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https://www.readbyqxmd.com/read/28809591/reducing-inappropriate-non-steroidal-anti-inflammatory-prescription-in-primary-care-patients-with-chronic-kidney-disease
#1
David M Keohane, Thomas Dennehy, Kenneth P Keohane, Eamonn Shanahan
Purpose The purpose of this paper is to reduce inappropriate non-steroidal anti-inflammatory prescribing in primary care patients with chronic kidney disease (CKD). Once diagnosed, CKD management involves delaying progression to end stage renal failure and preventing complications. It is well established that non-steroidal anti-inflammatories have a negative effect on kidney function and consequently, all nephrology consensus groups suggest avoiding this drug class in CKD. Design/methodology/approach The sampling criteria included all practice patients with a known CKD risk factor...
August 14, 2017: International Journal of Health Care Quality Assurance
https://www.readbyqxmd.com/read/28808489/what-should-be-the-appropriate-minimal-duration-for-patient-examination-and-evaluation-in-pulmonary-outpatient-clinics
#2
Benan Musellim, Sermin Borekci, Gulfidan Uzan, Zafer Hasan Ali Sak, Secil Kepil Ozdemir, Goksel Altinisik, Sinem Agca Altunbey, Nazan Sen, Oguz Kilinc, Arzu Yorgancioglu
INTRODUCTION: Patient examinations performed in a limited time period may lead to impairment in patient and physician relationship, defective and erroneous diagnosis, inappropriate prescriptions, less common use of preventive medicine practices, poor patient satisfaction, and increased violent acts against health-care staff. OBJECTIVE: This study aimed to determine the appropriate minimal duration of patient examination in the pulmonary practice. METHODS: A total of 49 researchers from ten different study groups of the Turkish Thoracic Society participated in the study...
July 2017: Annals of Thoracic Medicine
https://www.readbyqxmd.com/read/28806436/effectiveness-of-a-timing-and-coordination-group-exercise-program-to-improve-mobility-in-community-dwelling-older-adults-a-randomized-clinical-trial
#3
Jennifer S Brach, Subashan Perera, Sandra Gilmore, Jessie M VanSwearingen, Deborah Brodine, Neelesh K Nadkarni, Edmund Ricci
Importance: Timing and coordination exercises may be an important addition to community-based health promotion exercise programs to improve walking in older adults. Objective: To compare the effectiveness of the On the Move group exercise program, which focuses on the timing and coordination of movement, with a seated strength, endurance, and flexibility program (usual care) at improving function, disability, and walking ability of older adults. Design, Setting, and Participants: Cluster-randomized, single-blind intervention trial...
August 14, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28804870/effect-of-the-tool-to-reduce-inappropriate-medications-on-medication-communication-and-deprescribing
#4
Terri R Fried, Kristina M Niehoff, Richard L Street, Peter A Charpentier, Nallakkandi Rajeevan, Perry L Miller, Mary K Goldstein, John R O'Leary, Brenda T Fenton
OBJECTIVES: To examine the effect of the Tool to Reduce Inappropriate Medications (TRIM), a web tool linking an electronic health record (EHR) to a clinical decision support system, on medication communication and prescribing. DESIGN: Randomized clinical trial. SETTING: Primary care clinics at a Veterans Affairs Medical Center. PARTICIPANTS: Veterans aged 65 and older prescribed seven or more medications randomized to receipt of TRIM or usual care (N = 128)...
August 14, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28803624/the-quality-of-primary-care-provided-by-nurse-practitioners-to-vulnerable-medicare-beneficiaries
#5
Catherine M DesRoches, Sean Clarke, Jennifer Perloff, Monica O'Reilly-Jacob, Peter Buerhaus
BACKGROUND: Studies suggest nurse practitioners are heavily represented among primary care providers for vulnerable Medicare beneficiaries. PURPOSE: The purpose of this study was to compare quality indicators among three groups of vulnerable beneficiaries managed by MDs and nurse practitioners (NPs). METHODS: The methods include retrospective cohort design examining 2012 and 2013 Medicare claims for three beneficiary groups: (a) initially qualified for the program due to disability, (b) dually eligible for Medicare and Medicaid, and (c) both disabled and dually eligible...
