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https://www.readbyqxmd.com/read/28742645/quality-improvement-in-management-of-acute-coronary-syndrome-continuing-medical-education-and-peer-coaching-improve-antiplatelet-medication-adherence-and-reduce-hospital-readmissions
#1
Amy Larkin, Michael LaCouture, Kathleen Geissel, Peri Barr, Eric R Bates, Christopher P Cannon, Deepak L Bhatt
BACKGROUND: Reducing hospital readmissions and improving patient adherence to antiplatelet medications after an acute coronary syndrome (ACS) event are important goals for improving patient health and decreasing healthcare costs. Nearly half of patients will have a secondary event within 1 year of the initial ACS event. Quality improvement (QI) initiatives that include continuing medical education and peer coaching may improve physician practice patterns and, therefore, patient outcomes...
September 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28742544/the-marginal-costs-of-adverse-drug-events-associated-with-exposures-to-anticoagulants-and-hypoglycemic-agents-during-hospitalization
#2
William D Spector, Rhona Limcangco, Michael F Furukawa, William E Encinosa
BACKGROUND: Anticoagulants and hypoglycemic agents are 2 of the most challenging drug classes for medical management in the hospital resulting in many adverse drug events (ADE). OBJECTIVE: Estimating the marginal cost (MC) of ADEs associated with anticoagulants and hypoglycemic agents for adults in 5 patient groups during their hospital stay and the total annual ADE costs for all patients exposed to these drugs during their stay. RESEARCH DESIGN AND SUBJECT: Data are from 2010 to 2013 Healthcare Cost and Utilization Project (HCUP) State Inpatient Databases and Medicare Patient Safety Monitoring System (MPSMS)...
July 24, 2017: Medical Care
https://www.readbyqxmd.com/read/28742427/a-comparison-of-multimodal-analgesic-approaches-in-institutional-eras-protocols-for-colorectal-surgery-pharmacological-agents
#3
Erik M Helander, Michael P Webb, Meghan Bias, Edward E Whang, Alan D Kaye, Richard D Urman
INTRODUCTION: Enhanced recovery after surgery (ERAS(®)) protocols are the cornerstone of improved recovery after colorectal surgery. Their implementation leads to reduced morbidity and shorter hospital stays while attenuating the surgical stress response. Multimodal analgesia is an important part of ERAS protocols. We compared and contrasted protocols from 15 institutions to test our hypothesis that there is a fundamental consensus among them. MATERIALS AND METHODS: ERAS protocols for open and laparoscopic colorectal surgery were compared from 15 different healthcare facilities...
July 25, 2017: Journal of Laparoendoscopic & Advanced Surgical Techniques. Part A
https://www.readbyqxmd.com/read/28741873/cost-effectiveness-of-left-ventricular-assist-devices-for-patients-with-end-stage-heart-failure-analysis-of-the-french-hospital-discharge-database
#4
Abir Tadmouri, Josefin Blomkvist, Cécile Landais, Jerome Seymour, Alexandre Azmoun
AIMS: Although left ventricular assist devices (LVADs) are currently approved for coverage and reimbursement in France, no French cost-effectiveness (CE) data are available to support this decision. This study aimed at estimating the CE of LVAD compared with medical management in the French health system. METHODS AND RESULTS: Individual patient data from the 'French hospital discharge database' (Medicalization of information systems program) were analysed using Kaplan-Meier method...
July 25, 2017: ESC Heart Failure
https://www.readbyqxmd.com/read/28741382/sodium-glucose-co-transporter-2-inhibitor-luseogliflozin-in-the-management-of-type-2-diabetes-a-drug-safety-evaluation
#5
Daisuke Yabe, Yoshiyuki Hamamoto, Yusuke Seino, Hitoshi Kuwata, Takeshi Kurose, Yutaka Seino
Sodium glucose co-transporter-2 (SGLT2) inhibitors have been developed recently as a new class of anti-diabetic drug, and are becoming widely used in the management of type 2 diabetes (T2D). As these agents have a considerably different glucose-lowering mechanism from those of other anti-diabetic drugs, safe use of this drug class needs to be discussed based on data available from preapproval clinical trials as well as real-world studies. The SGLT2 inhibitor luseogliflozin was developed by Taisho Pharmaceutical Co...
