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https://www.readbyqxmd.com/read/29334347/methods-to-describe-referral-patterns-in-a-canadian-primary-care-electronic-medical-record-database-modelling-multilevel-count-data
#1
Bridget L Ryan, Joshua Shadd, Heather Maddocks, Moira Stewart, Amardeep Thind, Amanda L Terry
  A referral from a family physician (FP) to a specialist is an inflection point in the patient journey, with potential implications for clinical outcomes and health policy. Primary care electronic medical record (EMR) databases offer opportunities to examine referral patterns. Until recently, software techniques were not available to model these kinds of multi-level count data. OBJECTIVE:  To establish methodology for determining referral rates from FPs to medical specialists using the Canadian Primary Care Sentinel Surveillance Network (CPCSSN) EMR database...
November 17, 2017: Journal of Innovation in Health Informatics
https://www.readbyqxmd.com/read/29332683/insomnia-in-primary-care-a-study-from-india
#2
T S Jaisoorya, Ajit Bhalchandra Dahale, Kumar G Sunil, L Manoj, G R Gokul, K Thennarassu
OBJECTIVES: To study the prevalence and clinical correlates of insomnia among a sample of primary care attendees, in the state of Kerala, India. DESIGN: Cross-sectional survey. SETTING: Primary care. PARTICIPANTS: 7017 adult patients [18-60 years] attending 71 primary health centers selected by cluster random sampling. MEASUREMENTS: Patients were assessed for insomnia using the Insomnia Severity Index...
February 2018: Sleep Health
https://www.readbyqxmd.com/read/29332673/prevalence-and-comorbidity-of-sleep-conditions-in-australian-adults-2016-sleep-health-foundation-national-survey
#3
Sarah L Appleton, Tiffany K Gill, Carol J Lang, Anne W Taylor, R Douglas McEvoy, Nigel P Stocks, David A González-Chica, Robert J Adams
OBJECTIVE: To determine the prevalence of sleep conditions (obstructive sleep apnea [OSA], insomnia symptoms, simple snoring, and restless legs) and their associated burden of chronic conditions in a community sample. DESIGN: Cross-sectional national adult online survey. SETTING: Community-based sample. PARTICIPANTS: Australian adults ≥18 years, N = 1011. MEASUREMENTS: A cross-sectional national online survey assessed diagnosed OSA, OSA symptoms, insomnia symptoms, sleep problems, excessive daytime sleepiness (Epworth Sleepiness Scale ≥11), and physician-diagnosed health conditions (heart disease, diabetes, hypertension, reflux disease, lung disease, depression, anxiety/panic disorder, arthritis)...
February 2018: Sleep Health
https://www.readbyqxmd.com/read/29332657/primary-oral-tuberculosis-on-the-tongue-mimicking-squamous-cell-carcinoma
#4
Karandeep Singh Arora, Sunny Garg, Prabhpreet Kaur, Shreeyam Mohapatra
Tuberculosis is chronic granulomatous disease with rare oral manifestations. But if so are overlooked by most of the health care professionals. Clinically, most of the times, a tuberculous ulcer may mimic an ulcer of malignant origin and may be misdiagnosed. So, keeping in mind the etiology and the nature of the ulcer, it should be differentially diagnosed and a histopathological examination should only confirm the final diagnosis of the ulcer.
January 2018: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/29331655/what-makes-it-so-difficult-for-nurses-to-coach-patients-in-shared-decision-making-a-process-evaluation
#5
Stephanie Anna Lenzen, Ramon Daniëls, Marloes Amantia van Bokhoven, Trudy van der Weijden, Anna Beurskens
BACKGROUND: Primary care nurses play a crucial role in coaching patients in shared decision making about goals and actions. This presents a challenge to practice nurses, who are frequently used to protocol-based working routines. Therefore, an approach was developed to support nurses to coach patients in shared decision making. OBJECTIVES: To investigate how the approach was implemented and experienced by practice nurses and patients. DESIGN: A process evaluation was conducted using quantitative and qualitative methods...