June 15, 2017: Nursing Outlook
https://www.readbyqxmd.com/read/28802772/effectiveness-of-a-combined-exercise-training-and-home-based-walking-programme-on-physical-activity-compared-with-standard-medical-care-in-moderate-copd-a-randomised-controlled-trial
#6
P de Roos, C Lucas, J H Strijbos, E van Trijffel
OBJECTIVE: To estimate the effectiveness of a 10-week combined exercise training and home-based walking programme on daily physical activity (PA) compared with standard medical care in patients with moderate chronic obstructive pulmonary disease (COPD). DESIGN: Randomised controlled trial. SETTING: Primary care physiotherapy. PARTICIPANTS: Consecutive patients with stable COPD at Gold Stage II with a score of two or more on the Medical Research Council Dyspnoea Scale...
July 14, 2017: Physiotherapy
https://www.readbyqxmd.com/read/28801528/epidemiology-and-natural-history-of-the-cardiorenal-syndromes-in-a-cohort-with-echocardiography
#7
Thomas A Mavrakanas, Aisha Khattak, Karandeep Singh, David M Charytan
BACKGROUND AND OBJECTIVES: It is unknown whether echocardiographic parameters are independently associated with the cardiorenal syndrome. No direct comparison of the natural history of various cardiorenal syndrome types has been conducted. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Our retrospective cohort study enrolled adult patients with at least one transthoracic echocardiography between 2004 and 2014 at a single health care system. Information on comorbidities was extracted using condition-specific diagnostic codes...
August 11, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28800265/use-of-snomed-ct%C3%A2-and-loinc%C3%A2-to-standardize-terminology-for-primary-care-asthma-electronic-health-records
#8
M Diane Lougheed, Nicola J Thomas, Nastasia V Wasilewski, Alison H Morra, Janice P Minard
OBJECTIVES: The burden of asthma ranks among the highest for chronic diseases. Interoperable EHRs can improve the management of chronic diseases such as asthma by facilitating sharing of data between health care settings along the continuum of care. Terminology such as SNOMED CT® (Systematized Nomenclature of Medicine-Clinical Terms) and LOINC® (Logistical Observation Identifier Names and Codes) are prerequisites for interoperability of electronic health records (EHRs). We sought to determine the extent to which data elements in a validated asthma care map (ACM) are congruent with these terminologies...
August 11, 2017: Journal of Asthma: Official Journal of the Association for the Care of Asthma
https://www.readbyqxmd.com/read/28795910/achieving-a-patient-centered-value-based-system-of-diabetes-care-in-the-united-states-report-on-a-national-stakeholder-summit
#9
David B Nash, Alexis Skoufalos, Dennis Harris
Chronic instability in the health care environment has raised concerns among providers and patients, especially those who treat and cope with chronic conditions. Changes to existing health care laws are unlikely to alter what have become the primary goals of the US health care system: cost-effectiveness and patient-centricity. To that end, it is vital that patient and physician voices be incorporated in policy decisions and, importantly, that access to care and patient-reported outcomes are considered when calculating "value...
August 10, 2017: Population Health Management
https://www.readbyqxmd.com/read/28795881/understanding-biofilm-in-practice-a-global-survey-of-health-professionals
#10
T Swanson, R D Wolcott, H Wallis, E J Woodmansey
OBJECTIVE: The aim of this survey was to examine health professionals' views and practices relating to biofilm in chronic wounds. METHOD: A global online survey was conducted to assess the current understanding of biofilm and wound management practices. The survey consisted of 20 questions designed to evaluate health professional knowledge of biofilm, perception and understanding of biofilm behaviour, detection and diagnosis, and treatment. Respondents were classified as 'specialists' if wounds were their primary focus and they developed protocols and determined formularies...
