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https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#1
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29751285/improving-identification-and-management-of-familial-hypercholesterolaemia-in-primary-care-pre-and-post-intervention-study
#2
Stephen Weng, Joe Kai, Jennifer Tranter, Jo Leonardi-Bee, Nadeem Qureshi
BACKGROUND AND AIMS: Familial hypercholesterolaemia (FH) is a major cause of premature heart disease but remains unrecognised in most patients. This study investigated if a systematic primary care-based approach to identify and manage possible FH improves recommended best clinical practice. METHODS: Pre- and post-intervention study in six UK general practices (population 45,033), which invited patients with total cholesterol >7.5 mmol/L to be assessed for possible FH...
April 30, 2018: Atherosclerosis
https://www.readbyqxmd.com/read/29748356/variation-in-lipid-lowering-therapy-use-in-patients-with-low-density-lipoprotein-cholesterol-%C3%A2-190-mg-dl-insights-from-the-national-cardiovascular-data-registry-practice-innovation-and-clinical-excellence-registry
#3
Salim S Virani, Kevin F Kennedy, Julia M Akeroyd, Pamela B Morris, Vera A Bittner, Frederick A Masoudi, Neil J Stone, Laura A Petersen, Christie M Ballantyne
BACKGROUND: Patients with low-density lipoprotein cholesterol (LDL-C) ≥190 mg/dL are at high risk of atherosclerotic cardiovascular disease events. Treatment guidelines recommend intensive treatment in these patients. Variation in the use of lipid-lowering therapies (LLTs) in these patients in a national sample of cardiology practices is not known. METHODS AND RESULTS: Using data from the American College of Cardiology National Cardiovascular Data Registry-Practice Innovation and Clinical Excellence registry, we assessed the proportion of patients with LDL-C ≥190 mg/dL (n=49 447) receiving statin, high-intensity statin, LLT associated with ≥50% LDL-C lowering, ezetimibe, or a PCSK9 (proprotein convertase subtilisin/kexin type 9) inhibitor between January 2013 and December 2016...
May 2018: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/29737304/therapeutic-effects-of-statins-drugs-use-and-continuous-nursing-on-patients-with-chronic-obstructive-pulmonary-disease-and-the-influence-of-life-quality
#4
Ju Weina, Liu Yanhua, Wang Jian, Shao Yan
Chronic obstructive pulmonary disease (COPD) is able to be treated and delayed. Many interventions include smoking cessation and daily maintenance of drug therapy. In clinical practice, although respiratory physicians have given optimal drug treatment to patients, there is no treatment for etiological factors in these treatments, and they have little effect on the long-term prognosis of COPD. Therefore, this paper puts forward a method of continuing care. Through Meta analysis of the therapeutic effects of statins, it is shown that statins have a positive impact on the treatment of chronic obstructive pulmonary disease...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29735471/therapeutic-effects-of-statins-drugs-use-and-continuous-nursing-on-patients-with-chronic-obstructive-pulmonary-disease-and-the-influence-of-life-quality
#5
Ju Weina, Liu Yanhua, Wang Jian, Shao Yan
Chronic obstructive pulmonary disease (COPD) is able to be treated and delayed. Many interventions include smoking cessation and daily maintenance of drug therapy. In clinical practice, although respiratory physicians have given optimal drug treatment to patients, there is no treatment for etiological factors in these treatments, and they have little effect on the long-term prognosis of COPD. Therefore, this paper puts forward a method of continuing care. Through Meta analysis of the therapeutic effects of statins, it is shown that statins have a positive impact on the treatment of chronic obstructive pulmonary disease...
May 2018: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/29703600/vascular-toxicities-with-vegf-inhibitor-therapies-focus-on-hypertension-and-arterial-thrombotic-events
#6
REVIEW
Rhian M Touyz, Sandra M S Herrmann, Joerg Herrmann
The vascular endothelial growth factor (VEGF) signaling pathway (VSP) fulfills a cardinal role in endothelial cells and its inhibition has profound cardiovascular impact. This is true not only for the normal vasculature but also for the tumor vasculature when VSP inhibitors are used as anti-angiogenic therapies. Generalized endothelial dysfunction predisposes to vasoconstriction, atherosclerosis, platelet activation, and thrombosis (arterial more than venous). All of these have been reported with VSP inhibitors and collectively give rise to vascular toxicities, the most concerning of which are arterial thromboembolic events (ATE)...