December 16, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29331282/development-testing-and-implementation-of-a-training-curriculum-for-nonphysician-health-workers-to-reduce-cardiovascular-disease
#6
Maheer Khan, Pablo Lamelas, Hadi Musa, Jared Paty, Tara McCready, Robby Nieuwlaat, Eleonor Ng, Patricio Lopez-Jaramillo, Jose Lopez-Lopez, Khalid Yusoff, Fadhlina A Majid, Kien Keat Ng, Len Garis, Oyere Onuma, Salim Yusuf, Jon-David Schwalm
BACKGROUND: Cardiovascular disease (CVD) is the leading cause of death worldwide. The need to address CVD is greatest in low- and middle-income countries where there is a shortage of trained health workers in CVD detection, prevention, and control. OBJECTIVES: Based on the growing evidence that many elements of chronic disease management can be shifted to nonphysician health care workers (NPHW), the HOPE-4 (Heart Outcomes Prevention and Evaluation Program) aimed to develop, test, and implement a training curriculum on CVD prevention and control in Colombia, Malaysia, and low-resource settings in Canada...
January 10, 2018: Global Heart
https://www.readbyqxmd.com/read/29331046/prevalence-severity-and-risk-factors-for-acute-exacerbations-of-nasal-and-sinus-symptoms-by-chronic-rhinosinusitis-status
#7
Jordan R Kuiper, Annemarie G Hirsch, Karen Bandeen-Roche, Agnes S Sundaresan, Bruce K Tan, Robert P Schleimer, Robert C Kern, Walter F Stewart, Brian S Schwartz
BACKGROUND: Nasal and sinus symptoms (NSS) are common to many health conditions, including chronic rhinosinusitis (CRS). Few studies have investigated the occurrence and severity of, and risk factors for, acute exacerbations of NSS (AENSS) by CRS status (current, past, or never met European Position Paper on Rhinosinusitis [EPOS] criteria for CRS). METHODS: Four seasonal questionnaires were mailed to a stratified random sample of Geisinger primary care patients...
January 13, 2018: Allergy
https://www.readbyqxmd.com/read/29330237/-the-hand-on-the-doorknob-visit-agenda-setting-by-complex-patients-and-their-primary-care-physicians
#8
Christine P Kowalski, Deanna B McQuillan, Neetu Chawla, Courtney Lyles, Andrea Altschuler, Connie S Uratsu, Elizabeth A Bayliss, Michele Heisler, Richard W Grant
BACKGROUND: Choosing which issues to discuss in the limited time available during primary care visits is an important task for complex patients with chronic conditions. DESIGN, SETTING, AND PARTICIPANTS: We conducted sequential interviews with complex patients (n = 40) and their primary care physicians (n = 17) from 3 different health systems to investigate how patients and physicians prepare for visits, how visit agendas are determined, and how discussion priorities are established during time-limited visits...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330165/survival-in-relation-to-multimorbidity-patterns-in-older-adults-in-primary-care-in-barcelona-spain-2010-2014-a-longitudinal-study-based-on-electronic-health-records
#9
Carolina Ibarra-Castillo, Marina Guisado-Clavero, Concepció Violan-Fors, Mariona Pons-Vigués, Tomàs López-Jiménez, Albert Roso-Llorach
BACKGROUND: Several studies have analysed the characteristics of multimorbidity patterns but none have evaluated the relationship with survival. The purpose of this study was to compare survival across older adults with different chronic multimorbidity patterns (CMPs). METHODS: Prospective longitudinal observational study using electronic health records for 190 108 people aged ≥65 years in Barcelona, Spain (2009-2014). CMPs were identified by cluster analysis...
January 12, 2018: Journal of Epidemiology and Community Health
https://www.readbyqxmd.com/read/29325753/induced-hypothermia-in-patients-with-septic-shock-and-respiratory-failure-cass-a-randomised-controlled-open-label-trial
#10
Theis Skovsgaard Itenov, Maria Egede Johansen, Morten Bestle, Katrin Thormar, Lars Hein, Louise Gyldensted, Anne Lindhardt, Henrik Christensen, Stine Estrup, Henrik Planck Pedersen, Matthew Harmon, Uday Kant Soni, Silvia Perez-Protto, Nicolai Wesche, Ulrik Skram, John Asger Petersen, Thomas Mohr, Tina Waldau, Lone Musaeus Poulsen, Ditte Strange, Nicole P Juffermans, Daniel I Sessler, Else Tønnesen, Kirsten Møller, Dennis Karsten Kristensen, Alessandro Cozzi-Lepri, Jens D Lundgren, Jens-Ulrik Jensen
BACKGROUND: Animal models of serious infection suggest that 24 h of induced hypothermia improves circulatory and respiratory function and reduces mortality. We tested the hypothesis that a reduction of core temperature to 32-34°C attenuates organ dysfunction and reduces mortality in ventilator-dependent patients with septic shock. METHODS: In this randomised, controlled, open-label trial, we recruited patients from ten intensive care units (ICUs) in three countries in Europe and North America...