July 25, 2017: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/28740668/socioeconomic-impact-of-asthma-chronic-obstructive-pulmonary-disease-and-asthma-copd-overlap-syndrome
#6
Jinhee Kim, Young Sam Kim, Kyungjoo Kim, Yeon-Mok Oh, Kwang Ha Yoo, Chin Kook Rhee, Jin Hwa Lee
BACKGROUND: Asthma-chronic obstructive pulmonary disease (COPD) overlap syndrome (ACOS) is defined as having both features of asthma and COPD, which are airway hyper-responsiveness and incompletely reversible airway obstruction. However, socioeconomic impact of ACOS have not been well appreciated. METHODS: Adults with available wheezing history and acceptable spirometry were selected from the fourth Korean National Health and Nutrition Examination Survey (KNHANES IV) in 2007-2009...
June 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28740444/effective-deployment-of-technology-supported-management-of-chronic-respiratory-conditions-a-call-for-stakeholder-engagement
#7
Richard W Costello, Alexandra L Dima, Dermot Ryan, R Andrew McIvor, Kay Boycott, Alison Chisholm, David Price, John D Blakey
BACKGROUND: Healthcare systems are under increasing strain, predominantly due to chronic non-communicable diseases. Connected healthcare technologies are becoming ever more capable and their components cheaper. These innovations could facilitate both self-management and more efficient use of healthcare resources for common respiratory diseases such as asthma and chronic obstructive pulmonary disease. However, newer technologies can only facilitate major changes in practice, and cannot accomplish them in isolation...
2017: Pragmatic and Observational Research
https://www.readbyqxmd.com/read/28738744/pain-profiles-in-a-community-dwelling-population-following-spinal-cord-injury-a-national-survey
#8
Dearbhla Burke, Brona M Fullen, Olive Lennon
CONTEXT: While as many as 60% of patients with spinal cord injury (SCI) develop chronic pain, limited data currently exists on the prevalence and profile of pain post-SCI in community dwelling populations. STUDY DESIGN: A cross-sectional population survey. SETTING: Primary care. PARTICIPANTS: Community dwelling adults with SCI. METHODS: Following ethical approval members registered to a national SCI database (n=1,574) were surveyed...
July 24, 2017: Journal of Spinal Cord Medicine
https://www.readbyqxmd.com/read/28738687/critical-incident-stress-debriefing-after-adverse-patient-safety-events
#9
Reema Harrison, Albert Wu
Adverse events (AEs) are common, estimated to occur in around 10% internationally. Although preventable harm can be minimized, when AEs occur it is important that they be managed appropriately. AEs can be traumatic not only for patients, their friends, and relatives, but also for the involved clinicians, who have been referred to as "second victims" in a growing body of international research. Despite the frequency with which AEs occur, organizational mechanisms for supporting staff in these circumstances are not routinely embedded in healthcare settings...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28738686/disparities-in-diabetes-and-hypertension-care-for-individuals-with-serious-mental-illness
#10
Junqing Liu, Jonathan Brown, Suzanne Morton, D E B Potter, Lisa Patton, Milesh Patel, Rita Lewis, Sarah Hudson Scholle
OBJECTIVES: People with serious mental illnesses (SMI), including schizophrenia, bipolar disorder, and major depression, experience early mortality, partly due to comorbid physical health conditions such as diabetes and hypertension. This study examined the quality of diabetes and hypertension care for Medicaid and Medicare enrollees with SMI. STUDY DESIGN: We conducted a retrospective analysis of medical records and claims data from 3 health plans: a Medicaid plan for disabled adults, a Medicaid plan for low-income adults, and a Special Needs Plan for individuals dually enrolled in Medicaid and Medicare...
May 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28737990/cost-effectiveness-of-novel-agents-in-medicare-patients-with-multiple-myeloma-findings-from-a-u-s-payer-s-perspective
#11
Ying Chen, David R Lairson, Wenyaw Chan, Jinhai Huo, Xianglin L Du
BACKGROUND: Since multiple myeloma (MM) incurs a substantial economic burden in care management, more and more discussion has been generated in recent years about the costs of novel antimyeloma drugs and their associated value. Because of these costs, economic assessment that quantifies value of care over the long-term is essential. OBJECTIVE: To determine the cost-effectiveness (measured as cost per life-year saved) of front-line novel agent-based therapy use among a cohort of elderly patients with MM in a real-world setting...
