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Quality improvement in health care

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https://www.readbyqxmd.com/read/27914589/-big-data-and-their-perspectives-in-radiation-therapy
#1
REVIEW
Sébastien Guihard, Juliette Thariat, Jean-Baptiste Clavier
The concept of big data indicates a change of scale in the use of data and data aggregation into large databases through improved computer technology. One of the current challenges in the creation of big data in the context of radiation therapy is the transformation of routine care items into dark data, i.e. data not yet collected, and the fusion of databases collecting different types of information (dose-volume histograms and toxicity data for example). Processes and infrastructures devoted to big data collection should not impact negatively on the doctor-patient relationship, the general process of care or the quality of the data collected...
November 30, 2016: Bulletin du Cancer
https://www.readbyqxmd.com/read/27914499/exercise-training-improves-exercise-capacity-and-quality-of-life-after-transcatheter-aortic-valve-implantation-a-randomized-pilot-trial
#2
Axel Pressler, Jeffrey W Christle, Benjamin Lechner, Viola Grabs, Bernhard Haller, Ina Hettich, David Jochheim, Julinda Mehilli, Rüdiger Lange, Sabine Bleiziffer, Martin Halle
BACKGROUND: Transcatheter aortic valve implantation (TAVI) is increasingly applied for aortic stenosis in elderly patients with impaired mobility and reduced quality of life. These patients may particularly benefit from postinterventional exercise programs, but no randomized study has evaluated the safety and efficacy of exercise in this population. METHODS: In a prospective pilot study, 30 patients after TAVI (mean age, 81±6 years, 44% female, 83±34 days postintervention) were randomly allocated 1:1 to a training group (TG) performing 8 weeks of supervised combined endurance and resistance exercise or to usual care...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914467/impact-of-the-occurrence-of-a-response-shift-on-the-determination-of-the-minimal-important-difference-in-a-health-related-quality-of-life-score-over-time
#3
Ahmad Ousmen, Thierry Conroy, Francis Guillemin, Michel Velten, Damien Jolly, Mariette Mercier, Sylvain Causeret, Jean Cuisenier, Olivier Graesslin, Zeinab Hamidou, Franck Bonnetain, Amélie Anota
BACKGROUND: An important challenge of the longitudinal analysis of health-related quality of life (HRQOL) is the potential occurrence of a Response Shift (RS) effect. While the impact of RS effect on the longitudinal analysis of HRQOL has already been studied, few studies have been conducted on its impact on the determination of the Minimal Important Difference (MID). This study aims to investigate the impact of the RS effect on the determination of the MID over time for each scale of both EORTC QLQ-C30 and QLQ-BR23 questionnaires in breast cancer patients...
December 3, 2016: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/27914185/use-of-peers-to-improve-adherence-to-antiretroviral-therapy-a-global-network-meta-analysis
#4
REVIEW
Steve Kanters, Jay Jh Park, Keith Chan, Nathan Ford, Jamie Forrest, Kristian Thorlund, Jean B Nachega, Edward J Mills
INTRODUCTION: It is unclear whether using peers can improve adherence to antiretroviral therapy (ART). To construct the World Health Organization's global guidance on adherence interventions, we conducted a systematic review and network meta-analysis to determine the effectiveness of using peers for achieving adequate adherence and viral suppression. METHODS: We searched for randomized clinical trials of peer-based interventions to promote adherence to ART in HIV populations...
2016: Journal of the International AIDS Society
https://www.readbyqxmd.com/read/27914125/having-a-physician-rather-than-a-place-as-a-usual-source-of-care-would-be-better-from-2012-korea-health-panel-data
#5
Kyeong Min Kim, Hyunsoo Jeon, Jae Ho Lee
A usual source of care (USC) in primary care improves health care quality and can result in improved health. However, current research about the type of USC (place only vs. physician with a place) is insufficient as an evidence to support the value of primary care. We analyzed data from the 2012 Korea Health Panel survey of adults aged 18 years or older (n = 11,873) who reported whether having a USC or not to compare the effects by type of USC on medical care use and out-of-pocket costs. Descriptive analysis showed significant differences in the distributions of sociodemographic and health status factors except frequency of outpatient visit by type of USC...
January 2017: Journal of Korean Medical Science
https://www.readbyqxmd.com/read/27913940/cost-analysis-and-cost-benefit-analysis-of-a-medication-review-with-follow-up-service-in-aged-polypharmacy-patients
#6
Amaia Malet-Larrea, Estíbaliz Goyenechea, Miguel A Gastelurrutia, Begoña Calvo, Victoria García-Cárdenas, Juan M Cabases, Aránzazu Noain, Fernando Martínez-Martínez, Daniel Sabater-Hernández, Shalom I Benrimoj
BACKGROUND: Drug related problems have a significant clinical and economic burden on patients and the healthcare system. Medication review with follow-up (MRF) is a professional pharmacy service aimed at improving patient's health outcomes through an optimization of the medication. OBJECTIVE: To ascertain the economic impact of the MRF service provided in community pharmacies to aged polypharmacy patients comparing MRF with usual care, by undertaking a cost analysis and a cost-benefit analysis...