March 21, 2018: Journal of the American Society of Hypertension: JASH
https://www.readbyqxmd.com/read/29703063/novel-method-versus-the-friedewald-method-for-estimating-low-density-lipoprotein-cholesterol-in-determination-of-the-eligibility-for-statin-treatment-for-primary-prevention-in-the-united-states
#7
Doosup Shin, Chandrashekar Bohra, Kullatham Kongpakpaisarn
Although the Friedewald method has been used as the clinical standard to estimate low-density lipoprotein cholesterol (LDL-C) levels, a novel method with better accuracy was suggested and is now being adopted in real practice. We investigated the effect of this novel method on determining the eligibility for statin treatment for primary prevention in the United States.In this cross-sectional study, we determined the discordance in the statin-eligible population for primary prevention according to the 2 different LDL-C estimating methods based on the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guidelines...
April 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29694290/the-effect-of-clinical-pharmacist-led-comprehensive-medication-management-on-chronic-disease-state-goal-attainment-in-a-patient-centered-medical-home
#8
Jarred Prudencio, Timothy Cutler, Stephanie Roberts, Stephanie Marin, Machelle Wilson
BACKGROUND: Clinical pharmacy services were initiated at 7 of 11 clinics within a primary care network (PCN), which was designated as a patient-centered medical home and was affiliated with a large academic medical center in October 2014. The goal of the service was to target patients with uncontrolled chronic conditions, specifically diabetes. Patients met with a clinical pharmacist through individual clinic and telephonic appointments, in addition to usual appointments with physicians as needed...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29694288/predicting-adherence-to-chronic-disease-medications-in-patients-with-long-term-initial-medication-fills-using-indicators-of-clinical-events-and-health-behaviors
#9
Julie C Lauffenburger, Jessica M Franklin, Alexis A Krumme, William H Shrank, Olga S Matlin, Claire M Spettell, Gregory Brill, Niteesh K Choudhry
BACKGROUND: Efforts at predicting long-term adherence to medications have been focused on patients filling typical month-long supplies of medication. However, prediction remains difficult for patients filling longer initial supplies, a practice that is becoming increasingly common as a method to enhance medication adherence. OBJECTIVES: To (a) extend methods involving short-term filling behaviors and (b) develop novel variables to predict adherence in a cohort of patients receiving longer initial prescriptions...
May 2018: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/29691206/designing-for-clinical-change-creating-an-intervention-to-implement-new-statin-guidelines-in-a-primary-care-clinic
#10
Melissa DeJonckheere, Claire H Robinson, Lindsey Evans, Julie Lowery, Bradley Youles, Adam Tremblay, Caitlin Kelley, Jeremy B Sussman
BACKGROUND: Recent clinical practice guidelines from major national organizations, including a joint United States Department of Veterans Affairs (VA) and Department of Defense (DoD) committee, have substantially changed recommendations for the use of the cholesterol-lowering statin medications after years of relative stability. Because statin medications are among the most commonly prescribed treatments in the United States, any change in their use may have significant implications for patients and providers alike...
April 24, 2018: JMIR Human Factors
https://www.readbyqxmd.com/read/29670335/evaluation-of-drug-interactions-between-fimasartan-and-rosuvastatin-after-single-and-multiple-doses-in-healthy-caucasians
#11
Jieon Lee, Su-Jin Rhee, SeungHwan Lee, Kyung-Sang Yu
Objectives: As hypercholesterolemia is often accompanied by hypertension, statins are usually prescribed with angiotensin receptor blockers in clinical practice. This study was performed to evaluate the pharmacokinetics and safety of fimasartan and rosuvastatin when coadministered or administered alone as a single dose or as multiple doses to healthy Caucasians. Methods: Thirty-six subjects were enrolled into an open-labeled, randomized, 6-sequence, 3-period, 3-way crossover study, and randomly received fimasartan (120 mg), rosuvastatin (20 mg) or both...
