Patient Mgmt

Mar 13, 2017

Could automated, web-based cognitive behavioral therapy (CBT) replace flesh-and-blood healthcare practitioners?  Can computers deliver healthcare at lower cost and similar quality to face-to-face interactions with humans? Several web-based CBT programs have been developed and are now being marketed directly to consumers.  But do they actually work?

 

Comments: 0      Views: 0



Jan 25, 2017

Critically evaluating the primary literature and applying the information to patient care is vital to ensuring optimal patient outcomes.  Unfortunately, the foundational knowledge and skills that most of us acquire during our formal education and post-graduate training programs are unlikely to fully prepare us for the challenges and intricacies of interpreting the evolving methods used in clinical drug studies today.  Like the development of any skill, it requires practice and refinement over

Comments: 5      Views: 5



Dec 29, 2016

When you reach a certain age, bowel cleansing becomes a necessary poison.  Colorectal cancer is the third most common type of cancer in the United States with an estimated 95,270 new colon and 39,220 new rectal cancer diagnoses for 2016. More importantly, colorectal cancer (CRC) is the second most common cause of cancer-related mortality in the United States.

Comments: 0      Views: 0



Dec 6, 2016

A mom recieves a prescription for an oral clindamycin solution for her daughter.  The instructions: “give one teaspoon by mouth three times daily for 10 days.”  The mom is given a medicine cup marked with “mLs”  and “tsp” on the side.  Five days later she returns complaining that she ran out of medicine.  After a brief interview, you determine that she has been giving her daughter one “cupful” instead of one “teaspoon.”

 

Comments: 0      Views: 0



Nov 7, 2016

From 2000–2010, opioid overdose was the fastest growing cause of death in the United States.1 In 2014, opioids were implicated in 61% of all drug overdose deaths, killing 28,647 Americans.2 Forty states have passed legislation recognizing pharmacists as front-line providers for overdose prevention by allowing standing orders for naloxone.3 Unfortunately, many pharmacists are not well prepared to fully participate in opioid harm reduction efforts due to a lack

Comments: 0      Views: 0



Aug 16, 2016

Persons diagnosed with a psychiatric disorder consume nearly half of all cigarettes smoked in the United States!  Moreover, they are at higher risk for premature death, especially from vascular disease and cancer.1  Smoking cessation efforts are paramount in this population but often more challenging.

Comments: 0      Views: 0



Jul 17, 2016

We're all aware that there is an obesity epidemic and its linked to dozens of health problems.1  But nothing we've done so far — public awareness campaigns, changes in school lunch programs, and approving new drugs for weight loss — has halted this epidemic.  Although the rate of obesity in kids age 2 to 19 has plateaued around 17%, it continues to climb in young adults and most of us keep packing on the pounds as we get older!2

 

Comments: 0      Views: 0



Apr 8, 2016

Managing behavioral health in persons with dementia is an enormous and growing problem. Today more than 5.3 million Americans are living with Alzheimer’s disease (AD) and that number is expected to increase by 30% by 2025.1 Most patients with AD have challenging neuropsychiatric symptoms such as agitation.

Comments: 0      Views: 0



Mar 11, 2016

Basal, prandial, NPH, ultra-long, inhaled, 70/30, 75/25, 50/50, U-100, U-200, U-300, and U-500 insulin … the list of options for patients with diabetes requiring insulin continues to expand. Current guidelines for glycemic management of patients with type 2 diabetes provide specific recommendations for the initiation of insulin therapy, but not insulin intensification. This is due to a lack of clinical trials comparing treatment strategies.

Comments: 0      Views: 0



Feb 28, 2016

With over 75% of people using mobile phones worldwide, text messaging might be a simple, cost-effective platform to encourage lifestyle changes.1  mHealth involves the use of mobile and wireless devices (e.g., wearable sensor technology) to provide health services and information.2,3  Such technologies have the potential to fundamentally change health practices.  Indeed, several healthcare-related applications and mobile phone text messaging systems have already been des

Comments: 0      Views: 0



Jan 26, 2016

It’s time to tell your patients that mom was right. You shouldn’t believe everything you see on television. Televised medical talk shows have become a daily viewing ritual for millions around the world. The Dr Oz Show is so popular that it earned him the title “America’s Doctor”, attracting massive numbers of followers as did the show The Doctors.

Comments: 0      Views: 0



Dec 31, 2015

Several studies have evaluated the correlation between low-dose aspirin and NSAID use and the development of colorectal cancer. In 2007, the U.S.

