano Carlone, Salvatore Privitera, Luciano Sagliocca, Emmanuele Tupputi, Claudio Baccarani, Gennaro Caiffa, Maria Consiglia Calabrese, Antonio Capuozzo, Salvatore Cauchi, Valentina Conio, Giuseppe Coratella, Franco Crismancich, Roberto W Dal Negro, Franco Dellarole, Maurizio Delucchi, Carlo Favaretti, Silvia Forte, Franca Matilde Gallo, Riccardo Giuliano, Marco Grandi, Antonino Grillo, Maria Rosaria Gualano, Enrico Guffanti, Salvatore Locicero, Francesco Paolo Lombardo, Marco Mantero, Roberto Marasso, Laura Martino, Michele Mastroberardino, Carlo Mereu, Roberto Messina, Margherita Neri, Bruno Franco Novelletto, Paolo Parente, Sergio Pasquinucci, Massimo Pistolesi, Mario Polverino, Agnese Posca, Luca Richeldi, Fernando Roccia, Ettore Saffi Giustini, Michelangelo Salemi, Salvatore Santacroce, Mario Schisano, Matteo Schisano, Eleonora Selvi, Andrea Silenzi, Patrizio Soverina, Claudio Taranto, Marta Ugolini, Piero Visaggi, Alessandro Zanasi
Background: Non-communicable diseases (NCDs) kill 40 million people each year. The management of chronic respiratory NCDs such as chronic obstructive pulmonary disease (COPD) is particularly critical in Italy, where they are widespread and represent a heavy burden on healthcare resources. It is thus important to redefine the role and responsibility of respiratory specialists and their scientific societies, together with that of the whole healthcare system, in order to create a sustainable management of COPD, which could become a model for other chronic respiratory conditions...
2017: Multidisciplinary Respiratory Medicine
https://www.readbyqxmd.com/read/29151719/reducing-social-distress-for-chronic-disease-patients-in-primary-care-an-intervention-for-latino-type-2-diabetes-patients-seen-at-community-health-centers
#10
Nancy A Allen, Sofija Zagarins, Garry Welch
Background: Social and behavioral factors have important direct and indirect effects on chronic disease onset and progression. The U.S. health care system is beginning to focus on assessment and management of social and behavioral problems through federal mandates related to meaningful use of electronic health records and improved patient outcomes. Methods: We examined the clinical adoption of a 20-item screening tool to measure social distress focusing on type 2 diabetes...
November 2017: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29151384/endoscopic-ear-surgery-in-the-ear-camp-setting-forward-thinking-or-folly
#11
M P A Clark
BACKGROUND: Endoscopic ear surgery is becoming an accepted technique in otological surgery, in the management of chronic otitis media. METHODS: The technique was introduced to the humanitarian care setting of an ear camp in Nepal to consider the appropriateness of the technique in this type of clinical setting. RESULTS: Fifteen cases of myringoplasty were successfully completed. CONCLUSION: The apparent advantages of the endoscopic approach over the traditional microscopic one were the ease of transporting the equipment and the optimal view obtained of the tympanic membrane...
November 20, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29149912/trial-to-incentivise-adherence-for-diabetes-triad-study-protocol-for-a-randomised-controlled-trial
#12
Marcel Bilger, Mitesh Shah, Ngiap Chuan Tan, Kaye Louise Howard, Hui Yan Xu, Ecosse Luc Lamoureux, Eric Andrew Finkelstein
BACKGROUND: Many people with diabetes have suboptimal glycaemic control due to not being adherent to their treatment regimen. Behavioural economic theory suggests that the lack of adherence results from the disconnect between the timing of when costs and benefits accrue. One strategy to address this discontinuity is to offer patients a near-term benefit, such as a financial reward. Whereas there is evidence that rewards can improve treatment adherence and sometimes health outcomes, further research is needed to determine whether rewards are more effective when targeting processes or intermediary health outcomes...
November 17, 2017: Trials
https://www.readbyqxmd.com/read/29149877/key-bottlenecks-to-the-provision-of-safe-obstetric-anaesthesia-in-low-income-countries-a-cross-sectional-survey-of-64-hospitals-in-uganda
#13
Isabella Epiu, Agnes Wabule, Andrew Kambugu, Harriet Mayanja-Kizza, Jossy Verel Bahe Tindimwebwa, Gerald Dubowitz
BACKGROUND: Despite recent advances in surgery and anaesthesia which significantly improve safety, many health facilities in low-and middle-income countries (LMICs) remain chronically under-resourced with inability to cope effectively with serious obstetric complications (Knight et al., PLoS One 8:e63846, 2013). As a result many of these countries still have unacceptably high maternal and neonatal mortality rates. Recent data at the national referral hospitals in East Africa reported that none of the national referral hospitals met the World Federation of Societies of Anesthesiologists (WFSA) international standards required to provide safe obstetric anaesthesia (Epiu I: Challenges of Anesthesia in Low-and Middle-Income Countries...