January 8, 2018: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/29325105/predictors-of-secondary-role-strains-among-spousal-caregivers-of-older-adults-with-functional-disability
#11
Courtney A Polenick, Nicole DePasquale
Background and Objectives: Aging spouses commonly care for a partner with functional disability, but little is known about how spousal caregiving may impact different life domains. This study evaluated how caregiving characteristics are associated with secondary role strains among spousal caregivers. Research Design and Methods: This cross-sectional study examined 367 spousal caregivers and their partners from the 2011 National Health and Aging Trends Study and National Study of Caregiving...
January 8, 2018: Gerontologist
https://www.readbyqxmd.com/read/29320670/diagnosing-copd-and-supporting-smoking-cessation-in-general-practice-evidence-practice-gaps
#12
Jenifer Liang, Michael J Abramson, Nicholas A Zwar, Grant M Russell, Anne E Holland, Billie Bonevski, Ajay Mahal, Kirsten Phillips, Paula Eustace, Eldho Paul, Sally Wilson, Johnson George
OBJECTIVES: To review the accuracy of diagnoses of chronic obstructive pulmonary disease (COPD) in primary care in Australia, and to describe smokers' experiences with and preferences for smoking cessation. DESIGN, SETTING AND PARTICIPANTS: Patients were invited to participate if they were at least 40 years old and had visited participating general practice clinics in Melbourne at least twice during the previous 12 months, reported being current or ex-smokers with a smoking history of at least 10 pack-years, or were being managed for COPD...
January 15, 2018: Medical Journal of Australia
https://www.readbyqxmd.com/read/29320600/providing-physicians-with-feedback-on-medication-adherence-for-people-with-chronic-diseases-taking-long-term-medication
#13
REVIEW
Vincent Zaugg, Virginie Korb-Savoldelli, Pierre Durieux, Brigitte Sabatier
BACKGROUND: Poor medication adherence decreases treatment efficacy and worsens clinical outcomes, but average rates of adherence to long-term pharmacological treatments for chronic illnesses are only about 50%. Interventions for improving medication adherence largely focus on patients rather than on physicians; however, the strategies shown to be effective are complex and difficult to implement in clinical practice. There is a need for new care models addressing the problem of medication adherence, integrating this problem into the patient care process...
January 10, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29316889/a-systematic-review-of-chronic-disease-management-interventions-in-primary-care
#14
Rebecca Reynolds, Sarah Dennis, Iqbal Hasan, Jan Slewa, Winnie Chen, David Tian, Sangeetha Bobba, Nicholas Zwar
BACKGROUND: Primary and community care are key settings for the effective management of long term conditions. We aimed to evaluate the pattern of health outcomes in chronic disease management interventions for adults with physical health problems implemented in primary or community care settings. METHODS: The methods were based on our previous review published in 2006. We performed database searches for articles published from 2006 to 2014 and conducted a systematic review with narrative synthesis using the Cochrane Effective Practice and Organisation of Care taxonomy to classify interventions and outcomes...
January 9, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29316579/-management-of-compensated-liver-cirrhosis-2018-evidence-based-prophylactic-measures
#15
Kathrin Karkmann, Felix Piecha, Anna Caterina Rünzi, Lisa Schulz, Moritz von Wulffen, Daniel Benten, Johannes Kluwe, Henning Wege
In 2015, more than 13 000 people died due to the consequences of liver cirrhosis in Germany. Frequently, relevant liver fibrosis is diagnosed by non-invasive methods (e. g., ultrasound-based measurement of liver stiffness) already in the compensated stage. Following diagnosis of liver fibrosis, a thorough investigation of the underlying chronic liver disease and effective treatment are important to prevent progression to decompensated cirrhosis. Since morbidity and mortality dramatically increase in the decompensated stage (patients may present with jaundice, ascites, hepatic encephalopathy, gastrointestinal bleeding) with an upsurge in 1-year-mortality from 1 - 3...