2018: Drug Design, Development and Therapy
https://www.readbyqxmd.com/read/29667842/the-role-of-pcsk9-inhibitors-in-the-treatment-of-hypercholesterolemia
#12
Roshni S Patel, Emily M Scopelliti, Oludamilola Olugbile
OBJECTIVE: To evaluate the efficacy, safety, and cost-effectiveness of proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors and describe its place in therapy for the treatment of hypercholesterolemia. DATA SOURCES: A search of MEDLINE, CINAHL, and Clinicaltrials.gov was performed from January 2012 to March 2018 to identify literature pertaining to PCSK9 inhibitors using pre-specified search terms. Additional references were identified from citations of the literature...
April 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29667200/treatment-in-a-preventive-cardiology-clinic-utilizing-advanced-practice-providers-apps-effectively-closes-atherosclerotic-cardiovascular-disease-ascvd-risk-management-gaps-amongst-a-primary-prevention-population-compared-with-a-propensity-matched-primary-care
#13
Emilio Fentanes, Anthony G Vande Hei, R Scott Holuby, Norma Suarez, Yousif Slim, Jennifer N Slim, Ahmad M Slim, Dustin Thomas
BACKGROUND: Advanced Practice Providers (APPs) can fill access to care gaps created by physician shortages and improve adherence/compliance with preventive atherosclerotic cardiovascular disease (ASCVD) interventions. METHODS: We retrospectively reviewed data on 595 patients enrolled in a preventive cardiology clinic (PCC) utilizing APPs compared with a propensity-matched cohort (PMC) of 595 patients enrolled in primary care clinics alone. PCC patients were risk stratified using Framingham risk scoring (FRS) and coronary artery calcium scoring (CACS) and treated based on published guideline-based algorithms...
April 17, 2018: Clinical Cardiology
https://www.readbyqxmd.com/read/29650707/errors-in-electronic-health-record-based-data-query-of-statin-prescriptions-in-patients-with-coronary-artery-disease-in-a-large-academic-multispecialty-clinic-practice
#14
Eric Y Shin, Patricia Ochuko, Kunal Bhatt, Brian Howard, Gerard McGorisk, Linda Delaney, Kristan Langdon, Marjan Khosravanipour, Andiran A Nambi, Allison Grahovec, Douglas C Morris, Penny Z Castellano, Leslee J Shaw, Laurence S Sperling, Abhinav Goyal
BACKGROUND: With the recent implementation of the Medicare Quality Payment Program, providers face increasing accountability for delivering high-quality care. Such pay-for-performance programs aim to leverage systematic data captured by electronic health record (EHR) systems to measure performance; however, the fidelity of EHR query for assessing performance has not been validated compared with manual chart review. We sought to determine whether our institution's methodology of EHR query could accurately identify cases in which providers failed to prescribe statins for eligible patients with coronary artery disease...
April 12, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29627994/the-prevalence-low-density-lipoprotein-cholesterol-levels-and-treatment-of-patients-at-very-high-risk-of-cardiovascular-events-in-the-united-kingdom-a-cross-sectional-study
#15
Mark D Danese, Eduard Sidelnikov, Lucie Kutikova
OBJECTIVE: To assess the prevalence of patients at very high risk of cardiovascular (CV) events in the United Kingdom (UK) and evaluate low-density lipoprotein cholesterol (LDL-C) values and treatment patterns in these patients. METHODS: This cross-sectional study used primary care data from UK electronic medical records in the Clinical Practice Research Datalink (CPRD) in 2013. Very high-risk patients were defined per European Society of Cardiology guidelines as those with hyperlipidemia (assessed by co-medication) and documented cardiovascular disease (CVD) or hyperlipidemia and type 2 diabetes (DM2) without CVD (DM2w/oCVD)...
April 9, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29619841/preventable-statin-adverse-reactions-and-therapy-discontinuation-what-can-we-learn-from-the-spontaneous-reporting-system
#16
Maurizio Sessa, Concetta Rafaniello, Cristina Scavone, Annamaria Mascolo, Gabriella di Mauro, Annamaria Fucile, Francesco Rossi, Liberata Sportiello, Annalisa Capuano
BACKGROUND: Statin treatment is often associated with poor adherence, which may be due to the onset of adverse drug reactions (ADRs). We investigated on potential risk factors related to preventable cases of statin-induced ADRs and to the discontinuation of statin therapy. METHODS: We performed a study using the database of Italian spontaneous reporting. The target population for the preventability assessment was all patients with suspected statin-induced ADRs deriving from Campania Region (a territory of Southern Italy) between 2012 and 2017...