November 17, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29149237/multimorbidity-among-persons-living-with-hiv-in-the-u-s
#14
Cherise Wong, Stephen J Gange, Richard D Moore, Amy C Justice, Kate Buchacz, Alison G Abraham, Peter F Rebeiro, John R Koethe, Jeffrey N Martin, Michael A Horberg, Cynthia M Boyd, Mari M Kitahata, Heidi M Crane, Kelly A Gebo, M John Gill, Michael J Silverberg, Frank J Palella, Pragna Patel, Hasina Samji, Jennifer Thorne, Charles S Rabkin, Angel Mayor, Keri N Althoff
Background: Age-associated conditions are increasingly common among persons living with HIV. A longitudinal investigation of their accrual is needed given their implications on clinical care complexity. We examined trends in the co-occurrence of age-associated conditions among persons living with HIV receiving clinical care, and differences in their prevalence by demographic subgroup. Methods: This cohort study was nested within the North American AIDS Cohort Collaboration on Research and Design...
November 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29149155/lower-cutoffs-for-lc-ms-ms-urine-drug-testing-indicates-better-patient-compliance
#15
Kevin Krock, Amadeo Pesce, Dennis Ritz, Richard Thomas, Agnes Cua, Ryan Rogers, Phil Lipnick, Kristen Kilbourn
BACKGROUND: Urine drug testing is used by health care providers to determine a patient's compliance to their prescribed regimen and to detect non-prescribed medications and illicit drugs. However, the cutoff levels used by clinical labs are often arbitrarily set and may not reflect the urine drug concentrations of compliant patients. OBJECTIVES: Our aim was to test the hypothesis that commonly used cutoffs for many prescribed and illicit drugs were set too high, and methods using these cutoffs may yield a considerable number of false-negative results...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149147/hypothalamic-pituitary-adrenocortical-axis-suppression-following-a-single-epidural-injection-of-methylprednisolone-acetate
#16
Aleem Jameel Abdul, Babita Ghai, Dipika Bansal, Naresh Sachdeva, Anil Bhansali, Saravdeep Singh Dhatt
BACKGROUND: Epidural injections (EIs) are the most commonly performed minimally invasive intervention in managing chronic low back pain (CLBP). There is inconsistency in data to accurately predict the degree of hypothalamic-piuitary-adrenal (HPA) axis suppression in patients receiving exogenous steroid therapy, especially in the form of epidural steroid injections (ESIs). OBJECTIVE: We aim to quantify the degree and duration of HPA axis suppression after a single ESI of 80 mg methyl prednisolone acetate in patients with CLBP...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149139/reversal-of-growth-of-utilization-of-interventional-techniques-in-managing-chronic-pain-in-medicare-population-post-affordable-care-act
#17
Laxmaiah Manchikanti, Amol Soin, Dharam P Mann, Sanjay Bakshi, Vidyasagar Pampati, Joshua A Hirsch
BACKGROUND: Over the past 2 decades, the increase in the utilization of interventional techniques has been a cause for concern. Despite multiple regulations to reduce utilization of interventional techniques, growth patterns continued through 2009. A declining trend was observed in a previous evaluation; however, a comparative analysis of utilization patterns of interventional techniques has not been performed showing utilization before and after the enactment of the Affordable Care Act (ACA)...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148329/the-implementation-of-performance-management-systems-in-u-s-physician-organizations
#18
Alexander F Pimperl, Hector P Rodriguez, Julie A Schmittdiel, Stephen M Shortell
Performance management systems (PMSYS) aid in improving the quality and efficiency of care, but little is known about factors that influence more robust PMSYS among physician organizations. Using a nationally representative survey of U.S. medical practices, we examined the extent to which organizational capabilities and external factors were associated with more developed PMSYS. Linear regression estimated the relative impact of these factors on PMSYS. On average, practices implemented a minority (32 points out of 100) of the PMSYS processes assessed...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148198/ear-nose-and-throat-surgery-all-you-need-to-know-about-the-surgical-approach-to-the-management-of-middle-ear-effusions-in-australian-indigenous-and-non-indigenous-children
#19
REVIEW
Kelvin Kong, Francis J Lannigan, Peter S Morris, Amanda J Leach, Stephen J O'Leary
Otitis media (OM) is a common condition in Australia. It represents a spectrum of diseases from otitis media with effusion (OME) to chronic suppurative otitis media. For all the OM diagnoses, Australian Indigenous children have higher rates of early onset, severe and persistent disease. OME is the most common form of OM and often occurs after an upper respiratory tract infection. It can be difficult to diagnose (and often goes unrecognised). Hearing loss is the most important complication. The middle-ear effusion impedes the movement of the tympanic membrane and causes a conductive hearing loss of around 25 dB...
November 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/29145869/a-mixed-methods-analysis-of-quality-of-life-among-late-life-patients-diagnosed-with-chronic-illnesses
#20
Monica S Frazer, Patrick Mobley
BACKGROUND: Quality of life (QOL) is an important consideration for people living with advancing chronic conditions. Palliative care providers speak about how, despite physical decline in late life, many patients report growth and meaning in other domains. This mixed methods study uses QOL survey responses to explore domain trajectories and interview data to explore how patients with advancing chronic conditions experience distinct QOL domains. METHODS: The study sample includes 156 now-deceased participants who completed the FACIT-Pal quarterly, and 40 (10 now-deceased) participants who discussed QOL in an interview...
November 16, 2017: Health and Quality of Life Outcomes
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