August 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28794524/an-analysis-of-the-predictors-of-mortality-and-morbidity-in-patients-admitted-after-suicidal-hanging-to-an-indian-multidisciplinary-intensive-care-unit
#11
M K Renuka, M S Kalaiselvan, A S Arunkumar
BACKGROUND AND AIMS: Hanging is a frequently used method to attempt suicide in India. There is a lack of data in the Indian population regarding clinical features and outcomes of suicidal hanging. The purpose of this study was to evaluate the factors affecting mortality and morbidity in patients admitted with suicidal hanging to the Intensive Care Unit (ICU). METHODS: A 6-year retrospective study of adult patients admitted to the ICU with suicidal hanging was analysed for demographics, mode of hanging, lead time to emergency room (ER) admission, clinical presentation, Acute Physiology and Chronic Health Evaluation II (APACHE II) and Sequential Organ Failure Assessment (SOFA) scores, admission Glasgow coma scale (GCS) and neurological outcomes...
July 2017: Indian Journal of Anaesthesia
https://www.readbyqxmd.com/read/28793948/emotion-regulation-in-chronic-disease-populations-an-integrative-review
#12
Kelly L Wierenga, Rebecca H Lehto, Barbara Given
BACKGROUND AND PURPOSE: Emotion regulation, the experiencing, processing, and modulating of emotional response, is necessary to manage the emotional stressors common in patients with chronic illness. Overwhelming emotional demands deplete the resources needed for everyday self-care management of chronic disease, contributing to poor health outcomes. Emotion regulation is shown to impact behaviors in healthy individuals; yet, a review of literature examining evidence of associations in chronically ill populations is lacking...
August 1, 2017: Research and Theory for Nursing Practice
https://www.readbyqxmd.com/read/28793928/a-new-marker-of-primary-care-utilization-annual-accumulated-duration-of-time-of-visits
#13
Talya A Nathan, Arnon D Cohen, Shlomo Vinker
BACKGROUND: Most of the research on primary care workload has focused on the number of visits or the average duration of visits to a primary care physician (PCP) and their effect on the quality of medical care. However, the accumulated annual visit duration has yet to be examined. This measure could also have implications for the allocation of resources among health plans and across regions. In this study we aimed to define and characterize the concept of "Accumulated Annual Duration of Time" (AADT) spent with a PCP...
August 10, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28793377/are-characteristics-of-team-members-important-for-quality-management-of-chronic-patients-at-primary-care-level
#14
Zalika Klemenc-Ketis, Antonija Poplas-Susič
AIMS AND OBJECTIVES: We wanted to determine the possible associations between higher levels of selected quality indicators and the characteristics of providers. BACKGROUND: In 2011, an ongoing project on a new model of family medicine practice was launched in Slovenia; the a family physicians' working team (a family physician and a practice nurse), was extended by a nurse practitioner working 0.5 full-time equivalents. This was an example of a personalised team approach to managing chronic patients...
August 9, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28792572/-the-management-of-depression-in-older-adults-and-their-family-caregivers-findings-from-a-research-program-in-quebec
#15
Jane McCusker, Mark Yaffe, Tamara Sussman, Martin Cole, Maida Sewitch, Erin Strumpf, Ellen Freeman, Sylvie Lambert, Manon de Raad
Objectives A research group based at St. Mary's Research Centre, St. Mary's Hospital, Montreal, has conducted a research program over the past two decades that aims to inform improvements in the management of depression in primary care and general medical settings, among older adults. This paper reviews the findings from this research program, discusses the findings in the context of other research, and highlights the implications for practice and health policy.Methods Narrative review and synthesis of 25 published articles, that included: 4 systematic reviews, 10 observational studies, 9 intervention trials, and 2 consensus conference reports...