August 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28737688/canadian-potential-healthcare-and-societal-cost-savings-from-consumption-of-pulses-a-cost-of-illness-analysis
#12
Mohammad M H Abdullah, Christopher P F Marinangeli, Peter J H Jones, Jared G Carlberg
Consumption of dietary pulses, including beans, peas and lentils, is recommended by health authorities across jurisdictions for their nutritional value and effectiveness in helping to prevent and manage major diet-related illnesses of significant socioeconomic burden. The aim of this study was to estimate the potential annual healthcare and societal cost savings relevant to rates of reduction in complications from type 2 diabetes (T2D) and incidence of cardiovascular disease (CVD) following a low glycemic index (GI) or high fiber diet that includes pulses, or 100 g/day pulse intake in Canada, respectively...
July 22, 2017: Nutrients
https://www.readbyqxmd.com/read/28736726/social-and-emotional-wellbeing-screening-for-aboriginal-and-torres-strait-islanders-within-primary-health-care-a-series-of-missed-opportunities
#13
Erika Langham, Janya McCalman, Veronica Matthews, Roxanne Gwendalyn Bainbridge, Barbara Nattabi, Irina Kinchin, Ross Bailie
BACKGROUND: Social and emotional wellbeing (SEWB) is a critical determinant of health outcomes for Indigenous Australians. This study examined the extent to which primary healthcare services (PHSs) undertake SEWB screening and management of Aboriginal and Torres Strait Islander clients, and the variation in SEWB screening and management across Indigenous PHS. METHODS: Cross-sectional analysis between 2012 and 2014 of 3,407 Indigenous client records from a non-representative sample of 100 PHSs in 4 Australian states/territory was undertaken to examine variation in the documentation of: (1) SEWB screening using identified measurement instruments, (2) concern regarding SEWB, (3) actions in response to concern, and (4) follow up actions...
2017: Frontiers in Public Health
https://www.readbyqxmd.com/read/28736393/traditional-healers-faith-healers-and-medical-practitioners-the-contribution-of-medical-pluralism-to-bottlenecks-along-the-cascade-of-care-for-hiv-aids-in-eastern-and-southern-africa
#14
Mosa Moshabela, Dominic Bukenya, Gabriel Darong, Joyce Wamoyi, Estelle McLean, Morten Skovdal, William Ddaaki, Kenneth Ondeng'e, Oliver Bonnington, Janet Seeley, Victoria Hosegood, Alison Wringe
OBJECTIVES: There are concerns that medical pluralism may delay patients' progression through the HIV cascade-of-care. However, the pathways of impact through which medical pluralism influence the care of people living with HIV (PLHIV) in African settings remain unclear. We sought to establish the manifestation of medical pluralism among PLHIV, and explore mechanisms through which medical pluralism contributes bottlenecks along the HIV care cascade. METHODS: We conducted a multicountry exploratory qualitative study in seven health and demographic surveillance sites in six eastern and southern African countries: Uganda, Kenya, Tanzania, Malawi, Zimbabwe and South Africa...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28736390/-side-effects-are-central-effects-that-challenge-retention-in-hiv-treatment-programmes-in-six-sub-saharan-african-countries-a-multicountry-qualitative-study
#15
Jenny Renju, Mosa Moshabela, Estelle McLean, William Ddaaki, Morten Skovdal, Fred Odongo, Dominic Bukenya, Joyce Wamoyi, Oliver Bonnington, Janet Seeley, Basia Zaba, Alison Wringe
OBJECTIVES: To explore the bodily and relational experience of taking antiretroviral therapy (ART) and the subsequent effect on retention in HIV care in six sub-Saharan African countries. METHODS: In-depth interviews were conducted with 130 people living with HIV (PLHIV) who had initiated ART, 38 PLHIV who were lost to follow-up and 53 healthcare workers (HCWs) in Kenya, Uganda, Tanzania, Malawi, Zimbabwe and South Africa. PLHIV were purposely selected to include a range of HIV treatment histories...
