MedWorm: Health Management Top 20

No obligation to report adverse effects in British complementary and alternative medicine: evidence for double standards

Quality and Safety in Health Care — Fri, 19 Feb 2010 09:11:10 +0100

(Source: Quality and Safety in Health Care)

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Estimating Total Acetaminophen Burden in LTC Residents with Diabetes

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:52 +0100

The objective of this research was to determine total APAP dose burden from stand-alone orders and combination analgesics in residents with diabetes. (Source: Journal of the American Medical Directors Association)

Insurers Test Health Plans that Stress Patient Choices

RWJF News Digest - Quality/Equality — Thu, 11 Mar 2010 05:00:00 +0100

Workers at a Portland, Ore., steel mill soon will be able to pick a new type of insurance that offers free care for some illnesses, such as diabetes or depression, but requires hefty extra fees for treatments deemed overused, including knee replacements, hysterectomies and heart bypass surgery. (Source: RWJF News Digest - Quality/Equality)

Study Finds Increase in Pediatric Head, Neck MRSA Infections

RWJF News Digest - Quality/Equality — Fri, 23 Jan 2009 11:26:44 +0100

A study published in the January issue of Archives of Otolaryngology-Head & Neck Surgery suggests that the prevalence of pediatric head and neck infections with methicillin-resistant Staphylococcus aureus (MRSA) has risen alarmingly, underscoring the need for continued efforts to reduce antimicrobial resistance, the New York Times reports. (Source: RWJF News Digest - Quality/Equality)

Probe of Norovirus Outbreaks Yields LTC Clues

Caring for the Ages — Wed, 30 Sep 2009 23:00:00 +0100

An investigation of a string of norovirus outbreaks in one long-term care facility has yielded insights into how the gastroenteritis virus might spread in an institution, as well as how infection-control lapses might compound such viral outbreaks. (Source: Caring for the Ages)

Initial Diagnosis and Treatment Patterns in Parkinson's Disease

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:53 +0100

This study evaluates the diagnosis and treatment patterns in the US of newly identified PD patients by describing the timing and type of initial treatments. (Source: Journal of the American Medical Directors Association)

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Acorda Therapeutics' have established patient support services to assist with the costs of their new multiple sclerosis (MS) treatment Ampyra

PharmacoEconomics and Outcomes News — Mon, 22 Feb 2010 16:24:07 +0100

(Source: PharmacoEconomics and Outcomes News)

Hepatitis Surges in Residents With Diabetes: More outbreaks linked to contamination ore occurring in assisted living facilities.

Caring for the Ages — Wed, 30 Sep 2009 23:00:00 +0100

ATLANTA — At least 17 hepatitis B virus infection outbreaks have occurred since 1996 in people living with diabetes in long-term care settings, including assisted living facilities, according to a Centers for Disease Control and Prevention scientist. (Source: Caring for the Ages)

Economics of influenza vaccine administration timing for children.

The American Journal of Managed Care — Thu, 11 Mar 2010 12:56:02 +0100

CONCLUSION: Policymakers could invest up to $6 million to $9 million a year to get children vaccinated in September or October without expending any net costs. PMID: 20205492 [PubMed - in process] (Source: The American Journal of Managed Care)

Maternal Health Literacy and Late Initiation of Immunizations Among an Inner-City Birth Cohort

Maternal and Child Health Journal — Wed, 24 Feb 2010 06:51:57 +0100

Abstract To determine if maternal health literacy influences early infant immunization status. Longitudinal prospective cohort study of 506 Medicaid-eligible mother-infant dyads. Immunization status at age 3 and 7 months was assessed in relation to maternal health literacy measured at birth using the Test of Functional Health Literacy in Adults (short version). Multivariable logistic regression quantified the effect of maternal health literacy on immunization status adjusting for the relevant covariates. The cohort consists of primarily African-American (87%), single (87%) mothers (mean age 23.4 years). Health literacy was inadequate or marginal among 24% of mothers. Immunizations were up-to-date among 73% of infants at age 3 months and 43% at 7 months. ...

Unintentional Weight Loss in Long Term Care Residents with Alzheimer's Disease and Weight Response with the Use of Docosahexaenoic Acid (DHA)/Eicosapentaenoic Acid (EPA) and Bioflavinoids: A Case Series

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:58 +0100

Introduction/Objective: Cachexia/dehydration may be the immediate cause of death in the end stage of dementia in as many as 35% of nursing home residents. Cachexia is associated with suppressed appetite, food intake and body weight while proinflammatory cytokines are increased. Proinflammatory cytokines directly result in feeding suppression and lower intake of nutrients and cachexia is nearly always accompanied by anorexia. IL-1 beta and tumor necrosis factor alpha (TNFa) act on the glucose-sensitive neurons in the satiety and hunger sites in the hypothalamus. An association between high levels of circulating TNFa and unexplained weight loss in AD has been shown. Serum TNFa has been shown to be lower in mild-moderate Alzheimer's disease (AD) compared to severe AD.12 The levels of TNFa, IL...