January 2018: Zeitschrift Für Gastroenterologie
https://www.readbyqxmd.com/read/29314789/risk-factors-for-hospitalizations-due-to-bacterial-respiratory-tract-infections-after-tracheotomy
#16
Christopher J Russell, Cary Thurm, Matt Hall, Tamara D Simon, Michael N Neely, Jay G Berry
OBJECTIVE: Identify characteristics associated with hospital readmission due to bacterial respiratory tract infections (bRTI) after tracheotomy. STUDY DESIGN: Retrospective study of 8009 children 0-17 years undergoing tracheotomy from 2007 to 2013 at 48 children's hospitals in the Pediatric Health Information System database. The primary outcome was first hospital admission after tracheotomy for bRTI (ie, primary diagnosis of bRTI or a primary diagnosis of bRTI symptom and secondary diagnosis of bRTI)...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29313225/using-social-network-analysis-to-examine-the-effect-of-care-management-structure-on-chronic-disease-management-communication-within-primary-care
#17
Jodi Summers Holtrop, Sandra Ruland, Stephanie Diaz, Elaine H Morrato, Eric Jones
BACKGROUND: Care management and care managers are becoming increasingly prevalent in primary care medical practice as a means of improving population health and reducing unnecessary care. Care managers are often involved in chronic disease management and associated transitional care. In this study, we examined the communication regarding chronic disease care within 24 primary care practices in Michigan and Colorado. We sought to answer the following questions: Do care managers play a key role in chronic disease management in the practice? Does the prominence of the care manager's connectivity within the practice's communication network vary by the type of care management structure implemented? METHODS: Individual written surveys were given to all practice members in the participating practices...
January 8, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29311171/detecting-hepatitis-b-and-c-by-combined-public-health-and-primary-care-birth-cohort-testing
#18
Jeanne Heil, Christian J P A Hoebe, Jochen W L Cals, Henriëtte L G Ter Waarbeek, Inge H M van Loo, Nicole H T M Dukers-Muijrers
PURPOSE: Both chronic hepatitis C (HCV) and B virus (HBV) infections are generally asymptomatic, and many remain undetected or are diagnosed at a late stage. Studies that evaluate best practice hepatitis testing strategies are needed to better detect this hidden population. METHODS: In this prospective cohort study, we aimed to determine the diagnostic yield (test uptake and rate of positive test results) of a combined public health and primary care birth cohort testing strategy in detecting hidden cases of HCV and HBV infections...
January 2018: Annals of Family Medicine
https://www.readbyqxmd.com/read/29311001/up-to-date-and-projected-estimates-of-survival-for-people-with-cystic-fibrosis-using-baseline-characteristics-a-longitudinal-study-using-uk-patient-registry-data
#19
Ruth H Keogh, Rhonda Szczesniak, David Taylor-Robinson, Diana Bilton
BACKGROUND: Cystic fibrosis (CF) is the most common inherited disease in Caucasians, affecting around 10,000 individuals in the UK today. Prognosis has improved considerably over recent decades with ongoing improvements in treatment and care. Providing up-to-date survival predictions is important for patients, clinicians and health services planning. METHODS: Flexible parametric survival modelling of UK CF Registry data from 2011 to 2015, capturing 602 deaths in 10,428 individuals...
January 5, 2018: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
https://www.readbyqxmd.com/read/29310901/why-do-we-not-want-to-recommend-influenza-vaccination-to-young-children-a-qualitative-study-of-australian-parents-and-primary-care-providers
#20
Ruby Biezen, Danilla Grando, Danielle Mazza, Bianca Brijnath
INTRODUCTION: Influenza vaccination has been shown to be safe and effective against influenza and in the prevention of complicating secondary respiratory illnesses. However, its uptake in young children remains low. This study explored the views, attitudes and practices of parents and primary care providers (PCPs) on their knowledge and acceptance of influenza vaccination in children under 5. METHODS: Using a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs (i...
January 5, 2018: Vaccine
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