July 2017: Sexually Transmitted Infections
https://www.readbyqxmd.com/read/28735830/-i-just-googled-and-read-everything-exploring-breast-cancer-survivors-use-of-the-internet-to-find-information-on-complementary-medicine
#16
Michelle M Holmes, Felicity L Bishop, Lynn Calman
OBJECTIVE: Breast cancer survivors often turn to the internet as an information resource when deciding whether to use complementary and alternative medicine (CAM) but their use of online CAM-related resources is poorly understood. The objective was to explore breast cancer survivors' use of the internet when making decisions about CAM use. DESIGN: A purposive sample of 11 breast cancer survivors (mean age=56) completed a quantitative questionnaire and a qualitative telephone interview...
August 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28735276/mental-health-literacy-in-primary-care-canadian-research-and-education-for-the-advancement-of-child-health-canreach
#17
Eden S N McCaffrey, Samuel Chang, Geraldine Farrelly, Abdul Rahman, David Cawthorpe
The effectiveness of a continuing education programme in paediatric psychopharmacology designed for primary healthcare providers was objectively measured based on the assumption that training would lead to measurable changes in referral patterns and established clinical measures of referred patients. Using established, valid and reliable measures of clinical urgency embedded in to a regional healthcare system since 2002, the referrals to child and adolescent psychiatric services of physicians who participated in the training (n=99) were compared pretraining and post-training, and to non-participating/untrained referring physicians (n=7753) making referrals over the same time period...
July 22, 2017: Evidence-based Medicine
https://www.readbyqxmd.com/read/28734630/management-of-an-acinetobacter-baumannii-outbreak-in-an-intensive-care-unit
#18
M Tanguy, A Kouatchet, B Tanguy, É Pichard, S Fanello, M-L Joly-Guillou
INTRODUCTION: Acinetobacter baumannii is a ubiquitous pathogen resistant to desiccation and responsible for healthcare-associated infections (HAI), especially in intensive care units (ICU) where it is responsible for 5-10% of HAIs. An A. baumannii outbreak occurred in the ICU of the University Hospital of Angers, France. OBJECTIVES: To describe the A. baumannii outbreak and to evaluate the control measures taken. The secondary objective was to evaluate the impact of the electronic alert system on the incidence of multidrug resistance to antibiotics...
July 19, 2017: Médecine et Maladies Infectieuses
https://www.readbyqxmd.com/read/28733686/comparison-of-the-proportion-and-healthcare-utilisation-of-adult-patients-with-uncontrolled-severe-asthma-versus-non-severe-asthma-seen-in-a-southeast-asian-hospital-based-respiratory-specialist-clinic
#19
Tunn Ren Tay, Hang Siang Wong, Rosna Ihsan, Hsiao Peng Toh, Xuening Choo, Augustine Kh Tee
INTRODUCTION: Understanding the burden of uncontrolled severe asthma is essential for disease-targeted healthcare planning. There is a scarcity of data regarding the proportion, healthcare utilisation and costs of patients with uncontrolled severe asthma in Asia. This study aimed to plug the knowledge gap in this area. MATERIALS AND METHODS: Consecutive patients with asthma managed in our respiratory specialist clinic were evaluated prospectively. Healthcare utilisation comprising unscheduled asthma-related primary care visits, emergency department (ED) visits and hospital admissions were obtained from the national health records system...
June 2017: Annals of the Academy of Medicine, Singapore
https://www.readbyqxmd.com/read/28733191/ethnomedicobotanical-study-of-indigenous-knowledge-on-medicinal-plants-used-for-the-treatment-of-reproductive-problems-in-nalbari-district-assam-india
#20
Simi Talukdar, Partha Pradip Adhikari, Ananta Borah
ETHNOPHARMACOLOGICAL RELEVANCE: Reproductive problems are evolving as most predominant health care problems in many countries, furthermore, WHO, 2012 exemplified maternal illnesses, birth asphyxia and post birth difficulties, are rising at an alarming rate.Not all abnormalities of the human reproductive system have the same origin; the effects on reproductive problems would likely be affected by both male and female. For easy accessibility and affordability medicinal plants play a key role in primary healthcare care services in India and their use is an integral part of the cultural heritage...
July 18, 2017: Journal of Ethnopharmacology
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