April 5, 2018: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/29617000/statins-and-new-onset-diabetes-in-cardiovascular-and-kidney-disease-cohorts-a-meta-analysis
#17
Haroon Kamran, Eric Kupferstein, Navneet Sharma, Jocelyne G Karam, Alyson K Myers, Irini Youssef, James R Sowers, Deborah R Gustafson, Moro O Salifu, Samy I McFarlane
BACKGROUND: Statins have long been prescribed for the primary and secondary prevention of cardiovascular disease (CVD) and kidney disease. Their benefits and efficacy are widely accepted in current clinical practice, but like any other therapeutic agents, they have adverse effects. One of the emerging concerns with statin therapy is the development of new-onset diabetes mellitus (NODM), a dreaded risk factor for CVD and kidney disease and widely viewed as CVD equivalent. Accumulating evidence indicates that NODM is a consequence of statin use...
2018: Cardiorenal Medicine
https://www.readbyqxmd.com/read/29593789/drugs-involved-in-dyslipidemia-and-obesity-treatment-focus-on-adipose-tissue
#18
REVIEW
Sofia Dias, Sílvia Paredes, Laura Ribeiro
Metabolic syndrome can be defined as a state of disturbed metabolic homeostasis characterized by visceral obesity, atherogenic dyslipidemia, arterial hypertension, and insulin resistance. The growing prevalence of metabolic syndrome will certainly contribute to the burden of cardiovascular disease. Obesity and dyslipidemia are main features of metabolic syndrome, and both can present with adipose tissue dysfunction, involved in the pathogenic mechanisms underlying this syndrome. We revised the effects, and underlying mechanisms, of the current approved drugs for dyslipidemia and obesity (fibrates, statins, niacin, resins, ezetimibe, and orlistat; sibutramine; and diethylpropion, phentermine/topiramate, bupropion and naltrexone, and liraglutide) on adipose tissue...
2018: International Journal of Endocrinology
https://www.readbyqxmd.com/read/29582393/adverse-events-to-food-supplements-containing-red-yeast-rice-comparative-analysis-of-faers-and-caers-reporting-systems
#19
Emanuel Raschi, Anna Girardi, Elisabetta Poluzzi, Emanuele Forcesi, Francesca Menniti-Ippolito, Gabriela Mazzanti, Fabrizio De Ponti
INTRODUCTION: Food supplements containing red yeast rice (RYR) are proposed as an alternative in statin-intolerant patients, although they actually contain natural statin(s) and their safety in clinical practice is still incompletely characterized. We described and compared adverse events (AEs) associated with RYR products submitted to reporting systems maintained by the Food and Drug Administration (FDA), with a focus on liver and muscular events. METHODS: We extracted RYR-related AEs from the FDA Adverse Event Reporting System (FAERS) [first quarter (Q1)-2004 to Q2-2016], a drug-based archive, and the Center for Food Safety and Applied Nutrition Adverse Event Reporting System (CAERS) (Q1-2004 to Q1-2017)...
March 26, 2018: Drug Safety: An International Journal of Medical Toxicology and Drug Experience
https://www.readbyqxmd.com/read/29561173/evaluation-of-statin-eligibility-prescribing-practices-and-therapeutic-responses-using-atp-iii-acc-aha-and-nla-dyslipidemia-treatment-guidelines-in-a-large-urban-cohort-of-hiv-infected-outpatients
#20
Matthew E Levy, Alan E Greenberg, Manya Magnus, Naji Younes, Amanda Castel
Statin coverage has been examined among HIV-infected patients using Adult Treatment Panel III (ATP III) and American College of Cardiology/American Heart Association (ACC/AHA) guidelines, although not with newer National Lipid Association (NLA) guidelines. We investigated statin eligibility, prescribing practices, and therapeutic responses using these three guidelines. Sociodemographic, clinical, and laboratory data were collected between 2011 and 2016 for HIV-infected outpatients enrolled in the DC Cohort, a multi-center, prospective, observational study in Washington, DC...
February 2018: AIDS Patient Care and STDs
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