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The Safety Walker Program: Reducing Immobility Complications in Hospitalized Elderly

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:58 +0100

Introduction/Objective: A recent study by Korbstein et al. showed the devastating functional impact of prolonged bed rest on healthy older adults as evidenced by substantial loss of lower extremity strength, power, and aerobic capacity. Significant losses in performance measures in frail, hospitalized long term care (LTC) residents can be anticipated with possibly more severe and prolonged consequences. The time commitment to regularly walk these patients often overwhelms nursing and physical therapy staff. This 6-month pilot Safety Walker Program was designed to train non-licensed staff to provide extra ambulation time to hospitalized elderly to help prevent the well known complications of immobility, including falls, pressure ulcers, delirium and functional decline. (Source: Journal of t...

Bundled Payments Might Cut Hospital Costs Without Reducing Quality of Care

RWJF News Digest - Quality/Equality — Tue, 09 Mar 2010 05:00:00 +0100

A decade and a half ago, when I started my solo practice, I would say to my routine HIV patients, "Let's see you back in three months." (Source: RWJF News Digest - Quality/Equality)

S. aureus vaccine cost effective for orthopaedic patients

PharmacoEconomics and Outcomes News — Mon, 22 Feb 2010 16:24:07 +0100

(Source: PharmacoEconomics and Outcomes News)

Understandings of influenza and influenza vaccination among high-risk urban dwelling Thai adults: a qualitative study

Journal of Public Health — Wed, 24 Feb 2010 16:32:39 +0100

Conclusion These findings underscore the need to consider and understand factors underlying people's vaccination decisions to create an effective influenza vaccination programme. (Source: Journal of Public Health)

Demographics and Acute Medical Needs of Assisted Living Facility Residents

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:52 +0100

Introduction/Objective: Background. Increasing numbers of older adults live in assisted living residences (ALRs). Primary care medical practices focusing on the care of older adults who dwell in ALR are developing to meet these patient's special needs. To our knowledge, the types of patients in an ALR medical practice and the use of acute medical care by ALR dwellers have not been previously characterized. Objectives: To characterize the patients participating in an ALR primary care program and their use of acute medical care services. (Source: Journal of the American Medical Directors Association)

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Evaluating the Impact of Health Care Providers' Knowledge, Attitudes, and Behavior on MOLST Implementation in Long Term Care Facilities

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:52 +0100

Introduction/Objective: In 2006, the New York Department of Health approved the MOLST form, as an actionable medical order to transition patients through all health care settings statewide. We evaluated the impact of health care providers on MOLST implementation in long term care facilities. (Source: Journal of the American Medical Directors Association)

Muscle Weakness: An Unusual Cause

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:56 +0100

Introduction/Objective: This is a case presentation of a patient who presented with progressive muscle weakness. Differential diagnosis will be discussed. Design/Methodology: This is a 59 year old male with a history of Hepatitis C who presented with progressive weakness. He had been in a nursing home for short term rehabilitation after an ankle fracture following a fall. After three weeks of short term rehabilitation he was felt to have progressed sufficiently for transfer to an assisted living facility. There he was noted to develop progressive functional decline over one week, to the point that he was unable to walk, unable to transfer independently, had almost unintelligible speech, and experienced dysphagia. He also had difficulty lifting objects with his hands and holding up his hea...

Reduction of Antipsychotic Medication Use in a Nursing Facility: Thinking Outside of the Black Box

Journal of the American Medical Directors Association — Thu, 25 Feb 2010 16:11:57 +0100

Introduction/Objective: Antipsychotic medications used for treatment of dementia-associated behaviors pose increased risk of stroke and death and also carry black box warnings. In addition, research suggests this type of drug therapy has limited effectiveness and adverse effects outweigh the benefits. Despite this evidence, antipsychotics are frequently used in demented elderly nursing home residents for management of behavioral problems. Through its quality improvement (QI) process, our 103-bed nursing facility identified higher prevalence of antipsychotic use compared to state and national averages. We organized an interdisciplinary team to achieve the goal of promoting the highest quality of resident life with minimal use of antipsychotic medications. (Source: Journal of the American Me...

Adding lapatinib improves QOL in breast cancer subgroup

PharmacoEconomics and Outcomes News — Mon, 22 Feb 2010 16:24:07 +0100

(Source: PharmacoEconomics and Outcomes News)