December 2, 2016: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/27913765/prevalence-of-chronic-conditions-and-multimorbidities-in-a-geographically-defined-geriatric-population-with-diverse-races-and-ethnicities
#7
Eunjung Lim, Krupa Gandhi, James Davis, John J Chen
OBJECTIVE: The objective of this study is to examine racial/ethnic differences in prevalence of chronic conditions and multimorbidities in the geriatric population of a state with diverse races/ethnicities. METHOD: Fifteen chronic conditions and their dyads and triads were investigated using Hawaii Medicare 2012 data. For each condition, a multivariable logistic regression model was used to investigate differences in race/ethnicity, adjusting for subject characteristics...
December 2, 2016: Journal of Aging and Health
https://www.readbyqxmd.com/read/27913477/the-value-of-quality-of-life-assessment-in-chronic-myeloid-leukemia-patients-receiving-tyrosine-kinase-inhibitors
#8
Fabio Efficace, Laura Cannella
The development of the oral tyrosine kinase inhibitors (TKIs) to treat chronic myeloid leukemia (CML) is one of the great triumphs of cancer research. Although the efficacy of TKIs has dramatically improved the disease-specific overall survival rate, the prevalence of CML is increasing worldwide. Currently, CML patients receive prolonged (even lifelong) treatment, and over the last decade, clinical decision making has become challenging. Therefore, consideration of the effects of TKI therapies on patients' quality of life (QoL) and symptom burden (ie, patient-reported outcomes [PROs]) is now critical to more robustly inform patient care and improve health care quality...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913160/psychological-well-being-and-mental-health-recovery-in-the-nimh-raise-early-treatment-program
#9
Julia Browne, David L Penn, Piper S Meyer-Kalos, Kim T Mueser, Sue E Estroff, Mary F Brunette, Christoph U Correll, James Robinson, Robert A Rosenheck, Nina Schooler, Delbert G Robinson, Jean Addington, Patricia Marcy, John M Kane
Recovery-oriented practices that promote client-centered care, collaboration, and functional outcome have been recommended to improve treatment engagement, especially for individuals with serious mental illness (SMI). Psychological well-being (PWB) is related to recovery and refers to experiencing purpose and meaning in life through realizing one's potential. The recently completed Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP) study sought to improve quality of life, functional outcome, and well-being in individuals with first episode psychosis (FEP)...
November 29, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27913084/quality-of-communication-about-medicines-in-united-states-hospitals-a-national-retrospective-study
#10
Lauren Mullings, Jayashri Sankaranarayanan
BACKGROUND: Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. OBJECTIVES: To evaluate ComMed quality variations by hospital characteristics. METHODS: In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs...
October 26, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27912999/palliative-care-and-physiatry-in-the-oncology-care-spectrum-an-opportunity-for-distinct-and-collaborative-approaches
#11
REVIEW
Vishwa S Raj, Julie K Silver, Terrence M Pugh, Jack B Fu
As cancer evolves from a terminal illness to a chronic medical condition, so too does the view of clinical services. Palliative care and physical medicine and rehabilitation (PM&R) will increase in acceptance because they provide a valuable resource. The overarching theme is improving cancer-related symptoms or treatment-related side effects, improving patient health-related quality of life, lessening caregiver burden, and valuing patient-centered care and shared decision making. Managing symptom burden may improve therapy participation/performance...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912744/quality-of-life-after-stroke-in-pakistan
#12
Wardah Khalid, Shafquat Rozi, Tazeen Saeed Ali, Iqbal Azam, Michael T Mullen, Saleem Illyas, Qamar Un-Nisa, Nabila Soomro, Ayeesha Kamran Kamal
BACKGROUND: There is very little information about the quality of life (QOL) of stroke survivors in LMIC countries with underdeveloped non communicable health infrastructures, who bear two thirds of the global stroke burden. METHODOLOGY: We used a sequential mix methods approach. First, a quantitative analytical cross-sectional study was conducted on 700 participants, who constituted 350 stroke survivor and their caregiver dyads. QOL of stroke survivor was assessed via Stroke Specific Quality of Life Scale (SSQOLS) whereas QOL of caregivers was assessed through RAND-36...
December 3, 2016: BMC Neurology
https://www.readbyqxmd.com/read/27912108/encouraging-early-discussion-of-life-expectancy-and-end-of-life-care-a-randomised-controlled-trial-of-a-nurse-led-communication-support-program-for-patients-and-caregivers
#13
Adam Walczak, Phyllis N Butow, Martin H N Tattersall, Patricia M Davidson, Jane Young, Ronald M Epstein, Daniel S J Costa, Josephine M Clayton
BACKGROUND: Patients are often not given the information needed to understand their prognosis and make informed treatment choices, with many consequently experiencing less than optimal care and quality-of-life at end-of-life. OBJECTIVES: To evaluate the efficacy of a nurse-facilitated communication support program for patients with advanced, incurable cancer to assist them in discussing prognosis and end-of-life care. DESIGN: A parallel-group randomised controlled trial design was used...