2017: Santé Mentale Au Québec
https://www.readbyqxmd.com/read/28791239/muslim-patients-in-ramadan-a-review-for-primary-care-physicians
#16
REVIEW
Heba Abolaban, Ahmad Al-Moujahed
Fasting Ramadan, in which Muslims abstain from specific habits and behaviors from dawn to sunset, is one of the five Pillars of Islam. While there are several exemptions from fasting, many Muslim patients with acute or chronic medical conditions still choose to fast, which may adversely affect their health if not addressed properly. Some patients may not be well educated about the effects of some medical treatments and procedures on the validity of their fast, which can unnecessarily lead to suboptimal management of their conditions or treatment nonadherence...
July 2017: Avicenna Journal of Medicine
https://www.readbyqxmd.com/read/28790879/developing-and-implementing-a-community-based-model-of-care-for-fibromyalgia-a-feasibility-study
#17
Michelle Teo, Bindu Mohan, Nelly D Oelke
BACKGROUND: Fibromyalgia (FM) is a complex disease posing challenges for primary care providers and specialists in its management. AIM: To evaluate the development and implementation of a comprehensive, integrated, community-based model of care for FM. METHODS: A mixed methods feasibility study was completed in a small urban centre in southern British Columbia, Canada. Eleven adults with FM and a team of seven health care providers (HCPs) participated in a 10-week intervention involving education, exercise, and sleep management...
2017: Pain Research & Management: the Journal of the Canadian Pain Society
https://www.readbyqxmd.com/read/28790872/cognitive-behavioral-therapy-for-patients-with-irritable-bowel-syndrome-current-insights
#18
REVIEW
Sarah W Kinsinger
Irritable bowel syndrome (IBS) is a chronic gastrointestinal (GI) condition associated with significant health care utilization and quality-of-life impairment. Latest research indicates that the brain-gut axis plays a key role in the disorder, and the presence of psychological factors and central processing deficits contribute to symptom severity and disability. Psychological therapies as a whole have demonstrated good efficacy in reducing the severity of IBS symptoms. Cognitive-behavioral therapy (CBT) has been tested most rigorously in multiple randomized controlled trials and consistently demonstrates significant and durable effects on IBS symptoms and quality of life...
2017: Psychology Research and Behavior Management
https://www.readbyqxmd.com/read/28790075/implementation-of-a-pharmacist-managed-clinic-for-patients-with-chronic-nonmalignant-pain
#19
Jessica L Norman, Miranda E Kroehl, Huong Mindy Lam, Carmen L Lewis, Chelsea N Mitchell, Cindy L O'Bryant, Katy E Trinkley
PURPOSE: A pharmacist-managed chronic pain clinic (PMCPC) in a primary care setting is described. SUMMARY: As primary care providers (PCPs) may be unprepared or lack time to manage high-risk patients receiving opioids for chronic nonmalignant pain, alternative models of care are needed. The University of Colorado PMCPC is integrated into an internal medicine outpatient clinic. The PMCPC is staffed by 1 clinical pharmacist, with pharmacy students and residents also performing clinic duties...
August 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28789948/burden-of-multiple-chronic-conditions-among-urologic-cancer-patients
#20
Tullika Garg, Amanda J Young, Korey A Kost, John F Danella, Sharon Larson, Matthew E Nielsen, H Lester Kirchner
PURPOSE: To describe age, multiple chronic condition (MCC) profiles, and health system contact in urologic cancer patients. MATERIALS & METHODS: Using Geisinger Health System electronic health records, we identified adult primary care patients and a subset with at least one urology encounter between 2001-2015. Agency for Healthcare Research and Quality Chronic Condition Indicator and Clinical Classifications Software tools were applied to International Classification of Diseases, Ninth Revision (ICD-9) codes to identify chronic conditions...
August 5, 2017: Journal of Urology
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