Comments: 0      Views: 0



Oct 16, 2015

The recommended treatment duration for a first episode of unprovoked venous thromboembolism (VTE) is, at a minimum, 3 months with extended anticoagulation favored for those who are not at high risk for bleeding.  However, the optimal duration of anticoagulation therapy remains unknown.1  Earlier studies have shown that an extended course of oral anticoagulation (OAC) with warfarin reduced VTE recurrence but at the expense of increased bleeding.2,3  The Prolonged Anticoag

Comments: 0      Views: 0



Oct 3, 2015

Many clinicians are questioning the role pharmacists should play in anticoagulation therapy management as direct oral anticoagulants (DOACs) increasingly replace warfarin for a variety of indications. When we say “anticoagulation clinic” most of us envision a group of practitioners — often pharmacists — delivering coordinated care, providing ongoing patient education, and using laboratory data to make adjustments in warfarin doses.

Comments: 2      Views: 2



Sep 20, 2015

To treat acute asthma exacerbations in children, how about a single dose of dexamethasone and your done!  Sounds simple, easy, and convenient.  But is it too good to be true?

Comments: 0      Views: 0



Jul 28, 2015

Clinical practitioners have used calculators such as the Framingham Risk Score to assess the probability that a patient will develop coronary heart disease (CHD) and to guide primary prevention therapy for decades.1  In 2013, the American College of Cardiology (ACC) and the American Heart Association (AHA) released an updated risk calculator which has been widely criticized and may lead to over-prescribing of cholesterol-lowering agents (namely statins), aspirin, and antihypertensi

Comments: 7      Views: 7



Jul 18, 2015

Every health professional takes an oath to serve patients. To fulfill this covenant, patient trust must be earned. Without trust, patients are unlikely to share sensitive, personal information, hindering our ability to provide optimal care. Gaining trust is influenced by many factors. What influence does attire have on patients’ perceptions of their healthcare providers?

 

Comments: 7      Views: 7



Jul 9, 2015

The role of continuous subcutaneous insulin infusion (CSII) in Type 2 Diabetes Mellitus (T2DM) is not clearly defined.1 In patients with type 1 diabetes mellitus, CSII improves glycemic variability, lowers the risk of hypoglycemia, reduces hemoglobin A1C (A1C), and increases treatment satisfaction as well as quality of life when compared with multiple daily injections (MDI).2,3 However, studies in patients with T2DM have produced conflicting findings.4,5,6,7 S

Comments: 2      Views: 2



Jun 17, 2015

The results of the PEGASUS-TIMI 54 (Long-Term Use of Ticagrelor in patients with Prior Myocardial Infarction) trial were presented to a capacity audience at the opening session of the March 2015 American College of Cardiology meeting.  But after hearing the much anticipated results and reading the simultaneously published manuscript we’re left wondering if PEGASUS is a landmark clinical trial or simply a trial that validates what we have known for years.1

 

Comments: 0      Views: 0



Jun 17, 2015

The appropriate duration of dual antiplatelet therapy (DAPT) for patients following placement of a drug-eluting stent (DES) remains controversial.1 Many clinicians have pushed for prolonged DAPT — beyond 12 months — on the assumption that extended therapy reduces recurrent cardiovascular (CV) events.  However, the benefits and harms of extended DAPT therapy are unclear and many health systems won’t authorize it.  Does the Dual Antiplatelet Therapy (DAPT) study provide sufficient ev

Comments: 0      Views: 0



May 17, 2015

Could a commonly prescribed antibiotic, when combined with a renin-angiotensin system inhibitor, lead to sudden death?  Angiotensin converting enzyme inhibitors (ACE-I), angiotensin receptor blockers (ARB), and spironolactone are frequently used in older adults for a variety of indications.

Comments: 0      Views: 0



May 4, 2015

We all have an innate desire for clarity in our decisions. Often, however, we are faced with controversy and uncertainty.  Grey areas where there is a gap between clinical practice, logical reasoning, and evidence.  One of these grey areas is the “right” approach to the peri-procedural management of chronic anticoagulation.  There are so many clinical decisions involved (See Table 1) and little clarity about any of them!

 

Comments: 0      Views: 0



Mar 30, 2015

To some, “home-based primary care” (HBPC) may evoke images of frail shut ins — unable to leave their homes due to physical, mental, or cognitive impairments.  Others imagine a nostalgic past when physicians made house calls to acutely ill patients.

Comments: 0      Views: 0



Jan 27, 2015

The American Heart Association reports that 1 out of 3 adults in the Unites States have high blood pressure and the direct and indirect costs exceeded $50 billion in 2009.

Comments: 0      Views: 0



Nov 4, 2014

Have you ever had difficulty convincing some of your patients that generic medications work just as well as their brand-name counterparts?  While there is little evidence to suggest that generic medications aren’t therapeutically equivalent, a more subtle and perhaps more vexing problem is now emerging.

Comments: 0      Views: 0



Pages