October 21, 2016: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#14
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911487/external-inspection-of-compliance-with-standards-for-improved-healthcare-outcomes
#15
REVIEW
Gerd Flodgren, Daniela C Gonçalves-Bradley, Marie-Pascale Pomey
BACKGROUND: Inspection systems are used in healthcare to promote quality improvements (i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes). These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of healthcare. However, the benefits of external inspection in terms of organisational-, provider- and patient-level outcomes are not clear...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911002/what-is-quality-of-life-and-how-do-we-measure-it-relevance-to-parkinson-s-disease-and-movement-disorders
#16
REVIEW
Pablo Martinez-Martin
Health-related quality of life is a patient-reported outcome that complements clinical evaluation and provides information about disease activity and effects of the treatment. The objective of this review is to present the conceptual framework, the measures, and some of their most relevant applications in the field of Parkinson's disease and movement disorders. Health-related quality of life is a subjective, individual, and multidimensional construct, and its main dimensions are physical, mental, and social, besides global perceptions of health and personal domains...
December 2, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/27910751/recent-advances-in-pharmacotherapeutic-paradigm-of-mild-to-recalcitrant-atopic-dermatitis
#17
Zahid Hussain, Shariza Sahudin, Hnin Ei Thu, Ahmad Nazrun Shuid, Syed Nasir Abbas Bukhari, Endang Kumolosasi
Atopic dermatitis (AD) is a common, chronic skin inflammatory disorder characterized by perivascular infiltration of immunoglobulin E (IgE), T lymphocytes, and mast cells. The key factors responsible for the pathophysiology of this disease are immunological disorders and defects in epidermal barrier properties. Pruritus, intense itching, psychological stress, deprived physical and mental performance, and sleep disturbance are the hallmark features of this dermatological disorder. Preventive interventions such as educational programs, avoidance of allergens, and exclusive care toward the skin could play a partial role in suppressing the symptoms...
2016: Critical Reviews in Therapeutic Drug Carrier Systems
https://www.readbyqxmd.com/read/27910181/trends-and-risk-factors-of-stillbirths-and-neonatal-deaths-in-eastern-uganda-1982-2011-a-cross-sectional-population-based-study
#18
Sanni Kujala, Peter Waiswa, Daniel Kadobera, Joseph Akuze, George Pariyo, Claudia Hanson
OBJECTIVES: To identify mortality trends and risk factors associated with stillbirths and neonatal deaths 1982-2011. METHODS: Population-based cross-sectional study based on reported pregnancy history in Iganga-Mayuge Health and Demographic Surveillance Site (HDSS) in Uganda. A pregnancy history survey was conducted among women aged 15-49 years living in the HDSS during May-July 2011 (n = 10 540). Time trends were analysed with cubic splines and linear regression...
November 5, 2016: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/27910173/facilitators-and-barriers-to-person-centred-care-in-child-and-young-people-mental-health-services-a-systematic-review
#19
Dawid Gondek, Julian Edbrooke-Childs, Tjasa Velikonja, Louise Chapman, Felicity Saunders, Daniel Hayes, Miranda Wolpert
: Implementation of person-centred care has been widely advocated across various health settings and patient populations, including recent policy for child and family services. Nonetheless, evidence suggests that service users are rarely involved in decision-making, whilst their preferences and goals may be often unheard. The aim of the present research was to systematically review factors influencing person-centred care in mental health services for children, young people and families examining perspectives from professionals, service users and carers...
December 2, 2016: Clinical Psychology & Psychotherapy
https://www.readbyqxmd.com/read/27909518/symptoms-in-atrial-fibrillation-a-contemporary-review-and-future-directions
#20
REVIEW
Steven T Heidt Bs, Anna Kratz PhD, Kayvan Najarian PhD, Afton L Hassett PsyD, Hakan Oral Md, Richard Gonzalez PhD, Brahmajee K Nallamothu Md Mph, Daniel Clauw Md, Hamid Ghanbari Md Mph
Atrial fibrillation (AF) is the most prevalent arrhythmia leading to hospital admissions in the United States. The majority of patients with AF report symptoms associated with this condition that can lead to a decrease in health related quality of life (HRQOL) and functional status. Therefore, along with reducing the risk of stroke and mortality, improvements in such symptoms are important therapeutic goals in the management of patients with AF. Our current understanding of how AF and symptoms are linked is hampered by the dominant assessment paradigm, where symptoms thought to be associated with AF are measured at a single point in time (frequently at a clinic visit)...
June 2016: Journal of Atrial Fibrillation
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